maternity EQ

which cardiac disease has the lowest risk for maternal mortality

patent ductus arteriosus

which sign would indicate possible heart failure in a client with heart disease in the immediate postpartum period?

tachypnea

for which reason is a client with heavy bleeding from a complete placenta previa in a lateral trendelenburg position

to prevent shock

which nursing intervention holds the highest priority for a client tight class I heart disease during the postpartum period?

watching for signs of cardiac decompensation

a client states her husband is a fraternal twin and asks about her probability of having twins. which is an appropriate response by the nurse

you have no greater probability of having twins than anyone else in the general population

for which complication is a client with gestational hypertension at risk?

abruption placentae

which intervention would the plan of care for a client with a tentative diagnosis of partial abrupt placentae include

external fetal monitoring and observation

a pregnant client is admitted to the high risk unit with abruptio placentae. which priority assessment would be included with vital signs, skin color, urine output and fetal heart rate

fundal height

which procedure would the nurse anticipate when caring for a client with a tentative diagnosis of placenta previa?

ultrasound exam

a client comes to the emergency room reporting severe abdominal cramping and heavy bleeding at 10 weeks gestation. cervical examination reveals heavy bleeding; the cervical os is open and tissue is present. which type of abortion is the client experiencing?

inevitable

which would the nurse do to prepare a client in her third trimester who is scheduled for an amniocentesis?

instruct her to void immediately before the test

which is the nurses most critical assessment for a client with preeclampsia during the immediate postpartum period

vital signs

the nurse applies fetal and uterine monitors to the abdomen of a client tin active labor. when the client has contractions, the nurse notes a 15 beats/min deceleration of the fetal heart rate below the baseline lasting 15 seconds. which is the next nursing action?

changing the maternal position

which assessment finding in a pregnant client would prompt the nurse to notify the primary health care provider

fundal height at the umbilicus at 16 weeks gestation

which intervention would the nurse initiate when a fetal heart pattern signifying uteroplacental insufficiency occurs?

helping the client turn to the side lying position

which postpartum complication would the nurse monitor for in a client with hydramnios

hemmorrhage

when caring for a client in the third trimester of pregnancy with a history of myocardial infarction, which statement made by the client would concern the nurse the most?

i have been using cough drops to try and get rid of my cough

a recently postpartum client who has heavy vaginal bleeding that does not lessen after fundal massage says, "I'm so thirsty. may i have some gingerly?" which is an appropriate reply by the nurse?

i know this is difficult; however, its best for you to wait until the bleeding has subsided. i can give you a moisturizer for your lips to relieve the dryness

which statement by a woman with preeclampsia indicates the need for further teaching about needed dietary changes

i should avoid excess salt

which is the priority nursing action when caring for a client who has just had an amniotomy and the fetal heart rate immediately decreases from 140 to 180

inspecting the vagina

the nurse is admitting a client to the unit after fetal death was confirmed by ultrasound. while initiating iv therapy the nurse notes blood continually oozing from the puncture site. which is the nurses next action?

informing the pcp of this finding

for which condition is a pregnant client who takes levothyroxine at increased risk

preeclampsia

which is the nursing priority nursing intervention immediately following amniocentesis

monitoring for uterine contractions

a client at 28 weeks gestation visits the clinic for a routine examination. which finding is of greatest concern to the nurse

puffy fingers

assessment of a client at 39 weeks gestation reveals ruptured membranes, mild, irregular contractions 10 to 15 minutes apart, and a fetal heart rate of 186 between contractions. which conclusion would the nurse draw from these findings

a further assessment is necessary

a pregnant client is admitted to the high risk unit with abdominal pain and heavy vaginal bleeding. which is the nurses priority intervention

starting oxygen therapy

which finding indicates a complication of the labor process in a client with a history of T5 spinal cord injury

increased blood pressure

which is a potential cause of fetal tachycardia when a client is in active labor

increased maternal metabolism

the risk for which pregnancy complication is increased in the client with type 1 diabetes mellitus?

hypertensive disorders of pregnancy

a client is admitted to the high risk unit in preterm labor and is 8cm dilated. which is a possible cause of preterm labor

incompetent cervix

which is an early indication of decompensation in a pregnant woman with cardiac disease

increase in fatigue

which finding would indicate infection in a pregnant client? select all that apply

1. chills 2. fever 3. diarrhea 4. flank pain 5. burning on urination

which factor in a pregnant clients history would the nurse recognize as a risk factor for abruptio placentae?

hypertension

which are signs and symptoms of withdrawal that might be seen in a postpartum client with a history of opioid abuse

irritability and muscle tremors

which nursing intervention is specific to the client i n active labor who presents with a history of cardiac disease

auscultating the lungs for crackles with assessments

which is the most important nursing intervention for a client who is at 26 weeks gestation with pyelonehpritis

checking for signs of preterm labor

an electronic fetal monitor is applied to a client in labor who is dilated to 4cm. which assessment finding would cause the nurse to notify the health care provider

contractions every 1 to 2 minutes lasting 90 seconds

which orders are appropriate for a client with mild preeclampsia? select all that apply

daily weight monitor deep tendon reflexes

with which problem is a low maternal serum alpha fetoprotein associated?

down syndrome

a primigravida at 39 weeks gestation is admitted to the high risk unit with an acute infection and is to have labor induced. in which sequence would the nurse implement the primary health care providers orders

1. initiate monitoring with an electronic fetal/maternal monitor 2. give the client a 2g loading dose of ampicillin, followed by 1 g every 4 hours 3. start oxytocin 30 units in 1000mL of D5W per protocol 4. call the anesthesia department to evaluate the client for an epidural

which nursing interventions are applicable to a client receiving an infusion of magnesium sulfate for severe preeclampsia? select all that apply

1. restricting visitors 2. limiting fluid intake 3. maintaining a quiet environment

which risk to the fetus is associated with a maternal diagnosis of chorioamnionitis? select all that apply

1. sepsis 2. bacteremia 3. pneumonia 4. cerebral palsy 5. respiratory distress syndrome

women who become pregnant for the first time at a later reproductive age (35 years or older) are at risk for which complications? select all that apply

1. preterm labor 2. multiple gestation 3. chromosomal anomalies 4. bleeding in the first trimester

the health care provider prescribes a contraction stress test for a client at 33 weeks gestation whose non stress test was nonreactive and whose biophysical profile was inconclusive. which maternal conditions would prompt the nurse to question the prescription? elect all that apply

1. preterm labor 2. placenta previa 3. cervical insufficiency 4. premature rupture of membranes

a 37 year ld G3P2001 client with hypertension and type 1 diabetes with good glycemic control is seen in the antepartum testing unit for a non stress test at 36 weeks. her obstetric history includes an intrauterine fetal death at 38 weeks. what risk factors in the clients history indicate the need for an NST? select all that apply

1. age older than 35 years 2. the risk for placental insufficiency 3. a history of stillbirth from her last pregnancy 4. hypertension 5. type 1 diabetes

a woman in labor with no known complications rings the call bell to say she has had a "gush" from her vagina. the nurse identifies a large amount of bright red blood. in which order would the nurse perform the necessary interventions?

1. call for help 2. check fetal heart tones 3. increase the maintenance iv rate 4. start oxygen at 8L via face mask 5. call the PCP

an amniotomy is performed in a laboring client at 42 weeks gestation. place the nursing care actions in their order of priority

1. checking the fetal heart rate tracings 2. inspecting the perineum for umbilical cord prolapse 3. assessing the characteristics of the amniotic fluid 4. monitoring the client for signs of an infection

a client with a history of three spontaneous abortions is now at 16 weeks gestation and expresses a concern about remaining at home during this pregnancy. which questions will elicit responses most helpful to the nurse developing the clients plan of care? select all that apply

1. do you have a support system available to help you 2. have you been told about the status of your pregnancy

which information would the nurse include in the teaching for a client who received methotrexate? select all that apply

1. gastric distress is a possible side effect 2. stools will contain some residual methotrexate for 7 days 3. double flush the toilet with the lid down after urinating

which clinical condition concerns the nurse the most for an obstetrical client with heart disease? select all that apply

1. obesity 2. anemia 3. hypertension 4. emotional distress

a woman who is 34 weeks pregnant is hospitalized for pyelonephritis. which assessments would the nurse include in the plan of care? select all that apply

1. urine output 2. temperature 3. blood pressure 4. uterine contractions

a primary health care provider prescribes carboprost tromethamine to be administered to a postpartum client with intractable vagnal bleeding. the nurse should notify the provider of which current condition in the clients medical history

history of asthma

which would be included in the plan of care for an obstetrical client who has been taking carbamazepine throughout the first trimester of pregnancy?

evaluation for a neural tube defect

a client at 36 weeks gestation presents with severe abdominal pain, heavy vaginal bleeding, a drop in blood pressure, and an increased pulse rate. which complication of pregnancy is suggested by these signs and symptoms?

abrupt placentae

which occurs immediately after birth that increases the risk for cardiac decompensation in a client with a compromised cardiac system?

extravascular fluid is remobilized into the vascular compartment

which action would the nurse take before birth when meconium staining is present

gathering equipment for neonatal resucitation

why would the primary health care provider instruct a woman at 38 weeks gestation with slightly elevated blood pressure to rest in a side lying position

it increases blood flow to the fetus

which guideline regarding sexual intercourse would be given to a client with preterm contractions and cervical dilation of 2 cm

it is prohibited because it may stimulate labor

a contraction stress test result is considered positive when the fetal heart rate shows which during contractions?

late decelerations

which are risk factors of diabetes in pregnancy? select all that apply

1. preterm birth 2. hypertension 3. cesarean birth

which information would the nurse include when counseling a pregnant client at risk for the human immunodeficiency virus regarding HIV testing? select all that apply

1. the risks of passing the virus to the fetus 2. what positive or negative test results indicate 3. the emotional, legal, and medical implications of test results

a client with mild preeclampsia is admitted to the labor and birthing suite. which signs or symptoms would the client be likely to display if she were developing hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome)? select all that apply

1. headache 2. right upper quadrant abdominal pain 3. nausea and vomiting

which statement from a pregnant client with premature rupture of membranes (PROM) demonstrates an understanding of the infection risk? select all that apply

1. i will report a fever to my doctor 2. i will wipe from front to back when using the bathroom 3. if i have contractions, medications will be administered 4. if i develop chorioamnionitis, my doctor will induce labor 5. i will let my doctor know if i experience foul smelling vaginal discharge

a clients membranes rupture, and the nurse immediately detects the presence of a prolapsed umbilical cord. the primary health care provider has been notified. place the following nursing interventions in the order in which they would be performed

1. moving the presenting part off the cord 2. pacing the client in the trendelenburg position 3. administering oxygen by face mask 4. checking the fetal heart rate

which baseline assessment data would the nurse obtain on a client with preeclampsia before initiation of a magnesium sulfate infusion? select all that apply

1. patellar reflex 2. urine output 3. respiratory rate 4. blood pressure

between which weeks of gestation would a client with type 1 diabetes expect to increase her insulin dosage?

24th and 28th weeks of gestation

which position increases cardiac output in the obstetrical client with cardiac disease?

lateral positioning

where on the maternal abdomen would the nurse place the fetal heart transducer when the fetus is in the left sacrum anterior position?

left upper quadrant

reluctance of a client who is one day postpartum to engage in which activity raises a concern about mother infant bonding?

look at her newborns face

a client in labor is admitted to the birthing unit 20 hours after the membranes have ruptured. which is a possible complication for this client

maternal sepsis

which is the priority initial nursing intervention during the admission of a primigravida in labor?

monitoring the fetal heart rate

for which reason may insulin requirements of a client with type 1 diabetes decrease during the first trimester

morning sickness may result in decreased food intake

which factor will increase the risk for uterine atony in a postpartum client?

multiple gestation pregnancy

which finding would then ruse be most concerned about in the client receiving a bolus of magnesium sulfate intravenously for the treatment of preeclampsia

nausea and vomiting

which assessment would the nurse include in the plan of care for a postpartum client with large, painful varicose veins?

assessing for signs of thrombophlebtitis

which intervention is a priority when a clients membranes spontaneously rupture at 37 weeks and there are no contractions

assessing maternal temperature

when checking the cervical dilation in labor, the nurse notes that the umbilical cord has prolapsed. with action would the nurse take in response to this finding

assist the client into the trendelenburg position

which client would the nurse identify as being at greatest risk for a hypertensive disorder of pregnancy

obese primigravida

a woman in the third trimester of pregnancy presents with vaginal bleeding and states she snorted cocaine approximately 2 hours ago. which complication would this client profile suggest?

abrupt placentae

which condition contraindicates oxytocin induction

active genital herpes infection

which statement would the nurse tell the client in regards to a dinoprostone suppository before having a vacuum curettage abortion for a fetal demise?

after the suppository has been inserted, you will need to lie flat in bed for a set amount of time

a multiparous client with a history of gestational hypertension and previous history of abruption is in the transition phase of labor. the electronic fetal monitor shows bradycardia, and a change is seen in the counter of the clients abdomen. which is the nurses immediate action

alerting staff to the need for immediate cesarean delivery

why would the nurse encourage continued health care supervision for a pregnant woman with pyelonephritis

antibiotic therapy should be administered until the urine is negative

which nursing action is most appropriate for a pregnant client at 23 weeks gestation with pica

determining whether the diet is safe and nutritionally adequate

a client who is admitted for surgery for a ruptured tubal pregnancy tells the nurse that she has shoulder pain. which condition is the nurse concerned about based on these manifestations

blood accumulation under the diaphragm

a client who is admitted for surgery for a ruptured tubal pregnancy tells the nurse that she has shoulder pain. which condition is the nurse concerned about based on these manifestations?

blood accumulation under the diaphragm

the nurse instructs a pregnant woman in labor that she must avoid lying on her back. what is the primary reason for this instruction

decreased placental perfusion is seen in the supine position

which is the nurses concern when caring for a client just diagnosed with a ruptured tubal pregnancy

diminished cardiac output

a postpartum client is being treated with subcutaneous enoxaparin for deep vein thrombosis of the left calf. which client cue is of most concern to the nurse

dyspnea

a pregnant client is admitted with abdominal pain and heavy vaginal bleeding. which is the immediate nursing action

establish iv access

the nurse admits with severe preeclampsia to the high risk prenatal unit. which is the next nursing intervention after the vital signs have been obtained?

establishing an iv line

which client is most likely to require a cesarean birth

multipara with a shoulder presentation

which factor in a clients history suggests a risk for preterm labor

multiple urinary tract infections

a sonogram performed on a client in the third trimester reveals a low lying placenta. which would the nurse teach the client that she is at low risk for?

painless vaginal bleeding

the results of a second trimester fetal sonogram reveal a small for gestational age fetus and a low lying placenta. the nurse recognizes that these result increase the patients risk for which diagnosis

placenta previa

which is the priority nursing care focus for a client tat 34 weeks gestation with contractions every 5 minutes and cervical dilation of 4cm?

promoting maternal/fetal well being during labor

which significant clinical finding would the nurse expect when reviewing the history of a client with preeclampsia

proteinuria

assessment of a primigravida at 32 weeks gestation shows a blood pressure of 170/110, 4+ proteinuria, and edema of the face and extremities. which which complication are these findings consistent?

severe preeclampsia

the nurse is providing immediate postpartum care to a client. the nurse would monitor the client for which condition that is characterized by hemorrhage?

sheehan syndrome

when planning care for a client with type 1 diabetes, which change in insulin requirements would the nurse anticipate on the first postpartum day

sudden decrease

after receiving a diagnosis of placenta previa, the client asks the nurse what this means. which is an appropriate response

the placenta is implanted in the lower uterine segment, and its covering or all fo the cervical opening

which activity would the nurse suggest for a client in labor who is having frequent painful contractions and whose cervix has been dilated 2cm for several hours without progression

therapeutic rest

the pregnant client asks the nurse whether changing the cats litter box is harmful to her or the fetus. how would the nurse reply

there are several factors that determine a persons response to the toxins in cat litter

which is associated with in vitro fertilization embryo transfer?

tubal pregnancy

which is the nurses priority action when caring for an obstetrical client experiencing eclampsia

turn the head to one side

which assessment findings correlate with a diagnosis of enraptured tubal pregnancy? select all that apply

unilateral abdominal pain history of untreated chlamydia

why is it important for the nurse to encourage a client with preeclampsia to lie in the left lateral recumbent position?

uterine and kidney perfusion are maximized, and compression of the major vessels is relieved

while caring for a client who has had a positive contraction stress test, which complication would the nurse suspect?

uteroplacental insufficiency