OB CH. 30 EAQ

-Pulmonary edema -Pulmonary embolism -Right-sided heart failure

A client is diagnosed with mitral valve stenosis. Because of this diagnosis, the nurse is aware that the client has which increased risks? Select all that apply.

Approximately 25 pounds

A client who has cystic fibrosis (CF) and a normal body mass index (BMI) is pregnant. Which weight-gain recommendation would the nurse give to this client?

You may conceive 1 year after the transplant

A client who recently had a heart transplant with no evidence of rejection asks the nurse about the safety of conceiving a child. Which is the most accurate response by the nurse?

Maintain the client in a side-lying position with the head and shoulders elevated to facilitate hemodynamics

A nurse is caring for a client with mitral stenosis who is in the active stage of labor. Which action would the nurse take to promote cardiac dysfunction?

Instructing the client to maintain bed rest

A pregnant client has a medical history of bidirectional shunting and elevated pulmonary vascular resistance. Which is the most appropriate nursing intervention to ensure the client's safety?

Mitral valve prolapse

A pregnant client has atypical sharp pain in the left side of the chest that does not respond to nitrates. Which diagnosis would the nurse expect in this client?

Cardiac decompensation

During a physical assessment of an at-risk client, the nurse notes generalized edema, crackles at the base of the lungs, and some pulse irregularity. These are the most likely signs of which problem?

Increased plasma volume

The nurse is assessing a pregnant client with a history of atrial septal defect. The nurse knows that the client is at risk for right-sided heart failure because of which factor?

Instruct the client to avoid the Valsalva maneuver

The nurse is assisting the primary health care provider during the labor of a client with cardiac disease. Which intervention would the nurse preform to prevent cardiac complications in the client while performing maternal pushing

-Palpitations -Difficulty breathing -Feeling of smothering

The nurse is aware of which subjective symptoms of cardiac decompensation when assessing a pregnant client? Select all that apply.

Mitral valve prolapse

When assessing a pregnant client with heart disease, the nurse knows that which form of heart disease in women of childbearing years usually has a benign effect on pregnancy?

An insufficient amount of hemoglobin is produced to fill the red blood cells (RBCs)

When assessing a pregnant client with thalassemia, the nurse knows that which factor is related to this condition?

Between 17 and 24 weeks of gestation

When counseling a pregnant client with asthma, the nurse know that the severity of symptoms usually peak during which time?

-Leaking fluid -Abdominal pain -Vaginal bleeding -Decreased fetal movement

Which abnormal findings would the nurse immediately report to the health care provider for a client at 37 weeks of gestation who has been in a motor vehicle accident and is being discharged? Select all that apply.

-Serum laboratory levels of medications -Abdominal ultrasonography -Prenatal vitamins with vitamin D

A pregnant client in her first trimester with a history of epilepsy is transported to the hospital via ambulance after suffering a seizure in a restaurant. Which health care provider prescriptions would the nurse expect to be included in the plan of care? Select all that apply.

To diagnose myocardial infarction

A pregnant client in the 3rd trimester is advised to undergo an antiphospholipid test. The nurse knows that which is the objective of this test?

-Muscle aches -Weight change -Fever

A pregnant client is being examined by the nurse in an outpatient obstetric clinic. The nurse suspects systemic lupus erythematosus (SLE) after the examination reveals which symptoms? Select all that apply.

Appendicitis

A pregnant client reports abdominal pain in the right lower quadrant, along with nausea and vomiting. The urinalysis report shows an absence of urinary tract infection. A chest x-ray also rules out lower-lobe pneumonia. Which client condition would the nurse suspect?

-Monitor sodium levels in breast milk -Monitor total fat levels in breast milk -Monitor the infant growth pattern

A pregnant client with cystic fibrosis (CF) wants to breastfeed her infant. Which assessments would be performed to make sure that breastfeeding will be safe and effective? Select all that apply.

Class III

After assessing a pregnant client with a cardiac disorder, the nurse informs the primary health care provider that the client is symptomatic with marked limitation of activity. Which class of cardiac disorder would the client have according to the New York Heart Association (NYHA)?

-Bone deformities -Hepatosplenomegaly

The nurse is caring for a pregnant client with beta thalassemia. Which risks would be increased in the client and the fetus? Select all that apply.

Sickle cell anemia

The nurse is caring for a client with anemia. The nurse advises the client to have genetic counseling as a part of preconception care. Which type of anemia would the client most likely have?

The client has tetralogy of Fallot

The nurse is caring for a client with pulmonary stenosis. On conducting an echocardiogram, the nurse finds that the client has a right-to-left shunt and right ventricular hypertrophy. Which is the probable reason for these anatomic abnormities?

Furosemide

The nurse is caring for a client with rheumatic heart disease (RHD). Which medication would the primary health care provider prescribe to prevent pulmonary edema?

-Jitteriness -Cardiac arrhythmias

The nurse is caring for a postpartum breastfeeding client with asthma who has been prescribed theophylline. Which complications would the nurse assess for in the newborn? Select all that apply.

Side-lying

The nurse is caring for a pregnant client diagnosed with mitral valve stenosis. Which position would the nurse suggest to the client to ensure a safe labor?

Include yogurt, cheese, and milk in your diet

The nurse is caring for a pregnant client who is on antibiotic therapy to treat a urinary tract infection (UTI). Which dietary changes would the nurse suggest for this client?

Positioning the client with a lateral tilt

The nurse is caring for a pregnant client who is scheduled for surgery. Which nursing intervention would help provide sufficient fetal oxygenation during the surgery?

Digoxin

The nurse is caring for a pregnant client with an arrhythmia. Which medication would be the safest to administer?

Sickle cell anemia

The nurse is caring for a pregnant client with anemia. The nurse finds that the client's hemoglobin content does not improve in spite of taking iron supplements regularly. Which condition would the nurse suspect in this client?

-Advise the client to maintain an activity log -Encourage the client to reduce activity that causes fatigue -Help the client develop an individualized program of activity and rest

The nurse is caring for a pregnant client with rheumatic heart disease and activity intolerance. Which nursing interventions would the nurse preform to reduce activity intolerance? Select all that apply.

Decreasing energy levels

The nurse is educating a pregnant client with cardiac disease regarding signs of cardiac decompensation. The nurse would inform the client that which early sign of decompensation occurs most often?

-Take iron and folic acid supplements daily -Increase your daily intake of dietary fiber -Take a stool softener daily as prescribed -Include potassium-rich foods in the diet

The nurse is informing the pregnant client with a cardiac disorder about the dietary changes that are needed. Which instructions would the nurse include in the teaching? Select all that apply.

Peripartum cardiomyopathy (PCM)

The nurse is reviewing the medical history of a 35-year-old client who is in the first trimester of her second pregnancy. The medical history indicated that the client had twins in the first pregnancy, had congestive heart failure during the second month postpartum, and has a 40% left ventricular ejection fraction. Which risk would the nurse expect in this client?

Clients who have psoriasis during pregnancy experience a varied response

The nurse is teaching a pregnant client with a history of psoriasis. Which information would the nurse provide to the client?

Aortic stenosis has a mortality rate of 5% to 15%

The nurse is teaching a student nurse about maternal cardiac risk groups and mortality rates. Which statement is accurate regarding risk groups and mortality rates?

Magnesium sulfate

The nurse knows that which clinical factor may be associated with the development of acute respiratory distress syndrome (ARDS) during pregnancy?

Megaloblastic anemia

The nurse notices that a pregnant client shows signs of fatigue and lethargy, and has glossitis and rough skin. Which condition would the nurse likely suspect?

Electronic fetal monitoring

The nurse observes that maternal hypotension has decreased uterine and fetal perfusion in a pregnant client. To further assess this situation, which factor would the nurse select to understand the maternal status?

Chest compressions must be preformed at a rate of 80 per minute

The nursing instructor is teaching a student nurse about cardiopulmonary resuscitation (CPR) in an adult. Which statement by the student nurse indicates the need for further teaching?

Initiating an additional intravenous line

Which action would the nurse anticipate based on evaluation of information in the electronic health record (EHR) for a client who is admitted to labor and delivery after a motor vehicle accident?

Inserting an indwelling urinary catheter

Which action would the nurse anticipate based on evaluation of information in the electronic health record (EHR) for a client who is at 16 weeks of gestation and is scheduled for a laparoscopy?

Pulmonary injury

Which condition would the nurse monitor in a pregnant client diagnosed with acute pyelonephritis?

Progestin-only pills

Which contraceptive method is most often prescribed to clients who are on anticoagulant therapy for thromboembolism?

-Avoid fried foods -Use less oil when cooking -Avoid foods that cause discomfort

Which dietary modifications would the nurse suggest to a pregnant client with cholelithiasis? Select all that apply.

-Iron -Folic acid -Vitamin D

Which dietary supplements would the primary health care provider prescribe for a pregnant client who takes anticonvulsant medications? Select all that apply.

-There is an increased chance of maternal mortality -The newborn child may develop Marfan syndrome -You may not be able to deliver the child vaginally

Which information would the nurse include in the preconception teaching for a client with Marfan syndrome who presents with an aortic root diameter of more than 6 cm? Select all that apply.

Instruct her to avoid strenuous activity

Which instruction would the nurse include when teaching a pregnant client with class II heart disease?

-Assess the client's weight frequently -Assess for pulmonary infection -Assess for vitamin ADEK deficiency -Monitor the fetal movements

Which interventions would the nurse implement when providing care for a pregnant client with cystic fibrosis? Select all that apply.

Apply pressure support hose

Which is a priority intervention that the nurse would implement for a pregnant client with uncorrected tetralogy of Fallot in the late 3rd trimester of pregnancy?

Hydroxychloroquine

Which medication is ideal for the treatment of systemic lupus erythematosus (SLE) in a pregnant client?

Enoxaparin

Which medication would the nurse expect to find prescribed for a pregnant client who requires anticoagulant therapy for recurrent venous thrombosis?

Epidural analgesia

Which medication would the primary health care provider ask the nurse to administer during labor to a client who has a history of a myocardial infarction (MI) and is having a vaginal delivery?

-Initiating an intravenous line -Administering oxygen -Using a jaw thrust to establish an airway

Which nursing actions are included in the primary survey for a client at 19 weeks of gestation who has experienced a stab wound to the right upper quadrant and is not breathing? Select all that apply.

After 4 minutes of maternal pulselessness, the neonate must be delivered

Which nursing information is recognized as part of the protocol of a perimortem cesarean delivery?

-Restrict dietary sodium -Reduce activity -Assess the echocardiogram -Assess the client's respiratory status

Which nursing interventions are included in the plan of care for a pregnant client with mitral stenosis? Select all that apply.

-Arrhythmias -Heart failure -Pulmonary hypertension

Which risks would the nurse expect to find in a pregnant client with a large ventricular septal defect? Select all that apply.

Electrocardiography

Which test would the nurse evaluate to understand the cause of fatigue, shortness of breath, and dyspnea in a pregnant client?

External fetal monitoring

Which tool is the most sensitive assessment for the diagnosis of placental abruption after abdominal trauma?

It is high and to the right

Why is appendicitis more difficult to diagnose during pregnancy?