111-04
What are symptoms of eclampsia?
Proteinuria, seizure activity, and weight gain
What are some symptoms of HELLP syndrome?
Low RBC count, low platelet count, and elevated liver enzymes
Do you know which medication is given to prevent seizure activity and reduce blood pressure in the patient that has preeclampsia?
Several drugs may be used, but MgSO4 is the most common
What increases the risk for preterm labor?
Smoking, poor prenatal care, maternal age <18 or >35 and poverty
Ectopic pregnancy
development of the fetus outside the uterus
Hyperemesis gravidarum
excessive nausea and vomitting during pregnancy that interferes with fluid and food intake
Incompetent cervix
failure of the cervix to remain closed until the fetus is mature enough to survive outside the uterus
Placenta accreta
placenta is attached too deeply into the wall of the uterus, causing complications with removal
Placenta previa
placental attachment low in the uterus near or over the cervix
Abruptio placenta
premature seperation of the normally implanted placenta
Early postpartum hemorrhage occurs within how many hours if birth?
24
A postpartum woman has been diagnosed with postpartum psychosis. Which of the following signs/symptoms would the client exhibit? A: Hallucinations B: Polyphagia C: Induced vomitting D: Weepy sadness
A
A postpartum woman has been diagnosed with postpartum psychosis. Which the following is essential to be included in the family teaching for this client? A: The woman should never be left alone with her infant B: Symptoms rarely last more than one week C: Clinical response to medication is usually poor. D: The woman must have their vitals assessed every two days
A
The physician has ordered a nonstress test (NST) to be done on a 41-week-gestation client. During the 1/2 hour test, the nurse observed three periods of fetal heart accelerations that were 15 beats per minute above the baseline and that lasted 15 seconds each. No contractions were observed. Based on these results, what should the nurse do next?" A: "Send the client home and report the positive results to the physician." B: "Perform a nipple stimulation test to asses the fetal heart in response to contractions." C: Prepare the client for induction with IV oxytocin or endocervical prostaglandins." D: "Place the client on her side with oxygen via face mask."
A
Which symptom would the nurse expect to observe in a postpartum client with a vaginal hematoma? A: pain B: Bleeding C: warmth D: redness
A
The nurse is discharging five Rh- clients from maternity unit. The nurse knows that she must administer RhoGam to the clients who had which of the following: select all that apply A: Abortion at 10 weeks gestation B: Amniocentesis at 16 weeks gestation C: Fetal demise at 24 weeks gestation D: Birth of Rh- twins at 35 weeks gestation E: Delivery of a 40 week gestation, Rh+ baby
A, B, C, & E
A woman, 2 hours postpartum, is now experiencing increased lochia rubra, has passed several large clots, and is tachycardia. Priority nursing interventions should include which of the following? A: Uterine massage B: Assessment of blood pressure C: Assist the woman to breast feed D: Notify the physician E: Prepare equipment for the physician to perform a dilation and curettage
A, B, and D
A client just spontaneously ruptured membranes. Which of the following factors makes her especially high risk for having a prolapsed cord? Select all that apply A: breech presentation B: station -3 C: oligohydramnios D: dilation 2 cm E: transverse lie
A, B, and E
Which of these instances needs RhoGAM?
A- mom A+ baby
A breastfeeding mother calls the OB's office with a complain of pain in one breast. Upon inspection, a diagnosis of mastitis is made. Which of the following nursing interventions is appropriate? A: Advise the woman to apply ice packs to her breasts B: Encourage the woman to breastfeed frequently C: Inform the woman that she should wean immediately D: Direct the woman to notify her pediatrician as soon as possible
B
A client has just been diagnosed with gestational diabetes. She cries, "Oh no! I will never be able to give myself shot!!" Which of the following responses by the nurse is appropriate at this time? A: "I am sure you can learn for you baby." B: "I will work with you until you feel comfortable giving yourself the insulin." C: "We will be giving you pills for the diabetes." D: "If you follow your diet and exercise plan you will probably need no insulin."
B
What includes in the treatment of preterm labor?
Activity restriction, hydration, terbutaline
A couple, accompanied by their 5-year-old daughter, have been notified that their 32-week-gestation fetus is dead. The father is yelling at the staff. The mother is crying uncontrollably. The 5-year-old is banging the head of her doll on the floor. Which of the following nursing actions is appropriate at this time? A. Tell the father that his behavior is inappropriate. B: Sit with the family and quietly communicate sorrow at their loss. C: Help the couple to understand that their daughter is acting inappropriately. D: Encourage the couple to send their daughter to her grandparents.
B
A nurse is caring for a client, postpartum day 2, who is preparing to go home with her infant. The nurse notes that the client's blood type is O-negative, and the baby's type is A-positive, and the direct Coombs' test was negative. Which of the following action by the nurse is appropriate? A: "Advise the client to keep her physician appointment at the end of the weeks to receive her RhoGAM injection." B. "Make sure that the client receives a RhoGam injection before she is discharged from the hospital." C: "Notify the client that because her baby's Coombs' test was negative she will not receive an injection of RhoGAM." D: "Inform the client's physician that because the woman is being discharged on the second day, the RhoGam could not be given."
B
A preterm labor client, 30 weeks' gestation, who ruptured membranes 4 hours ago, is being given IM dexamethasone (Decadron). When she asks why she is receiving the drug, the nurse replies: A: To help to stop your labor contractions." B: "To prevent an infection in your uterus." C: "To help mature your baby's lungs." D: "To decrease the pain from the contractions."
C
A 25-year-old client is admitted with the following history: 12 weeks pregnant, vaginal bleeding, no fetal heartbeat seen on ultrasound. The nurse would expect the doctor to write an order to prepare the client for which of the following: A: cervical cerlage B: amniocentesis C: non-stress testing D: dilation and curettage
D
The young prenatal patient with gestational diabetes mellitus says, "I am frightened that I will have to deal with insulin injections for the rest of my life." The nurse's best response would be: A: "After delivery your doctor will prescribe oral hypoglycemia medication to control your disease. Pills are so much simpler than insulin injections." B "Have you considered an insulin pump?" C: "After a while those insulin injection won't seem so bad." D: "It will most likely resolve 6 weeks or so after the baby is born."
D
What are symptoms of gestational hypertension?
Elevated BP
A client who is 18 weeks' gestation has been diagnosed with a hydatiform mole (gestation trophoblastic disease). In addition to vaginal discharge, which of the following signs/symptoms would the nurse expect to see?
Hyperemesis and hypertension
Immediately after a woman spontaneously ruptures her membranes, the nurse notes a loop of the umbilical cord protruding from the woman's vagina. Which of the following actions should the nurse perform first?
Put the client in a knee chest position
A woman having preeclampsia is considered to have developed eclampsia when she has:
Seizures
Activity restriction would be a priority intervention for a pregnant woman with consistent hypertension
True
The nurse would suspect abruption placentae when the pregnant woman presents with:
Vaginal bleeding and back pain
What are symptoms of preeclampsia?
Weight gain and proteinuria
