chapter 19 prep u
The nurse should prepare to administer RhoGAM after which diagnostic procedure?
Amniocentesis
When caring for a client with premature rupture of membranes (PROM), the nurse observes an increase in the client's pulse. What should the nurse do next?
Assess the client's temperature.
Severe preeclampsia
BP 160/100 or greater, proteinuria greater than 3+, oliguria, elevated serum creatinine- 1.2+, cerebral or visual disturbances (headache or blurred vision), hyperreflexia with ankle clonus, peripheral edema, hepatic dysfunction, RUQ pain, and thrombocytopenia
mild preeclampsia
Hypertension beginning after the 20th week of pregnancy with 1 to 2+ proteinuria and a weight gain of more than 2 kg per week in the second and third trimesters.
The nurse is caring for a client with preeclampsia and understands the need to auscultate this client's lung sounds every 2 hours. Why would the nurse do this?
Pulmonary edema
the nurse is caring for a multigravid who experienced a placental abruption 4 hours ago. For which potential situation will the nurse prioritize assessment?
Uterine atony
threatened abortion
Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed.
inevitable abortion
Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open.
The risk of placenta previa is greatly increased when
a woman has had a previous cesarean delivery due to the scarring of the endometrial lining.
hallmark sign of ectopic pregnancy
abdominal pain with spotting within 6 to 8 weeks after missed menses
incomplete abortion
abortion without expulsion of all of the products of conception
grade 3 (severe)
absent to moderate bleeding (more than 1,500 mL), more than 50% separation, profound shock, dark vaginal bleeding, agonizing abdominal pain, decreased blood pressure, significant tachycardia, and development of disseminated intravascular coagulopathy
complete abortion
all products of conception are expelled
The most commonly reported symptoms of ectopic pregnancy
are pelvic pain and/or vaginal spotting
A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which action would be the priority for this woman on admission?
assessing fetal heart tones by use of an external monitor
Which assessment findings, experienced by the client at 36 weeks' gestation, would the nurse document as diagnostic signs of severe preeclampsia? Select all that apply.
blood pressure of 164/110 mm Hg elevated liver enzymes +1 proteinuria Elevated serum creatinine
first trimester spontaneous abortion
commonly due to fetal genetic abormalities
missed abortion
death of a fetus or embryo within the uterus that is not naturally expelled after death
The nurse is required to assess a client for HELLP syndrome. Which are the signs and symptoms of this condition?
epigastric pain upper right quadrant pain hyperbilirubinemia
The nurse is assessing a client at 12 weeks' gestation at a routine prenatal visit who reports something doesn't feel right. Which assessment findings should the nurse prioritize?
gestational hypertension, hyperemesis gravidarum, absence of FHR
Approximately 18% of all women with diabetes will develop
hydramnios during their pregnancy
uterine atony
inability of the uterus to contract effectively
When meconium is present in the amniotic fluid, it typically indicate
indicates fetal distress related to hypoxia.
preferred asthma therapy during pregnancy
inhaled corticosteroids
Pitting edema
leaves a small depression or pit after finger pressure is applied to a swollen area and can be measured
Dependent edema
may occur in clients who are both ambulatory and on bed rest.
Grade 1 (mild)
minimal bleeding (less than 500 mL), 10% to 20% separation, tender uterus, no coagulopathy, signs of shock or fetal distress
grade 2 (moderate)
moderate bleeding (1,000 to 1,500 mL), 20% to 50% separation, continuous abdominal pain, mild shock, normal maternal blood pressure, maternal tachycardia
second trimester spontaneous abortion
more likely related to maternal conditons
a pregnant client with severe preeclampsia has developed HELLP syndrome. In addition to the observations necessary for preeclampsia, what other nursing intervention is critical for this client?
observation for bleeding
if magnesium toxicity occurs,
one sign in the client will be a decrease in the respiratory rate and a potential respiratory arrest.
The classic signs of abruptio placentae are
pain, dark red vaginal bleeding, a rigid, board-like abdomen, hypertonic labor, and fetal distress.
Placenta previa usually produces
painless bright red bleeding. Preterm labor contractions are more often described as cramping.
Reflex assessment
part of the standard assessment for clients on magnesium sulfate.
A 24-year-old client presents in labor. The nurse notes there is an order to administer Rho(D) immune globulin after the birth of her infant. When asked by the client the reason for this injection, which reason should the nurse point out?
prevent maternal D antibody formation.
cerclage
purse string suture, is inserted into the cervix to prevent preterm cervical dilation (dilatation) and pregnancy loss
Premature separation of the placenta begins with
sharp fundal pain, usually followed by dark red vaginal bleeding.
habitual abortion
spontaneous abortion occurring in three or more consecutive pregnancies
The nurse instructs the client to bring the passed tissue to the hospital with her. What is the correct rationale for this instruction?
to determine whether gestational trophoblastic disease is present
The nurse knows that which factor is a known risk factor for ectopic pregnancy?
use of IUD for contraception
Gestational hypertension is caused by
vasospasms of the arteries.
In a partial molar pregnancy
two sperm penetrate the ovum, resulting in a total of 69 chromosomes
