Maternal Newborn 3.)- Preeclampsia
Nurse Morgan is preparing to administer hydralazine (Apresoline) 5 mg IV bolus. Available is hydralazine 20 mg/mL. How many mL should Morgan administer? Round the answer to the nearest hundredth
0.25
Nurse Morgan prepares to call Dr. Hunt and give a report. Which of the following is the most important clinical data Morgan needs to include in the SBAR report?
Elevated BP- priority clnical fininding to include in the SBAR report. The greatest risk to the client and her fetus is impaired tissue perfussion to the placenta and vital organs secondar to the arteriorlar vasospasm
Nurse Morgan is reviewing Ms. Klein's lab test results. Which of the following findings should Morgan discuss with Ms. Klein regarding her worsening condition?
Increased proteinuria-increases with the worsening of preeclampsia
Nurse Morgan completes an admission assessment for Ms. Klein. Based on the assessment, which of the following is the priority nursing intervention?
Initiatie seizure precautions!
In the SBAR reporting format, which of the following would be an example of data found in the assessment?
LOOK AT THE PICTURE
Nurse Morgan is preparing to teach Ms. Klein about delivery by cesarean section. Which of the following should Morgan include in the teaching? Select all that apply. a) you will receive pain medication following the procedure b) your spouse will give informed consent c) monitoring of the fetal heart will continue d) you will receive antiemetic medications e) I will review options for anesthesia with you
Pain meds following the procedure; Monitoring the FHR, You will receive antiemetic meds
Nurse Morgan is administering IV magnesium sulfate to Ms. Klein. Which of the following manifestations indicates Ms. Klein is experiencing magnesium toxicity? a) respirations 11/min b) 4+ deep tendon reflexes c) skin pallor d) urinary output of 60 mL/hr
Respirations 11/min
Nurse Morgan is preparing to administer magnesium sulfate IV at 2 g/hr. Available is mag sulfate 40 g/1000 mL lactated Ringer's. Morgan should set the IV pump to deliver how many mL/hr.
50 mL/hr
Nurse Morgan reviews the laboratory test results for Ms. Klein. Which of the following findings confirms a diagnosis of severe preeclampsia? a) platelets 158,000/mm3 b) aspartate aminotransferase (AST) 75 units/L c) hemoglobin 16 g/dL d) urine protein 1+
Aspartate aminotransferase AST 75 units/L
Nurse Morgan recognizes Ms. Klein is experiencing variable decelerations of the fetal heart rate. Which of the following nursing interventions should Morgan take at this time? a) administer oxygen via nasal cannula at 2 L/min b) elevate Ms. Klein's legs c) prepare Ms. Klein for immediate cesarean birth d) change Ms. Klein's position
Change Ms. Klein's position-positon to a lateral or knoee-chest positoin to attempt ot improve uteroplacental perfusion
Nurse Morgan is reviewing prescriptions from Dr. Hunt. For which of the following manifestations should she plan to monitor following administration of hydralazine?
Tachycardia. This is a vasodialtor- to help with BP lowers BP