NUR 2420 Maternal Nursing Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and Vulnerable Populations
A pregnant client with sickle cell anemia is admitted in crisis. Which nursing intervention should the nurse prioritize?
IV fluids
Which factor would contribute to a high-risk pregnancy?
type 1 diabetes
A pregnant client is diagnosed with syphilis. Which response would demonstrate respect for the client and therapeutic communication?
"I am sure it is frightening to you to be diagnosed with a disease that can affect your baby."
A pregnant single mom living alone tells the nurse she is considering getting a cat for her 2-year-old daughter. Which is the best response by the nurse?
"You should wait until after you give birth to obtain the cat for your daughter."
The nurse is caring for a pregnant woman determined to be at high risk for gestational diabetes. The nurse prepares to rescreen this client at which time frame?
24 to 28 weeks
A client is 33 weeks' pregnant and has had diabetes since age 21. When checking her fasting blood glucose level, which value would indicate the client's disease is controlled?
85 mg/dl
At 24 weeks' gestation, a client's 1-hour glucose tolerance test is elevated. The nurse explains that, based on this finding, the client will need to take which action?
A 3-hour glucose tolerance test for follow-up
Between her regularly scheduled visits, a woman in her first trimester of pregnancy who is taking iron supplements for anemia calls the nurse at her obstetrician's office reporting constipation. She reports that she has never had this problem before and asks for some advice about how to get relief. What is the best advice the nurse can give her?
Continue taking iron supplements but increase fluids and high-fiber foods; exercise more.
A woman with cardiac disease at 32 weeks' gestation reports she has been having spells of light-headedness and dizziness every few days. Which instruction should the nurse prioritize?
Decrease activity and rest more often.
What important instruction should the nurse give a pregnant client with tuberculosis?
Maintain adequate hydration.
A nurse caring for a pregnant client suspects substance use during pregnancy. What is the priority nursing intervention for this client?
Obtain a urine specimen for a drug screening.
A nurse is providing education to a woman at 28 weeks' gestation who has tested positive for gestational diabetes mellitus (GDM). What would be important for the nurse to include in the client teaching?
She is at increased risk for type 2 diabetes mellitus after her baby is born.
A nurse is teaching a 30-year-old gravida 1 who has sickle cell anemia. Providing education on which topic is the highest nursing priority?
avoidance of infection
A new young mother has tested positive for HIV. When discussing the situation with the client, the nurse should advise the mother that she should avoid which activity?
breastfeeding
A pregnant client with type I diabetes asks the nurse about how to best control her blood sugar while she is pregnant. The best reply would be for the woman to:
check her blood sugars frequently and adjust insulin accordingly.
A nurse is interviewing a pregnant woman who has come to the clinic for her first prenatal visit. During the interview, the client tells the nurse that she works in a day care center with 2- and 3-year olds. Based on the client's history, the nurse would be alert for the development of which condition?
cytomegalovirus
A 40-year-old woman comes to the clinic reporting having missed her period for two months. A pregnancy test is positive. What is she and her fetus at increased risk for?
placental abnormalities
What is the role of the nurse during the preconception counseling of a pregnant client with chronic hypertension?
stressing the positive benefits of a healthy lifestyle
A primigravida 21-year-old client at 24 weeks' gestation has a 2-year history of HIV. As the nurse explains the various options for delivery, which factor should the nurse point out will influence the decision for a vaginal birth?
the viral load
A pregnant client is screened for tuberculosis during her first prenatal visit. An intradermal injection of purified protein derivative (PPD) of the tuberculin bacilli is given. Which sign would indicate a positive test result?
An indurated wheal over 10 mm in diameter appears in 48 to 72 hours.
