OB Exam 2

Class 4

The client is symptomatic when resting and is incapacitated in class IV.

New York Heart Association 2

The client is symptomatic with increased activity and is in slight compromised state in class II.

New York Heart Association Class 1

The client is asymptomatic with all kinds of activity and is in uncompromised state in class I.

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?

A positive PPD result would be an indurated wheal over 10 mm in diameter that appears in 48 to 72 hours. The area must be a raised wheal, not a flat, circumscribed area.

The clinic nurse teaches a pregestational type 1 diabetic client that constant insulin levels are very important during pregnancy. The nurse tells the client that the best way to maintain a constant insulin level is to use:

Because a pregnant client will have some periods of relative hyperglycemia and hypoglycemia no matter how carefully she maintains her diet and balances her exercise levels, an effective method to keep serum glucose levels constant is to administer insulin with a continuous pump during pregnancy.

Parvovirus B19

common self-limiting benign childhood virus that causes fifth disease. A pregnant woman may transmit the virus transplacentally to her fetus if she is exposed to an infected child.

What criteria would the ob/gyn base a decision on to begin insulin therapy for a mother with gestational diabetes?

An ob/gyn usually recommends beginning a woman with gestational diabetes on insulin therapy when exercise and diet are ineffective and if she is unable to keep her fasting blood sugar levels below 95 mg/dl or her 2-hour postprandial glucose levels below 120 mg/dl.

A pregnant client has tested positive for cytomegalovirus. What can this cause in the newborn?

microcephaly

Toxoplasmosis

transferred by hand to mouth after touching cat feces while changing the litter box or through gardening in contaminated soil

An infant is born to a mother with gestational diabetes. Which long-term maternal complication is associated with this diagnosis?

A mother who had gestational diabetes is at a 30% to 50% higher risk of developing type 2 diabetes mellitus than the general population. Long-term hypertension and heart disease are not associated with gestational diabetes, nor is weight gain following pregnancy. There is no data that validates long-term weight gain as a complication of gestational diabetes.

A pregnant client with a history of heart disease has been admitted to a health care center reporting breathlessness. The client also reports shortness of breath and easy fatigue when doing ordinary activity. The client's condition is markedly compromised. The nurse would document the client's condition using the New York Heart Association (NYHA) classification system as which class?

Class 3

A nurse is caring for a pregnant client with heart disease in a labor unit. Which intervention is most important in the first 48 hours postpartum?

The nurse should assess the client with heart disease for cardiac decompensation, which is most common from 28 to 32 weeks' gestation and in the first 48 hours postpartum. Limiting sodium intake, inspecting the extremities for edema, and ensuring that the client consumes a high-fiber diet are interventions during pregnancy not in the first 48 hours postpartum.

Cytomegalovirus

transmitted via sexual contract, blood transfusions, kissing, and contact with children in daycare centers