Ricci Chapter 20 Prep U
A woman with cardiac disease has come to the office for prenatal counseling. According to the functional classification system developed by the Criteria Committee of the New York Heart Association, the woman would be cautioned against pregnancy based on which category?
class IV
The nurse is assessing a pregnant client with a known history of congestive heart failure who is in her third trimester. Which assessment findings should the nurse prioritize?
dyspnea, crackles, and irregular weak pulse
The nurse is providing care to a neonate. Review of the maternal history reveals that the mother is suspected of abusing heroin. The nurse would be alert for which finding when assessing the neonate?
hypertonicity
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 nurse is caring for a pregnant client who is human immunodeficiency virus (HIV) positive. What is a priority issue that the nurse should discuss with the client?
the need for the client to avoid breastfeeding
The nurse is assessing a pregnant client in the client who has a history of heart disease. The nurse will prioritize assessments focusing on the heart during which time frame?
28 to 32 weeks' gestation
A nurse is talking to a newly pregnant woman who had a mitral valve replacement in the past. Which statement by the client reveals an understanding about the preexisting condition?
"I understand that my fetus and I both are at risk for complications."
A woman's baby is HIV positive at birth. She asks the nurse if this means the baby will develop AIDS. Which statement would be the nurse's best answer?
"The antibodies may be those transferred across the placenta; the baby may not develop AIDS."
A 43-year-old, physically fit, healthy woman who is newly married tells the nurse that she and her husband would like to have a child. What is an appropriate first response?
"Well, I'm sure you know there are some risks involved so it's helpful that you've been taking such good care of yourself."
A nurse is caring for a client with cardiovascular disease who has just given birth. What nursing interventions should the nurse perform when caring for this client? Select all that apply.
Assess for shortness of breath. Assess for a moist cough. Assess for edema and note any pitting. Auscultate heart sounds for abnormalities.
A 38-year-old woman comes into the obstetrician's office for prenatal care, stating that she is about 12 weeks pregnant with her first child. What questions would the nurse ask this client, considering her age and potential sensitivity to being labeled an "older" primipara?
Be non-judgmental in your history gathering and offer her pregnancy resources to read and explore.
A patient with heart disease who is 28 weeks pregnant asks the nurse why office appointments have been scheduled every week for the next 4 weeks. What should the nurse respond to the patient?
During weeks 28 and 32, blood volume peaks, and heart function can be affected.
The nurse is assessing a mother who just delivered a 7 lb (3136 g) baby via cesarean delivery. Which assessment finding should the nurse prioritize if the mother has a history of controlled atrial fibrillation?
Jugular distention
A nurse caring for a pregnant client suspected substance use during pregnancy. What is the priority nursing intervention for this client?
Obtain a urine specimen for a drug screening.
Which medication would you expect to see prescribed for a pregnant woman with an artificial heart valve shortly before or during labor?
Penicillin
The nurse is assessing a woman with Class III heart disease who is in for a prenatal visit. What would be the first recognizable sign that this client is in heart failure?
Persistent rales in the bases of the lungs
A 15-year-old adolescent arrives at the office with a report of flu symptoms, including nausea and vomiting and recent weight loss. A pregnancy test is done and is positive. The client begins crying and tells the nurse her mother will be furious with her. What can the nurse do to assist this adolescent at this point?
Support her by respecting her right to privacy and confidentiality.
The nurse is assessing a 35-year-old Hispanic woman at 22 weeks' gestation who has had recent laboratory work. The nurse notes fasting blood glucose 146 mg/dL, hemoglobin 13 g/dL, and hematorcrit 37%. Based on these results which instruction should the nurse prioritize?
Take daily iron supplements.
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 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?
assessing for cardiac decompensation
A 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 woman diagnosed with cardiac disease 4 years ago is told that her pregnancy is a high-risk pregnancy. The nurse then explains that the danger occurs primarily because of the increase in circulatory volume. The nurse informs the client that the most dangerous time for her is when?
in weeks 28 to 32
A nurse is caring for a pregnant adolescent client, who is in her first trimester, during a visit to the maternal child clinic. Which important area should the nurse address during assessment of the client?
knowledge of child development
When providing education to a teenage prenatal class, the nurse states that infants born to teenage mothers are more likely to have which outcome?
low-birth weight
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
During the assessment of a laboring client, the nurse learns that the client has cardiovascular disease (CVD). Which assessment would be priority for the newborn?
respiratory function
