NUR 202 Mod F Prep U

NUR 202 Mod F Prep U The amniotic fluid is green when the membranes rupture. What finding would the nurse document? - Meconium in the amniotic sac. Green tinted fluid with ROM is indicative of meconium in the amniotic sac, or the infant having a bowel movement in utero. Infection would be shown by puss or cloudy fluid. Umbilical cord prolapse occurs when pressure on the cord stops the flow of oxygen to the fetus. Amniotic embolism results when amniotic fluid enters circulation. A patient who is in her 9th month of pregnancy comes to the emergency department and reports that bright red blood is coming from her vagina. She denies having any pain. What needs to be ruled out before a vaginal examination can be performed? - placenta previa. Vaginal examinations should never be done if the woman presents with bright red painless bleeding until placenta previa is ruled out. A labor and delivery nurse knows that when assessing a woman's contraction pattern, it is important to include which of the following? - frequency, duration, intensity. When assessing a woman's contraction pattern, it is important to include frequency, duration, and intensity. Although knowing the status of the membranes and activity of the fetus are both important, they are not part of the contraction pattern. A pt is admitted at 22 wks gestation with advanced cervical dilatation to 5 centimeters, cervical insufficiency, and a visible amniotic sac at the cervical opening. What is the primary goal for this patient at this point? - Bed rest to maintain pregnancy as long as possible. At 22 weeks gestation, the fetus is not viable. The woman would be placed on bed rest, total, with every attempt made to halt any further progression of dilatation as long as possible In returning to the hospital floor after a weekend off, the nurse takes over care of a pregnant patient who is resting in a darkened room. The patient is receiving betamethasone and magnesium sulfate. What could the nurse deduce from those findings? - The patient is suffering from severe preeclampsia and the care team is attempting to prevent advancement of the disorder to eclampsia; they are attempting to help the baby's lungs mature quickly so that they can deliver as soon as possible. The administration of magnesium sulfate is to relax the skeletal muscles and raise the threshold for a seizure. The administration of the betamethasone is to try and hasten the maturity of the fetus' lungs for delivery. This woman is in advanced preeclampsia and must be monitored for progression to eclampsia. A patient with preeclampsia is receiving magnesium sulfate. Which of the following nursing assessments should be ongoing while the medication is being administered? - Respiratory rate. The level of magnesium in therapeutic range is 4 to 8 mg/dL. If magnesium toxicity occurs, one sign in the patient will be a decrease in the respiratory rate and a potential respiratory arrest. Respiratory rate will be monitored when on this medication. Which of the following would the nurse have readily available for a client who is receiving magnesium sulfate to treat severe preeclampsia? - Calcium gluconate. The antidote for magnesium sulfate is calcium gluconate, and this should be readily available in case the woman has signs and symptoms of magnesium toxicity. Which one of the following findings would alert the nurse to the development of HELLP syndrome in a pregnant client? - HELLP is an acronym for hemolysis, elevated liver enzymes, and low platelets. Hypertonic labor is labor that is characterized by short, irregular contractions without complete relaxation of the uterine wall in between contractions. Hypertonic labor can be caused by an increased sensitivity to oxytocin. What would you do for a patient who is in hypertonic labor because of oxytocin augmentation? - Hypertonic labor may result from an increased sensitivity of uterine muscle to oxytocin induction or augmentation. Treatment for this iatrogenic cause of hypertonic labor is to decrease or shut off the oxytocin infusion. A multigravida presents at 31 weeks' gestation with signs and symptoms of preterm labor. The diagnosis is confirmed and she is admitted and given magnesium sulfate. What must you report as part of her care? - Respiratory depression, hypotension, absent tendon reflexes. Magnesium sulfate is a smooth muscle relaxant and can cause vaso-dilation and results in respiratory depression and severe hypotension at toxic levels A young woman experiencing contractions arrives at the emergency department. After examining her, the nurse learns that the patient is 33 weeks' gestation. What treatment can the nurse expect this patient to be ordered? - Tocolytic therapy is most likely ordered if preterm labor occurs before the 34th week of gestation in an attempt to delay birth and thereby reduce the severity of respiratory distress syndrome and other complications associated with prematurity. A 16-year-old client has been in the active phase of labor for 14 hours. An ultrasound reveals that the likely cause of delay in dilatation is cephalopelvic disproportion. Which of the following interventions should the nurse most expect in this case? - If the cause of the delay in dilatation is fetal malposition or cephalopelvic disproportion (CPD), cesarean birth may be necessary. A woman near term presents to the clinic highly agitated because her membranes have just ruptured and she felt something come out when they did. You are alone with her and notice that the umbilical cord is hanging out of the vagina. What should you do next? - Put her in bed immediately, call for help, and hold the presenting part of the cord. Umbilical cord prolapse occurs when the umbilical cord slips down in front of the presenting part, when the presenting part compresses the cord oxygen and nutrients are cut off to the baby and the baby is at risk of death. When teaching a class of pregnant women about the effects of substance abuse during pregnancy, which of the following would the nurse include? - Substance abuse during pregnancy is associated with low-birthweight infants, preterm labor, abortion, intrauterine growth restriction, abruptio placentae, neurobehavioral abnormalities, and long-term childhood developmental consequences. The nurse explains to a pregnant client that she will need to take iron during her pregnancy after being diagnosed with iron-deficiency anemia. The nurse suggests that absorption of the supplemental iron can be increased by taking it with which of the following? - Orange juice. Anemia is a condition in which the blood is deficient in red blood cells, from an underlying cause. The woman needs to take iron to manufacture enough red blood cells. Taking an iron supplement will help improve her iron levels, and taking iron with foods containing ascorbic acid, such as orange juice, improve the absorption of iron. A pregnant woman who has had cardiovascular disease for the last 3 years asks the nurse why this disorder makes her pregnancy an "at-risk" pregnancy. What is the nurse's best response? - "Pregnancy taxes the circulatory system of every woman." Pregnancy taxes the circulatory system of every woman because both the blood volume and cardiac output increase by approximately 30% to 50%. Half of these increases occur by 8 weeks; they are maximized by mid-pregnancy. When educating a pregestational patient on how to control her blood sugar, the nurse knows there are three main facets to glycemic control: diet, exercise and _______. Which of the following is the third facet? - Insulin A nurse is talking to a newly pregnant woman who had a mitral valve replacement in the past. Which of the following statements by the patient reveals an understanding about the pre-existing condition? - "I understand that my fetus and I both are at risk for complications." When a woman enters pregnancy with a pre-existing condition, both she and her fetus can be at risk of developing complications. A 41-year-old client in week 11 of her pregnancy has arrived for a prenatal visit. Which of the following assessments should the nurse offer to the client specifically because of the client's age? - Chromosomal assessment. Because the risk for Down syndrome is higher in older women than in younger women, offer a quad-screen or an integrated screen (sometimes referred to as a sequential screen) in order to detect if an open spinal cord or chromosomal defect could be present in the fetus. ....................