Vsim Olivia pre and post | Questions and Answers(A+ Solution guide)
PRE which of the entries on a pts medical record are evidence of the diagnosis of severe preeclampsia. SATA - -Scotomata -Epigastric pain -Oliguria - 3 lb weight gain in 1 week -blood pressure 182/116 PRE which of the following need to be implemented when a pt with severe preeclampsia is admitted to the hospital. SATA - -seizure precaustions -reduced stimulation -bed rest -dim light PRE what are the Priorities of care if a pregnant woman experiences an eclamptic seizure? STAT - - Administer O2 -protect the pt from injury -clear airway PRE Pts with severe preeclampsia are at risk for developing acute pulmonary edema. What can the nurse do to prevent the development of this condition? - control the rate of administration of IV fluids PRE what is the primary indication for the administration of magnesium sulfate to the pt with severe preeclampsia? - preventing eclamptic seizuresPRE which of the following findings from the nurse's assessment of the pt with severe preeclampsia would indicate central nervous system involvement? SATA - -Visual changes -4+ deep tendon reflexes -positive clonus Pre when reviewing a pts admission orders the nurse notes that the following lab studies have been ordered: BUN, BUN/CR ratio, and 24 urine protein. The results of these tests will provide info about the function of which organ? - kidneys PRE which of the following are signs of magnesium tox in a pt? SATA - -Hyporeflexia -Respiratory depression -CNS depression PRE to assess for clonus the nurse briskly dorsiflexes the pts foot and then releases it. What would a positive response look like? - Jerky, rapid contraction of the ankle and foot PRE what is the therapeutic blood level for a pt receiving an IV infusion of magnesium sulfate? - 4-7 mEq/L POST a pt wit preeclampsia is admitted with vital signs as follows: temp 98.6, HR 110, RR 28, BP182/116, SpO2 92%. The fetal heart rate is 150 bpm. Which of the following interventions would the nurse implement based on these findings? - administer oxygen POSTThe nurse knows to implement seizure precautions for ms jones because of her severe preeclampsia. Which of the following actions would the nurse take? - -bring suction to bedside -pad side rails -have O2 available POST Monitoring ms jones liver enzymes, chem panel, and coagulation studies will assist the nurse to determine if the pts condition is progressing to what? - HELLP POST Ms jones mag sulfate infusion is started. How does the nurse assess the effectiveness of the mag sulfate treatment? - monitor deep tendon reflexes POST ms jones mother asks the nurse is preeclampsia can be cured. What is the most appropriate response by the nurse? - birth of the infant is the only cure POST ms jones tells the nurse she has a severe pain under her right breast and asks do you think i am having a heart attack? what is the nurses best response? - no you are have epigastric pain which is caused by decreased blood flow to your liver because of your high blood pressure POST ms jones presents with chest tightness and coarse crackles. What additional assessment parameter would the nurse evaluate to determine her pulmonary/ resp status? SATA - -cough -restlessness - neck POST ms jones is complaining of nausea dn RUQ pain. Which set of labs would the nurse expect the provider to order based on her symptoms? - LDH, ALT, AST
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