UW: 4 Maternal and Newborn Health

UW: 4 Maternal and Newborn Health 1.A practical nurse is collaborating with the registered nurse to form a care plan for a client diagnosed with placenta previa at 33 weeks gestation. What does the nurse anticipate being included in the plan of care? Select all that apply. - Nonstress test 1 or 2 times a week - Prepare for cesarean birth at any time - Type and screen blood Explanation: In placenta previa, the placenta is implanted over or very near the cervix. As a result, placental blood vessels may be disrupted during dilation and effacement. Because of the increased risk of hemorrhage, the client should have a type and screen on file at the selected hospital. A nonstress test or biophysical profile should be performed once or twice a week to ensure fetal well-being. With asymptomatic clients, a cesarean birth is planned after 36 weeks gestation and prior to the onset of labor to prevent blood loss of mother and fetus. However, if the client is bleeding profusely or constantly or goes into active labor, a cesarean birth is typically performed immediately. (Option 1) The recommended activity for a client at less than 36 weeks gestation with diagnosed placenta previa is bed rest with bathroom privileges. A stable client may be released to continue bed rest at home, but the client must be closely monitored and return to the hospital immediately if bleeding occurs. 2.An obviously pregnant client walks into the emergency department screaming, "I am about to give birth!" What questions are essential to ask in preparation for and performance of possible neonatal resuscitation? Select all that apply. - Fetal distress and cesarean birth 3.The registered nurse is preparing to administer oxytocin to induce labor in a client. The practical nurse assists the registered nurse and recognizes that the oxytocin infusion can lead to which of the following conditions? - Fetal distress and cesarean birth 4.Which vaccine can safely be given in the second or third trimester of pregnancy? - Tetanus-diphtheria-pertussis vaccine 5.A client at 39 weeks gestation with preeclampsia has a blood pressure of 170/100 mm Hg, 2+ proteinuria, and moderate peripheral edema. Immediately after hospital admission, she develops seizures and uterine contractions. Magnesium sulfate is prescribed. Which finding indicates that the drug has achieved the desired therapeutic effect? - Seizure activity stops 6.A woman delivers her baby immediately on arrival at the emergency department and 5 minutes later delivers the placenta. The nurse's assessment is that the woman's uterus is boggy and midline. What action should the nurse take first? - Massage the fundus 7.A nurse is measuring the uterine fundal height of a client who is at 36 weeks gestation in supine position. The client suddenly reports dizziness and the nurse observes pallor and damp, cool skin. What should the nurse do first? - Reposition client into a lateral position 8.A client is at 20 weeks gestation. The client reports having to "run to the bathroom all the time," "it hurts to pee," and my urine "smells bad." Which statement by the nurse is the most appropriate? - "You may need to be checked for a urinary tract infection." 9.When assessing neonates in the nursery, the practical nurse should report which findings to the registered nurse? Select all that apply. - Chest wall retractions - Head circumference of 30 cm - Jaundice of the head and sclera - No voiding in 24 hours 10.A 36-year-old multigravida is admitted with a diagnosis of severe preeclampsia. IV magnesium sulfate is prescribed. Which nursing measures does the practical nurse anticipate in this client's plan of care? Select all that apply - Check deep tendon reflex frequently - Ensure calcium gluconate is available - Have suction equipment ready to use - Monitor for right upper quadrant pain 11.A pregnant client has labor induced with oxytocin infusion. The practical nurse notes that the fetal heart rate (FHR) tracing shows a change in the baseline rate from 145/min to 170/min and minimal variability. What is the nurse's first action? - Stop oxytocin infusion 12.A pregnant client in the third trimester completes an intake form for a clinic visit. Which signs and symptoms are priority problems for the nurse to evaluate? Select all that apply. -- Frequent urination with dysuria and nocturia - Headache and blurred vision - Nonmalodorous, copious, clear vaginal discharge 13.A nurse is caring for a pregnant client who has hyperemesis gravidarum. Which assessment findings should the nurse anticipate? Select all that apply. -- Positive urine ketones (moderate) - Pulse 106/min ..............