EAQs 6-10 Pregnancy At Risk

EAQs 6-10 Pregnancy At Risk Which information is most important for a large-for-gestational-age (LGA) infant of a diabetic mother (IDM)? - Blood glucose level less than 40 mg/dL A client has a blood pressure of 90/50 mm Hg during her first visit to the prenatal clinic. On a subsequent visit, at 34 weeks' gestation, her blood pressure is 120/76 mm Hg. The nurse concludes that could have occurred because of: - The possible development of preeclampsia A client is found to have gestational hypertension in the 22nd week of gestation. What is a major complication of hypertensive disease associated with pregnancy that the nurse should anticipate? - Abruptio placentae A client is admitted with a marginal placenta previa. What should the nurse have available? - Two units of typed and screened blood What signs and symptoms of withdrawal does the nurse identify in a postpartum client with a history of opioid abuse? - Irritability and muscle tremors A woman in active labor arrives at the birthing unit. She tells the nurse that she was found to have a chlamydial infection the last time she visited the clinic but that she stopped taking the antibiotic after 3 days because she "felt better." What would the nurse anticipate as part of the plan of care, in light of this history? - Administration of antibiotics before delivery A client with type 1 diabetes is scheduled for an amniocentesis at 36 weeks' gestation. She asks the nurse why this is being done so late in her pregnancy. What should the nurse consider before responding? - Fetal lung maturity may be evaluated. A 24-year-old client who has had type 1 diabetes for 6 years is concerned about how her pregnancy will affect her diet and insulin needs. How should the nurse respond? - "Insulin dosage and dietary needs will be adjusted in accordance with the results of blood glucose monitoring." A 28-year-old woman is recovering from her third consecutive spontaneous abortion in 2 years. What is the most therapeutic nursing intervention for this client at her follow-up appointment? - Encouraging the client to verbalize her feelings about the loss A nurse is teaching a prenatal class about smoking during pregnancy. What neonatal consequence of maternal smoking should the nurse include in the teaching? - Low birth weight A client has a cesarean birth. What is the most important nursing intervention to prevent thromboembolism on the client's first postpartum day? - Encouraging frequent ambulation A nurse is caring for a client with preeclampsia who is receiving intravenous magnesium sulfate therapy. What antidote should the nurse have readily available? - Calcium gluconate A nonstress test is scheduled for a client with preeclampsia. During the nonstress test the nurse concludes that if nonperiodic accelerations of the fetal heart rate occur with fetal movement, this probably indicates: - Fetal well-being A client being prepared for surgery because of a ruptured tubal pregnancy complains of feeling lightheaded. Her pulse is rapid, and her color is pale. What condition does the nurse anticipate as a common complication of a ruptured tubal pregnancy? - Shock A woman at 22 weeks' gestation is admitted with heavy bleeding and severe abdominal cramping. When told that no fetal heart sounds can be detected, the client says to the nurse, "We wanted this baby so badly." How should the nurse respond? - "It must be difficult to lose this baby that was important to you both." A nurse who is caring for a client in labor uses nitrazine paper to test the pH of the client's leaking vaginal fluid. What color will the nitrazine paper turn if the leakage is amniotic fluid? - Blue A client in labor is admitted to the birthing unit. Assessment reveals that the fetus is in a footling breech presentation. What should the nurse consider about breech presentations when caring for this client? - Cesarean birth probably will be necessary At 32 weeks' gestation a client undergoes ultrasound, which reveals a low-lying placenta. What complication should the nurse anticipate as the client's pregnancy approaches term? - Painless vaginal bleeding Two days after delivery, a client has a temperature of 101° F (38.3), general malaise, anorexia, and chills. What does the nurse expect to identify on the client's laboratory report? - Increased white blood cell (WBC) count A nurse teaching a prenatal class is asked why infants of diabetic mothers are larger than those born to women who do not have diabetes. On what information about pregnant women with diabetes should the nurse base the response? - Extra circulating glucose causes the fetus to acquire fatty deposits. What clinical manifestation requires immediate intervention in a woman with a probable ruptured tubal pregnancy? - Sudden onset of knifelike pain in one of the lower quadrants A nurse is providing nutritional counseling to a low-income pregnant client who has iron-deficiency anemia. What food should the nurse encourage the client to include in her diet each day to best address this problem? - ½ cup of red kidney beans A breastfeeding mother experiences redness and pain in the left breast, a temperature of 100.8° F (38.2° C), chills, and malaise. What condition does the nurse suspect? - Mastitis A client at 35 weeks' gestation who has had no prenatal care arrives in labor and delivery and is found to be 20 percent effaced and 2 cm dilated, with her membranes intact and contractions 3 minutes apart. The nurse notices some ruptured blisterlike vesicles in the genital area. What should the nurse's next action be? - Contacting the health care provider about the need for a cesarean birth Which client is at risk for a postpartum infection? - A woman who required catheterization after voiding less than 75 mL A client in the 38th week of gestation exhibits a slight increase in blood pressure. The health care provider advises her to remain in bed at home in a side-lying position. The client asks why this is important. What is the nurse's response regarding the advantage of this position? - It increases blood flow to the fetus. When entering the room of a client in active labor to answer the call light, the nurse sees that she ashen gray, dyspneic, and clutching her chest. What should the nurse do after pressing the emergency light in the client's room? - Administer oxygen by face mask A client is being prepared for an emergency cesarean birth because of fetal compromise. What is the most important preoperative nursing action? - Confirming the signed consent A nurse administers the prescribed intravenous dose of magnesium sulfate to a client with severe preeclampsia. What adverse effect should the nurse address when evaluating the client's response to the medication? - Respiratory depression During the first hour after a cesarean birth, a nurse notes that the client's lochia has saturated one perineal pad. In light of the knowledge of expected lochial flow, what should the nurse conclude that this indicates? - Lochial flow within expected limits