High Risk Pregnancy Exam 3 | Questions and Answers

High Risk Pregnancy Exam 3 | Questions and Answers Which statement made by the nursing student about the management of reduced cervical competence (premature dilation of the cervix) in a pregnant patient indicates effective learning? Prophylactic cerclage is used to constrict the internal os of the cervix At 37 weeks of gestation, the patient is in a severe automobile crash where her abdomen was hit by the steering wheel and her seat belt. What priority action would the emergency room nurse expect to perform upon the patient's arrival at the hospital? Assess the patient's vital signs, determine location and severity of pain, and establish continual fetal heart rate monitoring A woman with severe preeclampsia is being treated with an intravenous infusion of magnesium sulfate. This treatment is considered successful if: Seizures do not occur After being rehydrated in the emergency department, a 24 year-old primipara in her 18th week of pregnancy is at home and is to rest at home for the next two days and take in small but frequent fluids and food as possible. Discharge teaching at the hospital by the nurse has been effective if the patient makes which statement? "I'm going to eat five to six small servings per day, which contain such foods and fluids as tea, crackers, or a few bites of baked potato." A woman at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes; dark red vaginal bleeding; and a tense, painful abdomen. The nurse suspects the onset of: Placental abruption What dietary instructions does the nurse give a patient who has experienced miscarriage? Food that are high in iron and protein Which condition in a pregnant patient with severe preeclampsia is an indication for administering magnesium sulfate? Seizure activity At 38 weeks of gestation, a 24-year-old primipara delivers a 6 pound 2 ounce infant whose five-minute Apgar was 8. How should the neonatal nurse evaluate the outcome of this pregnancy because his mother had been experiencing hyperemesis gravidarum since the eighth week of pregnancy? Within healthy parameters for gestation, weight, and Apgar A woman at 37 weeks of gestation is admitted with a placental abruption after a motor vehicle accident. Which assessment data are most indicative of her condition worsening? Pulse (P) 112, respiration (R) 32, blood pressure (BP) 108/60; fetal heart rate (FHR) 166—178 The nurse observes that intravenous (I.V.) administration of magnesium sulfate has resulted in magnesium toxicity in a pregnant patient with preeclampsia. The nurse immediately discontinues the infusion and reports to the primary health care provider (PHP). For which drug does the nurse obtain a prescription from the PHP? Calcium gluconate A pregnant patient after 20 weeks' gestation reports painless, bright red vaginal bleeding. Upon assessment, the nurse finds that the patient's vital signs are normal. Which condition does the nurse suspect in the patient? Placenta previa Which medication does the nurse expect to find prescribed for a pregnant patient who requires anticoagulant therapy for recurrent venous thrombosis? Lovenox - Coumadin crosses the placenta to cause fetal anomalies and cognitive impairment Which condition is a fetus at risk for if the mother has poor glycemic control later on in pregnancy? Macrosomia In planning for the care of a 30-year-old woman with pregestational diabetes, the nurse recognizes that the most important factor affecting pregnancy outcome is the: Degree of glycemic control during pregnancy Thalassemia is a relatively common anemia in which: an insufficient amount of hemoglobin is produced to fill the red blood cells (RBCs) The fasting plasma glucose levels are greater than 95 mg/dL in a patient with gestational diabetes mellitus. The patient is unwilling to take the prescribed insulin therapy. Which medication can be used in this case? Glyburide (Micronase) The most important instruction to include in a teaching plan for a woman in early pregnancy who has class I heart disease is: She must report any chest discomfort or productive cough Which condition does the nurse suspect in a pregnant patient if there is weight loss and the patient's pulse rate is greater than 100 beats/min? Hyperthyroidism Maternal and neonatal risks associated with gestational diabetes mellitus are: Maternal preeclampsia, fetal macrosomia Which instruction should the nurse include when teaching a pregnant woman with class II heart disease? Instruct her to avoid strenuous activity The nurse is teaching a pregnant patient with diabetes mellitus about ways to prevent infant morbidity. What is the most important aspect to include? Strict control of blood glucose levels When planning intrapartum care for a woman with heart disease, the nurse should include: A woman with heart disease should have a cardiac monitor (telemetry) and possibly an arterial line for continuous blood pressure monitoring as well as hemodynamic monitoring. Vital signs may need to be taken more frequently because of the extra workload on the heart During a physical assessment of an at-risk patient, the nurse notes generalized edema, crackles at the base of the lungs, and some pulse irregularity. These are most likely signs of: Cardiac decompensation A patient who recently had a heart transplant with no evidence of rejection asks the nurse about the safety of conceiving a child. What is the best response by the nurse? You may conceive 1 year after transplant Which clinical reports does the nurse evaluate to identify ectopic pregnancy in a patient? Select all that apply. hCG levels, progesterone levels, transvaginal ultrasound Signs of a threatened abortion (miscarriage) are noted in a woman at 8 weeks of gestation. What is an appropriate management approach for this type of abortion? Prepare the women for an ultrasound and bloodwork Which actions does the nurse take when a pregnant patient has convulsions? Select all that apply. The nurse obtains a prescription for magnesium sulfate to prevent further convulsions. The nurse assesses the patient's airway, breathing, and pulse to understand the maternal condition. The nurse may need to suction secretions to clear the airway and administer oxygen to maintain sufficient oxygenation in the patient. The nurse lowers the bed and turns the patient onto one side to prevent aspiration of vomitus. The nurse raises the side rails of the bed and pads with pillows to prevent a fall. The nurse may call for help but should not leave the patient's bedside as the patient is in a serious condition. What instruction does the nurse provide to a pregnant patient with mild preeclampsia? Fetal movement counts daily What action does the nurse take before performing cardiopulmonary resuscitation (CPR) to revive a pregnant patient undergoing a cardiac arrest? Place a rolled blanket under the patient's hips - to displace the uterus The nurse finds diuresis, weight loss, and muscle atrophy in a pregnant patient with mild preeclampsia. What does the nurse conclude from these findings? The patient: On prolonged bedrest The emergency department nurse is assessing a pregnant trauma victim who just arrived at the hospital. What are the nurse's mostappropriate actions? Select all that apply. Assess for point of maximal impulse at fourth intercostal space, Collect urine for urinalysis and culture, frequent vital sign monitoring The most prevalent clinical manifestation of abruptio placentae (as opposed to placenta previa) is: Intense abdominal pain A pregnant patient with chronic hypertension is at risk for placental abruption. Which symptoms of abruption does the nurse instruct the patient to be alert for? Select all that apply. Abdominal pain, vaginal bleeding, uterine tenderness The nurse observes that eclampsia has developed in a pregnant patient after starting magnesium sulfate therapy. What action does the nurse take? Continue infusion Which hypertensive disorders can occur during pregnancy? Select all that apply. Chronic hypertension, Preeclampsia eclampsia, gestational hypertension What does the nurse advise a pregnant patient who is prescribed phenazopyridine (Pyridium) for cystitis? Do not wear contact lenses Which finding in a urine specimen of a pregnant patient indicates the client has proteinuria? Protein concentration that is 300 mg / 24 hours Which intervention will help prevent the risk of pulmonary edema in a pregnant patient with severe preeclampsia?