Chapter 32: Labor and Birth Complications
Lowdermilk: Maternity & Women's Health
Care, 12th Edition Verified and Updated
Questions and Answers (100% Correct
Answers)
1. In planning for home care of a woman with preterm labor, which concern should
the nurse need to address? a. Nursing assessments are different from those
performed in the hospital setting.
b. Restricted activity and medications are necessary to prevent a recurrence of
preterm labor.
c. Prolonged bed rest may cause negative physiologic effects.
d. Home health care providers are necessary.
Answer: ANS: C
Prolonged bed rest may cause adverse effects such as weight loss, loss of appetite,
muscle wasting, weakness, bone demineralization, decreased cardiac output, risk for
thrombophlebitis, alteration in bowel functions, sleep disturbance, and prolonged
postpartum recovery. Nursing assessments differ somewhat from those performed in
the acute care setting, but this concern does not need to be addressed. Restricted
activity and medications may prevent preterm labor but not in all women. In
addition, the plan of care is individualized to meet the needs of each client. Many
women receive home health nurse visits, but care is individualized for each woman.
2. Which nursing intervention is paramount when providing care to a client with
preterm labor who has received terbutaline?
a. Assess deep tendon reflexes (DTRs).
b. Assess for dyspnea and crackles.
c. Assess for bradycardia.
d. Assess for hypoglycemia.
Answer: ANS: B
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Terbutaline is a beta2-adrenergic agonist that affects the mother's cardiopulmonary
and metabolic systems. Signs of cardiopulmonary decompensation include
adventitious breath sounds and dyspnea. An assessment for dyspnea and crackles is
important for the nurse to perform if the woman is taking magnesium sulfate.
Assessing DTRs does not address the possible respiratory side effects of using
terbutaline. Since terbutaline is a beta2-adrenergic agonist, it can lead to
hyperglycemia, not hypoglycemia. Beta2-adrenergic agonist drugs cause tachycardia,
not bradycardia.
3. In evaluating the effectiveness of magnesium sulfate for the treatment of preterm
labor, which finding alerts the nurse to possible side effects?
a. Urine output of 160 ml in 4 hours
b. DTRs 2+ and no clonus
c. Respiratory rate (RR) of 16 breaths per minute
d. Serum magnesium level of 10 mg/dl
Answer: ANS: D
The therapeutic range for magnesium sulfate management is 4 to 7.5 mg/dl. A serum
magnesium level of 10 mg/dl could lead to signs and symptoms of magnesium
toxicity, including oliguria and respiratory distress. Urine output of 160 ml in 4
hours, DTRs of 2+, and a RR of 16 breaths per minute are all normal findings
4. A woman in preterm labor at 30 weeks of gestation receives two 12-mg
intramuscular (IM) doses of betamethasone. What is the purpose of this
pharmacologic intervention?
a. To stimulate fetal surfactant production
b. To reduce maternal and fetal tachycardia associated with ritodrine administration
c. To suppress uterine contractions
d. To maintain adequate maternal respiratory effort and ventilation during
magnesium sulfate therapy
Answer: ANS: A
Antenatal glucocorticoids administered as IM injections to the mother accelerate fetal
lung maturity. Propranolol (Inderal) is given to reduce the effects of ritodrine
administration. Betamethasone has no effect on uterine contractions. Calcium