Chapter 10: Complications of Pregnancy Foundations of Maternal-Newborn & Women’s Health Nursing, 8th Edition

Chapter 10: Complications of Pregnancy Foundations of Maternal-Newborn & Women’s Health Nursing, 8th Edition A patient with preeclampsia is admitted complaining of pounding headache, visual changes, and epigastric pain. Nursing care is based on the knowledge that these signs indicate d. worsening disease and impending convulsion. Rh incompatibility can occur if the patient is Rh-negative and the b. fetus is Rh-positive. In which situation would a dilation and curettage (D&C) be indicated? d. Incomplete abortion at 10 weeks Which data found on a patient's health history would place her at risk for an ectopic pregnancy? b. Recurrent pelvic infections Which finding on a prenatal visit at 10 weeks might suggest a hydatidiform mole? c. Fundal height measurement of 18 cm Which routine nursing assessment is contraindicated for a patient admitted with suspected placenta previa? a. Determining cervical dilation and effacement A laboratory finding indicative of DIC is one that shows a. decreased fibrinogen. Which assessment in a patient diagnosed with preeclampsia who is taking magnesium sulfate would indicate a therapeutic level of medication? c. Normal deep tendon reflexes A patient taking magnesium sulfate has a respiratory rate of 10 breaths per minute. In addition to discontinuing the medication, which action should the nurse take? b. Administer calcium gluconate. A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Nursing care is based on which of the following? a. Hemorrhage is the primary concern. A patient who was pregnant had a spontaneous abortion at approximately 4 weeks' gestation. At the time of the miscarriage, it was thought that all products of conception were expelled. Two weeks later, the patient presents at the clinic office complaining of "crampy" abdominal pain and a scant amount of serosanguineous vaginal drainage with a slight odor. The pregnancy test is negative. Vital signs reveal a temperature of 100F, with blood pressure of 100/60 mm Hg, irregular pulse 88 beats/minute (bpm), and respirations, 20 breaths per minute. Based on this assessment data, what does the nurse anticipate as a clinical diagnosis? b. Uterine infection A patient with preeclampsia is being treated with bed rest and intravenous magnesium sulfate. The drug classification of this medication is a c. anticonvulsant. Which clinical intervention is the only known cure for preeclampsia? b. Delivery of the fetus The clinic nurse is performing a prenatal assessment on a pregnant patient at risk for preeclampsia. Which clinical sign would not present as a symptom of preeclampsia? c. Glucosuria Which intrapartal assessment should be avoided when caring for a patient with HELLP syndrome? a. Abdominal palpation A nurse is explaining to the nursing students working on the antepartum unit how to assess for edema. Which edema assessment score indicates edema of the lower extremities, face, hands, and sacral area? c. +3 Which maternal condition always necessitates delivery by cesarean birth? b. Total placenta previa Spontaneous termination of a pregnancy is considered to be an abortion if a. the pregnancy is less than 20 weeks. An abortion when the fetus dies but is retained in the uterus is called b. missed. A placenta previa when the placental edge just reaches the internal os is called d. marginal. Which finding would indicate concealed hemorrhage in abruptio placentae? b. Hard boardlike abdomen The priority nursing intervention when admitting a pregnant patient who has experienced a bleeding episode in late pregnancy is to b. assess fetal heart rate and maternal vital signs. A patient with no prenatal care delivers a healthy male infant via the vaginal route, with minimal blood loss. During the labor period, vital signs were normal. At birth, significant maternal hypertension is noted. When the patient is questioned, she relates that there is history of heart disease in her family; but, that she has never been treated for hypertension. Blood pressure is treated in the hospital setting and the patient is discharged. The patient returns at her scheduled 6-week checkup and is found to be hypertensive. Which type of hypertension is the patient is exhibiting? d. Undiagnosed chronic hypertension A high-risk labor patient progresses from preeclampsia to eclampsia. Aggressive management is instituted, and the fetus is delivered via cesarean birth. Which finding in the immediate postoperative period indicates that the patient is at risk of developing HELLP syndrome? a. Platelet count of 50,000/mcL As the triage nurse in the emergency room, you are reviewing results for the high-risk obstetric patient who is in labor because of traumatic injury experienced as a result of a motor vehicle accident (MVA). You note that the Kleihauer-Betke test is positive. Based on this information, you anticipate that a. immediate birth is required. A patient who had premature rupture of the membranes (PROM) earlier in the pregnancy at 28 weeks returns to the labor unit 1 week later complaining that she is now in labor. The labor and