Chapter 13 Flashcards
Which statement is true about women who experience hyperemesis gravidarum?
a.
Seventy percent of all pregnant women suffer from it at some point in pregnancy.
b.
Such women have vomiting severe and persistent enough to cause weight loss, dehydration, and electrolyte imbalance.
c.
They need intravenous (IV) fluid and nutrition for most of their pregnancy.
d.
They often inspire similar, milder symptoms in their male partners and mothers.
B
What should the nurse be aware of in relation to women who may need surgery during pregnancy?
a.
The diagnosis of appendicitis may be difficult, because the normal signs and symptoms mimic some normal changes in pregnancy.
b.
Rupture of the appendix is less likely in pregnant women because of the close monitoring.
c.
Surgery for intestinal obstructions should be delayed as long as possible because it usually affects the pregnancy.
d.
When pregnancy takes over, a woman is less likely to have ovarian problems that require invasive responses.
A
Which laboratory marker is indicative of disseminated intravascular coagulation (DIC)? a. Bleeding time of 10 minutes b. Presence of fibrin split products c. Thrombocytopenia d. Hyperfibrinogenemia
B
In caring for an immediate postpartum patient, you note petechiae and oozing from her IV site. Based on this assessment, what clotting disorder would the nurse monitor her closely for? a. Disseminated intravascular coagulation (DIC) b. Amniotic fluid embolism (AFE) c. Hemorrhage d. HELLP syndrome
A
In caring for the woman with disseminated intravascular coagulation (DIC), which order should the nurse anticipate? a. Administration of blood b. Preparation of the patient for invasive hemodynamic monitoring c. Restriction of intravascular fluids d. Administration of steroids
A
A primigravida is being monitored in her prenatal clinic for pre-eclampsia. Which finding should concern her nurse?
a.
Blood pressure (BP) increase to 138/86 mm Hg
b.
Weight gain of 0.5 kg during the past 2 weeks
c.
Urine protein reading of 0.05 g/L on two occasions
d.
Pitting pedal edema at the end of the day
C
The labour of a pregnant woman with pre-eclampsia is going to be induced. Before initiating the oxytocin infusion, the nurse reviews the woman’s latest laboratory test findings, which reveal a platelet count of 90,000, an elevated aspartate transaminase (AST) level, and a falling hematocrit. These findings are indicative of which of the following? a. Eclampsia b. Disseminated intravascular coagulation (DIC) c. HELLP syndrome d. Idiopathic thrombocytopenia
C
A woman with pre-eclampsia has a seizure. What is the nurse’s priority intervention? a. Ensure a patent airway. b. Suction the mouth to prevent aspiration. c. Administer oxygen by mask. d. Stay with the patient to provide emotional support.
A
A pregnant woman has been receiving a magnesium sulphate infusion for treatment of severe pre-eclampsia for 24 hours. On assessment the nurse finds the following vital signs: temperature of 37.3°C, pulse rate of 88 beats/min, respiratory rate of 10 breaths/min, blood pressure (BP) of 148/90 mm Hg, absent deep tendon reflexes, and no ankle clonus. The patient complains, “I’m so thirsty and warm.” What is the nurse’s initial intervention?
a.
Call for a stat magnesium sulphate level.
b.
Administer oxygen.
c.
Discontinue the magnesium sulphate infusion.
d.
Prepare to administer hydralazine.
C
A woman with severe pre-eclampsia has been receiving magnesium sulfphate by intravenous infusion for 8 hours. The nurse assesses the woman and documents the following findings: temperature of 37.1°C, pulse rate of 96 beats/min, respiratory rate of 24 breaths/min, blood pressure (BP) of 155/112 mm Hg, 3+ deep tendon reflexes, and no ankle clonus. The nurse should anticipate a doctor’s order for which of the following? a. Hydralazine b. Magnesium sulphate bolus c. Diazepam d. Calcium gluconate
A
A woman at 39 weeks of gestation with a history of pre-eclampsia is admitted to the labour 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 which of the following? a. Eclamptic seizure b. Rupture of the uterus c. Placenta previa d. Placental abruption
D
A woman with severe pre-eclampsia is receiving a magnesium sulphate infusion. Which finding should the nurse be concerned about? a. A sleepy, sedated affect b. A respiratory rate of 10 breaths/min c. Deep tendon reflexes of 2 d. Absent ankle clonus
B
Your patient has been on magnesium sulphate for 20 hours for treatment of pre-eclampsia. She just delivered a viable infant girl 30 minutes ago. What uterine findings would you expect to assess in this patient?
a.
Absence of uterine bleeding in the postpartum period
b.
A fundus firm below the level of the umbilicus
c.
Scant lochia flow
d.
A boggy uterus with heavy lochia flow
D
Your patient is being induced because of her worsening pre-eclampsia. She is also receiving magnesium sulphate. It appears that her labour has not become active, despite several hours of oxytocin administration. She asks the nurse, “Why is it taking so long?” What is the most appropriate response by the nurse?
a.
“The magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labour.”
b.
“I don’t know why it is taking so long. Maybe we can stop the magnesium sulphate administration.”
c.
“The length of labour varies for different women.”
d.
“Your baby is just being stubborn.”
A
What nursing diagnosis would be most appropriate for a woman experiencing severe pre-eclampsia?
a.
Risk for injury to the fetus related to uteroplacental insufficiency
b.
Risk for eclampsia
c.
Risk for deficient fluid volume related to increased sodium retention secondary to administration of MgSO4
d.
Risk for increased cardiac output related to use of antihypertensive drugs
A
