Abnormal OB Flashcards
(30 cards)
SITUATION: A 32 y/o multigravida returns to the clinic for a routine prenatal vsit at 36 weeks’ gestation. The assessments during the visit include: BP:140/90 mmHg; PR: 80 bpm; RR: 16 bpm
What is the further information should the nurse obtain to determine if this client is becoming pre eclamptic?
a. headaches
b. blood glucose levels
c. proteinuria
d. peripheral edema
, Rationale: It indicates kidney damage and can lead to other serious health problems. During pregnancy, high blood pressure and high levels of protein in urine is often associated to each other. This usally occurs often after 20 weeks of gestation.
**Answer: **Proteinuria
SITUATION: A 32 y/o multigravida returns to the clinic for a routine prenatal vsit at 36 weeks’ gestation. The assessments during the visit include: BP:140/90 mmHg; PR: 80 bpm; RR: 16 bpm
The nurse is completing the client’s assessment. All but which of the following findss must be reported to the physician?
a. weight gain of 1lb per week
b. blurred vissing
c. 1+ urine
d. swelling in the wrist and forearm
Rationale: Pregnant women are expected to gain weight in order to support fetal growth, increased blood volume, amniotic fluid, placeta, and maternal tissue development
**Answer: **Weight gain of 1lb per week
SITUATION: A 32 y/o multigravida returns to the clinic for a routine prenatal vsit at 36 weeks’ gestation. The assessments during the visit include: BP:140/90 mmHg; PR: 80 bpm; RR: 16 bpm
When teaching the client about her nutritional needs, the nurse should discuss which type of diet?
a. high-residue diet
b. low-sodium diet
c. low-protein diet
d. moderate to high protein diet
protein intake needs increase mostly in the third trimester to support rapid fetal growth and maternal tissue expansion.
Answer: Moderate to high protein diet
SITUATION: A 32 y/o multigravida returns to the clinic for a routine prenatal vsit at 36 weeks’ gestation. The assessments during the visit include: BP:140/90 mmHg; PR: 80 bpm; RR: 16 bpm
After educating the client on how preeclampsia can affect the growing fetus, the nurse realizs that the client needs additional teaching when she says that pre eclampsia can ;ead to which problem?
a. small for gestational age baby
b. macromasia
c. intrauterine growth restriction
d. poor placental perfusion
Preeclampsia restricts blood flow to the placenta, leading to growth problems, not excessibe growth.
**Answer: ** Macrosomia
SITUATION: A 32 y/o multigravida returns to the clinic for a routine prenatal vsit at 36 weeks’ gestation. The assessments during the visit include: BP:140/90 mmHg; PR: 80 bpm; RR: 16 bpm’
The cause of pregnancy induced hypertetions is?
Pregnancy indunced hypertension is primarily caused by abnormal placental development, leading to poor placental perfusion, vascular dysnfunction, and systemic hypertension in the mother
Answer: Unknwon
SITUATION: **A nurse in a prenatal clinic is assessing a 32week 15 y/o primagravid who is 5”2 has gained a total of 20lb, with a 1lb gain in the last 2 weeks. Urinalysis reveals negatove glucose and a trace of protein.
The nurse should advise the the client that which factor increases her risk for preeclampsia?
a. total weigh gain
b. short stature
c. adolescent age group
d. trace proteinuria
SITUATION: **A nurse in a prenatal clinic is assessing a 32week 15 y/o primagravid who is 5”2 has gained a total of 20lb, with a 1lb gain in the last 2 weeks. Urinalysis reveals negatove glucose and a trace of protein.
Which findings would lead this nurse to suspect that the client has developed mild preeclampsia?
a. glysuria, hypertention, seizure
b. hematuria, blurry vision, reduced urine output
c. buring in urination, hypotensio, abdominal pain
d. hypertention, edema, proteinuria
SITUATION: **A nurse in a prenatal clinic is assessing a 32week 15 y/o primagravid who is 5”2 has gained a total of 20lb, with a 1lb gain in the last 2 weeks. Urinalysis reveals negatove glucose and a trace of protein.
Which finding would alert te nurse that the client may be about to experience a seizure?
a. decreased contraction intensity
b. decreased temperature
c. epigastric pain
d. hyporeflexia
SITUATION: **A nurse in a prenatal clinic is assessing a 32week 15 y/o primagravid who is 5”2 has gained a total of 20lb, with a 1lb gain in the last 2 weeks. Urinalysis reveals negatove glucose and a trace of protein.
When caring for the client, which action is a priority to prevent convulsion?
a. monitoring the client’s labor carefully and preparing for a fast delivery
b. continually assessing the fetal tracing for signs of fetal distress
c. checking vital signs q15mins to watch for increasing blood pressure
SITUATION: **A nurse in a prenatal clinic is assessing a 32week 15 y/o primagravid who is 5”2 has gained a total of 20lb, with a 1lb gain in the last 2 weeks. Urinalysis reveals negatove glucose and a trace of protein.
Which labor room assignment would the nurse give to the client?
a. near the elevator sp she can be transported quickly
b. two doors away from the nursing station
c. in a back hallway where there is privacy
d. close to the nursery so she’ll maintain hope of a positive outcome
SITUATION: *A 16 y/o primagravid client at 37 weeks’ gestation with severe preeclampsia is in early active labor. The client’s blood pressure is 164/110 mmHg.
*
When the nurse is preparing for the room for admission, which item is most important for the nurse to obtain?
a. oxytocin infusion solution
b. disposable tongue blades
c. portable ultrasound machine
d. padding for the side rails
SITUATION: *A 16 y/o primagravid client at 37 weeks’ gestation with severe preeclampsia is in early active labor. The client’s blood pressure is 164/110 mmHg.
*
Soon after the admission of the client, the primary health care provider (HCP) prescribes a continuous intravenuos infusion of 5% dextrose in Ringer’s solution and 4g of magnesium sulfate. Prior to giving magnesium sulfate, assessment mst be done to prevent toxicity. All the following would stop the nurse from giving the ordered dose, EXCEPT:
a. a urine output of 30mL in 2hrs
b. a positive patellar reflex
c. a respiratory rate of 8
d. a DTR score of 0
SITUATION: *A 16 y/o primagravid client at 37 weeks’ gestation with severe preeclampsia is in early active labor. The client’s blood pressure is 164/110 mmHg.
*
While the medication is being administered, which assessment finding hsould the nurse report immediately?
a. respiratory rate if 10 bpm
b. patellar reflex of +2
c. blood pressure of 160/88 mmHg
d. urinary outpur exceeding intake
SITUATION: *A 16 y/o primagravid client at 37 weeks’ gestation with severe preeclampsia is in early active labor. The client’s blood pressure is 164/110 mmHg.
*
What is the priority intervention to maintain safety for this client?
a. maintain continuous fetal monitoring
b. encourage family members to remain a bedside
c. assess reflexes, clonus, visual disturbances, and headache
d. monitor maternal liver studies every 4 hours
SITUATION: *A 16 y/o primagravid client at 37 weeks’ gestation with severe preeclampsia is in early active labor. The client’s blood pressure is 164/110 mmHg.
*
Which of the following medication must be available in case sogns of toxicity occur?
a. beta blockers
b. ace inhibitor
c. clacium gluconate
d. rho gam
SITUATION: *A 16 y/o primagravid client at 37 weeks’ gestation with severe preeclampsia is in early active labor. The client’s blood pressure is 164/110 mmHg.
*
Which of the following test for glucose is done during the initial renatal visit to determine risk for GDM?
a. 50g oral glucose tolerance test
b. 100g iral glucose tolerance test
c. 3hr glucose tolerance test
d. glycosylated hemoglobin
SITUATION: *A 16 y/o primagravid client at 37 weeks’ gestation with severe preeclampsia is in early active labor. The client’s blood pressure is 164/110 mmHg.
*
A client have been subjected for 3hr glucose tolerance test after having obtained an above normal result for a 50g screeing tesst , which result would indicate the need to repeat the test:
a. BGL of 120mg/dL
b. BGL of 160mg/dL
c. BGL of 130mg/dL
d. BGL of 140mg/dL
SITUATION: *A 16 y/o primagravid client at 37 weeks’ gestation with severe preeclampsia is in early active labor. The client’s blood pressure is 164/110 mmHg.
*
After teaching the client about symptoms of hyperglucemia, the nurse determines that the client understands the instruction when she says that hyperglycemia may be manifested by which symtoms?
a. thirst
b. pallor
c. sweating
d. nervousness
SITUATION: *A 16 y/o primagravid client at 37 weeks’ gestation with severe preeclampsia is in early active labor. The client’s blood pressure is 164/110 mmHg.
*
Which of the following test is usually done to determine the degree of hyperglycemia present in patients with diabetes?
a. 3ht GTT
b. 50g screening test
c. glycosylated hemoglobin
d. fasting blood sugar
SITUATION: *A 16 y/o primagravid client at 37 weeks’ gestation with severe preeclampsia is in early active labor. The client’s blood pressure is 164/110 mmHg.
*
An Hb1Ac of 5.7% indicates:
a, a need for additonal done of insulin
b. there is a risk for spontaneuos abortion
c. client’s blood sugar control is adequate
d. client needs further instruction regarding the treatment plan for GDM
SITUATION: *The antenatal clinic nurse is attending to a 40 y/o multigravida client on her 39th week of gestation, and is diagnosed to have gestational DM. She has a family history of T2DM. Assessment indicates that the client has a BMI of 26kg/m2. The client also informs that nurse that she had a miscarriage prior to her current pregnancy. *
All but which of the following factors could have led to the client’s condition?
a. age
b. BMI
c. history of abortion
d. family history of T2DM
SITUATION: *The antenatal clinic nurse is attending to a 40 y/o multigravida client on her 39th week of gestation, and is diagnosed to have gestational DM. She has a family history of T2DM. Assessment indicates that the client has a BMI of 26kg/m2. The client also informs that nurse that she had a miscarriage prior to her current pregnancy. *
A coomon type of infection frequently associated with the client;s condition is
a. herpes simplex
b. trichomoniasis
c. vulvovagibal candidiasis
d. gonorrhea
SITUATION: *The antenatal clinic nurse is attending to a 40 y/o multigravida client on her 39th week of gestation, and is diagnosed to have gestational DM. She has a family history of T2DM. Assessment indicates that the client has a BMI of 26kg/m2. The client also informs that nurse that she had a miscarriage prior to her current pregnancy. *
Another commonly associated condition with patients who have GDM is
a. oligohydramnios
b. fetal renal problem
c. polyhydramnios
d. syphilis
SITUATION: *The antenatal clinic nurse is attending to a 40 y/o multigravida client on her 39th week of gestation, and is diagnosed to have gestational DM. She has a family history of T2DM. Assessment indicates that the client has a BMI of 26kg/m2. The client also informs that nurse that she had a miscarriage prior to her current pregnancy. *
The physician estimates the client’s baby weighs at least 4 500g (10lb). This is usually related to which of the following?
a. hydrocephalus
b. fetal anomalies
c. fetal hyperinsulinism
d. maternal ketoacidosis
