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Women with hyperemesis gravidarum:
Women with hyperemesis gravidarum have severe vomiting; however, treatment for several days sets things right in most cases. Although 80% of pregnant women experience nausea and vomiting, fewer than 1% (0.5%) proceed to this severe level. IV administration may be used at first to restore fluid levels, but it is seldom needed for very long. Women suffering from this condition want sympathy because some authorities believe that difficult relationships with mothers and/or partners may be the cause.
Because pregnant women may need surgery during pregnancy, nurses should be aware that:
Both appendicitis and pregnancy are linked with nausea, vomiting, and increased white blood cell count. Rupture of the appendix is two to three times more likely in pregnant women. Surgery to remove obstructions should be done right away. It usually does not affect the pregnancy. Pregnancy predisposes a woman to ovarian problems.
What laboratory marker is indicative of disseminated intravascular coagulation (DIC)?
Degradation of fibrin leads to the accumulation of fibrin split products in the blood. Bleeding time in DIC is normal. Low platelets may occur with but are not indicative of DIC because they may result from other coagulopathies. Hypofibrinogenemia would occur with DIC.
In caring for an immediate postpartum client, you note petechiae and oozing from her IV site. You would monitor her closely for the clotting disorder:
In caring for the woman with disseminated intravascular coagulation (DIC), what order should the nurse anticipate?
A primigravida is being monitored in her prenatal clinic for preeclampsia. What finding should concern her nurse?
The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the Pitocin infusion, the nurse reviews the womans latest laboratory test findings, which reveal a platelet count of 90,000, an elevated aspartate transaminase (AST) level, and a falling hematocrit. The nurse notifies the physician because the laboratory results are indicative of:
A woman with preeclampsia has a seizure. The nurses primary duty during the seizure is to:
A pregnant woman has been receiving a magnesium sulfate infusion for treatment of severe preeclampsia 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 client complains, Im so thirsty and warm. The nurse:
A woman with severe preeclampsia has been receiving magnesium sulfate 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 calls the physician, anticipating an order for:
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:
The patient that you are caring for has severe preeclampsia and is receiving a magnesium sulfate infusion. You become concerned after assessment when the woman exhibits:
Your patient has been receiving magnesium sulfate for 20 hours for treatment of preeclampsia. She just delivered a viable infant girl 30 minutes ago. What uterine findings would you expect to observe/assess in this client?
Your patient is being induced because of her worsening preeclampsia. She is also receiving magnesium sulfate. It appears that her labor has not become active despite several hours of oxytocin administration. She asks the nurse, Why is it taking so long? The most appropriate response by the nurse would be:
What nursing diagnosis would be the most appropriate for a woman experiencing severe preeclampsia?
The nurse caring for pregnant women must be aware that the most common medical complication of pregnancy is:
Nurses should be aware that HELLP syndrome:
Nurses should be aware that chronic hypertension:
In planning care for women with preeclampsia, nurses should be aware that:
Magnesium sulfate is given to women with preeclampsia and eclampsia to:
Preeclampsia is a unique disease process related only to human pregnancy. The exact cause of this condition continues to elude researchers. The American College of Obstetricians and Gynecologists has developed a comprehensive list of risk factors associated with the development of preeclampsia. Which client exhibits the greatest number of these risk factors?
A woman presents to the emergency department with complaints of bleeding and cramping. The initial nursing history is significant for a last menstrual period 6 weeks ago. On sterile speculum examination, the primary care provider finds that the cervix is closed. The anticipated plan of care for this woman would be based on a probable diagnosis of which type of spontaneous abortion?
The perinatal nurse is giving discharge instructions to a woman after suction curettage secondary to a hydatidiform mole. The woman asks why she must take oral contraceptives for the next 12 months. The best response from the nurse would be:
The most prevalent clinical manifestation of abruptio placentae (as opposed to placenta previa) is:
Methotrexate is recommended as part of the treatment plan for which obstetric complication?
A 26-year-old pregnant woman, gravida 2, para 1-0-0-1 is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, what would be an expected diagnostic procedure?
A laboring woman with no known risk factors suddenly experiences spontaneous rupture of membranes (ROM). The fluid consists of bright red blood. Her contractions are consistent with her current stage of labor. There is no change in uterine resting tone. The fetal heart rate begins to decline rapidly after the ROM. The nurse should suspect the possibility of:
A woman arrives for evaluation of her symptoms, which include a missed period, adnexal fullness, tenderness, and dark red vaginal bleeding. On examination the nurse notices an ecchymotic blueness around the womans umbilicus and recognizes this assessment finding as:
As related to the care of the patient with miscarriage, nurses should be aware that:
Which condition would not be classified as a bleeding disorder in late pregnancy?
In providing nutritional counseling for the pregnant woman experiencing cholecystitis, the nurse would:
Which maternal condition always necessitates delivery by cesarean section?
Spontaneous termination of a pregnancy is considered to be an abortion if:
An abortion in which the fetus dies but is retained within the uterus is called a(n):
A placenta previa in which the placental edge just reaches the internal os is more commonly known as:
What condition indicates concealed hemorrhage when the patient experiences an abruptio placentae?
The priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy is to:
A patient with pregnancy-induced hypertension is admitted complaining of pounding headache, visual changes, and epigastric pain. Nursing care is based on the knowledge that these signs are an indication of:
Which order should the nurse expect for a patient admitted with a threatened abortion?
What finding on a prenatal visit at 10 weeks could suggest a hydatidiform mole?
A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Nursing care is based on the knowledge that:
Approximately 10% to 15% of all clinically recognized pregnancies end in miscarriage. Which is the most common cause of spontaneous abortion?
The nurse caring for a woman hospitalized for hyperemesis gravidarum should expect that initial treatment to involve:
[Multiple Response] A client who has undergone a dilation and curettage for early pregnancy loss is likely to be discharged the same day. The nurse must ensure that vital signs are stable, bleeding has been controlled, and the woman has adequately recovered from the administration of anesthesia. To promote an optimal recovery, discharge teaching should include (Select all that apply):
a. Iron supplementation.
b. Resumption of intercourse at 6 weeks following the procedure.
c. Referral to a support group if necessary.
d. Expectation of heavy bleeding for at least 2 weeks.
e. Emphasizing the need for rest.
[Multiple Response] The reported incidence of ectopic pregnancy in the United States has risen steadily over the past 2 decades. Causes include the increase in STDs accompanied by tubal infection and damage. The popularity of contraceptive devices such as the IUD has also increased the risk for ectopic pregnancy. The nurse who suspects that a patient has early signs of ectopic pregnancy should be observing her for symptoms such as (Select all that apply):
a. Pelvic pain
b. Abdominal pain
c. Unanticipated heavy bleeding
d. Vaginal spotting or light bleeding
e. Missed period