maternity ch20-24
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| In assessing the knowledge of a pregestational woman with type 1 diabetes concerning changing insulin needs during pregnancy, the nurse recognizes that further teaching is warranted when the woman states; | "I will need to increase my insulin dosage during the first 3 months of pregnancy"
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| Preconception counseling is critical to the outcome of diabetic pregnancies because poor glycemic control before pregnancy is associated with; | frequent episodes of maternal hypoglycemia
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| In teaching a woman with pregestational diabetes about desired glucose levels, the nurse explainsthat normal fasting glucose level before breakfast should be; | 65-95mg/dl
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| 24 weeks of gestation reveals that a pregnaant woman has gestational diabetes mellitus. In planning her care, the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. Fetus greatest rish | congenital anomalies of the central nervous system
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| A 26wk gestation is losing weight and diagnosed with hyperthyroidism. What is the nursing diagnosis? | Imbalanced nutrition; less than body requirements
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| Maternal phenylketonuria (PKU) is an important health concernduring pregnancy because; | the fetus may develop neurological problems
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| In terms of the incidence and classification of diabetes, maternity nurses should know that- | Type II diabetes often goes undiagnosed
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| Metabolic changes throughout pregnancy that affect glucose and insulin in the mother and the fetus are complicated but important to understand. Nurses should know that; | During the second and third trimesters, pregnancy exerts a diabetogenic effect that ensures an abundantsupply of glucose to the fetus
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| methamphetamine use during pregnancy is a growing problem that the nurse working with obstetric patients must be cagnizant of. When caring for a patient who uses meth, it is important for the nurse to to be aware of which factor related to the abuse? | meth users are extremely psychologically addicted
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| With regard to the association of maternal diabetes and other risk situations affecting mother and fetus, the nurse should be aware that; | diabetic ketoacidosis can lead to fetal death at any time during pregnancy
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| The nurse providing care for a woman with gestational diabetes understands that the laboratory test for glycoslated hemoglobin A1c is; | would be considered evidence of good diabetes controlwith a result of 2.5% to 5.9%
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| When caring for a pregnant woman with cardiac problems, the nurse must be alert for signs and symptoms of cariac decomposition, which are; | shortness of breath, bradycardia, and hypertension
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| Prophylaxis of subacute bacterial endocarditis is given before and after birth when a pregnant woman has | congestive heart disease
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| In caring for a pregnant woman with sickle cell crisis, the nurse understands that management of this patient includes all the following except; | antibiotics
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| Since the gene for CF was identified in 1989, genetic counseling has become available. How often does CF occure? | 1 in 3200
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| With what heart condition is pregnancy not usually contraindicated? | Eisenmenger syndrome
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| Nurses caring for antepartum women with cardiac conditions should be aware that; | Women with class II cardiac disease should avoid heavy exertion and any activity that causes minor symptoms
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| Screening questions for alcohol and drug abuse should be included in the overall assessment during the first prenatal visit for all women. The 4 p's plus is a screening tool designed specifically to identify a need for more assessment | The P's include partner, past, and pregnancy
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| A primigravida is being monitored for preeclampsia. Which finding should concern her nurse? | A dipstick value of 3+ for protein in her urine
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| In caring for a woman with disseminated intravascular coagulation (DIC), what order should the nurse anticipate? | administration of blood
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| Women with hyperemesis gravidarum | Have vomiting severe and persistent enough to cause weight loss, dehydration, and electrolyte imbalance.
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| The labor of a pregnant woman w/ preeclampsia is going to be induced. Before administering pitocin, lab test results reveal a platelet count of 90,000 and elevated AST, falling Htc. these indicate; | HELLP syndrome
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| A pregnant woman has been receiving a Mg sulfate infusion for treatment of severe preeclampsia for 24hr. Her vitals are; 37.3 degree C, HR 88, RR 10, BP 148/90, absent DTR, and no ankle clonus | discontinue magnesium sulfate infusion
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| What laboratory marker is indicative of disseminated intravascular coagulation (DIC) | Hyperfibrinogenemia
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| Your patient has been on magnesium sulfate for 20hr for treatment of preeclampsia. She just delivered a viable infant 20min ago, what uterine findings would you expect to observe? | scant lochia flow
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| The nurse caring for pregnant women must be aware that the most common medical complication of pregnancy is; | Hemorrhagic complications
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| Nurses should be aware that chronic hypertension: | Is general hypertension plus proteinuria
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| A woman presents to the emergency department complaining of bleeding and cramping. Her last period was 6wks ago, her cervix was closed. What is the probable diagnosis of which type of spontaneous abortion. | Threatened
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| Your pt is being induced because of worsening preeclampsia. She is also receiving mg sulfate. Her labor has not become active despite several hrs of oxytocin administration. The pt asks why is it taking so long? | "the magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labor
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| The perinatal nurse is giving discharge instructions to a woman, status postsuction cutterage secondary to hydatidiform mole. The woman asks why she must take oral contraceptives for the next 12 months? | "If you can avoid pregnancy for the next year, the chance of developing a second molar pregnancy is rare. Therefore, to improve your chance of a successful pregnancy, it is important to not get pregnant right now."
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| The most prevalent clinical manifestation of abrupptio placentae (as opposed to placenta previa) is | intense abdominal pain
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| In planning care for women with preeclampsia, nurses should be aware that; | If at home, the women should be confined to bed, even with mild preeclampsia.
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| Methotrexate is recommended as part of the treatment plan for which obstetric complication | Unruptured ecotopic pregnancy
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| A 26yr old pregnant woman gravida 2 para 1-0-0-1 is 28 weeks when she experiences bright red painless bleeding . What would be the expected diagnostic procedure? | Ultrasound for placenta location
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| A laboring woman with no known risks experiences ROM. The fluid has bright red colored blood. Her contractions are consistent with her staf=ge of labor. Th FHR begins to decline. The nurse should suspect; | severe abruptio placentae
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| A woman who arrives for evaluation of her symptoms, which include a missed periodm adnexal fullness, tenderness, and dark vaginal bleeding. The nurse notices ecchymotic blueness around a womans umbilicus and recognizes this is; | Cullen's sign associated with a ruptured ectopic pregnancy
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| With regard to miscarriage, nurses should be aware that; | If it occurs before the 12th week of pregnancy, it may present only as moderate discomfort and blood loss
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| Magnesium sulfate is given to women with preeclampsia and eclampsia to; | prevent and treat convulsions
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| The perinatal nurse is caring for a women in the immediate post birth period. Assessment reveals that the woman is experiencing profuse bleeding. The likely etiology for the bleeding is; | Uterine atony
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| To provide adequate postpartum care, the nurse should be aware that PPD without psychotic features; | is distinguished by irritability severe anxiety, and panic attacks
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