Antenatal care for complicated pregnancies

Antenatal care for complicated pregnancies Related

Review Antenatal care for complicated pregnancies related questions and content

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.
  • B. She will be unable to conceive in the future.
  • C. Bed rest and analgesics are the recommended treatment.
  • D. A D&C will be performed to remove the products of conception.
Correct Answer: A

Rationale: The correct answer is A: Hemorrhage is the primary concern. In an ectopic pregnancy, the fertilized egg implants outside the uterus, typically in the fallopian tube, which can lead to life-threatening internal bleeding. Nursing care focuses on monitoring for signs of hemorrhage, such as abdominal pain, vaginal bleeding, and signs of shock. Prompt intervention is crucial to prevent serious complications.

Explanation of why the other choices are incorrect:
B: She will be unable to conceive in the future - This statement is not true as having an ectopic pregnancy does not necessarily impact future fertility.
C: Bed rest and analgesics are the recommended treatment - Bed rest and analgesics are not the primary treatments for ectopic pregnancy, as surgical intervention is often necessary.
D: A D&C will be performed to remove the products of conception - A D&C is not typically performed for ectopic pregnancy management, as it involves the removal of tissue from inside the uterus, not the fallopian

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A placenta previa when the placental edge just reaches the internal os is called

  • A. total.
  • B. partial.
  • C. low-lying.
  • D. marginal.
Correct Answer: D

Rationale: The correct answer is D: marginal. In placenta previa, when the placental edge just reaches the internal os, it is classified as marginal. This indicates that the placenta is close to, but not covering, the cervical os. Total previa covers the entire os, partial covers part of it, and low-lying indicates the placental edge is near the os but not reaching it. The key is to understand the specific location of the placental edge in relation to the internal os for each classification.

A patient with preeclampsia is being treated with bed rest and intravenous magnesium sulfate. The drug classification of this medication is a

  • A. diuretic.
  • B. tocolytic.
  • C. anticonvulsant.
  • D. antihypertensive.
Correct Answer: C

Rationale: The correct answer is C: anticonvulsant. Magnesium sulfate is commonly used in preeclampsia to prevent seizures/eclampsia. It works by reducing neuromuscular transmission and excitability, making it an effective anticonvulsant. Diuretics (A) help remove excess fluid, tocolytics (B) inhibit uterine contractions, and antihypertensives (D) lower blood pressure, but they do not address the primary purpose of using magnesium sulfate in preeclampsia, which is to prevent seizures.

What should the nurse recognize as evidence that the patient is recovering from preeclampsia?

  • A. 1+ protein in urine
  • B. 2+ pitting edema in lower extremities
  • C. Urine output >100 mL/hour
  • D. Deep tendon reflexes +2
Correct Answer: C

Rationale: The correct answer is C: Urine output >100 mL/hour. This signifies improved kidney function, a key indicator of recovery in preeclampsia. Increased urine output indicates better kidney perfusion and reduced risk of complications like renal failure. A: 1+ protein in urine suggests ongoing kidney damage. B: 2+ pitting edema in lower extremities indicates fluid retention, a common symptom of preeclampsia. D: Deep tendon reflexes +2 are not specific to preeclampsia recovery, although hyperreflexia can be seen in severe cases.

A pregnant client is admitted with abdominal pain and heavy vaginal bleeding. Which is the immediate nursing action?

  • A. Administering oxygen
  • B. Elevating the head of the bed
  • C. Drawing blood for a hematocrit level
  • D. Giving an intramuscular analgesic
Correct Answer: A

Rationale: The correct immediate nursing action is to administer oxygen (Choice A) to ensure adequate oxygenation for both the mother and the fetus. Oxygen is crucial in cases of vaginal bleeding as it helps maintain tissue perfusion and prevent hypoxia. Elevating the head of the bed (Choice B) is not the priority as oxygenation should be addressed first. Drawing blood for a hematocrit level (Choice C) may provide valuable information but does not address the immediate need for oxygen. Giving an intramuscular analgesic (Choice D) is not appropriate without knowing the cause of the pain and bleeding.

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.
  • B. the patient should be transferred to the critical care unit for closer observation.
  • C. RhoGAM should be administered.
  • D. a tetanus shot should be administered.
Correct Answer: A

Rationale: The correct answer is A: immediate birth is required. The positive Kleihauer–Betke test indicates fetal-maternal hemorrhage, where fetal blood enters the maternal circulation. This can lead to fetal-maternal transfusion, causing fetal anemia. Immediate birth is necessary to assess and manage potential fetal distress, such as anemia and hypoxia, due to the trauma from the MVA.

Choices B, C, and D are incorrect:
B: Transferring to critical care unit is not the immediate priority. The focus should be on addressing the fetal distress.
C: RhoGAM is given to Rh-negative mothers to prevent Rh sensitization, but it is not directly related to the positive Kleihauer–Betke test result.
D: Tetanus shot administration is important for tetanus prevention, but it is not the priority in this case where immediate birth is required due to fetal-maternal hemorrhage.

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