Nokea
A nurse is providing teaching to a client about exercise safety during pregnancy. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply).
- A. "will limit my time in the hot tub to 30 minutes after exercise."
- B. "should consume three 8-ounce glasses of water after I exercise."
- C. "will check my heart rate every 15 minutes during exercise sessions."
- D. "should limit exercise sessions to 30 minutes when the weather is humid."
Correct Answer: C
Rationale: This response indicates an understanding of the importance of monitoring heart rate during exercise to ensure it stays within a safe range for the pregnant woman and the baby.
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The nurse is planning to admit a pregnant client who is obese. Which potential client needs should the nurse anticipate?
- A. Routine administration of subcutaneous heparin may be prescribed.
- B. Bed rest as a necessary preventive measure may be prescribed.
- C. An overbed lift may be necessary if the client requires a cesarean section.
- D. Thromboembolism stockings or sequential compression devices may be prescribed.
Correct Answer: D
Rationale: Obese clients may need thromboembolism prevention and specialized equipment for safe cesarean handling.
The nurse is monitoring a pregnant client with gestational hypertension. What is the primary complication to prevent?
- A. Preterm labor.
- B. Placenta previa.
- C. Eclampsia.
- D. Abruptio placentae.
Correct Answer: C
Rationale: Gestational hypertension can progress to eclampsia, characterized by seizures, and requires close monitoring.
During a nursing assessment the woman with rupture
- A. What is the nurse's priority action?
- B. Use gravity and manipulation to relieve compression of the cord (butt up in the air and face down until ready to delivery)
- C. Help the fetal head descend faster
- D. Facilitate dilation of the cervix with prostaglandin gel
Correct Answer: A
Rationale: In the scenario presented, the nurse's priority action should be to call for emergent medical assistance. A woman with a rupture during a nursing assessment could be experiencing a serious complication known as umbilical cord prolapse. This occurs when the umbilical cord slips through the cervix ahead of the baby, which can lead to compression of the cord and a serious decrease in oxygen supply to the baby. It is a medical emergency that requires immediate intervention by the healthcare team, which may include moving the mother into a knee-chest position or performing a cesarean section. Therefore, the priority action for the nurse is to ensure prompt medical intervention to protect the well-being of both the mother and the baby.
A nurse is preparing to administer methylergonovine 0.2 mg orally to a client who is 2 hr. postpartum and has a boggy uterus. For which of the following assessment findings should the nurse withhold the medication?
- A. Blood pressure 142/92 mm Hg
- B. Urine output 100 mL in hr.
- C. Pulse 58/min
- D. Respiratory rate 14/min
Correct Answer: A
Rationale: Methylergonovine is a medication used to help contract the uterus and control postpartum hemorrhage. One of its side effects is vasoconstriction, which can lead to increased blood pressure. The client's blood pressure of 142/92 mm Hg is elevated, and administering methylergonovine could further increase the blood pressure, potentially causing harm to the client. It is important to withhold the medication in this situation to prevent worsening of hypertension. The other assessment findings are within normal ranges and do not contraindicate the administration of methylergonovine.
Which circumstance is most likely to cause uterine partum assessment with a woman who is 4 days atony and lead to excessive blood loss?
- A. Orthostatic hypotension
- B. Involution of the uterus
- C. Urine retention
- D. Afterpains
Correct Answer: A
Rationale: Orthostatic hypotension, which is a sudden drop in blood pressure upon standing, can result in decreased perfusion to the uterus, leading to poor contraction of the uterine muscles. This can result in uterine atony, where the uterus fails to contract properly after delivery. Uterine atony is a common cause of excessive postpartum bleeding (postpartum hemorrhage). Without proper contraction of the uterus, the blood vessels that supplied the placenta during pregnancy remain open and bleeding can continue unchecked.