Nokea
A patient who is 30 weeks pregnant delivers a stillborn child in the emergency department (ED). What should the ED nurse offer the patient? (Select all that apply.)
- A. Privacy
- B. An opportunity to hold the infant
- C. Materials about support groups
- D. A memento (footprint or lock of hair)
- E. A warm beverage
Correct Answer: A,B,C,D
Rationale: The patient should be offered privacy, an opportunity to hold the infant, support group information, and a memento. A warm beverage is not a priority at this time.
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A woman, gravida 3, para 2, is attending her fourth prenatal visit and confides in the nurse that she is battered by her husband. She is assessed to have multiple bruises at various stages of healing. What nursing actions are appropriate for the nurse to implement? (Select all that apply.)
- A. Tell the husband that authorities will be notified immediately.
- B. Provide privacy for the assessment.
- C. Determine if children are being hurt.
- D. Communicate in a nonjudgmental way.
- E. Determine factors that increase the risk of injury.
Correct Answer: B,C,D,E
Rationale: The woman being assessed for abuse is taken to a private area. The nurse determines whether there are factors that increase the risk for severe injuries or homicide, such as drug use by the abuser, a gun in the house, prior use of a weapon, or violent behavior by the abuser outside the home. The nurse also determines whether children are being hurt. It is vital that the abuser not find out that the woman has reported the abuse or that she intends to leave.
A woman who is 35 weeks pregnant has a total placenta previa. She asks the nurse, 'Will I be able to deliver vaginally?' What explanation by the nurse is the most appropriate?
- A. Yes, you can deliver vaginally until 36 weeks.'
- B. A vaginal delivery can be attempted, but if bleeding occurs, a cesarean section will be done.'
- C. A cesarean section is performed when the mother has a total placenta previa.'
- D. There is no reason why you cannot have a vaginal delivery.'
Correct Answer: C
Rationale: A cesarean delivery is done for a partial or total placenta previa.
The nurse assesses a pregnant woman for pregnancy-induced hypertension. What is the first sign of fluid retention suggestive of this complication?
- A. Abdominal enlargement
- B. Facial swelling
- C. Sudden weight gain
- D. Swelling of the feet and ankles
Correct Answer: C
Rationale: Sudden, excessive weight gain is the first sign of fluid retention; facial swelling and swelling of the feet, legs, and hands follow weight gain.
The nurse is caring for a pregnant woman diagnosed with preeclampsia. What will the nurse explain is the objective of magnesium sulfate therapy for this patient?
- A. To prevent convulsions
- B. To promote diaphoresis
- C. To increase reflex irritability
- D. To act as a saline cathartic
Correct Answer: A
Rationale: Magnesium sulfate is a central nervous system depressant given to prevent seizures.
The nurse takes into consideration that the patient with placenta previa is at risk for postpartum infection for what reasons? (Select all that apply.)
- A. Vaginal organisms can invade the placenta.
- B. The undernourished placenta becomes necrotic.
- C. The amniotic fluid can become infected.
- D. The placenta is an excellent growth medium.
- E. The misplaced placenta weakens the uterine wall.
Correct Answer: A,D
Rationale: Vaginal organisms reach the placenta through the cervix. Once there, the organisms can multiply in the nutrient-rich environment of the placenta. The weak musculature of the lower segment of the uterus will cause postpartum hemorrhage rather than infection.