Nokea
An ultrasound on a woman who is 32 weeks pregnant reveals the placenta implanted over the entire cervical os. What does the nurse understand best describes this condition?
- A. Low-lying placenta
- B. Marginal placenta previa
- C. Partial placenta previa
- D. Total placenta previa
Correct Answer: D
Rationale: A total placenta previa describes a condition in which the placenta completely covers the cervical opening.
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The young prenatal patient with gestational diabetes mellitus (GDM) says, 'I am frightened that I will have to deal with insulin injections for the rest of my life.' What is the best response by the nurse?
- A. After delivery your doctor will prescribe oral hypoglycemic medication to control your disease. Pills are so much simpler than insulin injections.'
- B. Have you considered an insulin pump?'
- C. After a while those insulin injections won't seem so bad.'
- D. It will most likely resolve 6 weeks or so after the baby is born.'
Correct Answer: D
Rationale: GDM usually resolves by 6 weeks after delivery.
The nurse finds a woman crying after she has undergone a dilation and evacuation (D&E) for a missed abortion. What is the most appropriate statement by the nurse?
- A. There is usually something wrong with the fetus when this happens early in pregnancy.'
- B. Now there. You can try to conceive on your next cycle.'
- C. I'm here if you need to talk.'
- D. You are young and strong. I know you can have a healthy pregnancy.'
Correct Answer: C
Rationale: An effective technique when communicating with a woman experiencing pregnancy loss is to say, 'I'm here if you need to talk.' The nurse listens and acknowledges the woman's grief.
What drug will the nurse plan to have available for immediate IV administration whenever magnesium sulfate is administered to a maternity patient?
- A. Ergonovine maleate (Ergotrate)
- B. Oxytocin
- C. Calcium gluconate
- D. Hydralazine (Apresoline)
Correct Answer: C
Rationale: Calcium gluconate reverses the effects of magnesium sulfate and should be available for immediate use when a woman receives magnesium sulfate.
The nurse is caring for a prenatal patient diagnosed with a placenta previa. What is the best position for this patient?
- A. Flat on her back with knees flexed to help prevent hemorrhage
- B. On her side to prevent supine hypotension
- C. In the semi-Fowler's position to prevent supine hypotension
- D. In the knee-chest position to reduce pressure on the placenta
Correct Answer: B
Rationale: The prenatal patient with placenta previa is best placed on her side with a pillow for support. This position not only reduces stress on the placenta but also reduces the possibility of supine hypotension.
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.