Nokea
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.
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The nurse is obtaining history and physical information on a new patient attending her first prenatal visit. After recording current height, weight, and BMI, it is determined that the patient is obese. What complications related to obesity will the nurse assess for during pregnancy? (Select all that apply.)
- A. Gestational diabetes
- B. RH incompatibility
- C. Hypertension
- D. Pre-eclampsia
- E. Infection
Correct Answer: A,C,D
Rationale: The obese woman who is pregnant has a high risk for developing complications during pregnancy such as gestational diabetes, hypertension, cardiac problems, pre-eclampsia, and respiratory problems.
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.
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.
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.