Nokea
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.
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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.
What symptom reported by a pregnant patient would lead the nurse to suspect pyelonephritis?
- A. Frequency and urgency of urination
- B. Nausea and weight loss
- C. Burning sensation when voiding
- D. Tenderness in the flank area
Correct Answer: D
Rationale: Pyelonephritis is a particularly serious infection in pregnancy. Signs and symptoms include high fever, chills, flank pain or tenderness, nausea, and vomiting.
The nurse emphasizes to a patient with a high-risk pregnancy that the impact of such a pregnancy might result in which problems? (Select all that apply.)
- A. Disruption of family roles
- B. Financial pressures
- C. Excessive attachment to infant
- D. Frustration with activity restriction
- E. Alteration in child care practices
Correct Answer: A,B,D,E
Rationale: High-risk pregnancies may produce problems such as disruption of family roles, financial pressures, delayed attachment to the infant, alteration in child care practices, and frustration with activity restriction.
A patient with gestational hypertension is exhibiting all of the signs below. What should the nurse report immediately?
- A. Diarrhea
- B. Urticaria
- C. Blurred vision
- D. Backache
Correct Answer: C
Rationale: Visual disturbances indicate worsening pregnancy-induced hypertension and must be reported promptly for effective intervention to prevent preeclampsia and convulsion.
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.