Nokea
The nurse is caring for the client with mild preeclampsia. The nurse should monitor for which complications associated with mild preeclampsia? Select all that apply.
- A. Placental abruption
- B. Hyperbilirubinemia
- C. Nonreassuring fetal status
- D. Severe preeclampsia
- E. Gestational diabetes
Correct Answer: A,B,C,D
Rationale: Placental abruption can occur as a complication of preeclampsia due to hypoperfusion of the placenta and endothelial injury. Hyperbilirubinemia can occur as a complication of preeclampsia due to hypoperfusion to the liver. Nonreassuring fetal status can occur as a complication of preeclampsia due to hypoperfusion to the placenta. Severe preeclampsia can occur as a complication of preeclampsia if the BP remains uncontrolled. Gestational diabetes is not associated with preeclampsia.
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The Caucasian postpartum client asks the nurse if the stretch marks (striae gravidarum) on her abdomen will ever go away. Which response by the nurse is most accurate?
- A. “Your stretch marks should totally disappear over the next month.”
- B. “Your stretch marks will always appear raised and reddened.”
- C. “Your stretch marks will lighten in color with good skin hydration.”
- D. “Your stretch marks will fade to pale white over the next 3 to 6 months.”
Correct Answer: D
Rationale: Stretch marks will fade but will not totally disappear. Stretch marks will fade and will not always appear reddened. There is no evidence that keeping the skin hydrated will lighten the appearance of the stretch marks. In Caucasian women, stretch marks will fade to a pale white over 3 to 6 months.
Which advice can the nurse give to relieve the client's backache? Select all that apply.
- A. Avoid clothing that fits tightly around the waist.
- B. Sleep on a heating pad.
- C. Take a nonopioid pain reliever regularly.
- D. Wear low-heeled shoes.
- E. Carry objects close to your body.
- F. Squat when picking objects off the floor.
Correct Answer: A,D,E,F
Rationale: Tight clothing, high heels, and improper lifting exacerbate backaches; low-heeled shoes, proper lifting, and loose clothing help relieve strain.
Two hours after delivery, the mother tells the nurse that she will be bottle feeding. She asks what she can do to prevent the terrible pain experienced when her milk came in with her last baby. Which response by the nurse is most appropriate?
- A. “Once you have recovered from the birth, I will help you bind your breasts.”
- B. “Engorgement is familial. If you had it with your last baby, it is inevitable.”
- C. “I can help you put on a supportive bra; wear one constantly for 1 to 2 weeks.”
- D. “Engorgement occurs right after birth; if you don’t have it yet, it won’t occur.”
Correct Answer: C
Rationale: In comparison studies between breast binders and bras, mothers using binders experienced more engorgement and discomfort. Engorgement is not familial and not inevitable in bottle-feeding mothers. Wearing a supportive, well-fitting bra within 6 hours after birth can suppress lactation. The bra should be worn continuously, except for showering, until lactation is suppressed (usually 7 to 14 days). Signs of engorgement usually occur on the third to fifth postpartum day (not right after birth), and engorgement will spontaneously resolve by the tenth day postpartum.
Which finding indicates a need for further evaluation during a prenatal visit?
- A. Blood pressure of 120/80 mmHg
- B. Trace protein in urine
- C. Weight gain of 1 pound per week
- D. Fetal heart rate of 140 bpm
Correct Answer: B
Rationale: Trace protein in urine may indicate early preeclampsia or kidney issues, warranting further evaluation.
Which response by the nurse is most appropriate?
- A. A weight gain of about 10 pounds is recommended during pregnancy.
- B. Your weight gain depends on the amount of food that you eat.
- C. It's normal for adolescent girls to be worried about weight gain.
- D. You're average weight gain during pregnancy is between 25 and 35 pounds.
Correct Answer: D
Rationale: The average weight gain of 25-35 pounds is appropriate for a teenager with normal prepregnancy weight, addressing her concerns.