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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.
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The nurse is preparing a pregnant patient for an abdominal ultrasound at 8 weeks' gestation. What intervention will the nurse implement before this diagnostic test?
- A. Instruct the patient to take nothing by mouth after midnight the night before the test.
- B. Initiate an IV.
- C. Encourage the patient to drink 1 to 2 quarts of water before the test.
- D. Instruct the patient to remove all jewelry.
Correct Answer: C
Rationale: Ultrasound uses high-frequency sound waves to visualize structures within the body; the examination may use a transvaginal probe or an abdominal transducer; abdominal ultrasound during early pregnancy requires a full bladder for proper visualization (have the woman drink 1 to 2 quarts of water before the examination).
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.
What symptom presented by a pregnant woman is indicative of abruptio placentae?
- A. Painless vaginal bleeding
- B. Uterine irritability with contractions
- C. Vaginal bleeding and back pain
- D. Premature rupture of membranes
Correct Answer: C
Rationale: Bleeding accompanied by abdominal or lower back pain is a typical manifestation of abruptio placentae.
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.
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.