Nokea
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.
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A primigravida in her first trimester is Rh negative. What will this woman receive to prevent anti-Rh antibodies from forming?
- A. Rh immune globulin during labor
- B. Intrauterine transfusions with O-negative blood
- C. Rh immune globulin at 28 weeks and within 72 hours after the birth of an Rh-positive infant
- D. Rh immune globulin now and again in the last trimester
Correct Answer: C
Rationale: An Rh-negative woman would receive Rh immune globulin at 28 weeks of gestation and within 72 hours after the birth of an Rh-positive infant or abortion.
Why does the woman taking oral hypoglycemic agents to control diabetes mellitus need to take insulin during pregnancy?
- A. Insulin can cross the placental barrier to the fetus.
- B. Insulin does not cross the placental barrier to the fetus.
- C. Oral agents do not cross the placenta.
- D. Oral agents are not sufficient to meet maternal insulin needs.
Correct Answer: B
Rationale: Oral hypoglycemic agents are not used during pregnancy, because they can cross the placenta, possibly resulting in fetal birth defects or hypoglycemia.
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.
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.