Nokea
Which position increases cardiac output in the obstetrical client with cardiac disease?
- A. Trendelenburg
- B. Low semi-Fowler
- C. Lateral positioning
- D. Supine with legs elevated
Correct Answer: C
Rationale: The correct answer is C: Lateral positioning. This position increases cardiac output in obstetrical clients with cardiac disease by improving venous return to the heart, reducing pressure on the vena cava, and optimizing uteroplacental perfusion. The other choices are incorrect because Trendelenburg can worsen cardiac function by increasing venous return and intracardiac volume, low semi-Fowler does not optimize venous return and may decrease preload, and supine positioning with legs elevated can compress the vena cava, leading to decreased cardiac output and potential hypotension.
You may also like to solve these questions
What medication is not recommended for hypertension during pregnancy due to teratogenic effects?
- A. lisinopril
- B. nifedipine
- C. labetalol
- D. hydralazine
Correct Answer: A
Rationale: The correct answer is A: lisinopril. Lisinopril is contraindicated in pregnancy due to its teratogenic effects, particularly in the first trimester. It can cause fetal harm, including renal dysfunction and skull hypoplasia. Nifedipine, labetalol, and hydralazine are considered safe options for hypertension during pregnancy with no known teratogenic effects.
Anti-infective prophylaxis is indicated for a pregnant patient with a history of mitral valve stenosis related to rheumatic heart disease because the patient is at risk of developing
- A. hypertension.
- B. postpartum infection.
- C. bacterial endocarditis.
- D. upper respiratory infections.
Correct Answer: C
Rationale: The correct answer is C: bacterial endocarditis. Pregnant patients with mitral valve stenosis are at increased risk for developing bacterial endocarditis due to the presence of abnormal valve structures. This condition can lead to serious complications including septic emboli and heart failure. Hypertension (choice A) is not directly related to mitral valve stenosis. Postpartum infection (choice B) is not a primary concern in this scenario. Upper respiratory infections (choice D) are not specifically associated with mitral valve stenosis. In summary, anti-infective prophylaxis is indicated to prevent bacterial endocarditis in pregnant patients with a history of mitral valve stenosis.
A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Nursing care is based on which of the following?
- A. Hemorrhage is the primary concern.
- B. She will be unable to conceive in the future.
- C. Bed rest and analgesics are the recommended treatment.
- D. A D&C will be performed to remove the products of conception.
Correct Answer: A
Rationale: The correct answer is A: Hemorrhage is the primary concern. In an ectopic pregnancy, the fertilized egg implants outside the uterus, typically in the fallopian tube, which can lead to life-threatening internal bleeding. Nursing care focuses on monitoring for signs of hemorrhage, such as abdominal pain, vaginal bleeding, and signs of shock. Prompt intervention is crucial to prevent serious complications.
Explanation of why the other choices are incorrect:
B: She will be unable to conceive in the future - This statement is not true as having an ectopic pregnancy does not necessarily impact future fertility.
C: Bed rest and analgesics are the recommended treatment - Bed rest and analgesics are not the primary treatments for ectopic pregnancy, as surgical intervention is often necessary.
D: A D&C will be performed to remove the products of conception - A D&C is not typically performed for ectopic pregnancy management, as it involves the removal of tissue from inside the uterus, not the fallopian
As the triage nurse in the emergency room, you are reviewing results for the high-risk obstetric patient who is in labor because of traumatic injury experienced as a result of a motor vehicle accident (MVA). You note that the Kleihauer–Betke test is positive. Based on this information, you anticipate that
- A. immediate birth is required.
- B. the patient should be transferred to the critical care unit for closer observation.
- C. RhoGAM should be administered.
- D. a tetanus shot should be administered.
Correct Answer: A
Rationale: The correct answer is A: immediate birth is required. The positive Kleihauer–Betke test indicates fetal-maternal hemorrhage, where fetal blood enters the maternal circulation. This can lead to fetal-maternal transfusion, causing fetal anemia. Immediate birth is necessary to assess and manage potential fetal distress, such as anemia and hypoxia, due to the trauma from the MVA.
Choices B, C, and D are incorrect:
B: Transferring to critical care unit is not the immediate priority. The focus should be on addressing the fetal distress.
C: RhoGAM is given to Rh-negative mothers to prevent Rh sensitization, but it is not directly related to the positive Kleihauer–Betke test result.
D: Tetanus shot administration is important for tetanus prevention, but it is not the priority in this case where immediate birth is required due to fetal-maternal hemorrhage.
A placenta previa when the placental edge just reaches the internal os is called
- A. total.
- B. partial.
- C. low-lying.
- D. marginal.
Correct Answer: D
Rationale: The correct answer is D: marginal. In placenta previa, when the placental edge just reaches the internal os, it is classified as marginal. This indicates that the placenta is close to, but not covering, the cervical os. Total previa covers the entire os, partial covers part of it, and low-lying indicates the placental edge is near the os but not reaching it. The key is to understand the specific location of the placental edge in relation to the internal os for each classification.