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Ch 25 Pregnancy-Related Complications

Terms in this set (35)

1. The perinatal nurse is giving discharge instructions to a woman, status post suction and curettage secondary to a hydatidiform mole. The woman asks why she must take oral contraceptives for the next 12 months. The best response from the nurse is
b. "The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by measuring the same hormone that your body produces during pregnancy. If you were to get pregnant, it would make the diagnosis of this cancer more difficult."

(This is an accurate statement. Beta-hCG levels will be drawn for 1 year to ensure that the mole is completely gone. There is an increased chance of developing choriocarcinoma after the development of a hydatidiform mole. The goal is to achieve a "zero" hCG level. If the woman were to become pregnant, it may obscure the presence of the potentially carcinogenic cells.)
2. Which maternal condition always necessitates delivery by cesarean section?
b. Total placenta previa

(In total placenta previa, the placenta completely covers the cervical os. The fetus would die if a vaginal delivery occurred.)
3. Spontaneous termination of a pregnancy is considered to be an abortion if
a. The pregnancy is less than 20 weeks.

(An abortion is the termination of pregnancy before the age of viability [20 weeks])
4. An abortion in which the fetus dies but is retained in the uterus is called _____ abortion.
b. Missed

(Missed abortion refers to a dead fetus being retained in the uterus.)
5. A placenta previa in which the placental edge just reaches the internal os is called
d. Marginal

(A placenta previa that does not cover any part of the cervix is termed marginal.)
6. What condition indicates concealed hemorrhage in an abruptio placentae?
c. Hard, boardlike abdomen

(Concealed hemorrhage occurs when the edges of the placenta do not separate. The formation of a hematoma behind the placenta and subsequent infiltration of the blood into the uterine muscle results in a very firm, boardlike abdomen.)
7. The priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy is to
a. Assess fetal heart rate (FHR) and maternal vital signs.

(Assessment of the FHR and maternal vital signs will assist the nurse in determining the degree of the blood loss and its effect on the mother and fetus.)
8. A pregnant woman is being discharged from the hospital after placement of a cerclage because of a history of recurrent pregnancy loss secondary to an incompetent cervix. Discharge teaching should emphasize that
b. The presence of any contractions, rupture of membranes, or severe perineal pressure should be reported.

(Nursing care should stress the importance of monitoring signs and symptoms of preterm labor.)
9. A woman with severe preeclampsia is being treated with bed rest and intravenous magnesium sulfate. The drug classification of this medication is
b. Anticonvulsant

(Anticonvulsant drugs act by blocking neuromuscular transmission and depress the central nervous system to control seizure activity.)
10. What is the only known cure for preeclampsia?
c. Delivery of the fetus

(If the fetus is viable and near term, delivery is the only known "cure" for preeclampsia.)
11. Which clinical sign is not included in the classic symptoms of preeclampsia?
d. Glycosuria

(Spilling glucose into the urine is not one of the three classic symptoms of preeclampsia.)
12. Which assessment finding should convince the nurse to "hold" the next dose of magnesium sulfate?
a. Absence of deep tendon reflexes

(Because absence of deep tendon reflexes is a sign of magnesium toxicity, the next scheduled dose should not be administered. Calcium gluconate is the antidote that should be administered.)
13. The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the Pitocin infusion, the nurse reviews the woman's latest laboratory test findings, which reveal a low platelet count, an elevated aspartate transaminase (AST) level, and a falling hematocrit. The nurse notifies the physician, because the lab results are indicative of
c. HELLP syndrome

(HELLP syndrome is a laboratory diagnosis for a variant of severe preeclampsia that involves hepatic dysfunction characterized by hemolysis [H] elevated liver enzymes [EL] and low platelets [LP])
14. The nurse is explaining how to assess edema to the nursing students working on the antepartum unit. Which score indicates edema of lower extremities, face, hands, and sacral area?
c. +3 edema

(Edema of the extremities, face, and sacral area is classified as +3 edema.)
15. A primigravida is being monitored in her prenatal clinic for preeclampsia. What finding should concern her nurse?
c. A dipstick value of 3+ for protein in her urine

(Proteinuria is defined as a concentration of 1+ or greater via dipstick measurement. A dipstick value of 3+ should alert the nurse that additional testing or assessment should be made.)
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