Chapter 14 Flashcards
A pregnant client who uses cocaine and ecstasy on a regular basis asks why ecstasy should not be used during pregnancy. What should the nurse explain about this drug?
“It can cause a high fever in you if high doses are taken and therefore cause the baby harm.”
The nurse is doing preconception counseling with a 28-year-old woman with no prior pregnancies. Which client statement indicates that teaching has been effective?
“I need to stop drinking alcohol completely when I start trying to get pregnant.”
The nurse suspects that a pregnant client is a substance user. Which approach should the nurse take during the health history?
Asking the woman directly, “Do you use any street drugs?”
A 20-year-old woman at 28 weeks’ gestation has a history of past drug abuse and her urine screening indicates recent heroin use. What should the nurse recognize this client is at risk for developing?
Pregnancy-induced hypertension
The client with insulin-dependent type 2 diabetes and an HbA1c of 5% is planning to become pregnant soon. What anticipatory guidance should the nurse provide this client?
Insulin needs decrease in the first trimester and increase during the third trimester.
A newly diagnosed type 1, insulin-dependent diabetic with good blood sugar control at 20 weeks’ gestation asks how the diabetes will affect the baby. How should the nurse respond?
“Your baby will probably be larger than average at birth.”
A 26-year-old multigravida who is 28 weeks pregnant and follows a program of regular exercise develops gestational diabetes. What instructions should be included in a teaching plan for this client?
“Carry hard candy (or other simple sugar) when exercising.”
A 31-year-old woman who is at high risk for diabetes is at 18 weeks’ gestation. During her first antenatal visit, which is the accurate approach to evaluate the client for diabetes?
Conduct screening for type 2 diabetes mellitus as soon as possible.
A pregnant client at 23 weeks’ gestation has a hemoglobin of 9.5. Which diet choice indicates that teaching has been effective?
Roast beef, steamed spinach, tomato soup, orange juice
A woman at 30 weeks’ gestation and a history of sickle cell anemia is experiencing fever, chills, and diarrhea for 3 days. What are the most serious potential complications that this client faces?
Sickle cell crisis
A client who is at 18 weeks’ gestation has been newly diagnosed with megaloblastic anemia. Which client statement indicates teaching has been effective?
“I should include fresh leafy green vegetables, red meat, fish, poultry, and legumes in my diet.”
A client at 9 weeks’ gestation learns about being HIV positive. Which client statement indicates teaching about the effects on the baby has been effective?
“My baby will probably be born with anti-HIV antibodies, but that does not mean the baby is infected.”
During the first antepartal visit, a client who is at 10 weeks’ gestation learns of being HIV positive. Which client statement indicates an understanding of the plan of care both during the pregnancy and postpartally?
“I should not breastfeed my baby.”
A client who is 32 weeks pregnant is HIV positive, but asymptomatic. What would be important in managing her pregnancy and delivery?
Weekly non-stress testing beginning at 32 weeks’ gestation
A pregnant woman married to an intravenous drug user had a negative HIV screening test just after missing her first menstrual period. What would indicate that the client needs to be retested for HIV?
Unusual fatigue and recurring Candida vaginitis
A client at 24 weeks has a history of class II heart disease secondary to rheumatic fever. What should the nurse expect to see in the medical record?
Discussed need for labor epidural and vacuum extraction
The prenatal clinic nurse has received four phone calls. Which client should be called back first?
Primipara at 28 weeks with a history of asthma reporting difficulty breathing and shortness of breath
A client is identified as having hepatitis B surface antigen (HBsAG) early in her pregnancy. Which client statement about the labor and birth process and having hepatitis B infection indicates the need for additional teaching?
“An internal fetal monitor will be applied as soon as possible during labor.”
The nurse is concerned that a pregnant client is experiencing depression. Which potential health issues should the nurse include when planning care for this client? Select all that apply.
- Alcohol use
- Preterm birth
- Poor appetite
- Poor weight gain
- Antenatal hemorrhage
2,3,4
After completing a physical assessment the nurse determines that a laboring client is experiencing a panic attack. What findings did the nurse use to make this clinical determination? Select all that apply.
- Flat affect
- Monotone replies
- Heart rate 120 bpm
- Respiratory rate 28/minute
- Disoriented to place and time
3,4
A client in labor is demonstrating acute manifestations of schizophrenia. What should the nurse identify as a priority for this client? Select all that apply.
- Ensuring fetal well-being
- Ensuring maternal well-being
- Maintaining a safe environment
- Medicating for pain as necessary
- Considering pharmacologic intervention
1,2,3,5
A pregnant client is diagnosed with a cardiac problem. What should the nurse prepare to instruct this client to do, to ensure a safe pregnancy? Select all that apply.
- Restrict activities.
- Follow a diet high in iron and protein.
- Restrict the intake of sodium.
- Obtain 8 to 10 hours of sleep.
- Obtain pneumococcal vaccination.
1,2,3,4
A 32-year-old pregnant client is diagnosed with active tuberculosis (TB). What fetal health issues is this client at risk for developing? Select all that apply.
- Cleft palate
- Preterm labor
- Microcephaly
- Spontaneous abortion
- Suboptimal weight gain
2,4,5
