MCN Flashcards
1
Q
The patient develops an elevated blood pressure (140/90 mmHg) but has no proteinuria or edema
A
Gestational Hypertension
2
Q
No drug therapy needed for this type of hypertension
A
Gestational Hypertension
3
Q
4 Classifications of Hypertension
A
- Gestational Hypertension
- Mild Pre-eclampsia
- Severe Pre-eclampsia
- Eclampsia
4
Q
Most severe classification of PIH
A
Eclampsia
5
Q
A patient has this condition when the cerebral edema is so acute that seizure or coma occurs.
A
Eclampsia
6
Q
With eclampsia, the maternal mortality is high from what causes
A
Cerebral hemorrhage, and Circulatory collapse or Renal failure
7
Q
The reason why fetal prognosis in eclampsia is poor
A
Hypoxia and Consequent Fetal Acidosis
8
Q
Diagnosis of the patient if her blood pressure has risen to 160 mmHg systolic and 110 mmHg diastolic or above on at least two occasions 6 hours apart at bed rest
A
Severe Preeclampsia
9
Q
Edema is most readily palpated over what area?
A
BONY SURFACES:
1. Tibia on the anterior leg
2. Ulnar Surface of Forearm
3. Cheekbones
10
Q
Weight gain at pre-eclampsia indicates…
A
Abnormal tissue fluid retention
11
Q
This reduces the urine output at approximately 400 to 600 mL for 24 hours
A
EDEMA
12
Q
How many mL edema reduces to the urine output for 24 hours
A
400 to 600 mL
13
Q
Pulmonary Edema
A
Shortness of breathe / Difficulty of Breathing (dyspnea)
14
Q
Cerebral edema causes
A
Visual disturbances; blurred vision or seeing spots before the eys
15
Q
Cerebral edema produces what symptoms?
A
- headache
- hyperreflexia
- ankle clonus (continues motion of the foot)
16
Q
With the severe preeclampsia, the extreme edema will be noticeable as puffiness in a woman’s –
A
hands and face
17
Q
Severe preeclampsia signs and symptoms
A
- Hypertension (160/110 mmHg)
- Proteinuria (+3 or +4 )
- Extreme edema
- Oliguria (altered renal function)
- Elevated serum creatinine (more than 1.2 mg/dL)
- Cerebral Edema; visual disturbances (blurred vision)
- Thrombocytopenia
- Epigastric pain
18
Q
A condition where vasospasm occurs during pregnancy in both small and large arteries
A
Pregnancy Induced Hypertension
19
Q
S/s of PIH
A
hypertension, proteinuria, and edema
20
Q
Risk factors of PIH
A
- women of color
- multiple preg
- primipara
- age; <20 or >40
- from low socioeconomic background
- have hydramnios
- with an underlying disease like heart disease, diabetes, and essential hypertension
21
Q
Try to explain the Pathophysiology of PIH
A
.
22
Q
What is PIH?
A
try to explain on your own
23
Q
PIH usually occurs at what AOG?
A
After the 20th week AOG
24
Q
If there is vasoconstriction, the blood pressure will decrease or increase?
A
Increase
25
A condition with physical changes including the breakdown of red blood cells, changes in the liver, and low platelets.
HELLP SYNDROME
26
Meaning of HELLP Syndrome
Hemolysis
Elevated
Liver
Low
Platelets
27
if the protein has already leaked out and it is responsible for containing water inside the vessels, this will occur
edema
28
This is one of the most common diagnostic tests that determine the presence of protein in the urine.
Urinalysis
29
this position will help to avoid uterine pressure on the vena cava and this will prevent supine hypertension syndrome
Lateral recumbent position
30
best method for aiding increased evacuation of sodium and encouraging diuresis
BED REST
31
Muscle relaxant; prevents seizures
Magnesium sulfate
32
used to decrease hypertension
Anti hypertensive drug; hydralazine (apresoline)
33
this drug will halt the seizure
Diazepam (valium)
34
antidote for magnesium intoxication
calcium gluconate
35
if a woman is receiving magnesium sulfate, you must watch out if the baby is born because the baby may have ____ because the drug crosses placenta
respiratory depression
36
how will you prevent aspiration of a woman having a seizure
turn the woman on her side
37
If a patient is experiencing a tonic-clonic seizure, these two drugs are administered IV as an emergency measure
Magnesium sulfate
Diazepam
38
3 stages of (tonic-clonic) seizure
1st - tonic stage
2nd - clonic stage
3rd - postictal stage
39
3 hypotensive drugs for severe PIH
1. Hydralazine (apresoline)
2. labetalol
3. nifedipine
40
Severe oliguria may be treated by
IV, salt-poor albumin
41
HELLP SYNDROME
complications associated;
(a) subcapular liver hematoma
(b) hyponatremia
(c) renal failure
(d) hypoglycemia
(e) cerebral hemorrhage
(f) aspiration pneumonia
(g) hypoxic encephalopathy
Fetal complication:
(a) growth restriction
(b) preterm birth
42
Nursing intervention that will improve the platelet count of the patient
Transfusion of fresh-frozen plasma/platelets
43
Preterm labor occurs at what AOG?
before the end of week 37 of gestation
44
how many uterine contractions a woman should have to be considered as true'labor'
4 contractions every 20 minutes
45
what are the causes of preterm labor
1. DEHYDRATION
2. URINARY TRACT INFECTION
3. PERIODONTAL DISEASE
4. CHORIOAMNIONITIS
46
if the patient is dehydrated, the pituitary gland will secrete what hormone? and what will hormone may cause to release?
the antidiuretic hormone will cause to release oxytocin
47
this will accelerate the formation of lung maturity
Corticosteriod
48
the drug used to hasten the fetal lung maturity
Betamethasone (steriod)
49
the will stop labor from progressing
calcium blockers / prostaglandin antagonist
50
the drug used to manage pain
analgesic agent
51
At what week PROM usually occurs?
before 37 weeks
52
this is the rupture of fetal membranes with loss of amniotic fluid during pregnancy
Preterm Rupture of Membrane
53
extension of the cord out of the uterine cavity into the vagina
cord prolapse
54
the first s/s for PROM
sudden gush of clear fluid with continued minimal leakage
55
what does a PROM patient needs to avoid because it might increase the risk of infection?
Avoid doing routine vaginal examination
56
IV drug used to educe the possibility of infection in newborn in PROM
IV penicilin/ampicillin
57
This will reduce the pressure on the fetus or cord and allows a term birth
Amnioinfusion
58
This procedure will help to reseal the membrane of PROM by the use of fibrin-based commercial sealant so that it will again intact
Endoscopic Intrauterine procedure
59
What is the causative agent of syphilis?
a. Chlamydia Trachomatis
b. Neisseria gonorrhoeae
c. Treponema pallidum
d. Trichomonaes vaginalis
C. Treponema pallidum
60
1. Maternal and Child Nursing is a challenging role for nurses, to be an advocate the nurse should protect the rights of family members, including the fetus. Which of the following are the philosophy of Maternal and Child Nursing.
A. Family Centered
B. Community Centered
C. Evidence-based
D. All are considered as philosophy of MCN
D. All are considered as philosophy of MCN
61
What does the framework of Maternal and child care would like to achieve in the practice of nursing?
A. Nursing Research
B. Nursing Theory
C. ADPIE
D. All may apply
D. All may apply
62
Your patient is being prepared for an amniocentesis. Before the procedure is performed, it is most important for the nurse to obtain which of the following?
A. The heart rate of the fetus
B. A urine specimen from the mother
C. The mother's body temperature
D. A blood specimen for the mother
A. The heart rate of the fetus
63
A client is having a non-stress test. The fetal heart rate is 130-150 bpm, but there has been no fetal movement for 15 minutes. Which of the following is the most appropriate nursing response?
A. Encourage her to walk around the monitoring unit for 10 minutes, then resume monitoring
B. Immediately report the situation to her physician and prepare her for induction of labor
C. Offer her a snack of orange juice and crackers
D. Turn her on her left side and attempt to auscultate fetal heart sounds with a Doppler
64
Following an amniocentesis, the client should be monitored for an hour for:
A. Breast tenderness
B. Temperature elevation
C. Increased fetal activity
D. Rupture of membranes
65
A client is admitted to the labor and delivery unit. As she is placed on the electronic fetal monitor, she asks the nurse to explain her baby's heart beat. Which of the following is the normal range for a term fetal heart rate per minute?
A. 80 to 100 beats per minute
B. 120 to 160 beats per minute
C. 100 to 160 beats per minute
D. 130 to 180 beats per minute
B. 120 to 160 beats per minute
66
A 17 year old primigravida comes in for her 32 week prenatal appointment. The nurse asks her about her plans after delivery. Which of the following information would indicate that this family may be at high risk for ineffective family functioning:
A. "I plan to live at home with my parents. My mom will take care of the baby while I go to school for half a day and then work the other half. We have a nursery fixed up in a corner of my room. It'll be hard, but I think we can make it."
B. "I'm going to get an apartment in a few weeks. Hopefully my parents and my boyfriend will give me money otherwise I don't know how we will survive."
C. "My boyfriend and I are getting married after the baby is born. He's older - 20, and in the army. They pay pretty well and they have good benefits. He'll be going to Germany pretty soon, so I'll move back home to my parents. I plan to finish my high school later on when the baby is older."
D. "I'm giving the baby up for adoption. I'm just not ready to be a parent yet. It'll be an open adoption and I'll get to see the baby and stuff."
D. "I'm giving the baby up for adoption. I'm just not ready to be a parent yet. It'll be an open adoption and I'll get to see the baby and stuff."
67
A fetal ultrasound is done prior to an amniocentesis in order to:
A. Ensure the baby is mature enough to withstand the amniocentesis
B. Evaluate the amount of amniotic fluid
C. Locate the fetus and implantation site of the placenta
D. Evaluate fetal lung maturity
C. Locate the fetus and implantation site of the placenta
68
When a woman who is at 34 weeks gestation has a non-reactive results to successive non-stress tests, a nurse would prepare the woman for which of the following?
A. An emergency cesarean delivery
B. Internal fetal monitoring
C. Induction of labor
D. A biophysical profile
D. A biophysical profile
69
Your client is scheduled for a nonstress test (NST). After 20 minutes, you have noted four fetal movements accompanied by accelerations of the fetal heart rate 15 or more beats per minute, each lasting 15 seconds. You interpret this test to be:
A. Nonreactive
B. Positive
C. Reactive
D. Negative
C. Reactive
