OB Exam #4 Flashcards
The perinatal nurse assisting with establishing lactation is aware that acute mastitis can be minimized by:
A. Wearing a supportive bra 24 hours a day
B. Using proper breastfeeding techniques
C. Washing the nipples and breasts with mild soap and water once a day
D. Wearing a nipple shield for the first few days of breastfeeding
B. Using proper breastfeeding techniques
Which client is at greatest risk for early postpartum hemorrhage (PPH)?
A. A primigravida in spontaneous labor with preterm twins
B. A multiparous woman (G3, P2-0-0-2) with an 8-hour labor
C. A primiparous woman (G2, P1-0-0-1) being prepared for an emergency cesarean birth for fetal distress
D. A woman with severe preeclampsia on magnesium sulfate whose labor is being induced
D. A woman with severe preeclampsia on magnesium sulfate whose labor is being induced
Nurses need to know the basic definitions and incidence data about postpartum hemorrhage (PPH). For instance:
A. Traditionally, it takes more than 1000 ml of blood after vaginal birth and 2500 ml after cesarean birth to define the condition as PPH.
B. Traditionally, PPH has been classified as early or late with respect to birth.
C. If anything, nurses and doctors tend to overestimate the amount of blood loss.
D. PPH is easy to recognize early; after all, the woman is bleeding.
B. Traditionally, PPH has been classified as early or late with respect to birth.
A perinatal nurse caring for a postpartum woman understands that late postpartum hemorrhage (PPH) is most likely caused by:
A. Cervical lacerations
B. Defective vascularity of the decidua
C. Subinvolution of the uterus
D. Coagulation disorders
C. Subinvolution of the uterus
A perinatal nurse is caring for a woman in the immediate postbirth period. Assessment reveals that the woman is experiencing profuse bleeding. The most likely etiology for the bleeding is:
A. Uterine inversion
B. Vaginal laceration
C. Vaginal hematoma
D. Uterine atony
D. Uterine atony
As a powerful central nervous system (CNS) stimulant, which of these substances can lead to miscarriage, preterm labor, placental separation (abruption), and stillbirth?
A. PCP
B. Alcohol
C. Cocaine
D. Heroin
C. Cocaine
When caring for a postpartum woman experiencing hemorrhagic shock, the nurse recognizes that the most objective and least invasive assessment of adequate organ perfusion and oxygenation is:
A. Absence of cyanosis in the buccal mucosa
B. Urinary output of at least 30 ml/hr
C. Diminished restlessness
D. Cool, dry skin
B. Urinary output of at least 30 ml/hr
Despite warnings, prenatal exposure to alcohol continues to far exceed exposure to illicit drugs. A diagnosis of fetal alcohol syndrome (FAS) is made when there are visible markers in each of three categories. Which is not a recognized category for diagnosis of FAS?
A. Craniofacial dysmorphologies
B. Impaired growth
C. Central nervous system (CNS) abnormality
D. Respiratory conditions
D. Respiratory conditions
A primary nursing responsibility when caring for a woman experiencing an obstetric hemorrhage associated with uterine atony is to:
A. Catheterize the bladder
B. Establish venous access
C. Perform fundal massage
D. Prepare the woman for surgical intervention
C. Perform fundal massage
During inpatient psychiatric hospitalization, it is important for the new mother to have:
A. Contact with her significant other
B. No contact with anyone who annoys her
C. The infant with her at all times
D. Supervised and guided visits with her infant
D. Supervised and guided visits with her infant
Lacerations of the cervix, vagina, or perineum are also causes of PPH. Factors that influence the causes and incidence of obstetric lacerations of the lower genital tract include all except:
A. Adherent retained placenta
B. Abnormal presentation of the fetus
C. Operative or precipitate birth
D. Congenital abnormalities of the maternal soft parts
A. Adherent retained placenta
According to Beck’s studies, what risk factor for postpartum depression (PPD) is likely to have the greatest effect on the woman’s condition?
A. Single-mother status
B. Unplanned or unwanted pregnancy
C. Low socioeconomic status
D. Prenatal depression
D. Prenatal depression
Anxiety disorders are the most common mental disorders that affect women. While providing care to the maternity client, a nurse should be aware that one of these disorders is likely to be triggered by the process of labor and delivery. This disorder is:
A. Phobias
B. Panic disorder
C. Obsessive-compulsive disorder (OCD)
D. Posttraumatic stress disorder (PTSD)
D. Post-traumatic stress disorder (PTSD)
It is important for the perinatal nurse to be knowledgeable regarding conditions of abnormal adherence of the placenta. This occurs when the zygote implants in an area of defective endometrium and results in little to no zone separation between the placenta an decidua. Which classification of separation is not recognized as an abnormal adherence pattern?
A. Placenta accreta
B. Placenta percreta
C. Placenta abruption
D. Placenta increta
C. Placenta abruption
A woman who has recently given birth complaints of pain and tenderness in her leg. On physical examination, the nurse notices warmth and redness over an enlarged, hardened area. The nurse should suspect ________ and should confirm the diagnosis by ________________.
A. Thrombophlebitis; using real-time and color Doppler ultrasound
B. Thrombocytopenic purpura; drawing blood for laboratory analysis
C. von Willebrand disease (vWD); noting whether bleeding times have been extended
D. Disseminated intravascular coagulation (DIC); asking for laboratory tests
A. Thrombophlebitis; using real-time and color Doppler ultrasound
Obese women are at risk for several complications during pregnancy and birth. These include all except:
Thromboembolism
Wound infection
Cesarean birth
Breech presentatioin
Breech presentatioin
An unmarried young woman describes her sex life as “active” and involving “many” partners. She wants a contraceptive method that is reliable and does not interfere with sex. She requests an intrauterine device (IUD). The nurse’s most appropriate response is:
A. “The IUD does not interfere with sex.”
B. “Pregnancy rates are high with the IUDs”.
C. “The risk of pelvic inflammatory disease will be higher for you.”
D. “The IUD will protect you from sexually transmitted infections.”
C. “The risk of pelvic inflammatory disease will be higher for you.”
In planning for home care of a woman with preterm labor, the nurse needs to address which concern?
A. Home health care providers are necessary.
B. Restricted activity and medications are necessary to prevent recurrence of preterm labor.
C. Prolonged bed rest may cause negative physiologic effects.
D. Nursing assessments are different from those done in the hospital setting.
C. Prolonged bed rest may cause negative physiologic effects.
A nurse providing care for a woman with preterm labor on terbutaline includes which intervention to identify side effects of the drug?
A. Assess for bradycardia
B. Assess for hypoglycemia
C. Assess for dyspnea and crackles
D. Assess deep tendon reflexes (DTRs)
C. Assess for dyspnea and crackles
In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor, which finding alerts the nurse to possible side effects?
A. Serum magnesium level of 10 mg/dl
B. Respiratory rate (RR) of 16 breaths/min
C. Deep tendon reflexes 2+ and no clonus
D. Urine output of 160 ml in 4 hours
A. Serum magnesium level of 10 mg/dl
A woman has chosen the calendar method of conception control. During the assessment process, it is most important that the nurse:
A. Obtain a history of menstrual cycle lengths for the past 6 to 12 months
B. Determine the client’s weight gain and loss pattern for the previous year
C. Examine skin pigmentation and hair texture for hormonal changes
D. Explore the client’s previous experiences with conception control
A. Obtain a history of menstrual cycle lengths for the past 6 to 12 months
The primary theme of the feminist perspective on violence against women recognizes the:
A. Dominance and coercive control over women by men
B. Cultural norm of violence in Western society
C. Basic human instinctual drive toward aggression
D. Role of testosterone as teh underlying cause of men’s violent behavior
A. Dominance and coercive control over women by men
Women who’s cervical length is greater than 30 mm are unlikely to give birth prematurely even if they have symptoms of preterm later
greater than 30 they are good
Fetalfibronectin is present during preterm labor
but may not have it if positive.
Which contraceptive method has a failure rate of less than 25%?
Standard days
Postovulation
Periodic abstinence
Coitus interruptus
Standard days
Intimate partner violence (IPV) is seen in all races, ethnicities, religions, and socioeconomic backgrounds. Which statement is most accurate regarding the reporting of IPV in the Unites States?
A. Caucasian women report less IPV than do non-Caucasians.
B. Native-American women report IPV at a rate similar to other gorups.
C. African-American women are less likely to report IPV than Caucasian women.
D. Asian women report more IPV than do other minority groups.
A. Caucasian women report less IPV than do non-Caucasians.
Which statement is the most complete and accurate description of medical abortions?
A. They can be either elective or therapeutic.
B. They are performed only for maternal health.
C. They can be achieved through surgical procedures or with drugs.
D. They are mostly performed in the second trimester.
A. They can be either elective or therapeutic.
You (the nurse) are reviewing the educational packet provided to a client about a tubal ligation. What is an important fact you should point out? Choose all that apply.
A. “This is an effective form of 100% permanent sterilization. You won’t be able to get pregnant.”
B. “Your menstrual cycle will greatly increase after your sterilization.”
C “Sterilizationi offers some form of protection against sexually transmitted infections.”
D “Sterilization offers no protection against sexually transmitted infections.”
E “It is highly unlikely that you will become pregnant after the procedure.”
D “Sterilization offers no protection against sexually transmitted infections.”
E “It is highly unlikely that you will become pregnant after the procedure.”
Before 20 weeks is called
abortion
The nurse who is evaluating the client for potential abuse should be aware that intimate partner violence includes (choose all that apply):
Economic abuse Sexual abuse Emotional abuse Physical abuse Psychologic abuse
All of them
Common characteristics of a potential batterer include (choose all that apply):
Substance abuse problems Excellent verbal skills Personality disorders High frustration tolerance High level of self-esteem
Substance abuse problems Personality disorders
The nurse recognizes that uterine hyperstimulation with oxytocin requires emergency interventions. What clinical cues alert the n ruse that the woman is experiencing uterine hyperstimulation? Choose all that apply:
A Uterine contractions lasting >90 seconds and occurring 20 mm Hg
A Uterine contractions lasting >90 seconds and occurring 20 mm Hg
B Increased uterine activity accompanied by a nonreassuring fetal heart rate (FHR) and pattern
Complications and risks associated with cesarean births include (choose all that apply):
Fetal risks Hemorrhage Wound dehiscence Urinary tract infections Pulmonary edema
All of them
Less than 36 weeks then can be given a tocalytic is the less than 6 cm
Side effects
Increased Heart rate
dyspnea crackles
Sign and symptoms of late postpartum hemorrhage include: (choose all that apply)
a. Fever, pelvic pain
b Excessive lochial flow
c Excessive maternal activity
d Foul smelling lochia
e Lochia alba
f Uterine and fundal tenderness
a. Fever, pelvic pain
b Excessive lochial flow
d Foul smelling lochia
f Uterine and fundal tenderness
Prevention of future gynecological problems for the obstetrical client would be best helped by: (choose all that apply)
A, Pelvic stretching exercises
b Performing an episiotomy for vaginal births
c Avoiding straining and constipation
d Kegel exercises
e Avoiding heavy lifting
c Avoiding straining and constipation
d Kegel exercises
e Avoiding heavy lifting
You have the following orders for your postpartum client: Methergine (methylergonovine) 0.2 mg po every 6 hours for 2 days and Oxytocin (pitocin) 20 units to first 2 liters of Lactated Ringers to infuse at 125 ml/hr. What would be important to assess for this client? (choose all that apply)
a Skin integrity
b Vaginal bleeding
c Pain scale
d History of hypertension
e History of asthma
f Frequent vital signs
b Vaginal bleeding
c Pain scale
d History of hypertension
f Frequent vital signs
Maternal Tocalytic contraindications
HTN
Significant vaginal Bleeding
Cardiac Disease
Which of the following increase a client’s risk for thrombophlebitis? (choose all that apply)
a Obesity
b Blood type AB negative
c Cesarean birth
d Early ambulation
e Dehydration
a Obesity
b Blood type AB negative
c Cesarean birth
e Dehydration
What is the most common tocalytic?
Magnesium
Complications Mag level of 10 Low resp low HR LOC Changes
Antidote is calcium gluconate
It is important for the perinatal nurse to be knowledgeable regarding conditions of abnormal adherence of the placenta. This occurs when the zygote implants in an area of defective endometrium and results in little to no zone separation between the placenta and decidua. Which classification of separation is not recognized as an abnormal adherence pattern?
a Placenta accreta
b Placenta increta
c Placenta percreta
d Placenta abruptio
d Placenta abruptio
Less than 10% of women who are substance abusers receive treatment for their addiction during pregnancy. Is this statement true or false?
True
False
True
When a client admits to drug use in pregnancy it is important to: (choose all that apply)
a Screen for sexually transmitted infections
b Request a social work referral
c Obtain meconium from the infant and test for the presence of drugs
d Assess the clients readiness to withdraw from drugs
e Place the client in a drug treatment program to begin withdrawal as soon as possible
f Obtain a urine drug screen even if she does not give permission
a Screen for sexually transmitted infections
b Request a social work referral
d Assess the clients readiness to withdraw from drugs
Causes of postpartum hemorrhage include which of the following: (choose all that apply)
a Uterine atony
b Lacerations of the cervix and genital tract
c Subinvolution
d Adherent retained placenta
e Nonadherent retained placenta
f Endometritis
a Uterine atony
b Lacerations of the cervix and genital tract
c Subinvolution
d Adherent retained placenta
e Nonadherent retained placenta
Nifedipine (tocalytic CCB)
Related to HTN
causes headache
flushing
dizzy
nausea
On admission to labor and delivery, your client reports a history of occasional methamphetamine use in the past. What is your nursing action?
a Referral to social services
b Referral to psychiatrist
c Notify your nurse manager
d Referral to child protective services
a Referral to social services
Your client who is 1 week postpartum calls with complaints of fatigue, lack of energy, inability to sleep, and increased sadness. What would be your priority nursing action?
A Explain to her that she should be the only caregiver for her infant to improve bonding
B Tell her to keep her feelings of sadness to herself
C Assess her for signs and symptoms of more serious postpartum depression
D Tell her to stay home and avoid outside activities to ensure adequate rest
C Assess her for signs and symptoms of more serious postpartum depression
You arrive in your client’s room for a postpartum assessment at 2 hours after her C/section for a twin gestation. She is pale with a pulse rate of 125 and blood pressure of 92/36. Your priority nursing action is to:
A Have another nurse come in to assess her with you.
B Go out to call the healthcare provider immediately of your findings.
C Press the emergency button in the client’s room
D Massage her fundus while assessing vaginal bleeding.
D Massage her fundus while assessing vaginal bleeding.
Antinatal Glycocorticoids-
Betamethasone
For fetal lung maturity
between 24-34 weeks if pregnancy is threatened
2 injections 24 hours apart
Your pregnant client with a diagnosis of schizophrenia tells you that she is Madonna. What would be your priority action?
A Confront the client regarding this delusion and bring her back to reality.
B Reflect this statement back to the client to encourage therapeutic communication.
C Respond with an open ended response to get the client to further discuss her thoughts.
D. Verify the identity of the client prior to administering her medication.
D. Verify the identity of the client prior to administering her medication.
Clinical manifestations of a manic episode in the pregnant woman include all except:
a Psychomotor agitation and lack of sleep
b Increased appetite and lack of interest in activities
c Hyperactivity and distractibility
d Pressured speech and grandiosity
b Increased appetite and lack of interest in activities
A nurse is caring for a postpartum client with a diagnosis of superficial thrombophlebitis. What is the most appropriate nursing intervention?
a Apply cold packs to the affected limb.
b Administer antibiotics per physician orders.
c Administer anticoagulants per physician orders.
d Elevate the affected limb.
d Elevate the affected limb.
Your client, a G1, has experienced a long labor before giving birth vaginally to a 9 pound 2 oz infant. Her initial blood loss was 600 ml after which she stabilized. On postpartum day 3 she complains of severe uterine cramping and when you massage her fundus, she states it is very tender and painful. You anticipate/perform the following (choose all that apply)
A Strict lateral bedrest with bathroom priviledges
B Obtain vital signs with temperature
C Semi fowlers and/or ambulation as tolerated
D The administration of antivirals
E The administration of oxytocics
F The administration of broad spectrum antibiotics
B Obtain vital signs with temperature
C Semi fowlers and/or ambulation as tolerated
E The administration of oxytocics
F The administration of broad spectrum antibiotics
To date the U.S. Food and Drug Administration (FDA) has approved several specific categories of psychotropic medications as safe for use during pregnancy. Is this statement true or false?
True
False
False
Despite warnings, prenatal exposure to alcohol continues to far exceed exposure to illicit drugs. A diagnosis of fetal alcohol syndrome (FAS) is made when there are visible markers in each of three categories. Which is not a recognized category for diagnosis of FAS?
a. Impaired growth
b Respiratory conditions
c Central nervous system (CNS) abnormality
d Craniofacial dysmorphologies
b Respiratory conditions
If pre mature rupture of membranes
check temp and pulse ever 4 hours while awake
No sex
Insert nothing into the vagina
report temp greater than 38 c
moderate bed rest
no baths
fetal movement counts daily
monitor for contracts
foul smell
front to back wiping
antibiotics
The standard of care for pregnant women who are dependent on heroin or other narcotics is ____________________ maintenance treatment (MMT).
methadone
Treatment of urinary tract infections/pyelonephritis in the postpartum patient includes which of the following? (choose all that apply)
a Vital signs every 4 hours (temperature, pulse, blood pressure, respirations)
b Include SaO2 (pulse oximetry) with vital signs
c Strict bedrest without bathroom priviledges
d Strict intake and output
e Frequent catheterizations
a Vital signs every 4 hours (temperature, pulse, blood pressure, respirations)
b Include SaO2 (pulse oximetry) with vital signs
d Strict intake and output
Of all pregnant women being treated for depression, approximately one third have a first occurrence during pregnancy. All pregnant and postpartum women should be screened for perinatal mood disorders by using the _________________ Postnatal/Postpartum Depression Scale/Screening.
Edinburgh
Beck
Which of the following clients would be at increased risk for postpartum hemorrhage? (choose all that apply)
a Client having her eighth child
b Client with idiopathic thrombocytopenic purpura (ITP)
c Client with history of von Willebrand’s disease
d Client with asthma
e Client with polyhydramnios
a Client having her eighth child
c Client with history of von Willebrand’s disease
e Client with polyhydramnios
The most frequent illegal drug abused is:
Opiates
Methamphetamine
Cocaine
Marijuana
Marijuana
Lacerations of the cervix, vagina, or perineum are also causes of PPH. Factors that influence the causes and incidence of obstetric lacerations of the lower genital tract include all except:
A. Operative or precipitate birth
b Adherent retained placenta
c Abnormal presentation of the fetus
D Congenital abnormalities of the maternal soft parts
b Adherent retained placenta
Your client at 2 weeks post vaginal delivery arrives with significant vaginal bleeding, saturating more than 2 pads per hour. You would anticipate which of the following actions to be performed? (choose all that apply)
a. Close monitoring of the client at home
b. Prepare for possible dilation and curettage (D&C)
c Complete blood count (CBC) to be performed
d Stimulation of the uterus to expel fragments
e. Genetic testing for coagulopathies
b. Prepare for possible dilation and curettage (D&C)
c Complete blood count (CBC) to be performed
d Stimulation of the uterus to expel fragments
Alcohol abuse during pregnancy is the leading cause of mental retardation in the United States.
True
False
True
According to Beck’s studies, what risk factor for postpartum depression (PPD) is likely to have the greatest effect on the woman’s condition?
a Prenatal depression
b Single-mother status
c Low socioeconomic status
d Unplanned or unwanted pregnancy
a Prenatal depression
Cocaine use in pregnancy is most closely associated with:
Placenta accreta
Placental abruption
Placenta previa
Placental abruption
Sexual assault is:
An act of force in which an unwanted and uncomfortable sexual act occurs
During a health history interview, a woman tells the nurse that her husband physically abuses her. The nurse’s first response should be to:
Advise the woman of mandatory state reporting laws pertaining to abuse and confidentiality
Women with severe and persistent mental illness are likely to be more vulnerable to being involved in controlling and/or violent relationships. However, many women develop mental health problems as a result of long-term abuse. The psychologic consequences of continued abuse do not include:
Bipolar disorder
The nurse’s best measure when evaluating the care of a woman in an abusive situation is based on the:
Woman’s declaration of a safety plan
In the 1970s rape-trauma syndrome (RTS) was identified as a cluster of characteristics, symptoms, and related behaviors seen in the weeks and months after a rape. Which pattern of responses would not apply to a victim of rape?
Acute phase: rearranging
Precipitious labor is
labor lasting less than 3 hours
soft tissue distocia can be caused by a
full bladder
A woman is using the basal body temperature (BBT) method of contraception. She calls the clinic and tells the nurse, “My period is due in a few days, and my temperature has not gone up.” The nurse’s most appropriate response is:
“You probably didn’t ovulate during this cycle.”
A male client asks the nurse why it is better to purchase condoms that are not lubricated with nonoxynol-9 (a common spermicide). The nurse’s most appropriate response is:
“Nonoxynol-9 does not provide protection against sexually transmitted infections, as originally thought; also it has been linked to an increase in the transmission of human immunodeficiency virus (HIV) and can cause genital lesions.”
A woman was treated recently for toxic shock syndrome (TSS). She has intercourse occasionally and uses over-the-counter protection. Based on her history, what contraceptive method should she and her partner avoid?
Cervical cap
Which statement is true about the term contraceptive failure rate?
It varies from couple to couple, depending on the method and the users.
What important aspects do all the fertility awareness methods (FAMs) have in common?
They all require the cooperation of the woman’s partner.
With regard to emergency contraception pills, nurses should be aware that:
The pills should be readily available during the initial learning phase when a woman is using a new method of contraception
Nurses, certified nurse-midwives, and other advanced practice nurses have the knowledge and expertise to assist women in making informed choices regarding contraception. A multidisciplinary approach should ensure that the woman’s social, cultural, and interpersonal needs are met. Which action should the nurse take first when meeting with a new client to discuss contraception?
Determine the woman’s level of knowledge about contraception and commitment to any particular method.
A woman taking an oral contraceptive pill (OCP) as her birth control method of choice should notify her health care provider immediately if she notes:
Swelling and pain in one of her legs
A married couple is discussing male and female sterilization with the nurse. Which statement is most appropriate for the nurse to make?
“Major complications after sterilization are rare.”
If used consistently and correctly, which of the barrier methods of contraception has the lowest failure rate?
Male condoms
A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor. What finding indicates that preterm labor is occurring?
The cervix is effacing and dilated to 2 cm.
In planning for an expected cesarean birth for a woman who has given birth by cesarean previously and who has a fetus in the transverse presentation, the nurse includes which information?
“Even though this is your second cesarean birth, you may wish to review the preoperative and postoperative procedures.”
For a woman at 42 weeks of gestation, which finding requires more assessment by the nurse?
One fetal movement noted in 1 hour of assessment by the mother
A pregnant woman’s amniotic membranes rupture. Prolapsed cord is suspected. Which intervention is the nurse’s top priority?
Place the woman in the knee-chest position.
A nurse is caring for a client whose labor is being augmented with oxytocin. The nurse recognizes that the oxytocin should be discontinued immediately if there is evidence of:
A fetal heart rate (FHR) of 180 with absence of variability
With regard to the use of tocolytic therapy to suppress uterine activity, nurses should be aware that:
Its most important function is to afford the opportunity to administer antenatal glucocorticoids
With regard to dysfunctional labor, nurses should be aware that:
Women experiencing precipitous labor are about the only “dysfunctionals” not to be exhausted
A nurse providing care to a woman in labor should be aware that cesarean birth:
Is performed primarily for the benefit of the fetus
Which statement is most likely to be associated with a breech presentation?
High rate of neuromuscular disorders
Which opiate causes euphoria, relaxation, drowsiness, and detachment from reality and has possible effects on the pregnancy, including preeclampsia, intrauterine growth restriction, and premature rupture of membranes?
Heroin
During pregnancy, alcohol withdrawal may be treated using:
Benzodiazepines
Bishops score of 8 or more
indicates that delivery will be successful
To provide adequate postpartum care, the nurse should be aware that postpartum depression (PPD) with psychotic features:
Is typified by auditory or visual hallucinations
Nurses must be cognizant of the growing problem of methamphetamine use during pregnancy. When caring for a woman who uses methamphetamines, it is important for the nurse to be aware of which factor related to the abuse of this substance?
Methamphetamine users are extremely psychologically addicted.
Screening questions for alcohol and drug abuse should be included in the overall assessment during the first prenatal visit for all women. The 4 Ps-Plus is a screening tool designed specifically to identify when there is a need for a more in-depth assessment. The 4 Ps include all except:
Present
In planning for the care of a 30-year-old woman with pregestational diabetes, the nurse recognizes that the most important factor affecting pregnancy outcome is the:
Degree of glycemic control during pregnancy
Diabetes in pregnancy puts the fetus at risk in several ways. Nurses should be aware that:
The most important cause of perinatal loss in diabetic pregnancy is congenital malformations
A pregnant woman at 28 weeks of gestation has been diagnosed with gestational diabetes. The nurse caring for this client understands that:
Dietary management involves distributing nutrient requirements over three meals and two or three snacks
Hypothyroidism occurs in 2 to 3 pregnancies per 1000. Pregnant women with untreated hypothyroidism are at risk for all except:
Macrosomia
A pregnant woman at 14 weeks of gestation is admitted to the hospital with a diagnosis of hyperemesis gravidarum. The primary goal of her treatment at this time is to:
Reverse fluid, electrolyte, and acid-base imbalances
A pregnant woman at 14 weeks of gestation is admitted to the hospital with a diagnosis of hyperemesis gravidarum. The primary goal of her treatment at this time is to:
Reverse fluid, electrolyte, and acid-base imbalances
The first and most important nursing intervention when a nurse observes profuse postpartum bleeding is to:
Palpate the uterus and massage it if it is boggy
Which PPH conditions are considered medical emergencies that require immediate treatment?
Inversion of the uterus and hypovolemic shock
Which postpartum infection is most often contracted by first-time mothers who are breastfeeding?
Mastitis
Despite popular belief, there is a rare type of hemophilia that affects women of childbearing age. von Willebrand disease is the most common of the hereditary bleeding disorders and can affect males and females alike. It results from a factor VIII deficiency and platelet dysfunction. Although factor VIII levels increase naturally during pregnancy, there is an increased risk for postpartum hemorrhage from birth until 4 weeks postpartum as levels of von Willebrand factor (vWf) and factor VIII decrease. The treatment that should be considered first for the client with von Willebrand disease who experiences a postpartum hemorrhage is:
Desmopressin
Herbal remedies have been used with some success to control PPH after initial management. Some herbs have homeostatic actions, whereas others work as oxytocic agents to contract the uterus. _______________ is a commonly used oxytocic herbal remedy.
Blue cohosh
A thrombosis results from the formation of a blood clot or clots inside a blood vessel and is caused by inflammation or partial obstruction of the vessel. Three thromboembolic conditions are of concern during the postpartum period and include all except:
Amniotic fluid embolism (AFE)
If a person is on methadone they can breastfeed
true
