Exam 7: High-Risk Antepartum Nursing Care

A patient is threatening spontaneous abortion at 18 weeks gestation. The patient's two previous pregnancies aborted in the same time frame. The patient states, "They want to sew my cervix shut." The nurse shares the terminology for surgical treatment of incompetent cervix, which is ____________________.

A patient just learns that her unborn fetus has a life-threatening condition and is not expected to survive long term. Which does the nurse include in a plan of care to meet psychological needs of the patient and her partner? Select all that apply.

The nurse in a prenatal clinic is reviewing the files of four patients scheduled for visits. Which patient does the nurse identify as having the highest-risk pregnancy?

The nurse is providing care to a postpartum patient after an emergency cesarean due to eclampsia. The patient received spinal anesthesia prior to delivery. Magnesium sulfate is infusing 2 g/hr in 100 mL of IV fluid. Which assessment finding will cause the nurse to administer calcium gluconate to the patient via IV push?

A patient with pregestational diabetes mellitus delivers a neonate who is diagnosed with macrosomia. The nurse is aware that the neonate is at risk for additional long-term conditions related to maternal diabetes mellitus. Which long-term effects may occur? Select all that apply.

The nurse is conducting a staff education session about preeclampsia and eclampsia complications. Which statements by the nurse are accurate about HELLP syndrome? Select all that apply.

A patient at 36 weeks gestation reports a constant dull backache, regular frequent contractions that are painless, and lower abdominal pressure. Physical examination reveals intact membranes and cervical dilation of 3 cm. Which order by the health care provider is unexpected by the nurse?

When a patient is diagnosed with preeclampsia, one sign that the fetus is at risk for hypoxia is a change in amniotic fluid called ____________________.

A patient at 30 weeks gestation is exhibiting signs of preterm labor and delivery. The health care provider (HCP) informs the patient that nothing can be done to disrupt this process. The patient is in distress and states, "Why can't something be done to save my baby?" The nurse understands the HCP's decision is likely based on which finding?

The nurse is assessing a patient at 26 weeks gestation. The patient has chronic hypertension and exhibited hypertension and proteinuria prior to 20 weeks gestation. Previous blood pressure (BP) readings have been in the range of 130 to 140/88 to 90 mm Hg. Due to superimposed preeclampsia, for which additional manifestations will the nurse immediately contact the health care provider? Select all that apply.

A patient undergoes chorionic villa sampling to rule out the presence of a genetic disorder. Following the procedure, the patient experiences iatrogenic PPROM. Which explanation does the nurse provide to promote patient understanding?

The nurse in a prenatal unit is providing care for a patient who experienced PPROM at 32 weeks gestation. Which assessment does the nurse consider unnecessary?

The nurse educator is preparing a presentation on preterm labor (PTL) and birth (PTB). Which information does the nurse recognize as being inaccurate?

A patient who is in the third trimester of pregnancy is informed that she will need a cesarean hysterectomy and bladder reconstruction due to a placenta defect. Which medical condition does the nurse explain to the patient?

A patient at 35 weeks gestation arrives at the prenatal clinic in physical distress. Assessment reveals hypotension, thready pulse, shallow respirations, pallor, cold and clammy skin, and anxiety. The nurse does not find evidence of vaginal bleeding but suspects placental abruption. For which reason does the nurse call for emergency transport to the hospital? Select all that apply.

The nursing staff in a labor and delivery unit has noticed an increase in the number of patients experiencing placental abruption. The nurses begin to review demographics for the patients involved. Which risk factors will the nurses expect? Select all that apply.

Premature rupture of membranes is defined as rupture of the ____________________ membranes before the onset of labor but at term.

When performing a physical assessment on a patient during the initial prenatal visit, the nurse notes spongy gums prone to bleeding during the oral exam. Which comment by the nurse is appropriate?

The nurse is interviewing a new patient who is in the first trimester of her second pregnancy. The patient shares that her first child was born at 36 weeks gestation. Which information does the patient share that places the patient at risk for a second premature birth?

The nurse in a prenatal clinic is assessing a patient who is at 37 weeks gestation for twins. The patient reports increased discomfort and increased lower pelvic pressure. Which action does the nurse take with this patient?