Exam 31: Obstetric Critical Care

A pregnant woman at term is transported to the emergency department (ED)after a severe vehicular accident.The obstetric nurse responds and rushes to the ED with a fetal monitor.Cardiopulmonary arrest occurs as the obstetric nurse arrives.The first thing for the ED and obstetric team to do is to:

Pregnancy is a ______________________ state,as preparation is made for the blood loss that accompanies childbirth.

Conditions that classify the parturient as critically ill and indicate the need for a pulmonary catheter include:

A pregnant woman at 33 weeks of gestation is brought to the birthing unit after a minor automobile accident.She has no pain and no vaginal bleeding,her vital signs are stable,and the fetal heart rate (FHR)is 132 with variability.The nurse should:

Removal of the stressor of pregnancy early in the process of resuscitation may increase the chance for maternal survival.Therefore,in the presence of multisystem trauma,_________________________ may be indicated.

A nurse caring for a critically ill pregnant woman at 36 weeks of gestation with a pulmonary artery catheter in place obtains the following hemodynamic profile: CVP,3 mm Hg;PAP,40/18 mm Hg;PCWP,18 mm Hg;CO,7 L/min.The nurse administers a diuretic drug as ordered for the client.From evaluation of the hemodynamic profile,the nurse recognizes that this drug was given to treat:

A nurse assessing for internal hemorrhage after blunt abdominal trauma in a pregnant woman at 28 weeks of gestation most closely observes for:

It is extremely rare for a woman to die in childbirth;however,it does happen.In the United States the yearly occurrence is 12 maternal deaths per 100,000 cases of live birth.Leading causes of maternal death are:

Obstetric nurses have been comfortable providing family-centered maternity care for many years.Many intensive care units (ICUs)are adopting a family-centered care philosophy;however,being far from the obstetric unit makes it much more difficult should a maternity client be transferred to this setting.What action would the nurse encourage to promote family-centered maternity care?

A nurse caring for a critically ill pregnant woman at 36 weeks of gestation with a pulmonary artery catheter in place obtains the following hemodynamic profile: CVP,3 mm Hg;PAP,40/18 mm Hg;PCWP,18 mm Hg;CO,7 L/min.The nurse interprets the hemodynamic profile as correlating with:

A pregnant woman at 38 weeks of gestation has severe preeclampsia with refractory oliguria.A pulmonary artery catheter is inserted,and the following hemodynamic profile is obtained: CVP,2 mm Hg;PAP,17/4 mm Hg;PCWP,4 mm Hg;CO,5.1 L/min.One hour after treatment the hemodynamic profile changes to the following: CVP,2 mm Hg;PAP,25/7 mm Hg;PCWP,7 mm Hg;CO,6.4 L/min.The nurse evaluates the woman's condition as:

A nurse caring for a pregnant woman at 32 weeks of gestation with the diagnosis of severe preeclampsia with pulmonary edema is assisting with the insertion of a pulmonary artery catheter (PAC).As the catheter enters the right ventricle,the main priority of nursing assessment is to: