Bleeding
A pregnant client presents with bright red vaginal bleeding at 32 weeks with no pain. What is the most likely diagnosis?
Placenta previa
What finding differentiates preeclampsia from gestational hypertension?
Proteinuria
What defines a reactive NST?
Two accelerations in 20 minutes
What hormone causes insulin resistance in pregnancy?
Human placental lactogen (hPL)
What is the most common cause of fetal growth restriction?
Maternal hypertension
A client has sudden abdominal pain, dark vaginal bleeding, and a firm uterus. What complication is occurring?
Placental abruption
A client has BP 168/112 with complaints of headache and blurred vision. What condition is this?
Preeclampsia with severe features
A non-reactive NST requires what next test?
Biophysical profile (BPP)
What 1-hour GTT result indicates a failed screen?
Greater than 140 mg/dL
What condition presents with itching of the palms and soles without a rash?
Cholestasis of pregnancy
A nurse is assessing a client with suspected placenta previa. Which action should be avoided?
Performing a vaginal exam
What medication is administered to prevent seizures in preeclampsia?
Magnesium sulfate
A BPP score of 4 indicates what?
Fetal hypoxia requiring delivery
A fetus of a diabetic mother is most at risk for what condition at birth?
Neonatal hypoglycemia
A client has unilateral abdominal pain and vaginal bleeding in early pregnancy. What should be suspected?
Ectopic pregnancy
A client presents with tachycardia, hypotension, and abdominal rigidity but no visible vaginal bleeding. What condition should the nurse suspect?
Concealed placental abruption
A client receiving magnesium sulfate becomes lethargic with a respiratory rate of 10. What is the nurse’s priority action?
Administer calcium gluconate
A client reports decreased fetal movement. What is the FIRST test the nurse should anticipate?
Nonstress test (NST)
A pregnant client has persistent vomiting, weight loss, and dehydration. What condition is this?
Hyperemesis gravidarum
A client has recurrent pregnancy loss and is diagnosed with an autoimmune disorder that increases clotting. What is the condition?
Antiphospholipid syndrome
A pregnant client with chronic hypertension develops sudden uterine pain, decreased fetal movement, and a non-reassuring fetal heart rate tracing. What is the priority diagnosis and rationale?
Placental abruption due to compromised placental perfusion and possible fetal hypoxia
A client presents with RUQ pain, fatigue, platelet count of 90,000, and elevated liver enzymes. Blood pressure is 138/88. What is the diagnosis and why can it be missed?
HELLP syndrome; it can occur without severe hypertension, making it harder to recognize
A fetus shows no accelerations, decreased tone, minimal movement, and low amniotic fluid. What is the expected BPP score and priority intervention?
Score ≤4; immediate delivery due to fetal hypoxia
Explain why maternal hyperglycemia leads to polyhydramnios in the fetus.
Fetal hyperglycemia causes osmotic diuresis (polyuria), increasing amniotic fluid volume
A fetus is small for gestational age, and the mother has a history of smoking, hypertension, and poor nutrition. Explain the underlying pathophysiology affecting fetal growth.
Uteroplacental insufficiency leading to decreased oxygen and nutrient delivery to the fetus