Preeclampsia
The nurse is caring for a patient admitted for preeclampsia. Which of the following assessments is the most significant for her care at this time:
BP 160/82, RR 12, 320 mL urine output for the past 4 hours, DTR 4+, pitting pedal edema
DTR 4+
A patient arrives in the labor triage area who is in the third trimester. She has been having bright red vaginal bleeding on and off for 2 days. The nurse suspects what condition for this patient?
placenta previa
The age at which testing for hyperbilirubinemia is initially completed
12 hours via Transcutaneous meter (Tcbili)
Verifying pregnancy to determine estimated due date is best completed by:
ultrasound in the first trimester
name 3 signs of neonatal respiratory distress
nasal flaring
sternal retractions
grunting
Which of the following medications is indicated for severe preeclampsia and why?
magnesium sulfate, oxytocin, betamethasone
magnesium sulfate to prevent seizures
A patient arrives in the labor triage unit with vaginal bleeding and abdominal pain for several hours. What condition dose the nurse suspect?
placental abruption
Describe the blood type scenario that puts a newborn at risk for hyperbilirubinemia
Anytime mom is antibody + (indirect Coombs test)
Mom Rh neg and infant Rh positive
to a lesser extent if mom is O and baby is A,B or AB
A patient has been told she has a molar pregnancy. Which of the following statements demonstrates understanding of this condition?
- what is the due date for the baby?
-The products of conception did not result in a viable pregnancy
-I will need to be on bedrest during my pregnancy
The products of conception did not result in a viable pregnancy
Vitamin K is given to the newborn to:
prevent hemorrhage/bleeding
(not to increase clotting)
The nurse is caring for a woman who arrives in the labor triage unit with the following symptoms: contractions every 10 minutes last 45-60 seconds for about 2 hours, pressure in her coccyx area over the past 45 minutes, complaining of a terrible headache and blurred vision over the past 24 hours. What is a priority assessment at this time?
check the woman's BP
headache and blurred vision can be signs of preeclampsia
A patient has a history of four previous cesarean deliveries. During the third stage of labor the placenta will not detach. Name the possible complication
placenta accreta
A direct Coombs test is ordered when:
How is it obtained?
Baby is Rh + and mom is Rh neg
preferably the blood is obtained from the cord blood
A woman is in the ED with right sided pelvic pain and bright red vaginal bleeding. She has been experiencing nausea and vomiting. Her LMP was 6-7 weeks ago. The nurse suspects which of the following conditions for this patient?
Molar pregnancy
Ectopic pregnancy
Hyperemesis gravidarum
Ectopic pregnancy
If a patient experiences prolonged bleeding or acute large blood loss during pregnancy, labor or postpartum they are at risk for this condition
DIC, disseminated intravascular coagulopathy
A patient is on magnesium sulfate IV infusion for preeclampsia and an oxytocin infusion to induce labor due to her preeclampsia.
Identify a priority postpartum complication for this patient
postpartum hemorrhage
A patient with a diagnosed complete placenta previa at 38 weeks gestation is requesting a VBAC. The priority education for this patient is:
Due to the placenta previa, a cesarean delivery is necessary
A newborn has a high risk result from a Tcbili at 36 hours of age. What should the nurse do next?
Obtain a heal stick for serum level
A patient is demonstrating eclampsia during a delivery, what is the priority position for this patient?
Side lying
This medication is contraindicated for postpartum hemorrhage for a woman who has hypertension
methergine
A patient in labor is on magnesium sulfate for preeclampsia. She has been identified as high risk for a seizure by her OB provider. Identify a priority nursing intervention for this patient.
Maintain Safety: make sure the side rails are in the raised position and padded
seizure precautions
A woman who is at 38 weeks gestation is in a car accident and arrives in the triage unit abdominal pain, no contractions and no vaginal bleeding. What diagnostic testing is necessary at this time
ultrasound to evaluate the placenta for concealed abruption
List three nursing interventions for a neonate under bili lights
cover their eyes
monitor for dehydration
monitor infant's temperature
monitor infant skin for breakdown
reposition at least every two hours
encourage frequent breast feeding/oral intake
Testing for gestational diabetes is generally assess at weeks of gestation _______ using what type of testing?
24-28 weeks of gestation
using glucose tolerance test
Priority assessment prior to obtaining an amniocenteses
determining the woman's blood type