Author:
TomWruble
ID:
186495
Filename:
NUR114 CH20
Updated:
2012-12-04 09:58:31
Tags:
nur114f Pregnancy Risk Preexisting Conditions
Folders:

Description:
Pregnancy at Risk: Preexisting Conditions
Show Answers:

  1. The main cause of diabetes-associated birth defects is ___ during the ___ trimester, when ___.
    • hyperglycemia
    • first
    • organ systems are forming
  2. Maternal complications for women with diabetes include ___, ___, ___, and ___.
    • miscarriage
    • infection
    • ketoacidosis
    • difficult labor
  3. The incidence of ___ malformations is related to the ___ and ___ of the diabetes.
    • congenital
    • severity and duration
  4. As pregnancy progresses, insulin requirements ___ for a woman with diabetes.
    increase
  5. Pregnant women with diabetes are much more likely to develop ___ than ___.
    • hypoglycemia
    • hyperglycemia
  6. Hyperthyroidism in pregnancy is ___, and hypothyroidism during pregnancy is ___ common than hyperthyroidism. 
    • rare
    • less
  7. Heart disease complicates ___ to ___ of pregnancies.
    0.5% to 2%
  8. The major cardiovascular changes of pregnancy that affect women who have cardiac disease include ___, ___, ___, and ___.
    • increased intravascular volume
    • decreased systemic vascular resistance
    • cardiac output changes during labor and birth
    • intravascular volume changes just after birth
  9. About ___ of women with mitral stenosis first become symptomatic during pregnancy.
    25%
  10. Anemia affects as many as ___ of pregnant women. 
    60%
  11. ___ may be the most common serious medical condition to complicate pregnancy.
    Asthma
  12. The effect of pregnancy on ___ is unpredictable.  
    asthma
  13. About ___ of patients with an autoimmune disease
    are women of childbearing age. 
    70%
  14. The nurse is caring for a woman with mitral stenosis who is in the active stage of labor. Which action should the nurse take to promote cardiac function?

    A. Maintain the woman in a side-lying position with the head and shoulders elevated to facilitate hemodynamics
    B. Prepare the woman for delivery by cesarean section because this is the recommended delivery method to sustain hemodynamics
    C. Encourage the woman to avoid the use of narcotics or epidural regional analgesia because this alters cardiac function
    D. Promote the use of the Valsalva maneuver during pushing in the second stage to improve diastolic ventricular filling
    A. Maintain the woman in a side-lying position with the head and shoulders elevated to facilitate hemodynamics
    (this multiple choice question has been scrambled)
  15. A ___ delivery is the preferred method of delivery for a woman with cardiac disease because it sustains hemodynamics better than a ___.
    • vaginal
    • cesarean section
  16. The use of supportive care, medication, and narcotics or epidural regional analgesia is OR is not contraindicated for a woman with heart disease.
    is not
  17. The use of the Valsalva maneuver during pushing in the second stage should be avoided because it ___ and ___.
    • reduces diastolic ventricular filling
    • obstructs left ventricular outflow
  18. 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:

    A. Mother’s age.
    B. Number of years since diabetes was diagnosed.
    C. Amount of insulin required prenatally.
    D. Degree of glycemic control during pregnancy.
    D. Degree of glycemic control during pregnancy.

    A, B and C have no impact.
    (this multiple choice question has been scrambled)
  19. Diabetes in pregnancy puts the fetus at risk in several ways. Nurses should be aware that:

    A. With good control of maternal glucose levels, sudden and unexplained stillbirth is no longer a major concern.
    B. The most important cause of perinatal loss in diabetic pregnancy is congenital malformations.
    C. Infants of mothers with diabetes have the same risks for respiratory distress syndrome because of the careful monitoring.
    D. At birth the neonate of a diabetic mother is no longer in any risk.
    B. The most important cause of perinatal loss in diabetic pregnancy is congenital malformations.
    (this multiple choice question has been scrambled)
  20. T/F: Diabetes in pregnancy puts the fetus at risk in several ways. Nurses should be aware that with good control of maternal glucose levels, sudden and unexplained stillbirth is no longer a major concern.
    FALSE
  21. Congenital malformations account for ___ of perinatal deaths.
    30% to 50%
  22. T/F: Diabetes in pregnancy puts the fetus at risk in several ways. Nurses should be aware that after birth the neonate of a diabetic mother is no longer in any risk.
    False: The transition to extrauterine life often is marked by hypoglycemia and other metabolic abnormalities
  23. T/F: With careful monitoring infants of mothers with diabetes have the same risks for respiratory distress syndrome as with non-diabetic mother.
    False: Infants of diabetic mothers are at increased risk for respiratory distress syndrome.
  24. A new mother with which of these thyroid disorders would be strongly discouraged from breastfeeding?

    A. Hyperthyroidism
    B. Phenylketonuria (PKU)
    C. Hypothyroidism
    D. Thyroid storm
    B. Phenylketonuria (PKU)

    PKU is a cause of mental retardation in infants; mothers with PKU pass on phenylalanine through breast milk.
    (this multiple choice question has been scrambled)
  25. PKU is a cause of ___ in infants; mothers with PKU pass on phenylalanine through breast milk.
    mental retardation
  26. While providing care in an obstetric setting, the nurse should understand that postpartum care of the woman with cardiac disease:

    A .Is the same as that for any pregnant woman.
    B. Includes rest, stool softeners, and monitoring of the effect of activity.
    C. Includes ambulating frequently, alternating with active range of motion.
    D. Includes limiting visits with the infant to once per day.
    B. Includes rest, stool softeners, and monitoring of the effect of activity.

    Bed rest may be ordered, with or without bathroom privileges. Bowel movements without stress or strain for the woman are promoted with stool softeners, diet, and fluid.
  27. T/F: While providing care in an obstetric setting, the nurse should understand that postpartum care of the woman with cardiac disease includes ambulating frequently, alternating with active range of motion.
    False: The woman will be on bed rest to conserve energy and reduce the strain on the heart.
  28. A woman with gestational diabetes has had little or no experience reading and interpreting glucose levels. She shows the nurse her readings for the past few days. Which one should the nurse tell her indicates a need for adjustment (insulin or sugar)?

    A. 75 mg/dl before lunch; this is low, better eat now
    B. 115 mg/dl 1 hour after lunch; this is a little high, maybe eat a little less next time
    C. 115 mg/dl 2 hours after lunch; this is too high, time for insulin
    D. 60 mg/dl just after waking up from a nap; this is too low, maybe eat a snack before going to sleep
    D. 60 mg/dl just after waking up from a nap; this is too low, maybe eat a snack before going to sleep
    (this multiple choice question has been scrambled)
  29. With gestational diabetes, any reading below ___  is too low. During hours of sleep glucose levels should not be under ___. Snacks before sleeping can be helpful.
    60 mg/dl
  30. The premeal acceptable range for blood glucose with women with gestational diabetes is ___ to ___ mg/dl.
    65 to 95
  31. With gestational diabetes the readings 1 hour after a meal should be less than ___ mg/dl.
    130
  32. With gestational diabetes the blood glucose readings two hours after eating should be under ___ mg/dl.
    120
  33. A woman with asthma is experiencing a postpartum hemorrhage. Which drug would NOT be used to treat her bleeding because it may exacerbate her asthma?

    A. Pitocin
    B. Nonsteroidal antiinflammatory drugs (NSAIDs)
    C. Hemabate
    D. Fentanyl
    C. Hemabate

    Prostaglandin derivatives should not be used to treat women with asthma, because they may exacerbate symptoms. Oxytocin is the recommended medication for uterine bleeding.
    (this multiple choice question has been scrambled)
  34. ___ should not be used to treat pregnant women with asthma, because they may exacerbate symptoms. ___ is the recommended medication for uterine bleeding.
    • Prostaglandin derivatives
    • Oxytocin (generic or trade named Pitocin)
  35. T/F: A woman with asthma is experiencing a postpartum hemorrhage. Fentanyl would NOT be used to treat her bleeding because it may exacerbate her asthma.
    F: Fentanyl is used to treat pain, not bleeding. Trade Pitocin(generic oxytocin) would be the drug of choice to treat this woman’s bleeding because it would not exacerbate her asthma.
  36. During a physical assessment of an at-risk patient, the nurse notes generalized edema, crackles at the base of the lungs, and some pulse irregularity. These are most likely signs of:

    A. Euglycemia.
    B. Rheumatic fever.
    C. Pneumonia.
    D. Cardiac decompensation.
    D. Cardiac decompensation.

    These symptoms of cardiac decompensation may appear abruptly or gradually.
    (this multiple choice question has been scrambled)
  37. With regard to anemia, nurses should be aware that:

    A. It is the most common medical disorder of pregnancy.
    B. It can trigger reflex brachycardia.
    C. The most common form of anemia is caused by folate deficiency.
    D. Thalassemia is a European version of sickle cell anemia.
    A. It is the most common medical disorder of pregnancy.

    Anemia is the most common medical disorder of pregnancy. Combined with any other complication, anemia can result in congestive heart failure.
    (this multiple choice question has been scrambled)
  38. T/F: Reflex tachycardia is the heart response to the blood flow that increases immediately after birth.
    False: reflex bradycardia
  39. T:F: The most common form of anemia is caused by folate deficiency.
    False: iron deficiency anemia
  40. The most common neurologic disorder accompanying pregnancy is:

    A. Eclampsia.
    B. Bell’s palsy.
    C. Epilepsy.
    D. Multiple sclerosis.
    C. Epilepsy.

    The effects of pregnancy on epilepsy are unpredictable.
    (this multiple choice question has been scrambled)
  41. Less than ___% of women who are substance abusers receive treatment for their addiction during pregnancy.
    10
  42. hydramnios
    an excess of amniotic (~2L)  fluid in the amniotic sac. It is seen in about 1% of pregnancies