NUR114 CH21

Card Set Information

Author:
TomWruble
ID:
186583
Filename:
NUR114 CH21
Updated:
2012-12-04 16:42:48
Tags:
nur114f Pregnancy Risk Gestational Conditions
Folders:

Description:
Pregnancy at Risk: Gestational Conditions
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user TomWruble on FreezingBlue Flashcards. What would you like to do?


  1. The four most common types of hypertensive disorders during pregnancy are ___, ___, ___, and ___.
    • gestational hypertension
    • preeclampsia
    • chronic hypertension
    • preeclampsia superimposed on chronic hypertension
  2. Gestational hypertension is hypertension with OR without proteinuria that develops after week ___ of gestation
    • without
    • 20
  3. Preeclampsia is a condition in which ___ and ___ develop after ___ weeks of gestation or early in the ___ in a previously normotensive woman. Preeclampsia complicates ___ to ___ of all pregnancies.
    • hypertension and proteinuria
    • 20
    • puerperium - after birth
    • 3% to 7%
  4. TORCH
    infections Infections caused by organisms that damage the embryo or fetus; acronym for:

    • Toxoplasmosis
    • Other (e.g.,syphilis)
    • Rubella
    • Cytomegalovirus - Human cytomegalovirus
    • Herpes simplex virus
  5. ___ is hypertension that begins before pregnancy or is diagnosed before ___ weeks of gestation.
    • Chronic hypertension
    • 20
  6. Preeclampsia superimposed on chronic hypertension increases ___ for the mother and fetus.
    morbidity
  7. HELLP syndrome, a variant of ___, involves ___ characterized by ___, ___ and ___>
    • Severe preeclampsia
    • Hepatic dysfunction
    • Hemolysis (H)
    • Elevated liver enzymes (EL)
    • Low platelets (LP).
  8. Women diagnosed with severe gestational hypertension or severe preeclampsia should be hospitalized ___.
    for a 24-hour observation period
  9. ___ is the drug of choice for preventing and treating ___ caused by preeclampsia.
    • Magnesium sulfate
    • convulsions
  10. After a woman experiences preeclampsia the first time, the chances that she will experience it in a future pregnancy increase ___.
    sevenfold
  11. The pregnant woman with hyperemesis gravidarum may experience ___, ___, ___, ___ and ___.
    • weight loss
    • dehydration
    • electrolyte imbalances
    • nutritional deficiencies
    • ketonuria
  12. Common bleeding disorders of early pregnancy include ___, ___, ___ and ___.
    • miscarriage (spontaneous abortion)
    • premature dilation of the cervix
    • ectopic pregnancy
    • hydatidiform mole.
  13. Medical management of recurrent premature dilation of the cervix includes ___, ___, ___, ___ and  ___. Surgical management consists of placing a ___.
    • bed rest
    • pessaries (medical device inserted into the vagina, either to provide structural support, or as a method of delivering medication)
    • antibiotics
    • antiinflammatory drugs
    • progesterone supplementation

    cervical cerclage
  14. The three classic symptoms of ectopic (or tubal) pregnancy are ___, ___ and ___.
    • abdominal pain
    • delayed menses
    • abnormal vaginal bleeding (spotting) 6 to 8 weeks after the last normal menstrual period
  15. The major causes of bleeding in late pregnancy are ___ and ___.  
    • placenta previa
    • premature separation of the placenta
  16. disseminated intravascular coagulation
    DIC leads to the formation of small blood clots inside the blood vessels throughout the body. As the small clots consume coagulation proteins and platelets, normal coagulation is disrupted and abnormal bleeding occurs from the skin (e.g. from sites where blood samples were taken), the gastrointestinal tract, the respiratory tract and surgical wounds. The small clots also disrupt normal blood flow to organs (such as the kidneys), which may malfunction as a result.
  17. disseminated intravascular coagulation can be trigered by ___, ___ and ___.
    • Severe preeclampsia
    • HELLP syndrome
    • gram-negative sepsis
  18. The most common medical complication of pregnancy is ___.
    urinary tract infection
  19. Urinary tract infection is:

    A. The most common medical complication of pregnancy.
    B. The most common medical disorder of pregnancy.
    C. The most common serious medical condition to complicate pregnancy.
    A. The most common medical complication of pregnancy.
    (this multiple choice question has been scrambled)
  20. Asthma may be:

    A. The most common medical complication of pregnancy.
    B. The most common medical disorder of pregnancy.
    C. The most common serious medical condition to complicate pregnancy.
    C. The most common serious medical condition to complicate pregnancy.
    (this multiple choice question has been scrambled)
  21. Anemia is:

    A. The most common medical complication of pregnancy.
    B. The most common medical disorder of pregnancy.
    C. The most common serious medical condition to complicate pregnancy.
    B. The most common medical disorder of pregnancy.
    (this multiple choice question has been scrambled)
  22. pyelonephritis
    an ascending urinary tract infection that has reached the pyelum or pelvis of the kidney.
  23. A pregnant woman diagnosed with pyelonephritis should be ___. 
    admitted to the hospital immediately and treated with IV antibiotics
  24. During pregnancy, the most common nongynecologic abdominal conditions requiring surgery are ___ and ___.
    • appendicitis
    • symptomatic cholelithiasis

    symptomatic gallstones
  25. Major trauma complicatesabout ___% of pregnancies, and trauma is the ___ cause of nonobstetric maternal death.
    • 8
    • leading
  26. A woman with severe preeclampsia is receiving a magnesium sulfate infusion. The nurse becomes concerned after assessment when the woman exhibits:

    A. Absent ankle clonus.
    B. Deep tendon reflexes of 2.
    C. A sleepy, sedated affect.
    D. A respiratory rate of 10 breaths/min.
    D.A respiratory rate of 10 breaths/min.

    A respiratory rate of 10 breaths/min indicates that the woman is experiencing respiratory depression from magnesium toxicity.
    (this multiple choice question has been scrambled)
  27. A respiratory rate of 10 breaths/min indicates that the woman is experiencing respiratory depression from magnesium toxicity.
    Average resting respiratory rates by age:

    • birth to 6 weeks: 30-60
    • 6 months: 25-40
    • 3 years: 20-30
    • 6 years: 18-25
    • 10 years: 15-20
    • adults: 12-20 breaths per minute
  28. T/F: A woman with severe preeclampsia is receiving a magnesium sulfate infusion. The nurse becomes concerned after assessment when the woman exhibits a sleepy, sedated affect.
    False: Because magnesium sulfate is a central nervous system depressant, the woman will most likely become sedated when the infusion is initiated.
  29. clonus
    is a series of involuntary, rhythmic, muscular contractions and relaxations. Clonus is a sign of certain neurological conditions, particularly associated with upper motor neuron lesions involving descending motor pathways, and in many cases is, accompanied by spasticity (another form of hyperexcitability). Unlike small, spontaneous twitches known as fasciculations (usually caused by lower motor neuron pathology), clonus causes large motions that are usually initiated by a reflex. Studies have shown clonus beat frequency to range from 3-8 Hertz (Hz) on average.
  30. Deep tendon reflexes of ___ is a normal finding.
    2
  31. The nurse is preparing to discharge a 30-year-old woman who has experienced a miscarriage at 10 weeks of gestation. Which statement by the woman would indicate a correct understanding of the discharge instructions?

    A. “I will not experience mood swings since I was only at 10 weeks of gestation.”
    B. “I will avoid sexual intercourse for 6 weeks and pregnancy for 6 months.”
    C. “I should eat foods that are high in iron and protein to help my body heal.”
    D. “I should expect the bleeding to be heavy and bright red for at least 1 week.”
    C. “I should eat foods that are high in iron and protein to help my body heal.”

    A woman who has experienced a miscarriage should be advised to eat foods that are high in iron and protein to help replenish her body after the loss.
    (this multiple choice question has been scrambled)
  32. A woman who has experienced a miscarriage should be advised to eat foods that are high in ___ and ___ to help replenish her body after the loss.
    iron and protein
  33. After a miscarriage a woman may experience mood swings and depression as a result of the ___ and ___.
    • reduction of hormones
    • the natural grieving process
  34. Woman who has experienced a miscarriage at 10 weeks of gestation: Sexual intercourse should be avoided for ___ or ___ and pregnancy should be avoided for ___.
    • 2 weeks
    • until the bleeding has stopped
    • 2 months
  35. T/F: The nurse is preparing to discharge a 30-year-old woman who has experienced a miscarriage at 10 weeks of gestation. “I should expect the bleeding to be heavy and bright red for at least 1 week.”
    False: The woman should not experience bright red, heavy, profuse bleeding; if such occurs, it should be reported to the health care provider.
  36. Because pregnant women may need surgery during pregnancy, nurses should be aware that:

    A. Surgery for intestinal obstructions should be delayed as long as possible because it usually affects the pregnancy.
    B. The diagnosis of appendicitis may be difficult to make, because the normal signs and symptoms mimic some normal changes in pregnancy.
    C. Rupture of the appendix is less likely in pregnant women because of the close monitoring.
    D. When pregnancy takes over, a woman is less likely to have ovarian problems that require invasive responses.
    B. The diagnosis of appendicitis may be difficult to make, because the normal signs and symptoms mimic some normal changes in pregnancy.

    Both appendicitis and pregnancy are linked with nausea, vomiting, and increased white blood cell count.
    (this multiple choice question has been scrambled)
  37. Both appendicitis and pregnancy are linked with ___, ___, and ___.
    • nausea
    • vomiting
    • increased white blood cell count
  38. Rupture of the appendix is ___ likely in pregnant women.
    two to three times more
  39. Surgery to remove intestinal obstructions in pregnant women should be done ___. It ___the pregnancy.
    • right away
    • usually does not affect
  40. T/F: When pregnancy takes over, a woman is less likely to have ovarian problems that require invasive responses.
    False - Pregnancy predisposes a woman to ovarian problems.
  41. In caring for an immediate postpartum woman, you note petechiae and oozing from her IV site. You would monitor her closely for the clotting disorder:

    A. Amniotic fluid embolism (AFE)
    B. HELLP syndrome
    C. Disseminated intravascular coagulation (DIC)
    D. Hemorrhage
    C. Disseminated intravascular coagulation (DIC)

    The diagnosis of DIC is made according to clinical findings and laboratory markers. Physical examination reveals unusual bleeding. Petechiae may appear around a blood pressure cuff on the woman’s arm. Excessive bleeding may occur from the site of a slight trauma such as venipuncture sites.
    (this multiple choice question has been scrambled)
  42. Amniotic fluid embolism
     a rare and incompletely understood obstetric emergency in which amniotic fluid, fetal cells, hair, or other debris enters the mother's blood stream via the placental bed of the uterus and trigger an allergic reaction. This reaction then results in cardiorespiratory (heart and lung) collapse and coagulopathy.
  43. T/F: Immediate postpartum woman, you note petechiae and oozing from her IV site. You would monitor her closely for the clotting disorder hemorrhage
    False: Hemorrhage occurs for a variety of reasons in the postpartum woman. These symptoms are associated with DIC. Hemorrhage would be a finding associated with DIC and is not a clotting disorder in and of itself.
  44. T/F: Immediate postpartum woman, you note petechiae and oozing from her IV site. You would monitor her closely for the clotting disorder: HELLP syndrome
    False: HELLP is not a clotting disorder, but it may contribute to the clotting disorder DIC.
  45. A woman with severe preeclampsia has been receiving magnesium sulfate by intravenous infusion for 8 hours. The nurse assesses the woman and documents the following findings: temperature of 37.1° C, pulse rate of 96 beats/min, respiratory rate of 24 breaths/min, blood pressure (BP) of 155/112 mm Hg, 3+ deep tendon reflexes, and no ankle clonus. The nurse calls the physician, anticipating an order for:

    A. Diazepam.
    B. Hydralazine.
    C. Magnesium sulfate bolus.
    D. Calcium gluconate.
    B. Hydralazine.

    Hydralazine is an antihypertensive commonly used to treat hypertension in severe preeclampsia. Typically it is administered for a systolic BP over 160 mm Hg or a diastolic BP over 110 mm Hg.
    (this multiple choice question has been scrambled)
  46. ___ may be ordered for increasing signs of central nervous system irritability related to severe preeclampsia (e.g., clonus or DTR of +3/+4) or if eclampsia develops.
    An additional bolus of magnesium sulfate
  47. ___ sometimes is used to stop or shorten eclamptic seizures.
    Diazepam
  48. ___ is used as the antidote for magnesium sulfate toxicity. Signs or symptoms of magnesium toxicity are ___, ___, ___ or ___.
    • Calcium gluconate
    • Loss of pateller reflexes
    • Respiratory depression, <= 12 RR
    • Oliguria, < 25-30 mL/hr
    • Decreased level of conciousness
  49. Nurses should be aware that HELLP syndrome:

    A. Is associated with preterm labor but not perinatal mortality.
    B. Is characterized by hemolysis, elevated liver enzymes, and low platelets.
    C. Is a mild form of preeclampsia.
    D. Can be diagnosed by a nurse alert to its symptoms.
    B. Is characterized by hemolysis, elevated liver enzymes, and low platelets.

    The acronym HELLP stands for hemolysis (H), elevated liver enzymes (EL), and low platelets (LP).
    (this multiple choice question has been scrambled)
  50. T/F: HELLP syndrome is a mild form of preeclampsia.
    False: HELLP syndrome is a variant of severe preeclampsia.
  51. T/F: Nurses should be aware that HELLP syndrome cannot be diagnosed by a nurse alert to its symptoms.
    True: HELLP syndrome is difficult to identify because the symptoms often are not obvious. It must be diagnosed in the laboratory.
  52. T/F: HELLP syndrome is associated with greatly increased preterm labor and perinatal mortality.
    True
  53. A woman at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes; dark red vaginal bleeding; and a tense, painful abdomen. The nurse suspects the onset of:

    A. Rupture of the uterus.
    B. Eclamptic seizure.
    C. Placental abruption.
    D. Placenta previa.
    C. Placental abruption.

    Uterine tenderness in the presence of increasing tone may be the earliest finding of premature separation of the placenta (abruptio placentae or placental abruption). Women with hypertension are at increased risk for an abruption.
    (this multiple choice question has been scrambled)
  54. Eclamptic seizures are evidenced by the presence of ___.
    generalized tonic-clonic convulsions
  55. T/F: A woman at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes; dark red vaginal bleeding; and a tense, painful abdomen. The nurse suspects the onset of placenta previa.
    False: Placenta previa presents with bright red, painless vaginal bleeding.
  56. Bleeding disorders in late pregnancy include all of the following except:

    A. Placenta previa.
    B. Spontaneous abortion.
    C. Abruptio placentae.
    D. Cord insertion.
    B. Spontaneous abortion.

    Spontaneous abortion is another name for miscarriage; by definition it occurs early in pregnancy.
    (this multiple choice question has been scrambled)
  57. The nurse is caring for a woman who is at 24 weeks of gestation with suspected severe preeclampsia. Which signs and symptoms would the nurse expect to observe? Select all that apply.

    A. Decreased urinary output and irritability
    B. Transient headache and +1 proteinuria
    C. Ankle clonus and epigastric pain
    D. Platelet count of less than 100,000/mm3 and visual problems
    E. Seizure activity and hypotension
    A, C, D
  58. A transient headache and +1 proteinuria are signs of ___ and should be monitored.
    preeclampsia
  59. Seizure activity and hyperreflexia are signs of ___.
    eclampsia
  60. ___ is responsible for 10% to 15% of all maternal mortality and is the leading cause of infertility.
    Ectopic pregnancy
  61. The condition in which the placenta is implanted in the lower uterine segment near or over the internal cervical os is ___.
    placenta previa
  62. Eclampsia
    Occurs more often in primagravida than in multiparous women; results in new-onset grand mal seizures during pregnancy or shortly after birth.
  63. cerclage
    Use of a nonabsorbable suture to keep a premature dilating cervix closed; usually removed when pregnancy is at term
  64. disseminated intravascular coagulation (DIC)
    Pathologic form of coagulation in which clotting factors are consumed to such anextent that generalized bleeding can occur; associated with:

    • abruptio placentae
    • eclampsia
    • intrauterine fetal demise
    • amniotic fluid embolism
    • hemorrhage
  65. ectopic pregnancy
    Implantation of the fertilized ovum outside of the uterine cavity; locations include the uterine tubes, ovaries, and abdomen
  66. hydatidiform mole
    (molar pregnancy) Gestational trophoblastic neoplasm usually resulting from fertilization of an egg that has no nucleus or an inactivated nucleus

What would you like to do?

Home > Flashcards > Print Preview