Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
1. A woman in labor has
sharp fundal pain accom-
panied by slight vagi-
nal bleeding. What is
the most likely cause of
these symptoms?
2. A woman is admitted with
a diagnosis of ectopic
pregnancy. For which ac-
tion would the nurse an-
ticipate beginning prepa-
ration?
3. A nurse in the materni-
ty triage unit is caring
for a client with a sus-
pected ectopic pregnan-
cy. Which nursing inter-
vention should the nurse
perform first?
4. A nurse has been as-
signed to assess a preg-
nant client for abrup-
tio placenta. For which
classic manifestation of
this condition should the
nurse assess?
5. The nurse is caring for
a pregnant client with
fallopian tube rupture.
Which intervention is the
priority for this client?
6.
N. Premature separation of the placenta
Premature separation of the placenta begins with
sharp fundal pain, usually followed by vaginal
bleeding.
N. Immediate surgery
Ectopic pregnancy means an embryo has im-
planted outside the uterus, usually in the fallop-
ian tube. Surgery is usually necessary to remove
the growing structure before the tube ruptures or
repair the tube if rupture has already occurred.
N. Assess the client's vital signs.
A suspected ectopic pregnancy can put the client
at risk for hypovolemic shock. The assessment of
vital signs should be performed first, followed by
any procedures to maintain the ABCs.
N. "Knife-like" abdominal pain with vaginal bleed-
ing
The classic manifestations of abruption placenta
are painful dark red vaginal bleeding, "knife-like"
abdominal pain, uterine tenderness, contrac-
tions, and decreased fetal movement.
N. Monitor the client's vital signs and bleeding.
A nurse should closely monitor the client's vital
signs and bleeding (peritoneal or vaginal) to iden-
tify hypovolemic shock that may occur with tubal
rupture.
N. Low placental implantation
1 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
What would be the physi-
ologic basis for a placen-
ta previa?

7. A woman with an in- N. Ensures passage of all the products of concep-

complete abortion is to tion
receive misoprostol. The
woman asks the nurse, Misoprostol is used to stimulate uterine contrac-
"Why am I getting this tions and evacuate the uterus after an abortion to
drug?" The nurse re- ensure passage of all the products of conception.
sponds to the client, in-
tegrating understanding
that this drug achieves
which effect?

8. A woman in week 16 of N. To determine whether gestational trophoblastic

her pregnancy calls her disease is present
primary care provider's
office to report that she Gestational trophoblastic disease is abnormal
has experienced abdomi- proliferation and then degeneration of the tro-
nal cramping, cervical di- phoblastic villi. The embryo fails to develop be-
lation, vaginal spotting, yond a primitive start. Abnormal trophoblast cells
and the passing of tissue. must be identified because they are associat-
The nurse instructs the ed with choriocarcinoma, a rapidly metastasizing
client to bring the passed malignancy. This is why it is important for any
tissue to the hospital with woman who begins to miscarry at home to bring
her. What is the correct any clots or tissue passed to the hospital with her.
rationale for this instruc- The presence of clear fluid-filled cysts changes
tion? the diagnosis from a simple miscarriage to gesta-
tional trophoblastic disease.

9. A client with a histo- N. "Purse-string sutures are placed in the cervix

ry of cervical insuffi-
ciency is seen for re-
ports of pink-tinged dis-
charge and pelvic pres-
sure. The primary care
provider decides to per-
form a cervical cerclage.
to prevent it from dilating."
The cerclage, or purse string suture is inserted
into the cervix to prevent preterm cervical dilata-
tion and pregnancy loss. Staples, glue, or a cer-
vical cap will not prevent the cervix from dilating.

2 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
The nurse teaches the
client about the proce-
dure. Which client re-
sponse indicates that the
teaching has been effec-
tive?

10. A 32-year-old gravida 3 N. Palpate the fundus, and check fetal heart rate.
para 2 at 36 weeks' gesta-
tion comes to the obstet- The classic signs of abruptio placentae are pain,
ric department report- dark red vaginal bleeding, a rigid, board-like ab-
ing abdominal pain. Her domen, hypertonic labor, and fetal distress.
blood pressure is 164/90
mm/Hg, her pulse is 100
beats per minute, and her
respirations are 24 per
minute. She is restless
and slightly diaphoretic
with a small amount of
dark red vaginal bleed-
ing. What assessment
should the nurse make
next?

11. A 28-year-old woman pre- N. Ectopic pregnancy

sents in the emergency
department with severe Ectopic pregnancy can present with severe uni-
abdominal pain. She has lateral abdominal pain. Given the history of the
not had a normal period client and the amount of pain, the possibility of
for 2 months, but she re- ectopic pregnancy needs to be considered. A
ports that that is not ab- healthy pregnancy would not present with severe
normal for her. She has abdominal pain unless the client were term and
a history of endometrio- she was in labor.
sis. What might the nurse
suggest to the primary
care provider as a possi-
ble cause of the client's
abdominal pain?

3 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
12. A woman of 16 weeks' N. "Come to the health facility with any vaginal
gestation telephones the material passed."
nurse because she has
passed some "berry-like" This is a typical time in pregnancy for gestation-
blood clots and now has al trophoblastic disease to present. Asking the
continued dark brown woman to bring any material passed vaginally
vaginal bleeding. Which would be important so it can be assessed for this.
action would the nurse
instruct the woman to
do?

13. A pregnant woman is N. Sudden dark, vaginal bleeding

diagnosed with abruptio
placentae. When review-
ing the woman's medical
record, the nurse would
expect which finding?
The uterus is firm to rigid to the touch with abrup-
tio placentae; it is soft and relaxed with placenta
previa. Bleeding associated with abruptio placen-
tae occurs suddenly and is usually dark in color.

14. When assessing a preg- N. Slight vaginal bleeding

nant woman with vagi-
nal bleeding, the nurse
would suspect a threat-
ened abortion based on
which finding?
Slight vaginal bleeding early in pregnancy, no
cervical dilation, and a closed cervical os are
associated with a threatened abortion.

15. A 16-year-old client gave N. "Spontaneous abortion is a more specific term

birth to a 12 weeks' ges- used to describe a spontaneous miscarriage,
tation fetus last week. which is a loss of pregnancy before 20 weeks.
The client has come to This term does not imply that you did anything to
the office for follow-up affect the pregnancy."
and while waiting in an
examination room no-
tices that on the sched-
ule is written her name
and "follow-up of spon-
taneous abortion." The
client is upset about what
is written on the sched-
ule. How can the nurse

4 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
best explain this termi-
nology?

16. A pregnant woman has N. Strong abdominal cramping

arrived to the office re-
porting vaginal bleeding. Strong abdominal cramping is associated with an
Which finding during the inevitable spontaneous abortion.
assessment would lead
the nurse to suspect an
inevitable abortion?

17. A woman at 8 weeks' ges- N. Use of IUD for contraception

tation is admitted for ec-
topic pregnancy. She is
asking why this has oc-
curred. The nurse knows
that which factor is a
known risk factor for ec-
topic pregnancy?
Use of an IUD with progesterone has a known
increased risk for development of ectopic preg-
nancies. The nurse needs to complete a full his-
tory of the client to determine if she had any other
risk factors for an ectopic pregnancy. Adhesions,
scarring, and narrowing of the tubal lumen may
block the zygote's progress to the uterus. Any
condition or surgical procedure that can injure a
fallopian tube increases the risk.

18. A pregnant client has N. Gestational trophoblastic disease

been admitted with re-
ports of brownish vaginal The client is most likely experiencing gestational
bleeding. On examination trophoblastic disease or a molar pregnancy. In
there is an elevated hCG gestational trophoblastic disease or molar preg-
level, absent fetal heart nancy, there is an abnormal proliferation and
sounds, and a discrep- eventual degeneration of the trophoblastic villi.
ancy between the uterine
size and the gestational
age. The nurse interprets
these findings to suggest
which condition?

19. After a regular prenatal
visit, a pregnant client
asks the nurse to de-
scribe the differences be-
N. "Placenta previa causes painless, bright red
bleeding during pregnancy due to an abnormally
implanted placenta that is too close to or covers
the cervix; abruptio placenta is associated with
5 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
tween abruptio placen-
ta and placenta previa.
Which statement should
the nurse include in the
teaching?
20. After an examination, a
client has been deter-
mined to have an unrup-
tured ectopic pregnancy.
Which medication would
the nurse anticipate be-
ing prescribed?
21. A client in her 38th week
of gestation is admitted
into the labor and birth
unit with painless bleed-
ing from the vagina. The
client is diagnosed with
placenta previa. When re-
viewing the client's histo-
ry, which factor would the
nurse identify as a risk
factor for placenta pre-
via?
22. A 35-year-old client is
seen for her 2-week post-
operative appointment
after a suction curettage
was performed to evacu-
ate a hydatidiform mole.
The nurse explains that
the human chorionic go-
dark red painful bleeding caused by premature
separation of the placenta from the wall of the
uterus before the end of labor."
Placenta previa is a condition of pregnancy in
which the placenta is implanted abnormally in the
lower part of the uterus and is the most common
cause of painless bright red bleeding in the third
trimester.
N. Methotrexate
Methotrexate, a folic acid antagonist that inhibits
cell division in the developing embryo, is most
commonly used to treat ectopic pregnancy.
N. Previous cesarean birth
A previous cesarean birth is a risk factor for devel-
oping placenta previa. This is due to the damage
caused to the endometrial tissue.
N. "A contraceptive is used so that a positive
pregnancy test resulting from a new pregnancy
will not be confused with the increased level of
hCG that occurs with a developing malignancy."
Because of the risk of choriocarcinoma, the
woman receives extensive treatment. Therapy in-
cludes baseline chest X-ray to detect lung metas-
6 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
nadotropin (hCG) levels
will be reviewed every 2
weeks and teaches about
the need for reliable con-
traception for the next
6 months to a year. The
client states, "I'm 35 al-
ready. Why do I have to
wait that long to get preg-
nant again?" What is the
nurse's best response?
23. A client has been ad-
mitted with abruptio pla-
centae. She has lost
1,200 mL of blood, is
normotensive, and ultra-
sound indicates approx-
imately 30% separation.
The nurse documents
this as which classifica-
tion of abruptio placen-
tae?
24. A client is admitted at
22 weeks' gestation with
advanced cervical dilata-
tion to 5 centimeters, cer-
vical insufficiency, and
a visible amniotic sac
at the cervical opening.
What is the primary goal
tasis physical exam including pelvic exam. Serum
B-hCG levels weekly until negative results are
obtained three consecutive times, then monthly
for 6 to 12 months. The woman is cautioned to
avoid pregnancy during this time because the in-
creasing B-hCG levels associated with pregnan-
cy would cause confusion as to whether cancer
had developed. If after a year B-hCG seruim titers
are within normal levels, a normal pregnancy can
be achieved.
N. Grade 2
The classifications for abruptio placentae are:
grade 1 (mild) - minimal bleeding (less than 500
mL), 10% to 20% separation, tender uterus, no
coagulopathy, signs of shock or fetal distress;
grade 2 (moderate) - moderate bleeding (1,000
to 1,500 mL), 20% to 50% separation, continu-
ous abdominal pain, mild shock, normal mater-
nal blood pressure, maternal tachycardia; grade
3 (severe) - absent to moderate bleeding (more
than 1,500 mL), more than 50% separation, pro-
found shock, dark vaginal bleeding, agonizing ab-
dominal pain, decreased blood pressure, signifi-
cant tachycardia, and development of disseminat-
ed intravascular coagulopathy. There is no grade
4
N. Bed rest to maintain pregnancy as long as
possible
At 22 weeks' gestation, the fetus is not viable. The
woman would be placed on bed rest, total, with
every attempt made to halt any further progres-
sion of dilatation as long as possible. The nurse
would not want this fetus to be born vaginally at
this stage of gestation
7 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
for this client at this
point?

25. A nurse is reviewing N. Low-lying

the medical record of
a pregnant client diag-
nosed with placenta pre-
via. The physical exam re-
veals that the placenta
is implanted near the in-
ternal os but does not
reach it. The nurse inter-
prets this as which type
of placenta previa?
Placenta previa is generally classified according
to the degree of coverage or proximity to the
internal os, as follows: total placenta previa - the
internal cervical os is completely covered by the
placenta; partial placenta previa - the internal
os is partially covered by the placenta; marginal
placenta previa - the placenta is at the margin or
edge of the internal os; low-lying placenta previa
- the placenta is implanted in the lower uterine
segment and is near the internal os but does not
reach it.

26. A woman in labor is at N. Sharp fundal pain and discomfort between

risk for abruptio placen- contractions
tae. Which assessment
would most likely lead
the nurse to suspect that
this has happened?

27. When assessing a N. Referred shoulder pain

woman with an ectopic
pregnancy, the nurse
would suspect that the
tube has ruptured based
on which finding?
Referred pain to the shoulder area indicates
bleeding into the abdomen caused by phrenic
nerve irritation when a tubal pregnancy ruptures.

28. A nurse is providing care N. Hydatidiform mole.

to a client who has
been diagnosed with a
common benign form of
gestational trophoblastic
disease. The nurse identi-
fies this as:

29.
8 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
A client at 11 weeks' ges-
tation experiences preg-
nancy loss. The client
asks the nurse if the
bleeding and cramping
that occurred during the
miscarriage were caused
by working long hours in
a stressful environment.
What is the most appro-
priate response from the
nurse?
30. When providing counsel-
ing on early pregnancy
loss, the nurse should
discuss which factor as
the most common cause
for spontaneous abor-
tion?
31. Which is the best ques-
tion the nurse can ask
a woman who is leaving
the hospital after experi-
encing a complete spon-
taneous abortion?
N."I can understand your need to find an answer
to what caused this. Let's talk about this further."
Talking with the client may assist her to explore
her feelings. She and her family may search for a
cause for a spontaneous early bleeding so they
can plan for future pregnancies. Even with mod-
ern technology and medical advances, however,
a direct cause cannot usually be determined.
N. Chromosomal abnormality
The most common cause for the loss of a fetus
in the first trimester is associated with a genet-
ic defect or chromosomal abnormality. There is
nothing that can be done, and the mother should
feel no fault.
N. "Do you have someone to talk to, or may I give
you the names and numbers for some possible
grief counselors?"
When a woman has a spontaneous abortion one
important consideration is the emotional needs of
the woman once she is home. She may not want
to talk about the loss for a period of time, but the
nurse needs to determine her support system for
the future. Asking the woman if she is "going to try
again" is an inappropriate question for the nurse
to ask and diminishes the experience of having
a spontaneous abortion. Giving the woman sta-
tistical information on spontaneous abortions is
not appropriate when this client needs support
and caring concern. Offering to give the client
resources to aid in smoking cessation is not ad-
9 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
dressed in the scenario, so this is an inappropri-
ate response.

32. A client in the first 2. "I will maintain strict bed rest throughout the
trimester of pregnancy remainder of the pregnancy."
arrives at a health care
clinic and reports that
she has been experi-
encing vaginal bleeding.
A threatened abortion is
suspected, and the nurse
instructs the client re-
garding management of
care. Which statement
made by the client indi-
cates a need for further
instruction?

33. The nurse is preparing a 4. Assess the client's and spouse's perception of
plan of care for a client the event.
who just delivered a dead
fetus. Which initial action
should the nurse include
in the client's plan of
care to meet the emotion-
al needs of the client and
spouse?

34. A client arrives at the
health care clinic and
tells the nurse that her
last menstrual period
was 9 weeks ago. The
client tells the nurse
that a home pregnan-
cy test was positive but
that she began to have
mild cramps and is now
having moderate vaginal
4. "I will need to prepare myself and my family for
the loss of this pregnancy."
The nurse is reviewing the record of a pregnant
client seen in the health care clinic for the first
prenatal visit. Which data, if noted on the client's
record, should alert the nurse that the client is at
risk for a spontaneous abortion?

10 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
bleeding. On physical ex-
amination of the client,
it is noted that she has
a dilated cervix. Which
statement, if made by the
client, indicates that the
client is interpreting the
situation correctly?

35. The nurse is reviewing 2. History of syphilis

the record of a pregnant
client seen in the health
care clinic for the first
prenatal visit. Which data,
if noted on the client's
record, should alert the
nurse that the client is
at risk for a spontaneous
abortion?

36. The nurse is assessing 2. Uterine tenderness

a pregnant client in the
second trimester of preg-
nancy who was admit-
ted to the maternity unit
with a suspected diagno-
sis of abruptio placentae.
Which assessment find-
ing should the nurse ex-
pect to note if this condi-
tion is present?

37. An ultrasound is per- 1. Delivery of the fetus

formed on a client at term
gestation who is experi-
encing moderate vaginal
bleeding. The results of
the ultrasound indicate
that abruptio placentae is

11 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
present. On the basis of
these findings, the nurse
should prepare the client
for which anticipated pre-
scription?

38. A 35-week-gestation 3. Abruptio placentae

pregnant woman is trans-
ferred to the materni-
ty unit from the emer-
gency department, where
she was treated for minor
injuries sustained in a
motor vehicle crash. The
maternity nurse's priori-
ty will be to assess for
which complication?

39. A pregnant woman, ap- N. Inevitable abortion

proximately 12 weeks'
gestation, comes to the
emergency department
after calling her health
care provider's office
and reporting moder-
ate vaginal bleeding. As-
sessment reveals cervi-
cal dilation and moder-
ately strong abdominal
cramps. She reports that
she has passed some
tissue with the bleed-
ing. The nurse interprets
these findings to suggest
which of the following?

40. A pregnant woman is ad- N. Assessing fetal heart tones by use of an exter-
mitted to the hospital nal monitor
with a diagnosis of pla-

12 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
centa previa. Which of the
following would be the
priority for this woman on
admission?

41. When assessing a preg- N. Strong abdominal cramping

nant woman with vagi-
nal bleeding, which find-
ing would lead the nurse
to suspect an inevitable
abortion?

42. A young woman pre- N. Threatened abortion

sents at the emergency
department with com-
plaints of lower abdom-
inal cramping and spot-
ting at 12 weeks' gesta-
tion. The physician per-
forms a pelvic examina-
tion and finds that the
cervix is closed. What
does the physician sus-
pect is the cause of the
cramps and spotting?

43. A pregnant client is N. Administer cryoprecipitate and platelets

admitted to a health
care unit with dissem-
inated intravascular co-
agulation (DIC). Which of
the following orders is
the nurse most likely
to receive regarding the
therapy for such a client?

44. A 28-year-old woman pre- N. Ectopic pregnancy

sents in the emergency
room with severe abdom-
inal pain. She has not
13 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
had a normal period for
2 months but she reports
that that is not abnormal
for her. She has a histo-
ry of endometriosis. What
might the nurse suggest
to the physician as a pos-
sible cause of the pa-
tient's abdominal pain?

45. A client experiences a N. "Restrict your physical activity to moderate

threatened abortion. She bedrest."
is concerned about los-
ing the pregnancy and
asks what activity lev-
el she should maintain.
What is the most appro-
priate response from the
nurse?

46. The nurse is required to N. Assessing the amount and color of the bleed-
assess a pregnant client ing
who is complaining of
vaginal bleeding. Which
of the following assess-
ments should be consid-
ered as a priority by the
nurse?

47. A pregnant woman is N. Firm, rigid uterus on palpation

diagnosed with abruptio
placentae. When review-
ing the woman's medical
record, which of the fol-
lowing would the nurse
expect to find?

48. A client in her first N. Abnormal fetal development

trimester has just experi-
enced a miscarriage. The
14 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
nurse knows that which
of the following is the
most likely cause of the
miscarriage?

49. Sometimes an ectopic N. Shoulder pain

pregnancy occurs out-
side the woman's uterus.
This usually occurs in
one of the fallopian
tubes. If the embryo con-
tinues to grow, it may rup-
ture the tube. What are
the signs and symptoms
of a ruptured fallopian
tube?

50. To which of the follow- N. Has experienced a molar pregnancy

ing patients being dis-
charged for home must
the nurse stress that it
is absolutely critical the
patient return for month-
ly follow-up visits? A
woman who:

51. You are caring for a N. Dark red, "clumpy" vaginal discharge
young woman who is in
her 10th week of ges-
tation. She comes into
the clinic complaining of
vaginal bleeding. Which
assessment finding best
correlates with a diagno-
sis of hydatidiform mole?

52. A nurse is assessing N. A client who had undergone a myomectomy to

pregnant clients for the remove fibroids
risk of placenta previa.
Which of the following
15 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
clients faces the greatest
risk for this condition?

53. A client in her 38th week N. Previous cesarean birth

of gestation is admitted
into the labor and birth
unit with painless bleed-
ing from the vagina. The
client is diagnosed with
placenta previa. When re-
viewing the client's histo-
ry, which of the following
would the nurse identify
as a risk factor for pla-
centa previa?

54. The maternity nurse is 2. Obtain equipment for a manual pelvic examina-
preparing for the admis- tion.
sion of a client in the third
trimester of pregnancy
who is experiencing vagi-
nal bleeding and has
a suspected diagnosis
of placenta previa. The
nurse reviews the prima-
ry health care provider's
prescriptions and should
question which prescrip-
tion?

55. The nurse in the post- 2. Hemorrhage

partum unit is caring for
a client who has just
delivered a newborn in-
fant following a preg-
nancy with placenta pre-
via. The nurse reviews
the plan of care and
prepares to monitor the

16 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
client for which risk asso-
ciated with placenta pre-
via?

56. A stillborn baby was de- 1. "What can I do for you?"

livered in the birthing
suite a few hours ago.
After the delivery, the
family remained together,
holding and touching the
baby. Which statement by
the nurse would assist
the family in their period
of grief?

57. The nurse in a materni- 1. "We want to attend a support group."

ty unit is providing emo-
tional support to a client
and her significant oth-
er who are preparing to
be discharged from the
hospital after the birth
of a dead fetus. Which
statement made by the
client indicates a compo-
nent of the normal griev-
ing process?

58. The nurse receives an or-
der to start an infusion
for a client whos hemor-
rhaging due to a placenta
previa. What supplies will
be needed?
3. Y tubing, normal saline, 18G cath
Blood transfusions require
Y tubing
Normal Saline solution to mix with the blood prod-
uct and an
18G cath to avoid lysing breaking the RBCs.

59. A woman who's 36 week 2. Vaginal bleeding

pregnant comes into L&D
with mild contractions.
Which of the following
17 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
complications should the
nurse watch for when the
client informs her that
she has placenta previa?

60. The nurse is performing 3. The client has a history of hypertension.

a prenatal assessment
on a pregnant client. The
nurse should plan to im-
plement teaching related
to risk for abruptio pla-
centae if which informa-
tion is obtained on as-
sessment?

61. The nurse in a materni-
ty unit is reviewing the
clients' records. Which
clients should the nurse
identify as being at the
most risk for developing
disseminated intravascu-
lar coagulation (DIC)?
3. A gravida II who has just been diagnosed with
dead fetus syndrome
5. A primigravida at 29 weeks of gestation who
was recently diagnosed with severe preeclamp-
sia
Ada la ito ha duha dida

62. In planning for home C. Prolonged bed rest may cause negative phys-
care of a woman with iologic effects.
preterm labor, which con-
cern must the nurse ad-
dress?

63. In evaluating the effec- D. Serum magnesium level of 10 mg/dL

tiveness of magnesium
sulfate for the treatment
of preterm labor, what
finding would alert the
nurse to possible side ef-
fects?

64. A woman at 26 weeks D. The cervix is effacing and dilated to 2 cm.

of gestation is being
18 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
assessed to determine
whether she is expe-
riencing preterm labor.
What finding indicates
that preterm labor is oc-
curring?

65. Nurses should know B. Preterm labor is defined as cervical changes

some basic defini- and uterine contractions occurring between 20
tions concerning preterm and 37 weeks of pregnancy.
birth, preterm labor, and
low birth weight. For in-
stance:

66. With regard to the care D. The diagnosis of preterm labor is based on
management of preterm gestational age, uterine activity, and progressive
labor, nurses should be cervical change.
aware that:

67. The nurse providing care B. Assessing for chest discomfort and palpitations
for a woman with preterm
labor who is receiv-
ing terbutaline would in-
clude which intervention
to identify side effects of
the drug?

68. A pregnant client ex- B. Magnesium sulfate.

perienced preterm la-
bor at 30 weeks gesta-
tion. Upon assessing the
client the nurse finds that
the newborn is at risk
of having cerebral pal-
sy. Which medication ad-
ministration should the
nurse perform to prevent
cerebral palsy in the new-
born?

19 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
69. During a prenatal vis- A. Teach gentle lower extremity exercises to the
it, the nurse finds that client.
the client has decreased
mobility and symptoms
of preterm labor. Which
nursing intervention is to
be followed to prevent
thrombophlebitis?

70. The nurse is teaching a C. "I will lie in the supine position for 1 hour."
group of pregnant clients
about preterm labor and
the actions to take if
the signs and symptoms
of preterm labor develop.
Which patient statement
indicates the need for fur-
ther teaching?

71. If a pregnant client sus- C. Fluid leakage from vagina

pects signs and symp- D. Presence of vaginal bleeding
toms of preterm labor, E. Contractions every 10 minutes
which conditions would
lead the client to go
to hospital immediately?
Select all that apply.

72. The nurse examines a D. Administering magnesium sulfate (Epsom

client at 30 weeks of salts) to the client
gestation for cervical di-
lation. The nurse under-
stands that the infant
may be at risk of cere-
bral palsy if it is born
preterm. Which interven-
tion would help to pre-
vent cerebral palsy?

73. The primary health care C. Infuse 500 mg of calcium chloride intravenous-
provider prescribes mag- ly for 30 minutes.
20 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
nesium sulfate (Epsom
salts) for a client
to prevent preterm la-
bor. Following adminis-
tration, the nurse ob-
serves that the client has
a respiratory rate of 10
breaths/minute and deep
tendon reflexes. Based
on these findings, what
interventions would help
to prevent complications
in the client?

74. A woman in preterm la- A. Stimulate fetal surfactant production.

bor at 30 weeks of ges-
tation receives two 12-mg
doses of betamethasone
intramuscularly. The pur-
pose of this pharmaco-
logic treatment is to:

75. A pregnant woman at B. "When we can stabilize your preterm labor and
29 weeks of gestation arrange home health visits."
has been diagnosed with
preterm labor. Her la-
bor is being controlled
with tocolytic medica-
tions. She asks when
she would be able to go
home. Which response
by the nurse is most ac-
curate?

76. The exact cause of A. Viral

preterm labor is unknown
and believed to be mul-
tifactorial. Infection is
thought to be a major

21 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
factor in many preterm
labors. Select the type
of infection that has not
been linked to preterm
births.

77. The client is admitted 1. Oozing blood from the IV catheter site
with full-thickness burns
may be developing DIC.
Which signs/symptoms
would support the diag-
nosis of DIC?

78. Which lab result would 2. A low fibrinogen level

the nurse expect in the
client diagnosed with
DIC?

79. Which collaborative 3. Administer fresh frozen plasma

treatment would the
nurse anticipate in the
client diagnosed with
DIC?

80. The nurse writes a di- 4. The client's urine output will be > 30 mL per
agnosis of "potential for hour
fluid volume deficit re-
lated to bleeding" for
a client diagnosed with
DIC. Which would be an
appropriate goal?

81. The maternity nurse is 1.Petechiae

caring for a client with 2.Hematuria
abruptio placentae and is 4.Prolonged clotting times
monitoring her for dis- 5.Oozing from injection sites
seminated intravascular
coagulation (DIC). Which
assessment findings are
most likely associated
22 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
with disseminated in-
travascular coagulation?
Select all that apply.

82. The nurse concludes that D. Excess release of thrombin uses up clotting
both clotting and bleed- factors quicker than they can be replaced.
ing occur during dissem-
inated intravascular co-
agulation (DIC) due to
which process?

83. The nurse suspects that A. Petechiae

a patient who has severe
sepsis now has dissemi-
nated intravascular coag-
ulation (DIC). Which find-
ing, if observed, helps
confirm this suspicion?

84. A client with a diagno- B. "The effects of the disorder will resolve com-
sis of chronic dissem- pletely."
inated intravascular co-
agulation (DIC) is being
discharged home. Which
statement by the client
requires the nurse to fol-
low up?

85. The nurse is evaluat- D) No evidence of bleeding

ing care provided to a
client with disseminat-
ed intravascular coag-
ulation. Which observa-
tion indicates care has
been successful for this
client?

86. A client diagnosed with C) Fresh frozen plasma and platelets

disseminated intravascu-
lar coagulation (DIC)
23 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
is currently bleeding
through the gastrointesti-
nal tract. What will the
nurse expect to provide
for the client?

87. A client with disseminat- B) Cool compresses

ed intravascular coagula-
tion is experiencing joint
pain. Which nursing inter-
vention should the nurse
use to help the client at
this time?

88. A nurse caring for a C) Decreased fibrinogen level

client with disseminat-
ed intravascular coagula-
tion (DIC) is reviewing the
client's diagnostic tests.
Which test result is com-
mon in DIC?

89. A nurse working in labor C) Placental abruption

and delivery is caring for
a client with suspected
DIC. The nurse is aware
that DIC most often oc-
curs in which pregnancy
complication?

90. The nurse is evaluating B. Decreased platelet count

the lab results for a client C. The presence of schistocytes
suspected of having dis- D. Increased fibrin degradation products
seminated intravascular
coagulation (DIC). Which
laboratory finding sup-
ports the diagnosis? (Se-
lect all that apply.)

91. B. Heparin
24 / 25
 Nursing Care With Sudden Pregnant Complications
Study online at https://quizlet.com/_cxu418
Which therapy will the
healthcare provider pre-
scribe for the client with
chronic disseminated in-
travascular coagulation
(DIC)?

92. The nurse is caring for B. Leaked fluid is similar to a coagulation factor.
a client diagnosed with
placental abruption who
now has disseminated in-
travascular coagulation
(DIC). Which statement
correctly explains why
this client is at risk for
DIC?

93. A nurse is assessing a C) Placental abruption

client during labor and
delivery. Which condition
should the nurse recog-
nize as a risk factor for
disseminated intravascu-
lar coagulation (DIC)?

25 / 25