A 22-year-old homeless woman arrives at a walk-in clinic seeking pregnancy confirmation. The nurse notes on assessment a 12-week gestational uterus, a BP of 110/70, a BMI of 17.5. The client admits to using cocaine a few times. She has been pregnant before and indicates she "loses them early." What characteristics place the client in the high-risk pregnancy category? Select all that apply.
Homelessness
Age
BP 110/70
BMI 17.5
Prenatal care
Prenatal history
Correct Answer : A,D,E,F
Choice A Reason: Homelessness is a risk factor for high-risk pregnancy because it exposes the woman to various challenges and stressors that can affect her health and well-being. Homeless women may face difficulties in accessing adequate nutrition, hygiene, safety, shelter, transportation, and health care. They may also experience higher levels of violence, substance abuse, mental illness, and social isolation. These factors can increase the risk of infections, complications, preterm birth, low birth weight, and infant mortality.
Choice B Reason: Age is not a risk factor for high-risk pregnancy in this case because the woman is 22 years old, which is within the optimal age range for childbearing. The optimal age range is considered to be between 20 and 35 years old, as women in this age group tend to have fewer complications and better outcomes than women who are younger or older. Women who are younger than 20 or older than 35 are considered to have advanced maternal age or adolescent pregnancy, respectively, which are risk factors for high-risk pregnancy.
Choice C Reason: BP 110/70 is not a risk factor for high-risk pregnancy because it is within the normal range for blood pressure. The normal range for blood pressure is considered to be between 90/60 and 120/80 mmHg. Blood pressure that is too high or too low can indicate problems such as preeclampsia, eclampsia, or hypotension, which are risk factors for high-risk pregnancy.
Choice D Reason: BMI 17.5 is a risk factor for high-risk pregnancy because it indicates that the woman is underweight. BMI stands for body mass index, which is a measure of body fat based on height and weight. The normal range for BMI is considered to be between 18.5 and 24.9 kg/m2. BMI that is too low or too high can indicate problems such as malnutrition, obesity, or gestational diabetes, which are risk factors for high-risk pregnancy.
Choice E Reason: Prenatal care is a risk factor for high-risk pregnancy because it indicates that the woman has not received adequate medical attention and support during her pregnancy. Prenatal care is essential for ensuring the health and well-being of both the mother and the baby. Prenatal care involves regular visits to a health care provider who can monitor the progress of the pregnancy, screen for any complications or infections, provide education and counseling, and prescribe any necessary medications or interventions. Lack of prenatal care can increase the risk of maternal mortality, morbidity, preterm birth, low birth weight, congenital anomalies, and infant mortality.
Choice F Reason: Prenatal history is a risk factor for high-risk pregnancy because it indicates that the woman has had previous pregnancies that ended in miscarriage or stillbirth. Prenatal history can provide important information about the woman's reproductive health and potential complications that may recur or affect her current pregnancy. Previous pregnancy losses can indicate problems such as genetic abnormalities, chromosomal disorders, infections, immunological factors, hormonal imbalances, uterine abnormalities, or placental issues. These factors can increase the risk of spontaneous abortion, fetal demise, preterm birth, intrauterine growth restriction (IUGR), or placenta previa.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason: This is incorrect because administering Rho(D) immune globulin 24 hours before delivery is too early and may not provide adequate protection for the fetus. Administering it 24 hours after delivery is too late and may not prevent the mother from developing antibodies against the fetal Rh-positive blood cells.
Choice B Reason: This is incorrect because administering Rho(D) immune globulin in the first trimester is unnecessary and may not be effective, as the risk of Rh isoimmunization is very low before 28 weeks of gestation. Administering it within 2 hours of delivery is appropriate, but not sufficient, as it should be repeated within 72 hours after delivery.
Choice C Reason: This is correct because administering Rho(D) immune globulin at 28 weeks gestation and again within 72 hours after delivery is the recommended schedule for preventing Rh isoimmunization in Rh-negative pregnant women who have Rh-positive partners. This regimen can prevent up to 99% of cases of Rh isoimmunization by blocking the maternal immune response to the fetal Rh-positive blood cells.
Choice D Reason: This is incorrect because administering Rho(D) immune globulin at 32 weeks gestation is too late and may not prevent Rh isoimmunization if there has been any fetal-maternal hemorrhage before that time. Administering it immediately before discharge is also too late and may not prevent the mother from developing antibodies against the fetal Rh-positive blood cells.
Correct Answer is B
Explanation
Choice A Reason: This is incorrect because wearing spandex-type full-length pants can constrict the blood flow and increase the swelling in the feet. The nurse should advise the woman to wear loose-fitting clothes and comfortable shoes that do not squeeze or rub her feet.
Choice B Reason: This is correct because elevating the legs when sitting can improve venous return and reduce the swelling in the feet. The nurse should encourage the woman to elevate her legs above her heart level whenever possible and avoid crossing her legs or standing for long periods.
Choice C Reason: This is incorrect because limiting the intake of fluids can cause dehydration and worsen the swelling in the feet. The nurse should recommend the woman drink plenty of water and other healthy fluids to maintain hydration and flush out excess sodium and waste products from her body.
Choice D Reason: This is incorrect because eliminating salt from the diet can cause electrolyte imbalance and affect the fluid balance in the body. The nurse should advise the woman to consume salt in moderation and avoid processed foods that are high in sodium.
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