A nurse in a provider’s office is reinforcing teaching about home care to a client who has mild preeclampsia. Which of the following information should the nurse include in the teaching? Choice Options:

Perform daily fetal movement counts.

Limit fluid intake to 1,000 ml/day.

Limit sodium intake to 2,000 mg/day.

Rest in bed in the supine position.

Answer and Explanation

The Correct Answer is A

Choice A rationale:
Fetal movement counts are a simple yet effective tool to monitor fetal well-being in women with preeclampsia. They provide valuable insights into the baby's activity level and can alert the healthcare team to potential concerns early on.
Preeclampsia can compromise placental blood flow, which can lead to decreased fetal movement. By tracking fetal movements daily, the mother can detect any significant changes or reductions in activity, prompting further assessment and intervention if necessary.
Research has shown that regular fetal movement counts can reduce the risk of stillbirth in women with preeclampsia. This is because prompt recognition of decreased fetal movements allows for timely interventions, such as closer monitoring, induction of labor, or delivery, to prevent adverse outcomes.
Daily fetal movement counts empower women to take an active role in their pregnancy care and contribute to a sense of control in a condition that can often feel unpredictable. This increased involvement can promote maternal-fetal bonding and reduce anxiety.
Choice B rationale:
While fluid restriction has been a traditional recommendation for preeclampsia, current evidence does not support limiting fluid intake to 1,000 ml/day. In fact, excessive fluid restriction can lead to dehydration, which can worsen placental perfusion and compromise fetal well-being.
It's essential for women with preeclampsia to maintain adequate hydration to support essential bodily functions and fetal growth. Adequate fluid intake also helps to prevent urinary tract infections, which are more common in women with preeclampsia.
Choice C rationale:
Although reducing sodium intake can be beneficial for overall blood pressure control, there's insufficient evidence to support a strict sodium restriction of 2,000 mg/day specifically for managing mild preeclampsia. Individual needs may vary, and a more moderate approach to sodium reduction is often recommended.
Focusing on a balanced, healthy diet with appropriate sodium intake is generally more effective than strict limitations. This approach promotes overall well-being and supports healthy blood pressure levels without compromising nutritional needs. Choice D rationale:
Rest is often recommended for women with preeclampsia to reduce stress on the cardiovascular system and promote placental blood flow. However, the supine position (lying on the back) is not ideal, as it can further compress the large blood vessels in the abdomen and potentially reduce blood flow to the placenta.
Side-lying positions, particularly the left lateral position, are preferred for women with preeclampsia. These positions help to alleviate pressure on the major blood vessels, enhance blood flow, and improve uteroplacental circulation, which benefits both the mother and the baby.

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Correct Answer is C

Explanation

Choice A: Vitamin E
While vitamin E is an essential nutrient with antioxidant properties, there is no specific recommendation to increase its intake during pregnancy.
Adequate intake of vitamin E can typically be achieved through a balanced diet.
Excessive intake of vitamin E, particularly through supplements, could potentially have adverse effects.

Choice B: Vitamin D
Vitamin D is crucial for bone health and immune function, and it plays a role in fetal development.
However, the primary recommendation during pregnancy is to maintain adequate vitamin D levels, not necessarily to increase them significantly.
This can often be achieved through a combination of sunlight exposure, dietary intake, and, if needed, supplementation.

Choice C: Calcium
Calcium is essential for the development of strong bones and teeth in the fetus.
The fetal demand for calcium increases significantly during pregnancy, particularly in the third trimester.

If the mother's dietary intake of calcium is insufficient, the body will draw calcium from her bones to meet the fetal needs, potentially putting her at risk of osteoporosis later in life.
Therefore, it is crucial for pregnant women to increase their calcium intake to meet the recommended daily allowance of 1,000-1,300 mg.

Choice D: Vitamin A
Vitamin A is important for vision, immune function, and cell growth.
However, excessive intake of vitamin A, particularly from supplements, can be teratogenic (causing birth defects). Pregnant women should aim to meet their vitamin A needs through food sources rather than supplements, and they should avoid consuming high-dose vitamin A supplements.

A. Severe nausea and vomiting. B. Uterine enlargement greater than expected for gestational age. C. Copious vaginal bleeding. D. Pelvic pain.

Correct Answer is D

Explanation

Choice A: Severe nausea and vomiting

While nausea and vomiting can be common in early pregnancy, including ectopic pregnancies, they are not specific indicators of an ectopic pregnancy.

Approximately 70-80% of pregnant women experience nausea and vomiting, regardless of the location of the pregnancy. Hence, the presence of severe nausea and vomiting alone would not definitively point towards an ectopic pregnancy.

Choice B: Uterine enlargement greater than expected for gestational age

In an ectopic pregnancy, the fertilized egg implants outside the uterus, typically in the fallopian tube. This means the uterus would not be expected to enlarge as it would in a normal intrauterine pregnancy. In fact, uterine size might be smaller than expected for gestational age in cases of ectopic pregnancy.

Choice C: Copious vaginal bleeding

While vaginal bleeding can occur in ectopic pregnancies, it's not always present and is not the most common initial symptom. When bleeding does occur, it's often lighter than a normal menstrual period and may be brown or dark in color.

Copious vaginal bleeding is more likely to occur in cases of miscarriage or other pregnancy complications.

Choice D: Pelvic pain

Pelvic pain is the most common and characteristic symptom of an ectopic pregnancy.

The pain is often described as sharp, stabbing, or cramping, and it may be localized to one side of the abdomen. The pain can be intermittent or constant, and it may worsen with activity or movement.

The pain is caused by the stretching of the fallopian tube as the ectopic pregnancy grows. In some cases, the pain can be severe enough to cause nausea and vomiting.

Therefore, pelvic pain is the most reliable finding that the nurse should expect in a client with a possible ectopic pregnancy at 8 weeks of gestation.

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A nurse in a provider’s office is reinforcing teaching about home care to a client who has mild preeclampsia. Which of the following information should the nurse include in the teaching? Choice Options:

Nursing Test Bank

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