A primigravida who is 28 weeks pregnant visits the clinic fearing she is experiencing preeclampsia. Which of the following assessments would the nurse make to confirm or negate these thoughts? Select all that apply.

Right Sided Epigastric pain

Uterine contractions

Bright red painless vaginal bleeding

Severe headache

Visual disturbances

Dull back ache

Answer and Explanation

Correct Answer : A,D,E

A. Right-sided epigastric pain. Epigastric pain, especially on the right side, is a concerning sign of preeclampsia and may indicate liver involvement due to elevated liver enzymes or HELLP syndrome. This symptom should be assessed further as it suggests worsening disease progression.

B. Uterine contractions. Uterine contractions are not a defining feature of preeclampsia. They are more commonly associated with preterm labor rather than hypertension-related complications. While preeclampsia can lead to preterm birth, contractions alone do not confirm or negate the condition.

C. Bright red painless vaginal bleeding. Bright red painless vaginal bleeding is more indicative of placenta previa or another obstetric complication rather than preeclampsia. Preeclampsia primarily presents with hypertension, proteinuria, and systemic symptoms rather than vaginal bleeding.

D. Severe headache. A severe headache is a classic symptom of preeclampsia, often due to elevated blood pressure and cerebral edema. Persistent headaches that do not resolve with usual interventions should be evaluated promptly as they may indicate worsening hypertension or an impending seizure.

E. Visual disturbances. Visual disturbances such as blurred vision, photophobia, or seeing spots are common in preeclampsia and can signal cerebral edema or increased intracranial pressure. This is a significant warning sign requiring immediate assessment.

F. Dull backache. A dull backache is more commonly associated with musculoskeletal strain, labor, or a urinary tract infection rather than preeclampsia. While discomfort can be present in pregnancy, it is not a defining symptom of preeclampsia.

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Correct Answer is A

Explanation

Professor Proctor emphasizes safety as the highest priority while traveling, including when coming to class. Ensuring that students arrive safely is considered more important than strict punctuality.

A. Consuming more calories covers the insulin secreted by the fetus. B. Fetal weight gain increases as a result of the common response of maternal overeating. C. Extra circulating glucose causes the fetus to acquire fatty deposits. D. Taking exogenous insulin stimulates fetal growth

Correct Answer is C

Explanation

A. Consuming more calories covers the insulin secreted by the fetus. The fetus does not secrete insulin to regulate maternal glucose levels. Instead, the maternal pancreas produces insulin in response to blood sugar levels, but in diabetes, maternal insulin resistance leads to excess glucose being transferred to the fetus.

B. Fetal weight gain increases as a result of the common response of maternal overeating. While some women with diabetes may have increased caloric intake, this is not the primary reason for fetal macrosomia (large birth weight). The major factor is maternal hyperglycemia leading to excess fetal insulin production and fat deposition.

C. Extra circulating glucose causes the fetus to acquire fatty deposits. In diabetic pregnancies, excess maternal glucose crosses the placenta, leading to fetal hyperinsulinemia. The increased insulin promotes fat storage and excessive fetal growth, leading to macrosomia, which increases the risk of birth complications such as shoulder dystocia.

D. Taking exogenous insulin stimulates fetal growth. Insulin does not cross the placenta, so maternal insulin therapy does not directly affect fetal growth. Instead, fetal macrosomia results from prolonged exposure to maternal hyperglycemia, which causes the fetus to produce excessive insulin and store extra fat.

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A primigravida who is 28 weeks pregnant visits the clinic fearing she is experiencing preeclampsia. Which of the following assessments would the nurse make to confirm or negate these thoughts? Select all that apply.

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Professor Proctor: Always wants us to be safe while traveling anywhere- especially when coming to class. This is prioritized even over being on time.

Correct Answer is A

Explanation

A nurse teaching a prenatal class is asked why infants of diabetic mothers are often larger than those born to women who do not have diabetes. On what information about pregnant women with diabetes should the nurse base the response?

Correct Answer is C

Explanation

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A primigravida who is 28 weeks pregnant visits the clinic fearing she is experiencing preeclampsia. Which of the following assessments would the nurse make to confirm or negate these thoughts? Select all that apply.