A woman with a history of systemic lupus erythematosus comes to the clinic for evaluation. The woman tells the nurse that she and her partner would like to have a baby but that they are afraid her lupus will be a problem. Which response would be most appropriate for the nurse to make?
Be sure that your lupus is stable or in remission for 6 months before getting pregnant.
It's probably not a good idea for you to get pregnant since you have lupus.
Your lupus will not have any effect on your pregnancy whatsoever.
When you get pregnant we'll have to add quite a few medications to your normal treatment plan.
The Correct Answer is A
Choice A Reason: This is correct because this response provides realistic and supportive advice for a woman who wants to have a baby with lupus. Lupus is an autoimmune disease that causes inflammation and damage to various organs and tissues. Lupus can affect fertility and pregnancy outcomes, such as increasing the risk of miscarriage, preterm delivery, preeclampsia, or neonatal lupus. Therefore, it is important for the woman to have her lupus under control before conceiving and to consult with her doctor about her treatment plan and prenatal care.
Choice B Reason: This is incorrect because this response is discouraging and insensitive for the woman who wants to have a baby with lupus. Lupus does not necessarily prevent a woman from having a healthy pregnancy and a healthy baby, as long as she follows her doctor's recommendations and monitors her condition closely. The nurse should respect the woman's reproductive choices and provide information and support.
Choice C Reason: This is incorrect because this response is inaccurate and misleading for the woman who wants to have a baby with lupus. Lupus can have various effects on pregnancy, such as causing flares or complications that can affect both the mother and the baby. The nurse should educate the woman about the possible risks and benefits of pregnancy with lupus and help her prepare for any challenges.
Choice D Reason: This is incorrect because this response is vague and alarming for the woman who wants to have a baby with lupus. Lupus treatment may or may not change during pregnancy, depending on the type and severity of lupus, the medications used, and the stage of pregnancy. The nurse should explain the rationale and safety of any medication changes and address any concerns or questions that the woman may have.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A: A clear liquid diet is not appropriate for a client with hyperemesis gravidarum, which is a severe form of nausea and vomiting during pregnancy that can lead to dehydration, electrolyte imbalance, and weight loss. A clear liquid diet does not provide adequate calories, protein, vitamins, or minerals for the client and the fetus.
Choice B: Administration of diethylstilbestrol is not indicated for a client with hyperemesis gravidarum. Diethylstilbestrol is a synthetic estrogen that was used in the past to prevent miscarriage and premature birth, but it was found to cause serious adverse effects such as vaginal cancer, infertility, and birth defects in the offspring.
Choice C: Total parenteral nutrition is the correct choice because it provides a complete and balanced source of nutrients through a central venous catheter. It is used for clients who cannot tolerate oral or enteral feeding due to severe gastrointestinal disorders such as hyperemesis gravidarum. It helps to prevent malnutrition, dehydration, and ketosis in the client and the fetus.
Choice D: Nothing by mouth is not a suitable option for a client with hyperemesis gravidarum. It can worsen the condition by causing starvation, acidosis, and ketosis. It can also increase the risk of aspiration pneumonia if the client vomits.
Correct Answer is B
Explanation
Choice A Reason: This is incorrect because difficulty in arousing is a sign of magnesium toxicity, which is a serious complication of magnesium sulfate therapy. Magnesium toxicity can cause central nervous system depression, muscle weakness, and cardiac arrest. The nurse should monitor the client's level of consciousness and stop the infusion if the client becomes lethargic or unresponsive.
Choice B Reason: This is correct because deep tendon reflexes 2+ indicate a normal and expected response to magnesium sulfate therapy. Magnesium sulfate is a muscle relaxant that can reduce the risk of seizures in gestational hypertension. The nurse should assess the client's deep tendon reflexes regularly and maintain them at 2+ or slightly diminished.
Choice C Reason: This is incorrect because urinary output of 30 mL per hour is below the normal range of 40 to 80 mL per hour and may indicate renal impairment or dehydration. Magnesium sulfate can cause renal toxicity or fluid retention, which can affect the urinary output. The nurse should monitor the client's urinary output and fluid balance and report any abnormalities to the doctor.
Choice D Reason: This is incorrect because respiratory rate of 10 breaths/minute is below the normal range of 12 to 20 breaths/minute and may indicate respiratory depression. Magnesium sulfate can cause respiratory depression or failure, which can be life-threatening. The nurse should monitor the client's respiratory rate and oxygen saturation and administer oxygen or antidote if needed.
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