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A nurse is caring for the client at the next prenatal visit.

Exhibits

After reviewing the assessment findings, which of the following complications is the client at an Increased risk for developing?

Select the 3 complications the client is at an increased risk for developing.

Thromboembolism

Electrolyte imbalance

Fetal growth restriction

Polyhydramnios

Gestational diabetes mellitus

Spontaneous abortion

Answer and Explanation

Correct Answer : B,C,F

A. Thromboembolism:

Thromboembolism refers to the formation of blood clots (thrombi) that break loose and travel through the bloodstream, potentially causing blockages in blood vessels (embolism). While thromboembolism is a risk in pregnancy, especially in individuals with risk factors such as obesity or a history of thromboembolic events, there are no specific indications in the scenario provided that suggest an increased risk of thromboembolism for this client.

B. Electrolyte imbalance:

The client's persistent nausea, vomiting, and ketonuria indicate significant dehydration and electrolyte imbalances. Dehydration can lead to imbalances in electrolytes such as potassium, sodium, and chloride, which are essential for proper bodily function. Laboratory findings of low potassium (hypokalemia) and elevated blood urea nitrogen (BUN) support the presence of electrolyte imbalances. These imbalances can have serious consequences for both the client and the fetus, including cardiac arrhythmias, muscle weakness, and metabolic disturbances.

C. Fetal growth restriction:

Hyperemesis gravidarum, characterized by severe nausea and vomiting leading to dehydration and weight loss, is associated with an increased risk of fetal growth restriction. Inadequate maternal nutrition and dehydration can compromise fetal growth and development, potentially leading to a smaller-than-expected size for gestational age. The client's weight loss and ketonuria further support the possibility of fetal growth restriction due to insufficient nutrient intake and placental perfusion.

D. Polyhydramnios:

Polyhydramnios refers to an excess of amniotic fluid surrounding the fetus in the uterus. While hyperemesis gravidarum and dehydration can lead to maternal complications, such as electrolyte imbalances and fetal growth restriction, they are not typically associated with an increased risk of polyhydramnios. Polyhydramnios is more commonly linked to fetal anomalies, maternal diabetes, or fetal conditions that affect swallowing or fluid regulation, none of which are evident in the provided scenario.

E. Gestational diabetes mellitus:

Gestational diabetes mellitus (GDM) is a condition characterized by high blood sugar levels during pregnancy. While GDM can lead to various complications for both the mother and the fetus, including macrosomia (large birth weight), birth injuries, and neonatal hypoglycemia, there are no indications in the scenario provided that suggest an increased risk of GDM for this client.

F. Spontaneous abortion:

Hyperemesis gravidarum, with severe nausea, vomiting, and weight loss, is associated with an increased risk of spontaneous abortion or miscarriage. Dehydration, electrolyte imbalances, and maternal malnutrition can compromise maternal and fetal well-being, potentially leading to pregnancy loss. Therefore, the client is at an increased risk of spontaneous abortion due to the severity of her symptoms and the impact on her overall health and pregnancy.

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Correct Answer is D

Explanation

A. Human papillomavirus (HPV) vaccine:
The HPV vaccine is not recommended during pregnancy because there is limited safety data regarding its use in pregnant women. It is typically administered to individuals before they become sexually active to prevent HPV infections, which can lead to cervical cancer and other HPV-related diseases. Since the client is currently pregnant, administering the HPV vaccine would not be appropriate due to the lack of safety data during pregnancy.

B. Rubella vaccine:
The rubella vaccine is a live attenuated vaccine, and its administration during pregnancy is contraindicated due to the risk of congenital rubella syndrome (CRS) if the vaccine were to cause rubella infection in the pregnant woman. Rubella vaccination should be provided to non-pregnant individuals, particularly women of childbearing age, to prevent CRS. Administering the rubella vaccine to a pregnant woman at 28 weeks of gestation would pose a risk to both the mother and the developing fetus.

C. Varicella vaccine:
Similar to the rubella vaccine, the varicella (chickenpox) vaccine is a live attenuated vaccine and is contraindicated during pregnancy due to the risk of varicella infection in the pregnant woman, which can lead to severe complications for both the mother and the fetus. Varicella vaccination is recommended for individuals who have not had chickenpox or received the vaccine previously but should not be administered to pregnant women.

D. Tetanus vaccine:
Tetanus vaccination during pregnancy is recommended to prevent maternal and neonatal tetanus. Tetanus toxoid is considered safe during pregnancy and is routinely administered as part of the tetanus-diphtheria-pertussis (Tdap) vaccine. The tetanus vaccine helps protect against tetanus, a potentially fatal bacterial infection. Administering the tetanus vaccine during pregnancy is important for the health and safety of both the mother and the developing fetus.

A. Apply an ice pack to the incision site. B. Administer 500 m lactated Ringer's IV bolus C. Replace the surgical dressing D. Evaluate urinary output.

Correct Answer is B

Explanation

a.This may help with incision pain or swelling but does not address the ongoing vaginal bleeding.

b.Administering a bolus of lactated Ringer's solution helps to restore fluid volume and maintain blood pressure, which is crucial in managing persistent vaginal bleeding. This action addresses the immediate concern of fluid loss and helps stabilize the patient while further assessments and interventions can be made.

c.While important for monitoring the incision, it does not address the immediate issue of ongoing vaginal bleeding.

d.Important to monitor, but not the first priority in the context of ongoing bleeding. This can be assessed after addressing the bleeding issue.

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A nurse is caring for the client at the next prenatal visit. Exhibits After reviewing the assessment findings, which of the following complications is the client at an Increased risk for developing? Select the 3 complications the client is at an increased risk for developing.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is at 28 weeks of gestation and received no immunizations during childhood. Which of the following vaccines should the nurse plan to administer?

Correct Answer is D

Explanation

A nurse is caring for a client who delivered by cesarean birth 6 hr ago. The nurse notes a steady trickle of vaginal bleeding that does not stop with fundal massage. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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A nurse is caring for the client at the next prenatal visit. Exhibits After reviewing the assessment findings, which of the following complications is the client at an Increased risk for developing? Select the 3 complications the client is at an increased risk for developing.

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A nurse is assessing a client who is 6 hr postpartum and is saturating perineal pads every 10 to 15 min. Which of the following actions should the nurse take first?

A nurse is caring for a client who is postpartum and has a perineal laceration. Which of the following findings places the client at risk for delayed wound healing?

A nurse is caring for the client at the next prenatal visit.

Exhibits

After reviewing the assessment findings, which of the following complications is the client at an Increased risk for developing?

Select the 3 complications the client is at an increased risk for developing.