Review Potential Complications and Outcomes

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Potential Complications and Outcomes

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Total Questions : 5

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Question 1:

A nurse is caring for a client who has PPROM at 32 weeks of gestation.

The nurse should monitor the client for which of the following signs of infection? (Select all that apply.).

A. Foul-smelling amniotic fluid B. Maternal tachycardia C. Fetal bradycardia D. Increased white blood cell count E. Decreased fetal movement.

Answer and Explanation

Choice A:

foul-smelling amniotic fluid indicates bacterial contamination of the fluid. Normal amniotic fluid should be clear or slightly yellowish and odorless.

Choice B:

maternal tachycardia is a sign of systemic infection or inflammation. Normal maternal heart rate should be between 60 and 100 beats per minute.

Choice C:

fetal bradycardia is a sign of fetal distress or hypoxia due to infection or cord compression. Normal fetal heart rate should be between 110 and 160 beats per minute.

Choice D:

increased white blood cell count is a sign of infection or inflammation in the body. Normal white blood cell count should be between 4,000 and 11,000 cells per microliter of blood.

Choice E:

decreased fetal movement is a sign of fetal compromise or distress due to infection or hypoxia. Normal fetal movement should be felt at least 10 times in two hours.

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Question 2:

A client who has PROM at 38 weeks of gestation is admitted to the labor and delivery unit.

The nurse should perform which of the following interventions first?

A. Administer antibiotics as prescribed B. Assess fetal heart rate and pattern C. Perform a sterile vaginal exam D. Obtain a sample of amniotic fluid

Answer and Explanation

Choice A:

antibiotics are not indicated for all cases of PROM, and they may delay the onset of labor.

Choice B:

PROM increases the risk of infection, cord compression, and fetal distress, so monitoring the fetal well-being is the priority intervention.

Choice C:

a sterile vaginal exam may introduce infection and should be avoided unless delivery is imminent.

Choice D:

obtaining a sample of amniotic fluid is not necessary for diagnosis or management of PROM, and it may also increase the risk of infection.Normal ranges for fetal heart rate are 110 to 160 beats per minute, and normal patterns are regular and moderate in variability.

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Question 3:

A nurse is teaching a pregnant client about the risk factors for PROM.

Which of the following statements by the client indicates a need for further teaching?

A. “I should avoid smoking during pregnancy.” B. “I should eat a balanced diet and take prenatal vitamins.” C. “I should have sex as often as possible to keep my cervix healthy.” D. “I should report any vaginal bleeding or discharge to my doctor.”.

Answer and Explanation

Choice A:

smoking during pregnancy can also increase the risk of PROM.

Choice B:

eating a balanced diet and taking prenatal vitamins are beneficial for pregnancy and do not cause PROM.

Choice C:

Having sex as often as possible does not keep the cervix healthy and may increase the risk of premature rupture of membranes (PROM), which is when the amniotic sac breaks before labor begins.PROM can cause infection, premature birth and other complications for the mother and the baby.

Choice D:

reporting any vaginal bleeding or discharge to the doctor is important to detect any signs of infection or PROM.

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Question 4:

A client who has PPROM at 28 weeks of gestation is receiving magnesium sulfate for fetal neuroprotection.

The nurse should monitor the client for which of the following adverse effects of magnesium sulfate?

A. Hypertension B. Hyperreflexia C. Respiratory depression D. Hyperglycemia

Answer and Explanation

Choice A:

magnesium sulfate can cause hypotension, not hypertension

Choice B:

magnesium sulfate can cause loss of deep tendon reflexes, not hyperreflexia

Choice C:

Magnesium sulfate is a drug that can reduce the risk of cerebral palsy in preterm infants when given to women at risk of early preterm birth.However, it can also cause adverse effects such as respiratory depression, hypotension, hypocalcemia, and loss of deep tendon reflexes in the mother.Therefore, the nurse should monitor the vital signs and reflexes of the woman receiving magnesium sulfate and stop the infusion if signs of toxicity appear.

Choice D:

magnesium sulfate does not affect blood glucose levels.

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Question 5:

A nurse is reviewing the electronic fetal monitor tracing of a client who has PROM at 34 weeks of gestation.

The nurse observes variable decelerations in the fetal heart rate.

The nurse should recognize that this finding indicates which of the following?

A. Fetal head compression B. Uteroplacental insufficiency C. Umbilical cord compression D. Fetal sleep cycle

Answer and Explanation

Choice A:

fetal head compression causes early decelerations, which are symmetrical decreases and return-to-normal of the fetal heart rate that is linked to uterine contractions.

Choice B:

uteroplacental insufficiency causes late decelerations, which are gradual decreases in fetal heart rate after a uterine contraction.

Choice C:

Variable decelerations are abrupt drops in the fetal heart rate below baseline that last 15 seconds to less than two minutes.They are caused by reduced blood flow and oxygen delivery to the fetus due to umbilical cord compression.The onset, depth, and duration of variable decelerations vary with uterine contractions or fetal movement.

Choice D:

fetal sleep cycle does not cause any significant changes in the fetal heart rate pattern.

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Potential Complications and Outcomes

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