A nurse is caring for a 36-year-old female client who is at 30 weeks of gestation in the antepartum unit.
Select the 3 factors that increase the client’s risk for preeclampsia.
Primigravida
Age
Type 1 diabetes mellitus
Hemoglobin level
Correct Answer : A,B,C
Choice A rationale: Primigravida
Primigravida (first-time pregnancy) is a known risk factor for preeclampsia. Studies show that nulliparous individuals (those who have never given birth before) have a higher likelihood of developing preeclampsia compared to multiparous individuals. The exact reason is not fully understood, but it is thought that immunological adaptation plays a role.
Choice B rationale: Age
Advanced maternal age (≥35 years) is a recognized risk factor for preeclampsia. This client is 36 years old, which places her in the higher-risk category. Older maternal age is associated with increased vascular dysfunction and underlying chronic conditions that predispose individuals to preeclampsia.
Choice C rationale: Type 1 diabetes mellitus
Type 1 diabetes mellitus significantly increases the risk of preeclampsia due to its impact on vascular health. Diabetes affects endothelial function and can cause chronic inflammation, both of which contribute to hypertension and proteinuria, hallmark symptoms of preeclampsia. Additionally, diabetes increases the risk of abnormal placentation, further raising the chances of hypertensive disorders in pregnancy.
Choice D rationale: Hemoglobin level
A hemoglobin level of 12.5 g/dL is within the normal range and does not contribute to an increased risk for preeclampsia. While anemia is sometimes associated with preeclampsia, a normal hemoglobin level does not raise concern in this case. Therefore, hemoglobin is not a risk factor for preeclampsia in this patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Rapid plasma regain is not a standard laboratory test associated with hyperemesis gravidarum. Hyperemesis gravidarum is characterized by severe nausea and vomiting leading to dehydration and electrolyte imbalances.
Choice B rationale
A urine culture is used to detect urinary tract infections, which are not a primary concern in hyperemesis gravidarum unless specifically indicated by symptoms of a UTI.
Choice C rationale
Prothrombin time (PT) and other coagulation studies assess blood clotting. While severe dehydration and malnutrition from hyperemesis gravidarum could theoretically affect coagulation, it is not a routine initial test to anticipate.
Choice D rationale
Urine ketones are a key laboratory finding in hyperemesis gravidarum. Due to persistent vomiting and inadequate oral intake, the body starts to break down fat for energy, leading to ketonuria. The presence of ketones in the urine indicates starvation and the need for intravenous fluids and nutritional support.
Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"B"},"C":{"answers":"B,C"},"D":{"answers":"C"},"E":{"answers":"B"},"F":{"answers":"A,B,C"}}
Explanation
- Postpartum Endometritis is the most likely concern here, considering the fever, foul-smelling lochia, uterine tenderness, and tachycardia.
- Postpartum Hemorrhage is a possibility due to the boggy uterus and tachycardia, though her bleeding appears moderate.
- Lactational Mastitis is unlikely since the patient has no breast tenderness or redness.
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