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A nurse is caring for a client at 34 weeks gestation.

Medical History: The client has a history of gestational diabetes and mild hypertension.

Diagnostic Results: The latest ultrasound shows normal fetal growth and development. Blood sugar levels have been slightly elevated in the past week.

Vital Signs: Blood pressure has been steadily increasing over the past few hours. Heart rate and temperature remain within normal limits.

Complete the diagram by selecting the condition the client is most likely experiencing? Two actions the nurse should take to address that condition and two parameters the nurse should monitor to assess the client’s progress

Answer and Explanation

The Correct Answer is []

Condition

A. Preeclampsia is the most likely condition the client is experiencing given the following:
- History of gestational diabetes and mild hypertension.
- Recent elevation in blood pressure.
- Preeclampsia is characterized by high blood pressure and can be associated with kidney involvement, as suggested by the increased blood pressure.

Actions

Administer prescribed antihypertensive medication: This is crucial for managing preeclampsia, as it helps lower blood pressure and prevent complications.
Monitor blood pressure and urine protein levels regularly: Essential for assessing the progression of preeclampsia and guiding treatment decisions. Monitoring helps track whether the condition is worsening or responding to treatment.

Parameters to Monitor

Blood pressure readings: These are directly related to the severity of preeclampsia and help assess if the treatment is effective.
Level of protein in urine: Elevated protein levels indicate kidney involvement, which is a common complication of preeclampsia.

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Correct Answer is B

Explanation

Choice A rationale:
Consuming any amount of alcohol during pregnancy is not recommended. Alcohol can cross the placenta and harm the developing fetus, potentially leading to fetal alcohol spectrum disorders (FASDs). FASDs can cause a range of physical, mental, and behavioral problems, including intellectual disabilities, learning disabilities, and physical abnormalities. Even small amounts of alcohol can increase the risk of FASDs, and there is no known safe amount of alcohol to consume during pregnancy.

Choice B rationale:
Switching to whole milk during pregnancy can be a beneficial choice for several reasons:
Increased calcium and vitamin D: Whole milk is a rich source of calcium and vitamin D, which are essential for the development of the baby's bones, teeth, and muscles. Calcium also supports the mother's bone health and helps prevent pregnancy-related osteoporosis.
Healthy fats: Whole milk contains healthy fats that are important for fetal brain development and the mother's overall health. These fats also contribute to satiety and can help manage weight gain during pregnancy.
Essential nutrients: Whole milk provides a variety of other essential nutrients, including protein, vitamins A and B12, riboflavin, and zinc. These nutrients support overall health and well-being during pregnancy.

Choice C rationale:
Weight loss during pregnancy is generally not recommended unless specifically advised by a healthcare provider. Pregnancy is a time for growth and nourishment of the baby, and restricting calories or attempting to lose weight can potentially harm the developing fetus. It's important to focus on consuming a healthy, balanced diet and gaining a healthy amount of weight during pregnancy.

Choice D rationale:
Consuming high amounts of caffeine during pregnancy is not recommended. Caffeine can cross the placenta and potentially affect the baby's heart rate and sleep patterns. It's generally advised to limit caffeine intake to less than 200 milligrams per day during pregnancy.

A. I need to schedule the test when the baby is usually active B. I have to lie on my back during the test C. The baby’s heart rate will be monitored during the test D. I will be able to go to the bathroom during the test if necessary

Correct Answer is B

Explanation

Rationale for Choice A:
It is accurate that scheduling the NST when the baby is usually active is beneficial. This is because fetal movement is expected to cause accelerations in the fetal heart rate, which is a positive sign of fetal well-being.
By scheduling the test during a time of typical fetal activity, the chances of obtaining a reactive NST (a normal result) are increased.
Therefore, this statement does not indicate a need for further teaching.

Rationale for Choice B:
Lying on the back during the NST is not recommended.
This position can cause the weight of the uterus to compress the major blood vessels (the inferior vena cava and aorta), potentially reducing blood flow to the placenta and fetus.
Reduced blood flow can, in turn, lead to a decrease in fetal heart rate and movement.
To avoid this, the recommended position for NST is a semi-Fowler's position, which involves being partially reclined with the head and upper body elevated.
This position helps to promote uterine perfusion and prevent supine hypotension.

Rationale for Choice C:
It is accurate that the baby's heart rate will be monitored during the NST.
This is the primary purpose of the test: to assess the fetal heart rate response to fetal movement. Therefore, this statement does not indicate a need for further teaching.

Rationale for Choice D:
It is accurate that the client will be able to go to the bathroom during the NST if necessary. The test is noninvasive and does not require strict immobility.
The client can move around and use the bathroom as needed, as long as the fetal heart rate monitor is not disconnected.
Therefore, this statement does not indicate a need for further teaching.

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Condition

Actions

Parameters to Monitor

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

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