A nurse is reinforcing teaching with a newly licensed nurse. Which of the following complications should the nurse include?

Pacenta Previa

Newborn Hypoglycemia

Oligohydramnios

Small for gestational age newborn

Maternal gestational diabetes

Answer and Explanation

The Correct Answer is E

Choice A rationale:

Placenta previa is a condition in which the placenta covers all or part of the cervix. It's a serious complication that can cause heavy bleeding during pregnancy and childbirth. However, it's not a direct complication of maternal gestational diabetes.

Choice B rationale:

Newborn hypoglycemia is a condition in which a newborn's blood sugar levels are too low. It can occur in infants of mothers with gestational diabetes, but it's not the most common or significant complication associated with the condition.

Choice C rationale:

Oligohydramnios is a condition characterized by a low amount of amniotic fluid around the baby. It can be associated with maternal gestational diabetes, but it's not as common as other complications, such as macrosomia (large for gestational age baby).

Choice D rationale:

Small for gestational age (SGA) newborn refers to a baby who is smaller than expected for their gestational age. It can be caused by several factors, including restricted intrauterine growth, which can be associated with maternal gestational diabetes. However, it's not the most direct or common complication of the condition.

Choice E rationale:

Maternal gestational diabetes is a condition in which a woman develops high blood sugar levels during pregnancy. It's the most common metabolic complication of pregnancy and can lead to several serious health risks for both the mother and baby. These risks include:

Macrosomia (large for gestational age baby): High blood sugar levels in the mother can cause the baby to grow excessively large, leading to complications during labor and delivery, such as shoulder dystocia, birth injuries, and cesarean delivery. Preeclampsia: Gestational diabetes increases the risk of preeclampsia, a serious condition characterized by high blood pressure and protein in the urine. It can affect multiple organs, including the liver and kidneys, and can be life-threatening for both mother and baby.

Premature birth: Women with gestational diabetes are more likely to deliver their babies prematurely, which can lead to health problems for the baby, such as respiratory distress syndrome, feeding difficulties, and developmental delays.

Neonatal hypoglycemia: Newborns of mothers with gestational diabetes are at increased risk of hypoglycemia (low blood sugar) after birth due to the sudden withdrawal of maternal glucose supply. This can cause seizures, brain damage, and even death if not promptly treated.

Type 2 diabetes later in life: Both mother and child are at increased risk of developing type 2 diabetes later in life.

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Correct Answer is B

Explanation

Choice A rationale:

A heart rate of 60/min is a sign of bradycardia, which can be a side effect of magnesium sulfate toxicity. Magnesium sulfate slows down neuromuscular transmission, which can lead to a decrease in heart rate. If the heart rate drops too low, it can compromise blood flow to vital organs, including the brain and heart. Therefore, a heart rate of 60/min is not a safe finding that would indicate the nurse should continue the infusion.

Choice C rationale:

A urine output of 50 ml in 4 hours is indicative of oliguria, which is a decreased urine output. Oliguria can be a sign of magnesium sulfate toxicity, as magnesium is primarily excreted through the kidneys. If the kidneys are not functioning properly, magnesium can build up in the body and lead to toxic levels. Therefore, a urine output of 50 ml in 4 hours is not a safe finding that would indicate the nurse should continue the infusion.

Choice D rationale:

Diminished deep-tendon reflexes are another sign of magnesium sulfate toxicity. Magnesium sulfate suppresses the nervous system, which can lead to decreased reflexes. If the reflexes are too diminished, it can indicate that the magnesium level in the body is too high. Therefore, diminished deep-tendon reflexes are not a safe finding that would indicate the nurse should continue the infusion.

Choice B rationale:

A respiratory rate of 16/min is within the normal range for an adult. It does not indicate any respiratory depression, which can be a side effect of magnesium sulfate toxicity. Therefore, a respiratory rate of 16/min is a safe finding that would indicate the nurse can continue the infusion.

A. Initiate an IV infusion of magnesium sulfate. B. Administer antibiotics. C. Request the RN perform a cervical examination. D. Prepare for cesarean birth.

Correct Answer is C

Explanation

Choice A:
Magnesium sulfate is a medication primarily used to prevent or manage seizures in women with preeclampsia or eclampsia, conditions characterized by high blood pressure and protein in the urine during pregnancy. It is not indicated for heavy vaginal bleeding in early pregnancy.
Administration of magnesium sulfate without a clear indication could potentially lead to adverse effects such as respiratory depression, decreased deep tendon reflexes, and cardiac arrhythmias.

Choice B:
Antibiotics are used to treat bacterial infections. While heavy vaginal bleeding can sometimes be a sign of infection, it is not the primary cause of bleeding in early pregnancy.
Indiscriminate use of antibiotics without a confirmed bacterial infection can contribute to antibiotic resistance and potentially mask the underlying cause of the bleeding.

Choice D:
Cesarean birth is a major surgical procedure that is typically reserved for situations where there is a risk to the mother or fetus, such as fetal distress, failure to progress in labor, or placental abruption.
It is not indicated as the first-line intervention for heavy vaginal bleeding in early pregnancy, as there are other less invasive diagnostic and management options available.

Choice C:
A cervical examination allows the healthcare provider to assess the condition of the cervix, including its dilation and effacement, as well as to potentially identify any sources of bleeding, such as cervical polyps or lesions.
This information is crucial in determining the appropriate course of management for the patient.
It can help differentiate between potential causes of bleeding, such as threatened miscarriage, inevitable miscarriage, or ectopic pregnancy.

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A nurse is reinforcing teaching with a newly licensed nurse. Which of the following complications should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a client who has severe preeclampsia and is receiving magnesium sulfate IV at 2 g/hr. Which of the following findings indicates that it is safe for the nurse to continue the infusion?

Correct Answer is B

Explanation

A nurse is assisting with the admission of a client who is at 8 weeks of gestation and has heavy vaginal bleeding. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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