A woman, G4P0210, and 12 weeks' gestation has been admitted to labor and delivery for a cerclage procedure. Which of the following long-term goals for this patient would we anticipate by doing this procedure?

The patient will deliver a baby that is appropriate for gestational age

The patient will have a normal blood glucose throughout the pregnancy

The patient will deliver after 38 weeks' gestation

The patient will gain less than 25 pounds during the pregnancy

Answer and Explanation

The Correct Answer is C

A. The patient will deliver a baby that is appropriate for gestational age. While cerclage helps prevent preterm birth, it does not directly influence fetal growth or ensure that the baby will be appropriate for gestational age (AGA). Factors such as maternal nutrition, placental function, and genetics play a larger role in fetal growth.

B. The patient will have a normal blood glucose throughout the pregnancy. Cerclage is performed to prevent cervical insufficiency and preterm birth, not to regulate blood glucose. Maintaining normal blood sugar levels is important for pregnancy outcomes but is unrelated to this procedure.

C. The patient will deliver after 38 weeks' gestation. The primary goal of a cerclage is to prevent preterm birth by reinforcing the cervix and allowing the pregnancy to progress to term. Women with a history of second-trimester pregnancy losses or cervical insufficiency benefit from this procedure to increase the likelihood of delivering at or near term.

D. The patient will gain less than 25 pounds during the pregnancy. Weight gain recommendations are based on maternal BMI and nutritional status, not the need for a cerclage. The procedure does not directly affect maternal weight gain.

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Correct Answer is B

Explanation

A. Induction of labor with intravenous oxytocin. Induction is contraindicated in cases of abruptio placentae with a Category III fetal heart rate tracing, as labor induction can worsen fetal distress and maternal bleeding. An immediate cesarean section is the safest intervention to prevent fetal and maternal complications.

B. An emergency cesarean section. A Category III fetal heart rate tracing with minimal variability and a prolonged deceleration indicates severe fetal distress, requiring immediate delivery. Partial abruptio placentae can cause fetal hypoxia, maternal hemorrhage, and potential fetal demise. The priority is an emergency cesarean section to ensure the best outcome for both mother and baby.

C. In-hospital fetal monitoring for 48 hours. Continuous monitoring is essential in cases of mild abruptio placentae without fetal distress, but in this case, a Category III tracing indicates an immediate threat to the fetus, making waiting inappropriate.

D. Discharge home on strict bed rest. Abruptio placentae is a serious obstetric emergency, and home management is never appropriate when fetal distress is present. Immediate intervention is necessary to prevent fetal and maternal complications.

A. Diuresis B. Hypotension C. Increased risk for seizures D. Excessive uterine bleeding.

Correct Answer is D

Explanation

A. Diuresis. Increased urine output is a positive sign in a postpartum woman with preeclampsia, indicating that fluid shifts are occurring and the kidneys are functioning well. Magnesium sulfate does not cause fluid retention, and diuresis is not a major concern at this time.

B. Hypotension. While magnesium sulfate can cause vasodilation, leading to a mild decrease in blood pressure, severe hypotension is not the primary concern. The main hemodynamic concern postpartum is ensuring adequate uterine tone and preventing hemorrhage.

C. Increased risk for seizures. Magnesium sulfate is given to prevent eclampsia-related seizures, and its continued administration postpartum helps reduce seizure risk. The risk of seizures decreases after delivery, but stopping the infusion too early could increase the risk, making this a secondary rather than primary concern.

D. Excessive uterine bleeding. Magnesium sulfate relaxes smooth muscle, including the uterus, which can lead to uterine atony and increased postpartum hemorrhage risk. This is a critical concern in the immediate postpartum period, as uterine atony can result in life-threatening blood loss requiring urgent intervention.

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A woman, G4P0210, and 12 weeks' gestation has been admitted to labor and delivery for a cerclage procedure. Which of the following long-term goals for this patient would we anticipate by doing this procedure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client at 35 weeks' gestation is admitted with a partial abruptio placenta and a Category III fetal heart rate tracing with minimal variability and a prolonged deceleration. The nurse anticipates a plan of care for this client that includes most importantly:

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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