A woman pregnant with twins comes to the clinic for an evaluation. While assessing the client, the nurse would be especially alert for signs and symptoms for which potential problem?
oligohydramnios
preeclampsia
chorioamnionitis
post-term labor
The Correct Answer is B
A. Oligohydramnios:
Oligohydramnios refers to a condition where there is too little amniotic fluid surrounding the fetus in the womb. It can be concerning because amniotic fluid plays a crucial role in protecting and cushioning the fetus, aiding in lung development, and preventing compression of the umbilical cord. While oligohydramnios can be a complication in pregnancy, it's not necessarily more common or specific to twin pregnancies compared to singleton pregnancies.
B. Preeclampsia:
Preeclampsia is a serious pregnancy complication characterized by high blood pressure and signs of damage to other organ systems, such as the liver and kidneys. It usually develops after 20 weeks of pregnancy and can lead to serious complications for both the mother and the babies if not managed properly. Multiple pregnancies, including twins, are considered a risk factor for developing preeclampsia. Therefore, pregnant women carrying twins require close monitoring for signs and symptoms of preeclampsia.
C. Chorioamnionitis:
Chorioamnionitis is an infection of the fetal membranes (chorion and amnion) and amniotic fluid. It typically occurs due to bacterial infection ascending from the vagina into the uterus, often during prolonged labor or rupture of membranes. While chorioamnionitis is a concern in pregnancy, it's not necessarily more common in twin pregnancies compared to singleton pregnancies.
D. Post-term labor:
Post-term labor refers to labor that begins after 42 weeks of gestation. Prolonged pregnancy beyond the due date can increase the risks of complications for both the mother and the baby, including fetal distress, macrosomia (large birth weight), and meconium aspiration. Post-term labor can occur in both singleton and multiple pregnancies, but it's not specifically more associated with twin pregnancies.
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Related Questions
Correct Answer is B
Explanation
A. Client has a twin sister.
Having a twin sister does not directly increase the client's risk of developing preeclampsia. While twin pregnancies are associated with higher rates of certain complications, such as preterm birth and gestational hypertension, having a twin sister herself does not inherently increase her risk of preeclampsia.
B. Her mother had preeclampsia during pregnancy.
This is the correct choice. A history of preeclampsia in the client's mother is a significant risk factor for preeclampsia in the client herself. Preeclampsia has a genetic component, and women with a family history of the condition, especially in their mothers, are at increased risk of developing it during their own pregnancies.
C. This is the client's second pregnancy.
While the number of pregnancies a woman has experienced can influence her risk of certain pregnancy complications, such as placental abnormalities, it is not as strong a risk factor for preeclampsia as a family history of the condition. Preeclampsia can occur in both first and subsequent pregnancies, regardless of the number of pregnancies a woman has had.
D. Her sister-in-law had gestational hypertension.
Gestational hypertension is a related condition to preeclampsia and shares some risk factors, such as high blood pressure during pregnancy. However, a sister-in-law having gestational hypertension does not directly increase the client's risk of preeclampsia. While it may suggest a family predisposition to hypertensive disorders during pregnancy, it is not as specific a risk factor for preeclampsia as a direct family history of the condition, such as in the client's mother.
Correct Answer is B
Explanation
A. "I won't use my birth control pills for at least a year or two." - This statement does not accurately reflect the teaching provided. After treatment for gestational trophoblastic disease, it is important for the woman to avoid pregnancy for a specified period of time to allow for monitoring and to reduce the risk of complications. However, the use of birth control pills is typically recommended to prevent pregnancy during this period.
B. "I will be sure to avoid getting pregnant for at least 1 year." - This statement demonstrates understanding of the teaching. After treatment for gestational trophoblastic disease, healthcare providers typically recommend avoiding pregnancy for at least one year. This allows for monitoring of hCG levels to ensure they return to normal and to reduce the risk of recurrence.
C. "My blood pressure will continue to be increased for about 6 more months." - This statement is not related to the teaching about gestational trophoblastic disease. Blood pressure may be affected during pregnancy, but it is not a specific concern related to treatment for gestational trophoblastic disease.
D. "My intake of iron will have to be closely monitored for 6 months." - This statement is not directly related to the teaching about gestational trophoblastic disease. While monitoring of iron levels may be important for overall health, it is not a specific recommendation related to treatment for this condition.
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