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A nurse is caring for the client at the next prenatal visit.

Exhibits

After reviewing the assessment findings, which of the following complications is the client at an Increased risk for developing?

Select the 3 complications the client is at an increased risk for developing.

Thromboembolism

Electrolyte imbalance

Fetal growth restriction

Polyhydramnios

Gestational diabetes mellitus

Spontaneous abortion

Answer and Explanation

Correct Answer : B,C,F

A. Thromboembolism:

Thromboembolism refers to the formation of blood clots (thrombi) that break loose and travel through the bloodstream, potentially causing blockages in blood vessels (embolism). While thromboembolism is a risk in pregnancy, especially in individuals with risk factors such as obesity or a history of thromboembolic events, there are no specific indications in the scenario provided that suggest an increased risk of thromboembolism for this client.

B. Electrolyte imbalance:

The client's persistent nausea, vomiting, and ketonuria indicate significant dehydration and electrolyte imbalances. Dehydration can lead to imbalances in electrolytes such as potassium, sodium, and chloride, which are essential for proper bodily function. Laboratory findings of low potassium (hypokalemia) and elevated blood urea nitrogen (BUN) support the presence of electrolyte imbalances. These imbalances can have serious consequences for both the client and the fetus, including cardiac arrhythmias, muscle weakness, and metabolic disturbances.

C. Fetal growth restriction:

Hyperemesis gravidarum, characterized by severe nausea and vomiting leading to dehydration and weight loss, is associated with an increased risk of fetal growth restriction. Inadequate maternal nutrition and dehydration can compromise fetal growth and development, potentially leading to a smaller-than-expected size for gestational age. The client's weight loss and ketonuria further support the possibility of fetal growth restriction due to insufficient nutrient intake and placental perfusion.

D. Polyhydramnios:

Polyhydramnios refers to an excess of amniotic fluid surrounding the fetus in the uterus. While hyperemesis gravidarum and dehydration can lead to maternal complications, such as electrolyte imbalances and fetal growth restriction, they are not typically associated with an increased risk of polyhydramnios. Polyhydramnios is more commonly linked to fetal anomalies, maternal diabetes, or fetal conditions that affect swallowing or fluid regulation, none of which are evident in the provided scenario.

E. Gestational diabetes mellitus:

Gestational diabetes mellitus (GDM) is a condition characterized by high blood sugar levels during pregnancy. While GDM can lead to various complications for both the mother and the fetus, including macrosomia (large birth weight), birth injuries, and neonatal hypoglycemia, there are no indications in the scenario provided that suggest an increased risk of GDM for this client.

F. Spontaneous abortion:

Hyperemesis gravidarum, with severe nausea, vomiting, and weight loss, is associated with an increased risk of spontaneous abortion or miscarriage. Dehydration, electrolyte imbalances, and maternal malnutrition can compromise maternal and fetal well-being, potentially leading to pregnancy loss. Therefore, the client is at an increased risk of spontaneous abortion due to the severity of her symptoms and the impact on her overall health and pregnancy.

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Correct Answer is C

Explanation

A. Depressed anterior fontanel:

A depressed anterior fontanel is not typically associated with forceps-assisted birth. The fontanelles may become depressed in conditions such as dehydration or if the newborn is in a hypovolemic state, but it is not directly related to forceps use during delivery.

B. Epicanthal folds:

Epicanthal folds are normal anatomical features that are commonly seen in newborns, especially those of certain ethnic backgrounds. They are not indicative of an injury caused by forceps.

C. Facial asymmetry:

Facial asymmetry can occur as a result of forceps application during birth. The forceps' pressure on the baby's face can cause bruising, swelling, or even facial nerve injury, leading to temporary or permanent facial asymmetry.

D. Uneven gluteal skinfolds:

Uneven gluteal skinfolds are not typically associated with forceps-assisted birth. This finding is more commonly seen in conditions such as hip dysplasia or developmental dysplasia of the hip (DDH), and it is not directly related to forceps use during delivery.

A. Encourage the client to apply a warm pack to the perineum for discomfort. B. Prepare the client for a pudendal nerve block. C. Apply hydrogel pads to the perineum every 4 hr. D. Place a witch hazel pad on the client's perineal pad after each voiding.

Correct Answer is D

Explanation

A. Encourage the client to apply a warm pack to the perineum for discomfort.

While warm packs can provide comfort and promote relaxation for some types of perineal discomfort, they may not be suitable for a third-degree perineal laceration. In fact, applying heat directly to the perineum may exacerbate swelling and increase discomfort in this particular case. Therefore, it is not the most appropriate intervention for this client.

B. Prepare the client for a pudendal nerve block.

A pudendal nerve block is typically used during labor or for specific procedures (such as episiotomy repair) to provide pain relief. It is not a routine intervention for postpartum perineal lacerations.

C. Apply hydrogel pads to the perineum every 4 hr.

While hydrogel pads can provide some relief for perineal discomfort, they are not typically used specifically for third-degree perineal lacerations. These types of lacerations require medical intervention and repair rather than solely relying on over-the-counter remedies like hydrogel pads. Therefore, this intervention may not address the underlying issue effectively.

D. Place a witch hazel pad on the client's perineal pad after each voiding.

Witch hazel pads can provide soothing relief to the perineum and help reduce swelling and discomfort after childbirth. They have a cooling effect and can also have mild astringent properties, which may aid in promoting healing.Placing a witch hazel pad on the perineal pad after each voiding helps ensure that the perineum remains clean and that the client experiences continuous relief from discomfort

Neuropathic Pain: Pudendal Nerve Block | SpringerLink

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A nurse is caring for the client at the next prenatal visit. Exhibits After reviewing the assessment findings, which of the following complications is the client at an Increased risk for developing? Select the 3 complications the client is at an increased risk for developing.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a newborn who was born via a forceps-assisted birth. Which of the following findings should the nurse identify as an injury caused by the forceps?

Correct Answer is C

Explanation

A nurse is planning care for a client who is 12 hr postpartum and has a third-degree perineal laceration. Which of the following interventions should the nurse include in the plan?

Correct Answer is D

Explanation

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A nurse is assessing a client who is 1 hr postpartum. Which of the following findings should the nurse report to the provider?

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A nurse on a labor and delivery unit is providing teaching to a client who plans to use hypnosis to control labor pain. Which of the following Information should the nurse Include?

A nurse is caring for a client who is in the second stage of labor and is experiencing a shoulder dystocia. The provider instructs the nurse to perform the McRoberts maneuver. Which of the following actions should the nurse take?

A nurse is assessing a newborn who is 2 hr old. Which of the following findings is an indication of hypoglycemia? (Select all that apply.)

A nurse is caring for the client at the next prenatal visit.

Exhibits

After reviewing the assessment findings, which of the following complications is the client at an Increased risk for developing?

Select the 3 complications the client is at an increased risk for developing.