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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 D

Explanation

A. Bilirubin 1 mg/dL (0.1 to 1 mg/dL):

Bilirubin levels can be elevated in conditions involving liver dysfunction or hemolysis, such as HELLP syndrome. However, a bilirubin level of 1 mg/dL falls within the normal range (0.1 to 1 mg/dL). While bilirubin levels may be elevated in some cases of HELLP syndrome, this particular value is not indicative of HELLP syndrome.

B. Uric acid 6.8 mg/dL (2 to 6.6 mg/dL):

Elevated uric acid levels are commonly seen in preeclampsia, but they are not specific to HELLP syndrome. Uric acid levels can rise due to decreased renal function and increased cell breakdown. However, while a level of 6.8 mg/dL is slightly elevated compared to the normal range (2 to 6.6 mg/dL), it alone does not confirm the presence of HELLP syndrome.

C. Fibrinogen 500 mg/dL (200 to 400 mg/dL):

Fibrinogen levels are typically increased in pregnancy, but they can be decreased in conditions associated with consumption coagulopathy, such as disseminated intravascular coagulation (DIC). However, elevated fibrinogen levels are not typically associated with HELLP syndrome. A level of 500 mg/dL is above the normal range (200 to 400 mg/dL), but this finding alone does not indicate HELLP syndrome.

D. Aspartate aminotransferase (AST) 80 units/L (4 to 20 units/L):

Aspartate aminotransferase (AST) is a liver enzyme that can be elevated in liver injury or dysfunction, which can occur in HELLP syndrome. An AST level of 80 units/L is significantly elevated compared to the normal range (4 to 20 units/L), suggesting liver dysfunction. Elevated liver enzymes are a characteristic feature of HELLP syndrome, making this finding the most indicative of HELLP syndrome among the options provided.

A. Weak cry B. Absent Moro reflex C. Respiratory rate of 30/min D. Poor feeding

Correct Answer is D

Explanation

A. Weak cry

While infants with neonatal abstinence syndrome (NAS) may exhibit irritability and excessive crying, a weak cry specifically is not typically associated with NAS. A weak cry could indicate other issues such as respiratory distress or neurological problems, but it is not a characteristic manifestation of NAS.

B. Absent Moro reflex

The Moro reflex is a normal primitive reflex present in newborns, involving the sudden extension and then flexion of the infant's arms in response to a sensation of falling or a loud noise. While NAS can affect the nervous system, leading to irritability and tremors, it typically does not cause the complete absence of the Moro reflex. Thus, this choice is less likely.

C. Respiratory rate of 30/min

A respiratory rate of 30/min in a newborn is within the normal range. While NAS can sometimes cause respiratory distress, it would typically present as symptoms such as rapid breathing, not necessarily a specific rate like 30/min. Therefore, this choice is not strongly associated with NAS.

D. Poor feeding

Poor feeding is a common manifestation of neonatal abstinence syndrome (NAS). Infants born to mothers who used methadone during pregnancy often experience withdrawal symptoms, including irritability and gastrointestinal issues, which can interfere with their ability to feed effectively. Poor feeding is a hallmark sign of NAS and is frequently observed in affected newborns.

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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 reviewing the laboratory results of a client who is at 32 weeks of gestation and has preeclampsia. The nurse should identify that which of the following findings is indicated with HELLP syndrome?

Correct Answer is D

Explanation

A nurse is assessing the newborn of a client who reports methadone use during pregnancy. The nurse should expect the newborn to exhibit which of the following manifestations?

Correct Answer is D

Explanation

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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.