Which condition is defined by seizures in pregnancy?
Eclampsia
Preeclampsia
HELLP syndrome
Gestational hypertension
The Correct Answer is A
Eclampsia is the occurrence of tonic-clonic seizures in a client with preeclampsia that cannot be attributed to other neurological causes. The pathophysiology involves cerebral edema, vasospasm, and hypertensive encephalopathy. It is a life-threatening complication that requires immediate stabilization with magnesium sulfate and delivery.
A. Eclampsia: This is the convulsive stage of the preeclampsia-eclampsia syndrome. The seizures are typically self-limiting but can cause maternal hypoxia, placental abruption, or intracranial hemorrhage. It represents the most severe end of the gestational hypertensive spectrum.
B. Preeclampsia: This condition is defined by new-onset hypertension (BP ≥ 140/90) and proteinuria or end-organ dysfunction after 20 weeks. While it is the precursor to eclampsia, it does not include seizures. It involves systemic endothelial dysfunction and impaired placental perfusion.
C. HELLP syndrome: HELLP is a severe variant of preeclampsia characterized by hemolysis, elevated liver enzymes, and low platelets. While it carries a high risk of hepatic rupture and bleeding, it is a laboratory diagnosis and does not inherently define the seizure activity of eclampsia.
D. Gestational hypertension: This is characterized by elevated blood pressure after 20 weeks without proteinuria or systemic signs of organ damage. It is the mildest form of pregnancy-induced hypertension. It does not involve the cerebral irritability required to trigger generalized seizure activity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Epidural analgesia is a versatile regional anesthetic technique used to provide continuous pain relief throughout labor. Modern clinical guidelines emphasize that the timing of administration should be individualized based on maternal perception of pain intensity. There is no evidence that early administration increases the risk of cesarean delivery.
A. Only at 6cm dilation: Waiting for a specific cervical measurement is an outdated practice that can lead to unnecessary suffering. Pain is subjective, and significant distress can occur well before the active phase of labor. Analgesia can be safely initiated regardless of the centimeter count.
B. Upon request: The current standard of care is to provide pain management whenever the laboring patient finds the intensity intolerable. As long as there are no contraindications and the patient is in established labor, the epidural can be placed. This prioritizes maternal autonomy and comfort.
C. Only during transition: Transition is the most intense phase of labor, but placing an epidural at this late stage may not provide relief in time for the expulsive phase. It is often technically difficult to place the catheter while the patient is experiencing frequent contractions. Earlier placement is generally preferred.
D. After delivery: An epidural is used primarily to manage the nociceptive signals of uterine contractions and cervical stretching during labor. While it can be used for postpartum repair, its primary purpose is intrapartum analgesia. Suggesting it only after delivery ignores the patient's need for pain control.
Correct Answer is B
Explanation
Effacement is the physiological process where the cervix thins, shortens, and softens in preparation for delivery. As the fetal presenting part descends, the cervix is drawn upward into the lower uterine segment. This process is measured in percentages, with 100% indicating that the cervix is paper-thin.
A. "It measures fetal descent.": Fetal descent is measured as "station," which describes the relationship of the fetal presenting part to the maternal ischial spines. While effacement and descent occur simultaneously, they are different mechanical parameters. Station is measured in positive and negative numbers.
B. "It measures cervical thinning.": This is the correct definition. In a nulliparous client, effacement usually occurs before significant dilation begins. The muscular fibers of the cervix are incorporated into the uterine body, allowing the fetus to pass through the birth canal more easily.
C. "It measures cervical width.": The width or opening of the cervix is referred to as "dilation," which is measured in centimeters from 0 to 10. Effacement refers to the vertical shortening and thickness of the tissue rather than how wide the opening has become. Both are essential for labor progress.
D. "It measures contraction strength.": Contraction strength is assessed via palpation or an intrauterine pressure catheter (IUPC) and is measured in Montevideo units or descriptive terms like "mild," "moderate," or "strong." It is a measure of uterine force, not cervical architecture.
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