The nurse recognizes that an expected change in the hematologic system that occurs during the 2nd trimester of pregnancy is:
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Solution
An increase in blood volume.
The blood volume increases by approximately 40-50% during pregnancy. The peak blood volume occurs between 30 and 34 weeks of gestation. The hematocrit decreases as a result of the increased blood volume.
After the first four months of pregnancy, the chief source of estrogen and progesterone is the:
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Solution
Placenta.
When the placental formation is complete, around the 16th week of pregnancy; it produces estrogen and progesterone.
The developing cells are called a fetus from the:
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Solution
Eighth week to the time of birth.
In the first 7-14 days, the ovum is known as a blastocyst; it is called an embryo until the eighth week; the developing cells are then called a fetus until birth.
The chief function of progesterone is the:
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Solution
Preparation of the uterus to receive a fertilized egg.
Progesterone stimulates differentiation of the endometrium into a secretory type of tissue.
In a lecture on sexual functioning, the nurse plans to include the fact that ovulation occurs when the:
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Solution
Blood level of LH is too high.
It is the surge of LH secretion in mid cycle that is responsible for ovulation.
In the 12th week of gestation, a client completely expels the products of conception. Because the client is Rh negative, the nurse must:
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Solution
Administer RhoGAM within 72 hours.
RhoGAM is given within 72 hours postpartum if the client has not been sensitized already.
A nurse is caring for a pregnant client with severe preeclampsia who is receiving IV magnesium sulfate. Select all nursing interventions that apply in the care for the client.
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Solution
Answers: C, D, E, F, and G.
When caring for a client receiving magnesium sulfate therapy, the nurse would monitor maternal vital signs, especially respirations, every 30-60 minutes and notify the physician if respirations are less than 12, because this would indicate respiratory depression. Calcium gluconate is kept on hand in case of magnesium sulfate overdose because calcium gluconate is the antidote for magnesium sulfate toxicity. Deep tendon reflexes are assessed hourly. Cardiac and renal function are monitored closely. The urine output should be maintained at 30 ml per hour because the medication is eliminated through the kidneys.
A woman with preeclampsia is receiving magnesium sulfate. The nurse assigned to care for the client determines that the magnesium therapy is effective if:
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Solution
Seizures do not occur.
For a client with preeclampsia, the goal of care is directed at preventing eclampsia (seizures).
Option A: Ankle clonus indicated hyperreflexia and may precede the onset of eclampsia.
Option B: Magnesium sulfate is an anticonvulsant, not an antihypertensive agent. Although a decrease in blood pressure may be noted initially, this effect is usually transient.
Option D: Scotomas are areas of complete or partial blindness. Visual disturbances, such as scotomas, often precede an eclamptic seizure.
A pregnant client is receiving magnesium sulfate for the management of preeclampsia. A nurse determines the client is experiencing toxicity from the medication if which of the following is noted on assessment?
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Solution
Respirations of 10 per minute.
Magnesium toxicity can occur from magnesium sulfate therapy. Signs of toxicity relate to the central nervous system depressant effects of the medication and include respiratory depression, loss of deep tendon reflexes, and a sudden drop in the fetal heart rate and maternal heart rate and blood pressure.
Option B: Therapeutic levels of magnesium are 4-7 mEq/L.
Option C: Proteinuria of +3 would be noted in a client with preeclampsia.
Rho (D) immune globulin (RhoGAM) is prescribed for a woman following delivery of a newborn infant and the nurse provides information to the woman about the purpose of the medication. The nurse determines that the woman understands the purpose of the medication if the woman states that it will protect her next baby from which of the following?
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Solution
Being affected by Rh incompatibility.
Rh incompatibility can occur when an Rh-negative mom becomes sensitized to the Rh antigen. Sensitization may develop when an Rh-negative woman becomes pregnant with a fetus who is Rh positive. During pregnancy and at delivery, some of the baby’s Rh positive blood can enter the maternal circulation, causing the woman’s immune system to form antibodies against Rh-positive blood. Administration of Rho(D) immune globulin prevents the woman from developing antibodies against Rh-positive blood by providing passive antibody protection against the Rh antigen.