Chapter 32: Labor and Birth Complications

Chapter 32: Labor and Birth Complications

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. In planning for home care of a woman with preterm labor, which concern should the nurse need to address?

ANS:  C

Prolonged bed rest may cause adverse effects such as weight loss, loss of appetite, muscle wasting, weakness, bone demineralization, decreased cardiac output, risk for thrombophlebitis, alteration in bowel functions, sleep disturbance, and prolonged postpartum recovery. Nursing assessments differ somewhat from those performed in the acute care setting, but this concern does not need to be addressed. Restricted activity and medications may prevent preterm labor but not in all women. In addition, the plan of care is individualized to meet the needs of each client. Many women receive home health nurse visits, but care is individualized for each woman.

DIF:    Cognitive Level: Analyze                REF:   p. 777             TOP:   Nursing Process: Planning

MSC:  Client Needs: Health Promotion and Maintenance

2. Which nursing intervention is paramount when providing care to a client with preterm labor who has received terbutaline?

ANS:  B

Terbutaline is a beta₂-adrenergic agonist that affects the mother’s cardiopulmonary and metabolic systems. Signs of cardiopulmonary decompensation include adventitious breath sounds and dyspnea. An assessment for dyspnea and crackles is important for the nurse to perform if the woman is taking magnesium sulfate. Assessing DTRs does not address the possible respiratory side effects of using terbutaline. Since terbutaline is a beta₂-adrenergic agonist, it can lead to hyperglycemia, not hypoglycemia. Beta₂-adrenergic agonist drugs cause tachycardia, not bradycardia.

DIF:    Cognitive Level: Analyze                REF:   pp. 767-768

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiologic Integrity

3. In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor, which finding alerts the nurse to possible side effects?

ANS:  D

The therapeutic range for magnesium sulfate management is 4 to 7.5 mg/dl. A serum magnesium level of 10 mg/dl could lead to signs and symptoms of magnesium toxicity, including oliguria and respiratory distress. Urine output of 160 ml in 4 hours, DTRs of 2+, and a RR of 16 breaths per minute are all normal findings.

DIF:    Cognitive Level: Apply                   REF:   p. 767             TOP:   Nursing Process: Evaluation

MSC:  Client Needs: Physiologic Integrity

4. A woman in preterm labor at 30 weeks of gestation receives two 12-mg intramuscular (IM) doses of betamethasone. What is the purpose of this pharmacologic intervention?

ANS:  A

Antenatal glucocorticoids administered as IM injections to the mother accelerate fetal lung maturity. Propranolol (Inderal) is given to reduce the effects of ritodrine administration. Betamethasone has no effect on uterine contractions. Calcium gluconate is given to reverse the respiratory depressive effects of magnesium sulfate therapy.

DIF:    Cognitive Level: Understand            REF:   p. 769             TOP:   Nursing Process: Planning

MSC:   Client Needs: Physiologic Integrity