Chapter 14 Pregnancy at Risk: Pregestational Problems

Chapter 14   Pregnancy at Risk: Pregestational Problems

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1) The nurse is caring for a pregnant woman who admits to cocaine and ecstasy use on a regular basis. The client states, “Everybody knows that alcohol is bad during pregnancy, but what’s the big deal about ecstasy?” The best response by the nurse is:

1. “Ecstasy can cause a high fever in you and therefore cause the baby harm.”
2. “Ecstasy leads to deficiencies of thiamine and folic acid, which help the baby develop.”
3. “Ecstasy produces babies with small heads and short bodies with brain function alterations.”
4. “Ecstasy produces intrauterine growth restriction and meconium aspiration.”

Answer:  1

Explanation:  1. High body temperature is a side effect of MDMA (ecstasy). Increased body temperature increases fetal oxygen needs, which can lead to hypoxia and subsequent brain and major organ damage.

2. Alcohol, not ecstasy, causes deficiencies of thiamine and folic acid. Folic acid helps prevent neural tube defects.
3. Cocaine causes these fetal effects, not ecstasy.
4. Heroin causes these fetal effects, not ecstasy.

Page Ref: 262

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Planning/Health teaching and health promotion

Learning Outcome:  LO 14.3-Summarize the effects of alcohol and illicit drugs on the childbearing woman and her fetus/newborn.

MNL LO:  Determine strategies for managing the care of the pregnant woman who abuses substances.

 

2) The nurse is doing preconception counseling with a 28-year-old woman with no prior pregnancies. Which of the following statements made by the client indicates to the nurse that the client has understood the teaching?

1. “I can continue to drink alcohol until I am diagnosed as pregnant.”
2. “I need to stop drinking alcohol completely when I start trying to get pregnant.”
3. “A beer once a week will not damage the fetus.”
4. “I can drink alcohol while breastfeeding since it doesn’t pass into breast milk.”

Answer:  2

Explanation:  1. Women should discontinue drinking alcohol when they start to attempt pregnancy.

2. Women should discontinue drinking alcohol when they start to attempt pregnancy.
3. It is not known how much alcohol will cause fetal damage; therefore, alcohol during pregnancy is contraindicated.
4. Alcohol passes readily into breast milk; therefore, it should be avoided, or the milk should be pumped and dumped after alcohol consumption.

Page Ref: 261-262

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential VII: Clinical prevention and population health | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Evaluation/Health teaching and health promotion

Learning Outcome:  LO 14.3-Summarize the effects of alcohol and illicit drugs on the childbearing woman and her fetus/newborn.

MNL LO:  Determine strategies for managing the care of the pregnant woman who abuses substances.

 

 

3) A woman’s history and appearance suggest drug abuse. The nurse’s best approach would be to:

1. Ask the woman directly, “Do you use any street drugs?”
2. Ask the woman if she would like to talk to a counselor.
3. Ask some questions about over-the-counter medications and avoid the mention of illicit drugs.
4. Explain how harmful drugs can be for her baby.

Answer:  1

Explanation:  1. The best method of dealing with the client that the nurse suspects of using drugs is to be direct and ask the question in a direct fashion without prejudice, bias, or negative body language. Lack of judgmental attitudes/body language typically results in honest answers.

2. It is the responsibility of the nurse to question the client.
3. It is the responsibility of the nurse not to avoid the issue.
4. When talking to clients in a therapeutic manner, it is important not to be threatening or judgmental; an example of the latter behavior would be stating that the drugs will harm the baby.

Page Ref: 259-261

Cognitive Level:  Analyzing

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Implementation/Coordination of care

Learning Outcome:  LO 14.3-Summarize the effects of alcohol and illicit drugs on the childbearing woman and her fetus/newborn.

MNL LO:  Determine strategies for managing the care of the pregnant woman who abuses substances.

 

4) A 20-year-old woman is at 28 weeks’ gestation. Her prenatal history reveals past drug abuse, and urine screening indicates that she has recently used heroin. The nurse should recognize that the woman is at increased risk for:

1. Erythroblastosis fetalis.
2. Diabetes mellitus.
3. Abruptio placentae.
4. Pregnancy-induced hypertension.

Answer:  4

Explanation:  1. Erythroblastosis fetalis is secondary to physiological blood disorders such as Rh incompatibility.

2. Diabetes is an endocrine disorder that is unrelated to drug use/abuse.
3. Abruptio placentae is seen more commonly with cocaine/crack use.
4. Women who use heroin are at risk for poor nutrition, anemia, and pregnancy-induced hypertension (or pre-eclampsia).

Page Ref: 262-263

Cognitive Level:  Application

Client Need&Sub:  Health Promotion and Maintenance

Standards:  QSEN Competencies: Patient-centered care | AACN Essential Competencies: Essential IX: Baccalaureate generalist nursing practice | NLN Competencies: Nursing judgement | Nursing/Integrated Concepts: Nursing Process: Assessment/Coordination of care

Learning Outcome:  LO 14.3-Summarize the effects of alcohol and illicit drugs on the childbearing woman and her fetus/newborn.

MNL LO:  Determine strategies for managing the care of the pregnant woman who abuses substances.