Gestational Hypertension > Maternal & Newborn
Exam Review
Outcomes and prognosis
Total Questions : 5
Showing 5 questions, Sign in for moreA nurse is caring for a client with gestational hypertension who is receiving magnesium sulfate intravenously.
What is the primary reason for administering magnesium sulfate to this client?
Explanation
The correct answer is choice B. To prevent seizures.Magnesium sulfate is primarily used for its anticonvulsive effects in treating hypertensive disorders of pregnancy.It helps to prevent and manage seizures during stabilization and until 24 hours after delivery.
Choice A is wrong because magnesium sulfate does not lower the blood pressure.It may have a mild vasodilatory effect, but it is not the main mechanism of action.Antihypertensive drugs such as nifedipine are used to lower the blood pressure in gestational hypertension.
Choice C is wrong because magnesium sulfate does not induce labor.It may have a tocolytic effect, which means it can relax the uterine muscles and delay preterm labor.
Choice D is wrong because magnesium sulfate does not increase urine output.It may cause fluid retention and edema, which are adverse effects that need to be monitored.Diuretics are used to increase urine output, but they are not recommended for hypertensive disorders during pregnancy.
A nurse is reviewing the laboratory results of a client with gestational hypertension who has developed preeclampsia.
Which of the following findings would indicate the presence of HELLP syndrome?
Explanation
The correct answer is choice C.Elevated serum transaminases indicate liver damage, which is one of the features of HELLP syndrome.HELLP syndrome is a rare pregnancy complication that is a type of preeclampsia and has similar symptoms.It stands for hemolysis, elevated liver enzymes, and low platelet count.
Choice A is wrong because elevated serum creatinine indicates kidney damage, which is not specific for HELLP syndrome.Kidney damage can occur in preeclampsia or eclampsia as well.
Choice B is wrong because elevated serum uric acid is also not specific for HELLP syndrome.It can be a marker of preeclampsia or eclampsia, but it is not part of the diagnostic criteria for HELLP syndrome.
Choice D is wrong because elevated serum glucose is not related to HELLP syndrome.It can be a sign of gestational diabetes, which is a different pregnancy complication.
Normal ranges for serum transaminases are 10 to 40 U/L for AST and 7 to 56 U/L for ALT.Normal ranges for serum creatinine are 0.5 to 1.1 mg/dL for women.Normal ranges for serum uric acid are 2.4 to 6.0 mg/dL for women.Normal ranges for serum glucose are 70 to 100 mg/dL for fasting and less than 140 mg/dL for postprandial.
A nurse is teaching a client with gestational hypertension about the signs and symptoms of placental abruption.
Which of the following statements by the client indicates a need for further teaching?
Explanation
The correct answer is choice D. Drinking plenty of fluids if there is decreased fetal movement is wrong because it will not improve the condition of the baby or the placenta.Decreased fetal movement can be a sign of fetal distress due to placental abruption and needs immediate medical attention.
Choice A is correct because vaginal bleeding is a common symptom of placental abruption and indicates that the placenta has separated from the uterus.
Choice B is correct because monitoring blood pressure at home regularly is important for women with gestational hypertension, as high blood pressure is a risk factor for placental abruption.
Choice C is correct because lying down on the left side can improve blood flow to the uterus and the baby, and may help relieve abdominal pain caused by placental abruption.
A nurse is preparing to discharge a client with gestational hypertension who delivered a healthy baby two days ago.
Which of the following instructions should the nurse include in the discharge teaching?
Explanation
The correct answer is choice B. You should continue taking your antihypertensive medication as prescribed.This is because gestational hypertension can persist for several days or weeks after delivery and may increase your risk of complications such as stroke or heart failure.You should also monitor your blood pressure at home and report any abnormal readings to your provider.
Choice A is wrong because you should not avoid breastfeeding your baby unless your provider advises you to do so.Breastfeeding has many benefits for both you and your baby and does not affect your blood pressure.
Choice C is wrong because you do not need to limit your sodium intake to less than 2 grams per day unless your provider tells you to do so.There is no evidence that sodium restriction lowers blood pressure or prevents preeclampsia in pregnant women.
Choice D is wrong because you should have a follow-up appointment with your provider within one week after delivery, not six weeks.This is to check your blood pressure, review your medication, and screen for any postpartum complications.
A nurse is assessing a client with gestational hypertension who is at 34 weeks of gestation.
The nurse notes that the client’s blood pressure is 160/100 mmHg, her urine protein is 3+, and she has mild edema in her lower extremities.
The nurse also observes that the client has brisk deep tendon reflexes and clonus.
How should the nurse interpret these findings?
Explanation
The correct answer is choice B. The client has severe preeclampsia and needs immediate delivery.Severe preeclampsia is diagnosed when the blood pressure is at least 160/100 mmHg, the urine protein is 3+ or more, and there are signs of organ damage or central nervous system involvement, such as brisk deep tendon reflexes and clonus.These findings indicate a high risk of eclampsia, which is a life-threatening condition characterized by seizures.Immediate delivery is the only definitive treatment for preeclampsia and eclampsia.
Choice A is wrong because the client has more than mild preeclampsia.Mild preeclampsia is diagnosed when the blood pressure is at least 140/90 mmHg, the urine protein is 1+ or 2+, and there are no signs of organ damage or central nervous system involvement.Close monitoring may be appropriate for mild preeclampsia, depending on the gestational age and fetal status.
Choice C is wrong because the client does not have eclampsia yet.Eclampsia is diagnosed when the client has preeclampsia and seizures.Magnesium sulfate and anticonvulsants are used to prevent and treat seizures in eclampsia, but they do not cure preeclampsia.Delivery is still necessary to resolve the condition.
Choice D is wrong because the client does not have chronic hypertension.Chronic hypertension is high blood pressure that was present before pregnancy or that occurs before 20 weeks of gestation.The client’s blood pressure was normal before pregnancy and increased after 20 weeks of gestation, indicating gestational hypertension or preeclampsia.
Antihypertensive medication adjustment may be needed for chronic hypertension
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