Chapter 32- Labor and Birth Complications
Lowdermilk- Maternity & Women's Health Care, 12th
Edition Latest Update 2022
1. In planning for home care
... [Show More] of a woman with preterm labor, which concern should the
nurse need to address? a. Nursing assessments are different from those performed in
the hospital setting.
b. Restricted activity and medications are necessary to prevent a recurrence of preterm
labor.
c. Prolonged bed rest may cause negative physiologic effects.
d. Home health care providers are necessary. - 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.
2. Which nursing intervention is paramount when providing care to a client with preterm
labor who has received terbutaline?
a. Assess deep tendon reflexes (DTRs).
b. Assess for dyspnea and crackles.
c. Assess for bradycardia.
d. Assess for hypoglycemia. - 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.
3. In evaluating the effectiveness of magnesium sulfate for the treatment of preterm
labor, which finding alerts the nurse to possible side effects?
a. Urine output of 160 ml in 4 hours
b. DTRs 2+ and no clonus
c. Respiratory rate (RR) of 16 breaths per minute
d. Serum magnesium level of 10 mg/dl - 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
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