Chapter 7- Life Span- Pregnant or Breast-Feeding Women
1. A pregnant patient asks the nurse what over-the-counter medication she can take for recurring
... [Show More] headaches. The nurse should recommend
A) aspirin.
B) advil.
C) tylenol.
D) motrin. Ans: C Feedback:
Tylenol, which is acetaminophen, is the only analgesic recommended for use during pregnancy.
2. A patient is pregnant and is at 7 weeks' gestation. She has type 1 diabetes and has been taking insulin since she was 13 years old. She asks the nurse if the insulin will be harmful to her baby. The best response to the patient by the nurse would be
A) “I will tell your physician that you are concerned about taking insulin during your pregnancy.”
B) “You will have to discontinue the insulin therapy during your pregnancy, but you will resume the medication after delivery.”
C) “You will need to continue taking your insulin because hyperglycemia is thought to contribute to low birth weight.”
D) “Insulin is usually the drug of choice for controlling blood glucose levels during pregnancy because it does not cross into the placenta.”
Ans: D
Feedback:
The best response would be to tell the patient that insulin is the drug of choice because it does not cross the placenta and reach the fetus. Hyperglycemia is not associated with low birth weight. Telling the patient's physician is also appropriate; however, the nurse can offer information that can immediately allay the patient's concern.
3. A 36-year-old patient comes to the clinic and tells the nurse that she suspects that she is pregnant. During the initial assessment, the nurse learns that the patient is currently taking medications for diabetes, hypertension, and a seizure disorder. The nurse would be most concerned about which of the following medications?
A) Insulin
B) Ibuprofen (Advil)
C) Phenytoin (Dilantin)
D) Furosemide (Lasix) Ans: C
Feedback:
Most anticonvulsant drugs can have a teratogenic effect on the fetus. Dilantin can cause fetal hydantoin syndrome, which is characterized by craniofacial abnormalities, limb defects, growth deficiency, and mental deficiency. Insulin is not harmful in the pregnant woman, since it cannot pass through to the placenta. Lasix is classified as a category C drug, which indicates that animal studies have shown an adverse effect on the fetus but there are no adequate studies in humans. Advil is classified as a category B drug, which indicates that animal studies have not demonstrated a risk to the fetus, but there are no adequate studies in pregnant women during the first and second trimesters of pregnancy. Advil is, however, considered a category D drug during the third semester (there is evidence of human fetal risk).
4. A 38-year-old pregnant patient admits to the nurse that she is an alcoholic and has been consuming alcohol during her pregnancy. The nurse knows that using alcohol during pregnancy may result in a child who presents with
A) a high-pitched cry.
B) microcephaly.
C) an electrolyte imbalance.
D) thrombocytopenia. Ans: B
Feedback:
Fetal alcohol syndrome (FAS) can be the result of a mother using alcohol during pregnancy. Microcephaly or smallness of the head is a teratogenic characteristic of FAS. A high-pitched cry is a characteristic seen in children of mothers who used clemastine (Tavist) during pregnancy. Electrolyte imbalances and thrombocytopenia would not be common findings in mothers who abuse alcohol during their pregnancy.
5. A 29-year-old pregnant patient is extremely upset about having to take medication for a pre-existing medical condition. She is consumed with fear that her baby will be born with a physical deformity or a congenital anomaly but knows that she has to take the medication. She talks constantly about this and is unable to sleep most nights. Which of the following is the most appropriate nursing diagnosis for this patient is?
A) Injury, Risk to the fetus related to adverse effects of maternal drug therapy
B) Injury, Risk to the patient related to failure to receive needed drug therapy
C) Anxiety related to perceived danger of drug therapy to fetus or infant
D) Noncompliance with Drug Therapy Ans: C
Feedback:
The nurse has assessed that the patient is anxious and fearful that her baby will suffer because of her drug therapy. The nurse should work with the mother to design a plan of care to help decrease the mother's anxiety. Even though the other nursing diagnoses are plausible, the most appropriate nursing diagnosis is anxiety related to perceived danger of drug therapy to fetus or infant. [Show Less]