Exam 2: NR 327 / NR327 Maternal-Child Nursing Exam Review | Complete Guide with Questions and Verified Answers| (Latest 2023/ 2024) -)-
... [Show More] Chamberlain
QUESTION
Preeclampsia
Answer:
**pre seizure**
After 20 wks including HTN w/ proteinuria leading to end organ dysfunction
24 hr urine will be ordered
Nursing care: BP q15 minutes Mild: just monitor Severe:
1 Hydralazine IV push immediately
2 Magnesium sulfate bolus
QUESTION
A doctor order Magnesium Sulfate to be ran 50 mL bolus in 20 min. At what rate will we set it to?
Answer:
20 goes into 60 = 3 times
3 x 50 = 150
150 mL over 1 hour
QUESTION
After starting a magnesium sulfate bolus on our patient, what symptoms do we want to tell them they might experience?
Answer:
You will feel hot (like your burning from inside out)
-N/V
-Burning in vein
-May not want to eat
QUESTION
Nation wide equation for Magnesium sulfate and its mixed solution for
IV
Answer:
1g MgSo4 = 25mL of mixed solution
QUESTION
When we check on our patients receiving magnesium sulfate every hour what do we assess? What would give us a reason to shut it off?
Answer:
· Respiratory rate - if less than 12 shut off
· VS & O2 stats
· FHT - decreased variability (expected)
· LOC - if unable to answer questions shut off
· I&O - output < 30mL an hour shut off
· DTRs - absent DTRs shut off
· Headache or visual changes
· Lung sounds
· Epigastric Pain
· Edema
· Weight gain
QUESTION
If we walk into a patients room who is receiving magnesium sulfate and has a respiratory rate < 12 what do we do?
Answer:
Shut it off and call the doctor
QUESTION
Risk factors for preeclampsia
Answer:
· Nulliparity
· Multifetal gestations
· Maternal age over 35
· Preeclampsia in a previous pregnancy
· Chronic hypertension
· Pregestational diabetes
· Vascular and connective tissue disorders
· Nephropathy
· Antiphospholipid syndrome
· Obesity
· African-American race
QUESTION
When can preeclampsia occur?
Answer:
During or after pregnancy
QUESTION
What do we assess in a post partum preeclampsia patient who is receiv- ing magnesium sulfate?
Answer:
· Fundus
· Uterus - boggy or firm
· More likely to have PPH
QUESTION
Patients who are on magnesium sulfate during delivery MUST remain on it for how long after?
Answer:
24 hours
-prevents seizures
QUESTION
Laboratory findings / baby assessments for the preeclampsia mom
Answer:
· Urin dipstick for protein
· 24 hour urine
· CBC
· Comprehensive metabolic profile*
· Liver enzymes*
· Uric acid
**may be combined as PIH profile
· Fetal Kick Counts
· NST
· BPP (more often)
· Amniocentesis for fetal lung maturity
· Steroids if premature delivery anticipated
· Cervical Ripeness
QUESTION
A preeclamptic patient who is low risk has been sent home and told to monitor baby with kick counts. How often do we tell her to do this?
Answer:
3x a day
QUESTION
Magnesium sulfate
Answer:
Drug most often used to prevent seizures
Must always be piggybacked in and on a pump not hypotensive
works as anticonvulsant smooth muscle relaxer
blocks neuromuscular conduction
QUESTION [Show Less]