The labor and birth nurse is reviewing the risk factors for ...

[lidoalex]

The labor and birth nurse is reviewing the risk factors for placenta previa with a group of nursing students.
 
  The nurse determines that the students understood the discussion when they identify which patient being at the highest risk for developing a placenta previa?
 
  a. Female fetus, Mexican-American, primigravida
  b. Male fetus, Asian-American, previous preterm birth
  c. Male fetus, African-American, previous cesarean section
  d. Female fetus, European-American, previous spontaneous abortion

Question 2

Which intervention would be the most effective if your client who is on magnesium sulfate has a respiratory rate of 10 breaths/min?
 
  a. Give oxygen by mask at 8-10 L/min.
  b. Administer calcium gluconate via IV pyelogram (IVP).
  c. Arouse client with tactile stimulation.
  d. Continually assess pulse oximeter levels.

[Ptupou85]

Answer to Question 1

ANS: C
The rate of placenta previa is increasing. It is more common in older women, multiparous women, women who have had cesarean births, and women who had suction curettage for an induced or spontaneous abortion. It is also more likely to recur if a woman has had a placenta previa. African or Asian ethnicity also increases the risk. Cigarette smoking and cocaine use are personal habits that add to a woman's risk for a previa. Previa is more likely if the fetus is male. The Mexican-American primipara has no risk factors for developing a placenta previa. The Asian-American multipara has two risk factors for developing a previa. The African-American multipara has three risk factors for developing a previa. The European-American multigravida has one risk factor for developing a placenta previa.

Answer to Question 2

ANS: B
A respiratory rate of less than 12 breaths/min in a client receiving magnesium sulfate is a sign of magnesium toxicity, which must be immediately reversed. Calcium gluconate opposes the effects of magnesium at the neuromuscular junction and is an antidote for magnesium toxicity. Oxygen by mask at 8 to 10 L/min, arousing a client with tactile stimulation, and continually assessing pulse oximeter levels will not be effective until the magnesium toxicity has been reversed.