The clinic nurse is reviewing home care dietary instructions for ...

[madam-professor]

The clinic nurse is reviewing home care dietary instructions for the patient diagnosed with mild preeclampsia at 34 weeks' gestation. The nurse determines that the client requires additional information when she makes which statement?
 
  a. I will limit my salt intake to 2 grams per day.
  b. I will drink no less than 2500 mL of fluid per day.
  c. I will make sure I eat 4 sources of protein per day.
  d. My overall intake of calories per day should be around 2500.

Question 2

A patient presents to labor and birth with complaints of persistent acute back pain at 36 weeks' gestation. The nursing assessment reveals a taught abdomen, fundal height at 40 cm, and late decelerations, with an FHR range of 124 to 128 bpm.
 
  The nurse will implement the protocol for which obstetric condition?
 
  a. Placenta previa
  b. Hypovolemic shock
  c. Abruptio placentae or abruption
  d. DIC

[kjo;oj]

Answer to Question 1

ANS: A
The diet should have ample protein, no less than 6 ounces/day, and approximately 2500 calories during the second half of pregnancy. A regular diet without salt or fluid restriction is usually prescribed. Adequate amounts of protein are essential, especially because there is pathologic protein loss with preeclampsia.

Answer to Question 2

ANS: C
There are five classic signs and symptoms of abruptio placentae and include the following: bleeding, which may be evident vaginally or be concealed behind the placenta; uterine tenderness, which may be localized at the site of the abruption; uterine irritability, with frequent low-intensity contractions and poor relaxation between contractions; abdominal or low back pain that may be described as aching or dull; and high uterine resting tone identified with the use of an intrauterine pressure catheter. Additional signs include nonreassuring FHR patterns, signs of hypovolemic shock, and fetal death. With a placenta previa there is bright red and painless bleeding. Hypovolemic shock can result from an abruption; however, if the protocol for shock is initiated, some of the blood work that can confirm an abruption will be omitted (e.g., a Kleihauer-Betke test). DIC can result from an abruption. First, look for the cause.