Screenshot_20231116-233548

12. The perinatal nurse knows that the term to describe a woman at 26 weeks gestation with a history ofelevated blood pressure who presents with a urine showing 2+ protein (by dipstick) is: a. Preeclampsia b. Chronic hypertension c. Gestational hypertension d. Chronic hypertension with superimposed preeclampsiaANS: d Feedback a. Preeclampsia is a multisystem, vasopressive disease process that targets the cardiovascular,hematologic, hepatic, and renal and central nervous systems. Maternal-Newbom Nursing: The Crtical Components Of Nursing Care, 3rd Edition, Roberta Durham, Linda Chapman b. Chronic hypertension is hypertension that is present and observable prior to pregnancy or hypertensionthat is diagnosed before the 20th week of gestation. c. Gestational hypertension is a nonspecific term used to describe the woman who has a blood pressureelevation detected for the first time during pregnancy, without proteinuria. d. The following criteria are necessary to establish a diagnosis of superimposed preeclampsia: hypertension and no proteinuria early in pregnancy (prior to 20 weeks gestation) and new-onset proteinuria, a sudden increase in proteinurinary excretion of 0.3 g protein or more in a 24-hour specimen,or two dipstick test results of 2+ (100 mg/dL), with the values recorded at least 4 hours apart, with no evidence of urinary tract infection; a sudden increase in blood pressure in a woman whose blood pressure has been well controlled; thrombocytopenia (platelet count lower than 100,000/mmC); and an increase inthe liver enzymes alanine transaminase (ALT) or aspartate transaminase (AST) to abnormal levels. KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Application | Content Area: Peds/Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Moderate 13. A patient is receiving magnesium sulfate for severe preeclampsia. The nurse must notify the attendingphysician immediately of which of the following findings? a. Patellar and biceps reflexes of +4 b. Urinary output of 50 mL/hr c. Respiratory rate of 10 rpm d. Serum magnesium level of 5 mg/dLANS: ¢ Feedback a. Magnesium sulfate has been ordered because the patient has severe pregnancy-induced hypertension. Patellar and biceps reflexes of +4 are symptoms of the disease. b. The urinary output must be above 25 mL/hr. c. The drop in respiratory rate may indicate that the patient is suffering from magnesium toxicity. Thenurse should report the finding to the physician. d. The therapeutic range of magnesium is 4 to 7 mg/dL. KEY: Integrated Process: Nursing Process: Analysis; Nursing Process: Implementation | Cognitive Level:Application | Content Area: Adverse Effects/Contraindications; Antepartum Maternal-Newbom Nursing: The Crtical Components Of Nursing Care, 3rd Edition, Roberta Durham, Linda Chapman Care: Potential for Alterations in Bodv Svstems: Reduction of Risk Potential: Diagnostic Tests | @ O 2