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Case Study

O Meet the Client: Jennie Smith

Jennie Smith is a 15-year-old female client who is a

gravida 1, para 0 at 36 weeks gestation by both
estimate date of birth and ultrasound. She began
prenatal care at 10 weeks gestation and has had an
uneventful pregnancy except for mild pedal edema
that developed 1 week ago. Her 17-year-old
boyfriend has been involved throughout the

O Which factors add to the risk of this patient

developing preeclampsia?
1. Molar pregnancy
2. Family history
3. History of headaches
4. Low socioeconomic status
5. Age
6. Nulliparity

O What is the pathophysiology behind Jeannies

1. Cerebral edema
2. Increased perfusion to the brain
3. Severe anxiety
4. Retinal spasms

O Jennie has generalized edema. Her family asks for

a fluid pill. Should this patient receive a diuretic?

Why or why not?

O The nurse starts an IV and hangs D5RL with 20

units of Pitocin. The order reads administer 2

mu/min. What is the rate you key in on the pump?

O While waiting on lab results what is the nursing

1. Teach Jennie the rationale for bed rest
2. Monitor for signs of dehydration
3. Educate about diet restrictions
4. Observe for CNS changes

O What labs would be seen in HELLP syndrome

(select all that apply)

1. Increased hematocrit
2. Normal PTT
3. Low platelets
4. Elevated liver enzymes
5. Elevated haptoglobin

O Which assessment finding would indicate

magnesium toxicity?
1. Complaints of chills and fever
2. RR < 12/bpm and absent DTRs.
3. Mild sedation
4. Urine output of 32 ml/hr.

O The nurse notes on the fetal strip a decrease in HR

with minimal variability. What is the cause?

1. Cord compression
2. Fetus is descending into the pelvis
3. The moms HTN has caused fetal distress
4. The MgSO4 level in mom and fetus is the same.

O Jennie has eclamptic seizure. When the nurse

enters the room what takes priority?

1. Monitor fetus for nonreassuring patterns
2. Turn patient on her side with pillow behind back
3. Make note of time of seizure
4. Suction mouth

O The nurse watches the Fetal monitor after the

seizure. At the peak of contractions, the HR drops to

117 bpm then returns to baseline of 130 beats after
15 seconds. She also notes minimal variability.
What change has occurred?
1. Tachycardia
2. Variable accelerations
3. Late decelerations
4. Transient bradycardia

O Jennie is on MgSO2. What medication should be

available for use?

1. Dilantin
2. Lebatolol
3. Potassium chloride
4. Calcium gluconate

O The baby is born. The nurse anticipates and

prepares for what complication related to the

mom receiving mag sulfate?
1. Hyperflexia and increased respirations
2. Hyporeflexia and irregular respirations
3. Hyporeflexia and decreased respirations
4. Hyperflexia and irregular respirations