When planning intrapartum care for a client with heart disease, the nurse should include:
a. taking vital signs according to standard protocols.
b. continuously monitoring cardiac rhythm with telemetry.
c. massaging the uterus to hasten birth of the placenta.
d. maintaining the infusion of intravenous fluids to avoid dehydration.
ANS: B
A client with heart disease should have a cardiac monitor and possibly an arterial line for continuous blood pressure monitoring, as well as hemodynamic monitoring. Vital signs may need to be taken more frequently because of the extra workload on the heart. The uterus should not be massaged to hasten the birth of the placenta because this could cause undue overload on the heart. Circulatory overload can occur, so IV fluids may not be used or may be used minimally.
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Indicate whether the statement is true or false.
Janice, a 30-year old pregnant woman at 22 weeks gestation has an obstetrical history of a previous miscarriage and a live preterm birth. She tells the prenatal nurse that she works as a waitress serving lunch and dinner at a restaurant
She explains that she is experiencing extreme fatigue, swelling of her feet, and back pain at the end of each work day. The perinatal nurse discusses with Janice some options for ongoing work including: Select all answers that apply: A) Negotiating for 8 hour shifts B) Resting when she is at home after work C) Ensuring that she has 20–30 minutes every two hours to put her feet up and rest D) Reviewing the signs and symptoms of preterm labor and the need to discontinue work if these symptoms occur