Chapter 15.docx

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Chapter 15 1. The nurse is caring for a pregnant woman who admits to cocaine and ecstasy use on a regular basis. The patient states, “Everybody knows that alcohol is bad during pregnancy, but what’s the big deal about ecstasy?” The best response by the nurse is: “Ecstasy: 1. “Can cause a high fever in you and therefore cause the baby harm.” Rationale 1: High body temperature is a side effect of MDMA (ecstasy). Increased body temperature increases fetal oxygen needs, which can lead to hypoxia and subsequent brain and major organ damage. 2. The nurse is doing preconception counseling with a 28-year-old woman with no prior pregnancies. Which of the following statements made by the patient indicates to the nurse that the patient has understood the teaching? 2. “I need to stop drinking alcohol completely when I start trying to get pregnant.” Rationale 2: Women should discontinue drinking alcohol when they start to attempt pregnancy. 3. A woman’s history and appearance suggest drug abuse. The nurse’s best approach would be to: 1. Ask the woman directly, “Do you use any street drugs?” Rationale 1: The best method of dealing with the patient that the nurse suspects of using drugs is to be direct and ask the question in a direct fashion without prejudice, bias, or negative body language. Lack of judgmental attitudes/body language typically results in honest answers. 4. A 20-year-old woman is at 28 weeks’ gestation. Her prenatal history reveals past drug abuse, and urine screening indicates that she has recently used heroin. The nurse should recognize that the woman is at increased risk for: 4. Pregnancy-induced hypertension. Rationale 3: Abruptio placentae is seen more commonly with cocaine/crack use. Rationale 4: Women who use heroin are at risk for poor nutrition, anemia, and pregnancy- induced hypertension (or pre-eclampsia).
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