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NUR UWORLD Uworld MATERNITY LATEST and Updated A+
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NUR UWORLD Uworld MATERNITYLATEST A+
MATERNITY
2024
,The nurse reviews laboratory test results for a pregnant client at 32 weeks gestation. What is the
nurse's best action based on these results? Click on the exhibit button for additional information.
Laboratory results
Hemoglobin 11.4 g/dL (114 g/L)
Hematocrit 34% (0.34)
Red blood cells 5.3 x 106/mm3 (5.3 x 1012/L)
White blood cells 14,000/mm³ (14.0 x 109/L)
Platelets 230,000/mm3 (230 x 109/L)
1. Complete the client assessment and documentation [56%]
2. Draw another sample for repeat complete blood count [7%]
3. Prepare for transfusion of packed red blood cells [9%]
4. Request a prescription for iron supplementation [26%]
EXPLANATION:
Pregnant women experience a 40%-45% increase in total blood volume during pregnancy to
meet the increased oxygen demand and nutritional needs of the growing fetus and maternal
tissues. Because the increase in plasma volume is greater than the increase in red
,blood cells, a hemodiluted state called physiologic anemia of pregnancy occurs, and is
reflected in lower hemoglobin and hematocrit values. It is also normal for the white blood cell
count to increase during pregnancy; counts can be as high as 15,000/mm3 (15.0 x 109/L).
These laboratory results are within the normal ranges for a pregnant client in the third trimester,
and no intervention is required (Options 1 and 2).
(Option 3) A blood transfusion should not be considered in pregnancy unless severe
anemia (hemoglobin <7.0 g/dL [<70 g/L]) is suspected.
(Option 4) Iron is frequently prescribed for pregnant women to prevent or treat iron
deficiency anemia (hemoglobin ≤11 g/dL [110 g/L] and hematocrit ≤33% [0.33]).
However, this pregnant client's laboratory results are within normal ranges, and iron
supplementation is not necessary.
Educational objective:
Pregnant women experience an increase in total blood volume to meet the increased oxygen
demand and nutritional needs of the growing fetus and maternal tissues. The increase in plasma
volume is greater than the increase in red blood cells, creating a hemodiluted state termed
physiologic anemia of pregnancy, which is reflected in decreased hemoglobin (>11.0 g/dL [>110
g/L]) and hematocrit (>33% [0.33]) values.
A A A
The nurse is preparing a nutritional teaching plan for a client planning to become pregnant. Which
foods would best prevent neural tube defects?
1. Calcium-rich snacks [7%]
2. Fortified cereals [68%]
3. Organ meats [16%]
4. Wild salmon [7%]
Explanation:
Women who are planning on becoming pregnant should consume 400-800 mcg of folic acid
daily. Food options that are rich in folic acid include fortified grain products (eg, cereals, bread,
pasta) and green, leafy vegetables (Option 2). Inadequate maternal intake of folic acid during the
critical first 8 weeks after conception (often before a woman knows she is pregnant) increases
the risk of fetal neural tube defects (NTDs), which inhibit proper development of the brain and
spinal cord. Common NTDs are spina bifida and anencephaly (lack of cerebral hemispheres and
overlying skull).
(Option 1) Adequate calcium intake is especially important during the last trimester for
mineralization of fetal bones and teeth, but it does not prevent NTDs.
, 3
(Option 3) Organ meats (eg, liver) may contain moderately high levels of folate but are
consumed more for their high iron content, which can promote red blood cell formation and
prevent maternal anemia.
(Option 4) A prenatal diet rich in omega-3 fatty acids is important for fetal neurologic function
and is linked to a lower risk of preterm birth. Dietary sources include wild salmon, anchovies,
flaxseed, and walnuts.
Educational objective:
Women who are planning to become pregnant should consume 400-800 mcg of folic acid daily
to prevent neural tube defects (eg, spina bifida, anencephaly). Food options that are rich in folic
acid include fortified grain products (eg, cereals, bread, pasta) and green, leafyvegetables.
A A A
A pregnant client at 30 weeks gestation comes to the prenatal clinic. Which vaccines may be
administered safely at this prenatal visit? Select all that apply.
1. Influenza injection
2. Influenza nasal spray
3. Measles, mumps, and rubella
4. Tetanus, diphtheria, and pertussis
5. Varicella
Explanation:
Health promotion during pregnancy includes the administration or avoidance of certain vaccines
to decrease risks to mother and fetus. Pregnant women have suppressed immune systems and are
at increased risk for illness and subsequent complications. Some viruses (eg, rubella, varicella)
can cause severe birth defects if contracted during pregnancy.
Inactivated vaccines contain a "killed" version of the virus and pose no risk of causing illness
from the vaccine. Some vaccines contain weakened (ie, attenuated) live virus and pose a slight
theoretical risk of contracting the illness from the vaccine. For this reason, women should not
receive live virus vaccines during pregnancy or become pregnant within 4 weeks of receiving
such a vaccine.
The tetanus, diphtheria, and pertussis (Tdap) vaccine is recommended for all pregnant women
between the beginning of the 27th and the end of the 36th week of gestation as it provides the
newborn with passive immunity against pertussis (whooping cough) (Option 4).
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