Chapter 11: Maternal Adaptation During Pregnancy (Prep U)

After teaching a class of newly pregnant women about the many changes the female body undergoes during pregnancy, the nurse determines that the teaching was successful when the class identifies which hormones as being secreted by the placenta? Select all that apply. cortisol hCG relaxin estrogen testosterone

hCG relaxin estrogen The placenta begins to produce the following hormones during pregnancy: hCG, hPL, relaxin, progesterone, and estrogen. Testosterone is secreted by ovaries and cortisol by the adrenal cortex.

Vitamin C deficiency can lead to what adverse effects for the gestating mother? Low weight gain Placental abruption Hyperglycemia Blood disorders such as easy bruising

Blood disorders such as easy bruising A gestating mother needs Vitamin C for formation of fetal bones and fetal growth. It also helps with iron absorption. A deficiency of Vitamin C can cause easy bruising in the mother and, if severe, cause dental abnormalities.

A nurse is assessing a pregnant client. The nurse understands that hormonal changes occur during pregnancy. Which hormones would the nurse most likely identify as being inhibited during the pregnancy? FSH and LH T4 and GH FSH and T4 LH and MSH

FSH and LH During pregnancy, FSH and LH are both inhibited as there is no need to develop a follicle and release an ovum. There is an increase in the secretion of T4 and MSH. There is a decrease in the production of GH and MSH but not an inhibition.

The nurse is performing an assessment of a woman who has come to a health care facility for a diagnosis of pregnancy. The women is positive for breast changes, nausea, and amenorrhea. On physical exam, it is noted that the client has softening of the cervix. How should the nurse document this in her notes? Hegar sign Goodell sign ballottement Chadwick sign

Goodell sign The description of a Goodell sign is softening of the cervix. Ballottement is when tapping the lower uterine segment on a bimanual exam elicits the fetus to rise against the abdominal wall. Chadwick sign is when the vagina changes color from pink to violet. Hegar sign is softening of the lower uterine segment.

What is a positive sign of pregnancy? uterine contractions Hegar sign positive pregnancy test fetal movement felt by examiner

fetal movement felt by examiner The positive signs of pregnancy are fetal image on sonogram, hearing a fetal heart rate, and the examiner feeling fetal movement.

After delivery, a postpartum mother discusses nutritional needs with her nurse related to breast-feeding. Which statement by the mother demonstrates understanding of the nurse's teaching on the subject? "My iron intake will be adequate if I increase my intake of milk and vegetables." "My baby will take much of my protein through the breast milk, so I will supplement my diet with fruit and cheeses. "I will need to eat more meat and whole grains to increase my zinc intake while I am nursing." "The amount of milk I will produce is dependent upon my calcium intake while I am nursing."

"I will need to eat more meat and whole grains to increase my zinc intake while I am nursing." Breast-feeding increases the daily requirements for zinc that were needed during the pregnancy. Increased intake of meat, seafood and grains will increase the zinc in the nursing mother's diet. The other approaches will not benefit the nursing mother or the infant. The calcium intake does not determine the milk production.

The nurse is teaching the pregnant woman about nutrition for herself and her baby. Which statement by the woman indicates that the teaching was effective? "I will need to take iron supplementation throughout my pregnancy even if I am not anemic." "Because I am pregnant, I can eat anything I want and not worry about weight gain." "Milk production requires higher levels of calcium; therefore, if I am going to breastfeed, I must take a calcium supplement during pregnancy." "I can eat any seafood that I like because it contains phosphorus, which is a nutrient that pregnant women need."

"I will need to take iron supplementation throughout my pregnancy even if I am not anemic." Iron is recommended for all pregnant women because it is almost impossible for the pregnant woman to get what is required from diet alone, especially after 20 weeks' gestation when the requirements of the fetus increase. Pregnant women can get many nutrients from seafood including phosphorus, but there are specific recommendations about types of fish to avoid because of the risk of mercury poisoning. Milk production actually requires higher levels of zinc, which can be obtained from a healthy diet. Calcium requirements do not increase above prepregnancy levels during pregnancy because calcium absorption is enhanced during pregnancy. It can be unsafe for the pregnant woman to eat anything she wants and gain too much weight. A woman who gains too much weight during pregnancy is at risk for delivering a macrosomic baby.

Which statement by a pregnant client would validate that she understood the nurse's teaching regarding the risk of venous stasis during pregnancy? "My clotting times and bleeding times will be unchanged during this pregnancy even though I am at higher risk of clots in my leg vein." "My clotting factors will be unchanged during pregnancy but I must be careful to not cross my legs at anytime." "If I lie down on my back, I will be less likely to develop blood clots in my legs." "The increase in my blood volume and increased clotting factors can cause me to bleed more at delivery."

"My clotting times and bleeding times will be unchanged during this pregnancy even though I am at higher risk of clots in my leg vein." Increased levels of fibrinogen make pregnancy a hypercoagulable state. Clotting times and bleeding times are unchanged, however. The pregnant woman does run the risk of development of a venous thrombosis as the uterus enlarges and inhibits venous return from the lower extremities due to the hypercoagulable state and venous stasis.

The nurse is teaching a prenatal class about preparing for their expanding families. What is helpful advice from the nurse? "Caring for your new infant is instinctual and will come naturally to you." "Your old coping methods will adequately get you through this period of adjustment." "Expect your other children to react positively to their new brother/sister." "The hormones of pregnancy may cause anxiety or depression postpartum."

"The hormones of pregnancy may cause anxiety or depression postpartum." The "raging hormones" of pregnancy can keep the woman slightly out of touch with her usual methods of coping. Although she may normally interact and communicate in quite mature ways, during a pregnancy she may become depressed, anxious, withdrawn, or angry as she accomplishes her own developmental tasks. Siblings often react to a pregnancy by regression in behavior and attitude because they fear they will be replaced or unloved. In addition to anticipatory guidance concerning the alterations in family structure and functioning, prenatal preparation for first-time parents involves learning the basics of infant care and preparing for infant feeding, particularly for women who plan to breastfeed.

A client at 36 weeks' gestation comes in for her weekly primary care provider visit. She tells the nurse, "I am having contractions, but they are irregular and go away when I rest. Do you think I am going into labor?" The best response by the nurse would be: "These are called Braxton-Hicks contractions and are preparing your body for labor but are not 'true' labor contractions." "It is too early for you too be in labor. Something may be wrong with the pregnancy." "I think we better send you to the hospital for admission. You could be in labor." "I think you are going into labor. We may need to give you medications to stop the contractions."

"These are called Braxton-Hicks contractions and are preparing your body for labor but are not 'true' labor contractions." Braxton-Hicks contractions prepare the body for labor. They are usually irregular in frequency and duration, with fewer than five contractions occurring in 1 hour. They are also short but may be painful. They may begin as early as the second trimester, especially for women who have had babies before, but are more common in the third trimester. They often resolve with position changes, a hot shower, hydration, or relaxation.

A pregnant client is concerned because she has noticed that she is developing brown blotches on her forehead and nose. The nurse realizes that the client understood the teaching about this problem when the client makes which statement? "This condition is called linea nigra and the spots may fade or go away between pregnancies." "Pregnant women often develop skin problems but this should go away in the third trimester." "I will get them with every pregnancy and they will get worse every time." "These spots are from hyperpigmentation caused by the pregnancy and may be permanent."

"These spots are from hyperpigmentation caused by the pregnancy and may be permanent." The brown blotches the client is experiencing on her face is called melasma (chloasma) or the "mask of pregnancy." Hyperpigmentation is one of the skin changes that pregnant women experience. This condition may be permanent or may regress between pregnancies. Linea nigra is the darkened line in the middle of the abdomen seen on some pregnant women. Melasma does not go away in the third trimester and there is no evidence that it will get worse with each pregnancy.

After teaching a group of women about the signs of pregnancy, the nurse understands that teaching was successful if the group makes which statement about positive signs? "The client will experience quickening." "They will be able to hear the fetal heart rate on auscultation." "There will be a positive Hegar sign." "The woman will have amenorrhea."

"They will be able to hear the fetal heart rate on auscultation." The positive signs of pregnancy confirm that a fetus is growing in the uterus. Visualizing the fetus by ultrasound, palpating for fetal movements, and hearing a fetal heartbeat are all signs that make the pregnancy a certainty. Amenorrhea is a presumptive sign of pregnancy. Hegar sign is a probable sign of pregnancy. Quickening is a presumptive sign of pregnancy.

A pregnant client reports an increase in a thick, whitish vaginal discharge. Which response by the nurse would be most appropriate? "You need to be assessed for a fungal infection." "You should refrain from any sexual activity." "This discharge is normal during pregnancy." "Use a local antifungal agent regularly."

"This discharge is normal during pregnancy." During pregnancy, vaginal secretions become more acidic, white, and thick. Most women experience an increase in a whitish vaginal discharge, called leukorrhea, during pregnancy. The nurse should inform the client that the vaginal discharge is normal except when it is accompanied by itching and irritation, possibly suggesting Candida albicans infection (a monilial vaginitis), which is a very common occurrence in this glycogen-rich environment. Monilial vaginitis is a benign fungal condition and is treated with local antifungal agents. The client need not refrain from sexual activity when there is an increase in a thick, whitish vaginal discharge.

A client in her second trimester of pregnancy arrives at the health care facility for a routine follow-up visit. The nurse is required to educate the client so that the client knows what to expect during her second trimester. Which information should the nurse offer? "You will be more conscious of the changes taking place in your body now." "You will experience quickening, and you will actually feel the baby." "You may feel physical discomfort as the baby inside grows." "You may have mood swings that could overwhelm your partner."

"You will experience quickening, and you will actually feel the baby." The nurse should inform the client that quickening occurs in the second trimester. The client will be able to physically feel the fetal movements, which will help her bond with her developing fetus. Physical discomfort actually starts to increase in the third trimester as the fetus grows rapidly. The client feels conscious of the changes taking place in her body due to her pregnancy primarily in the first trimester, not the second. The client is likely to have mood swings in the first trimester of the pregnancy, which can be very overwhelming for the client as well as her partner.

A woman's prepregnant weight is within the normal range. During her second trimester, the nurse would determine that the woman is gaining the appropriate amount of weight when her weight increases by which amount per week? 2/3 lb (0.30 kg) 1.5 lb (0.68 kg) 2 lb (0.90 kg) 1 lb (0.45 kg)

1 lb (0.45 kg) The recommended weight gain pattern for a woman whose prepregnant weight is within the normal range would be 1 lb (0.45 kg) per week during the second and third trimesters. Underweight women should gain slightly more than 1 lb (0.45 kg) per week. Overweight women should gain about 2/3 lb (0.30 kg) per week.

When discussing the many changes the woman's body undergoes during pregnancy, the nurse may include that the woman's total blood volume will increase by approximately how much by the 32nd week of gestation? 1,500 ml 500 ml 1,000 ml 2,000 ml

1,500 ml Blood volume increases by approximately 1,500 ml or 50% above nonpregnant levels by the 32nd week of gestation. This increase in blood volume is needed to provide adequate hydration of fetal and maternal tissues.

A urinalysis is done on a client in her third trimester. Which result would be considered abnormal? 2+ Protein in urine Specific gravity of 1.010 Trace of glucose Straw-like color

2+ Protein in urine During pregnancy, there may be a slight amount of glucose found in the urine due to the fact that the kidney tubules are not able to absorb as much glucose as there were before pregnancy. However, there should be minimal protein in the urine. A specific gravity of 1.010 and a straw- like color are both normal findings.

A woman comes to the clinic for her first prenatal checkup. The woman has a body mass index (BMI) of 22. The nurse would anticipate that this client should gain approximately how much weight during her pregnancy? 15 to 25 lbs (7 to 11 kg) 25 to 35 lbs (11 to 16 kg) 28 to 40 lbs (13 to 18 kg) 11 to 20 lbs (5 to 9 kg)

25 to 35 lbs (11 to 16 kg) A woman with a BMI of 18.5 to 24.9 is of normal weight and should gain 25 to 35 pounds (11 to 16 kg) during the pregnancy. For a woman who is underweight (BMI <18.5), the total weight gain range is 28 to 40 pounds (13 to 18 kg). For a woman who is overweight (BMI = 25-29.9), total weight gain range should be 15 to 25 pounds (7 to 11 kg). For a woman who is obese (BMI = 30 or higher), the total weight gain range should be 11 to 20 pounds (5 to 9 kg).

A client in her first trimester is concerned about how weight gain will affect her appearance and questions the nurse concerning dietary restrictions. How much weight gain should the nurse point out will be safe for this client with a low BMI? 16 to 30 pounds (7.25 to 14 kilograms) 28 to 40 pounds (13 to 18 kilograms) 25 to 35 pounds (11 to 16 kilograms) 15 to 25 pounds (7 to 11 kilograms)

28 to 40 pounds (13 to 18 kilograms) The recommendation for average weight gain is 25 to 35 lbs (11 to 16 kilograms). The woman who is underweight with a low BMI should gain 28 to 40 pounds (13 to 18 kilograms). Less than 28 pounds (13 kilograms) may hinder fetal development, and weight gain over 40 pounds (18 kilograms) may be dangerous to the mother. Individuals with a high BMI should gain 15 to 25 pounds (7 to 11 kilograms). A weight gain of less than 16 pounds (7.25 kilograms) may result in a low-birth-weight infant and gains over 30 pounds (14 kilograms) may necessitate a cesarean section.

Before becoming pregnant, a woman's heart rate averaged 72 beats per minute. The woman is now 15 weeks' pregnant. The nurse would expect this woman's heart rate to be approximately: 100 beats per minute. 95 beats per minute. 90 beats per minute. 85 beats per minute.

85 beats per minute. During pregnancy, heart rate increases by 10 to 15 beats per minute between 14 and 20 weeks of gestation, and this elevation persists to term. Therefore, a prepregnancy heart rate of 72 would increase by 10 to 15 beats per minute to a rate of 82 to 87 beats per minute.

A lacto-ovo-vegetarian client is pregnant and is seeking nutritional guidance at her initial prenatal visit. What foods would the nurse recommend to her in keeping with her current dietary practices? Fortified soy milk with increased nuts and seeds Increased intake of fruits and nuts A combination of egg and milk or other dairy products Broiled pork and whole grain rice

A combination of egg and milk or other dairy products Clients that are lacto-ovo-vegetarians do not eat meat but drink milk and eat other dairy products and eggs, so protein can be obtained through thee products, as well as combining legumes and grains. Increased fruits and nuts would be recommended for a fruitarian. Soymilk and nuts and seeds are recommended for a vegan and meat is not eaten by any of them.

At her 16-week checkup, a client's blood pressure is slightly decreased from her prepregnancy level. The nurse evaluates this change based on which statements concerning blood pressure during pregnancy? Blood pressure progressively decreases throughout the entire pregnancy. Normally, blood pressure increases steadily throughout pregnancy. A decrease in blood pressure in the second trimester may occur because of placental growth. Blood pressure remains stable until decreasing the day of the birth.

A decrease in blood pressure in the second trimester may occur because of placental growth. Because the placenta "traps" a great deal of blood for fetal circulation as it expands at about 3 months, maternal blood pressure may temporarily be slightly decreased. Otherwise, blood pressure stays fairly constant throughout pregnancy.

Hormone levels of a woman indicate that the corpus luteum stopped functioning and releasing progesterone after 5 weeks. The nurse would recognize that which scenario is the expected outcome? She will need progesterone supplement throughout the pregnancy. There is a higher than normal chance of a multifetal pregnancy. The pregnancy would continue unaffected. A spontaneous abortion (miscarriage) would occur.

A spontaneous abortion (miscarriage) would occur. If the corpus luteum fails to produce progesterone for approximately 6 to 7 weeks, a spontaneous abortion (miscarriage) will occur. After 7 weeks, the placenta will produce enough progesterone to sustain the pregnancy. There is no connection between multifetal pregnancies and the corpus luteum not functioning long enough in progesterone production.

A 17-year-old client arrives for an annual examination and reports no changes since the last exam; however, the nurse assesses a positive Chadwick sign, slightly enlarged uterus, and subsequent positive urine pregnancy test. Which task should the nurse prioritize to assist this client who is denying any possibility that she is pregnant? Accepting the baby Accepting the pregnancy Telling her partner and family Preparing for parenthood

Accepting the pregnancy Acceptance of pregnancy is multi-factorial, and how the woman responds to the pregnancy is certainly influenced by her age and if the pregnancy was planned. As a teenager, she may not have been trying to get pregnant and may not want to accept the role and experience. Baby and parenthood decisions should all occur later.

A woman tells the nurse that she is going to use a home pregnancy test to determine whether she is pregnant. Which precautions should the nurse give her? Refrain from eating for 4 hours before testing. Arrange for prenatal care if the test is positive. Use a diluted urine specimen. Wait until after two missed menstrual periods.

Arrange for prenatal care if the test is positive. Home pregnancy testing can be accurate as soon as a period is missed; it should not take the place of prenatal care.

During a routine antepartal visit, a pregnant woman reports a white, thick vaginal discharge. What would the nurse do next? Advise the woman about the need to culture the discharge. Tell the woman that this is entirely normal. Check the discharge for evidence of ruptured membranes. Ask the woman if she is having any itching or irritation.

Ask the woman if she is having any itching or irritation. Although vaginal secretions increase during pregnancy, the nurse would need to ascertain if this discharge is the normal leukorrhea of pregnancy or if it is a monilial vaginitis, which is common during pregnancy. The nurse needs additional information to conclude that the woman's report is normal. A culture may or may not be necessary. There is no evidence to suggest that her membranes have ruptured.

Which change related to the vital signs is expected in pregnant women? Blood pressure decreases. Lung space increases. Temperature decreases. Pulse decreases.

Blood pressure decreases. Pulse and temperature often increase, while lung space is decreased in pregnant women. It is common for blood pressure to decrease during pregnancy.

During an exam, the nurse notes that the blood pressure of a client at 22 weeks' gestation is lower, and her heart rate is 12 beats per minute higher than at her last visit. How should the nurse interpret these findings? The heart rate increase may indicate that the client is experiencing cardiac overload. The blood pressure should be higher since the cardiac volume is increased. Both findings are normal at this point of the pregnancy. Combined, both of these findings are very concerning and warrant further investigation.

Both findings are normal at this point of the pregnancy. A pregnant woman will normally experience a decrease in her blood pressure during the second trimester. An increase in the heart rate of 10 to 15 beats per minute on average is also normal, due to the increased blood volume and increased workload of other organ systems. Hormonal changes cause the blood vessels to dilate, leading to a lowering of blood pressure.

Which information provided by a client would be considered a presumptive sign of pregnancy? Breast tenderness Ballottement Reports of increased hunger Weight gain

Breast tenderness Presumptive signs of pregnancy are things reported by the woman to the health care provider and occur early in pregnancy. Breast tenderness is a common sign reported by women in early pregnancy but is not a definitive sign. Reports of increased hunger and weight gain could be caused by any disorder or could be normal responses to eating cycles. Ballottement occurs late in the pregnancy and is a probable sign.

The nurse is assessing a 37-year-old woman, pregnant with twins in her second trimester, and notes the following over the past 3 visits: blood pressure 128/88, 134/90, and 130/86. Which nutritional supplement should the nurse suggest the client take? Vitamin A Calcium Iron Lactase

Calcium The elevated blood pressures indicate the client is possibly developing gestational hypertension. This increases the risk of developing preeclampsia. Current research has demonstrated that calcium supplementation during pregnancy may reduce the risk of preeclampsia. Excessive levels of vitamin A may cause birth defects. Iron supplementation is used to fortify blood cell formation and decrease anemia. Lactase supplementation aids in the digestion of dairy.

A new mother asks the postpartum nurse if her baby is getting enough nourishment from breastfeeding within the first 24 hours following birth. The nurse would provide her what information? Breast milk comes in within 12 hours after delivery and nourishment should not be a problem. Colostrum, which is the first milk produced, is rich in calories and protein that nourishes the infant well. The mother needs to supplement breastfeedings with formula until her milk comes in. Most infants need minimal nourishment for the first 24 hours, so the mother should not be concerned.

Colostrum, which is the first milk produced, is rich in calories and protein that nourishes the infant well. Colostrum is present prior to delivery and provides the infant with adequate nutrition for the first 3 days of life, at which time the mother's actual milk should come in. Formula is not recommended. Infants need nutrition shortly after birth to keep their blood glucose normal.

If a woman is 3 months pregnant, which of the following findings related to breast changes would you expect to assess? Darkened breast areolae Slack, soft breast tissue Deeply fissured nipples Enlarged lymph nodes

Darkened breast areolae As part of the pigment changes that occur with pregnancy, breast areolae become darker.

Which would be a normal finding by the nurse during a physical exam of a woman in her third trimester? Dyspnea Ptyalism Increased hematocrit Kyphosis

Dyspnea In the third trimester, a women experiences dyspnea from the uterus pushing up into the diaphragm. A pregnant woman will experience lordosis, not kyphosis. Ptyalism is excessive saliva production and is often seen in the first trimester of pregnancy. The hematocrit of a pregnant woman will decrease in the third trimester, not increase.

The nurse has determined that based on the client's physical examination she is at high risk for developing varicose veins. Which suggestions might the nurse teach the client to help reduce her risk? Select all that apply. Walk daily. Sit in a hot tub at least three times a week. Elevate the feet and legs. Use thigh-high support hose. Use knee-high support hose.

Elevate the feet and legs. Walk daily. Use thigh-high support hose. Vascular changes during pregnancy manifested in the integumentary system include varicosities of the legs, vulva, and perineum. Varicose veins commonly are the result of distention, instability, and poor circulation. Various interventions to reduce the risk of developing varicosities include elevating both legs when sitting or lying down; avoiding prolonged standing or sitting; walking daily for exercise; avoiding tight clothing or knee-high hosiery; and wearing support hose if varicosities are a preexisting condition to pregnancy.

A client arrives to the clinic very excited and reporting a positive home pregnancy test. The nurse cautions that the home pregnancy test is considered a probable sign and will assess the client for which sign to confirm pregnancy? Fetal movement felt by examiner Positive office pregnancy test Chadwick sign Hegar sign

Fetal movement felt by examiner The positive signs of pregnancy are fetal image on a sonogram, hearing a fetal heart rate, and examiner feeling fetal movement. A pregnancy test has 95% accuracy; however, it may come back as a false positive. Hegar sign is a softening of the uterine isthmus. Chadwick sign may have other causes besides pregnancy.

Which of the following is a positive sign of pregnancy? Positive pregnancy test Fetal movement felt by examiner Hegar's sign Uterine contractions

Fetal movement felt by examiner The positive signs of pregnancy are fetal image on sonogram, hearing a fetal heart rate, and examiner feeling fetal movement.

A pregnant vegan reports eating lots of dark green leafy vegetables, legumes, citrus fruits, and berries. To ensure that her infant's nervous system will develop properly, what foods should the nurse recommend that she add to her diet? Milk and cheese Fortified cereals Carrots, sweet potatoes, and mangoes Nuts, seeds, and chocolate

Fortified cereals The best source to recommend are the fortified cereals to meet the amino acid needs necessary for the development of her infant's nervous system during pregnancy. She should be encouraged to include fortified cereals to meet these needs. The carrots, sweet potatoes, mangoes, nuts, and seeds will add other nutrients to her diet. A vegan will not eat milk and cheese, as they are animal products.

A client in her 39th week of gestation arrives at the maternity clinic stating that earlier in her pregnancy, she experienced shortness of breath. However, for the past few days, she has been able to breathe easily, but she has also begun to experience increased urinary frequency. A nurse is assigned to perform the physical examination of the client. Which observation is most likely? The fundus is at the level of the umbilicus and measures 20 cm. Fundal height has dropped since the last recording. The lower uterine segment and cervix have softened. Fundal height is at its highest level at the xiphoid process.

Fundal height has dropped since the last recording. Between 38 and 40 weeks of gestation, the fundal height drops as the fetus begins to descend and engage into the pelvis. Because it pushes against the diaphragm, many women experience shortness of breath. By 40 weeks, the fetal head begins to descend and engage into the pelvis. Although breathing becomes easier because of this descent, the pressure on the urinary bladder now increases, and women experience urinary frequency. The fundus reaches its highest level at the xiphoid process at approximately 36, not 39, weeks. By 20 weeks' gestation, the fundus is at the level of the umbilicus and measures 20 cm. At between 6 and 8 weeks of gestation, the cervix begins to soften (Goodell sign) and the lower uterine segment softens (Hegar's sign).

A client at 16 weeks' gestation comes to the office for a routine exam. At what location within the abdomen would the nurse anticipate the uterus to be found? At the level of the umbilicus Halfway between the symphysis pubis and the umbilicus Below the symphysis pubis At the xiphoid process

Halfway between the symphysis pubis and the umbilicus As the pregnancy progresses, the uterus enlarges and enters the abdominal cavity. At 16 weeks, the nurse should be able to palpate the uterus halfway between the symphysis pubis and the umbilicus.

A pregnant woman's husband does not voice concerns at prenatal visits. You would believe he is emotionally involved in the pregnancy by observing which of the following actions? He states he definitely wants a girl. He walks around furniture as if his abdomen is enlarged. He states he is concerned about the loss of his free time. He has refused to paint the baby's room blue.

He walks around furniture as if his abdomen is enlarged. Men who identify with their wife's pregnancy may act as if their abdomen is enlarging, the same as they may take on nausea of pregnancy.

A pregnant mother may experience constipation and the increased pressure in the veins below the uterus can lead to development of what problem? Varicose veins Gastrointestinal reflux Hemorrhoids Umbilical hernia

Hemorrhoids The displacement of the intestines and possible slowed motility of the intestines can lead to constipation in the pregnant woman. This, along with elevated venous pressure, can lead to development of hemorrhoids.

A student nurse is preparing for a presentation that will illustrate the various physiologic changes in the woman's body during pregnancy. Which cardiovascular changes up through the 26th week should the student point out? Decreased pulse rate and increased blood pressure No change in pulse rate or blood pressure Increased pulse rate and blood pressure Increased pulse rate and decreased blood pressure

Increased pulse rate and decreased blood pressure Pulse rate frequently increases during pregnancy, although the amount varies from a slight increase to 10 to 15 beats per minute. Blood pressure generally decreases slightly during pregnancy, reaching its lowest point during the second trimester.

A 28-year-old client in her first trimester of pregnancy reports conflicting feelings. She expresses feeling proud and excited about her pregnancy while at the same time feeling fearful and anxious of its implications. Which action should the nurse do next? Inform the client this is a normal response to pregnancy that many women experience. Schedule the client a consult with a psychiatric health care provider. Determine if the client's significant other is experiencing similar feelings about the pregnancy. Provide the client with information about pregnancy support groups.

Inform the client this is a normal response to pregnancy that many women experience. The maternal emotional response experienced by the client is ambivalence. Ambivalence, or having conflicting feelings at the same time, is universal and is considered normal when preparing for a lifestyle change and new role. Pregnant women commonly experience ambivalence during the first trimester.

What would the nurse recommend to a pregnant client at 35 weeks' gestation who reports irregular contractions and lower backache? Lie down and rest and see if the contractions stop and pain subsides. Have a family member rub her back and place moist heat on it. Ask her if she is having urinary frequency that may indicate an infection. Suggest that she try some isometric exercises to relieve the back pain.

Lie down and rest and see if the contractions stop and pain subsides. If a client is less than 37 weeks and having contractions that will not go away, she may be in preterm labor and this needs to be reported. The first thing for her to do is lie down and rest to see if the contractions go away. Lower backache and cramping or pain need to be taken seriously and reported to the health care provider if they persist.

A nurse is providing care to a pregnant woman in her first trimester who has come to the clinic for a follow-up visit. During the visit, the nurse teaches the woman about some of the changes that she will be experiencing during her pregnancy. Which information would the nurse include when describing changes in the breast? Prolactin, an anterior pituitary hormone, stimulates the breasts to grow. Estrogen causes the breasts to feel nodular. Montgomery glands (Montgomery tubercles) become more prominent. The areolas becomes lighter in color.

Montgomery glands (Montgomery tubercles) become more prominent. Montgomery glands (Montgomery tubercles), sebaceous glands on the areolas, produce secretions that lubricate the nipple. Montgomery glands become more prominent during pregnancy. The other listed phenomena do not happen.

The nurse is assessing a pregnant client at 12 weeks' gestation and the client reports some new bumps on the dark part of her nipples. What is the best response from the nurse when questioned by the client as to what they are? Montgomery glands (Montgomery tubercles); secrete lubricant for the nipples Might be sign of cancer; need to speak with health care provider Normal bumps of pregnancy; they do nothing Striae, stretching of the breast tissue

Montgomery glands (Montgomery tubercles); secrete lubricant for the nipples All women have Montgomery glands (Montgomery tubercles). They become more prominent during pregnancy and help to prepare the nipples for breastfeeding. The bumps are not specific to pregnancy and are not a sign of cancer. They are not the result of stretching.

A client in her 29th week of gestation reports dizziness and clamminess when assuming a supine position. During the assessment, the nurse observes there is a marked decrease in the client's blood pressure. Which intervention should the nurse implement to help alleviate this client's condition? Place the client in an orthopneic position. Place the client in the left lateral position. Keep the client's legs slightly elevated. Keep the head of the client's bed slightly elevated.

Place the client in the left lateral position. The symptoms experienced by the client indicate supine hypotension syndrome. When the pregnant woman assumes a supine position, the expanding uterus exerts pressure on the inferior vena. The nurse should place the client in the left lateral position to correct this syndrome and optimize cardiac output and uterine perfusion. Elevating the client's legs, placing the client in an orthopneic position, or keeping the head of the bed elevated will not help alleviate the client's condition.

The partner of a pregnant client in her first trimester asks the nurse about the client's behavior recently, stating that she is very moody, seems happy one moment and is crying the next and all she wants to talk about is herself. What response would correctly address these concerns? Pregnant women often experience mood swings and self-centeredness but this is normal. Moodiness and irritability are not usual responses to pregnancy. Her body is changing and she may be angry about it. What you are describing may be normal but we need to talk to her more in depth.

Pregnant women often experience mood swings and self-centeredness but this is normal. During the first trimester of pregnancy, the woman often has mood swings, bouts of irritability and is hypersensitive. The partner needs to know that these are all normal behaviors for a pregnant woman.

Early in pregnancy, frequent urination results mainly from which of the following? Increased concentration of urine Pressure on the bladder from the uterus Decreased glomerular selectivity Addition of fetal urine to maternal urine

Pressure on the bladder from the uterus Early in pregnancy, the expanding uterus presses on the bladder. Later, it rises above the bladder so pressure is relieved.

What effect does progesterone have on normal gallbladder function? Bile will be produced at a more rapid rate due to the progesterone. Progesterone interferes with gallbladder contraction, leading to stasis of bile. The gallbladder will hypertrophy. It has no effect on the gallbladder.

Progesterone interferes with gallbladder contraction, leading to stasis of bile. Progesterone interferes with normal gallbladder contractions, which leads to stasis of bile. This stasis results in cholestasis, either seen in the gallbladder or the liver.

The nursing instructor is teaching a class on the various hormones necessary for a successful pregnancy and birthing process. The instructor determines the session is successful when the students correctly choose which hormone as being necessary after birth to ensure growth of the newborn? Oxytocin Prolactin Progesterone Estrogen

Prolactin Prolactin is the hormone responsible for the initiation of lactation, the production of breast milk. Oxytocin is responsible for the letdown of milk and uterine contractions enabling the infant to be born, and estrogen and progesterone are responsible for uterine and pregnancy maintenance.

A pregnant client at 33 weeks' gestation is in the office for a routine visit. She lies down on her back and while the nurse is listening for fetal heart tones, the client tells the nurse that she feels lightheaded; her blood pressure is 82/58 mm Hg. What is the most likely explanation for this problem? Her hematocrit is low and she needs additional iron supplements. She did not drink enough fluids prior to coming to the office. She is experiencing supine hypotension syndrome The baby is kicking her spinal column, causing a pinched nerve.

She is experiencing supine hypotension syndrome As the uterus gets larger toward the end of the pregnancy, it presses the aorta and vena cava against the spine, causing decreased blood return to the heart. This reduces cardiac output and the woman may feel lightheaded and dizzy and her blood pressure will drop.

A client makes an appointment with an obstetrician and assessment reveals positive Hegar and Chadwick signs. What should the nurse teach the client about these results? The client more likely has a gynecologic disorder rather than pregnancy She is probably pregnant, but this must be confirmed by other means The client is definitively pregnant Pregnancy cannot be confirmed

She is probably pregnant, but this must be confirmed by other means These are probable signs of pregnancy that can be detected by a trained examiner. However, positive signs must confirm this.

In assessing the dietary intake over the last 24 hours of a pregnant client, which food would be most concerning to the nurse? Cooked hot dog on a bun with mustard Medium-well steak and a fresh salad. Smoked salmon and bagels 6 oz. of white tuna with crackers

Smoked salmon and bagels Pregnant women should not eat refrigerated meats or smoked seafood unless it is part of a cooked dish. 6 ounces of white tuna, a well-cooked hot dog and a steak that is cooked thoroughly are all safe foods.

The community nurse is preparing a presentation for a health fair illustrating successful pregnancies. Which component should the nurse prioritize as the most critical to ensure a positive psychological experience with the pregnancy by the mother? Having a planned pregnancy Social support Early prenatal care Age at the time of pregnancy

Social support All options are correct and play a role pregnancy, but the most critical for a positive psychological experience is for the woman to have a social support system. Early care, maternal age, and planned pregnancy all affect fetal and maternal health, but are not necessarily linked to positive psychological experiences.

During a routine prenatal visit, a pregnant woman reports a white, thick, vaginal discharge. She denies any itching or irritation. Which action would the nurse take next? Check the discharge for evidence of ruptured membranes. Tell the woman that this is entirely normal. Notify the health care provider of a possible infection. Advise the woman about the need to culture the discharge.

Tell the woman that this is entirely normal. Vaginal secretions increase during pregnancy and this is considered normal leukorrhea based on the woman's report that she is not experiencing any itching or irritation. There is no evidence indicating the need to notify the health care provider, check for rupture of membranes, or advise her about the need for a culture.

The nurse-midwife is performing a pelvic examination on a client who came to her following a positive home pregnancy test. The nurse checks the woman's cervix for the probable sign of pregnancy known as Goodell sign. Which description illustrates this alteration? The cervix softens. The cervix looks blue or purple when examined. The fundus enlarges. The lower uterine segment softens.

The cervix softens. At about the 8th week of gestation, the cervix softens, a probable sign known as Goodell sign. The cervix also looks blue or purple when examined; this is Chadwick sign, and may occur as early as the 6th week of pregnancy. At about 6 weeks, the lower uterine segment softens, a probable sign called Hegar sign. A softening of the uterine fundus, where the embryo has implanted, also occurs by about the 7th week, and the fundus enlarges by the 8th week.

The nurse is assessing a pregnant client in her third trimester who is reporting a first-time occurrence of constipation. When asked why this is happening, what is the best response from the nurse? There is not enough fiber in your diet. The intestines are displaced by the growing fetus. hCG is delaying peristalsis. This shouldn't be happening.

The intestines are displaced by the growing fetus. The growing fetus is displacing the intestines and interfering with peristalsis, delaying the passage of fecal matter and resulting in constipation. This is common and expected; however, the client should take measures to prevent hemorrhoids that can occur as the result of the pressure and straining. Progesterone, not hCG, can delay gastric emptying and decrease peristalsis.

A nurse is leading a discussion in a prenatal class for a group of primigravida clients. Which factor would the nurse include when explaining the changes that are expected to occur in the uterus during the pregnancy? The uterus moves into the abdomen by the second month of pregnancy. The uterus reaches its maximum height in the abdomen at 39 weeks. The uterus changes from a pear-shaped organ to an oval one. Uterine growth occurs because of an increase in the number of cells in the uterus.

The uterus changes from a pear-shaped organ to an oval one. The uterus starts as a pear-shaped organ and becomes oval as length increases over width. Uterine growth is primarily related to an increase in size of the myometrial cells. The uterus remains in the pelvic cavity for the first 3 months, after which it progressively ascends into the abdomen. The uterus reaches its highest level at the xiphoid process at approximately 36 weeks. Between 38 to 40 weeks, fundal height drops as the fetus begins to descend and engage into the pelvis.

The nurse is holding an education class for clients in their third trimester and their partners. What information would she share with them in preparation for the birth of their child? Select all that apply. If backaches occur, the mother needs to be examined due to the possibility of an often-seen disc problem induced by pregnancy. It is recommended that the couple attend childbirth classes soon. Urinary frequency will return toward the end of the pregnancy. The mother will sleep more at night during the third trimester in preparation of the birth. Nesting instincts begin during this period, allowing the mother to prepare for the baby.

Urinary frequency will return toward the end of the pregnancy. It is recommended that the couple attend childbirth classes soon. Nesting instincts begin during this period, allowing the mother to prepare for the baby. During the third trimester, the mother begins to shop for clothing and nursery furniture, which is nesting. Additionally, she will experience urinary frequency due to the gravid uterus pushing down on the bladder. Lastly, the couple needs to attend childbirth classes to better understand what to expect, as well as providing social contact with other parents going through the same thing.

Positive signs of pregnancy are diagnostic, meaning nothing else can elicit that sign except pregnancy. What is the earliest positive sign of pregnancy? Finding hCG in the urine Finding of hCG in the blood Visualization of the gestational sac or fetus Positive home pregnancy test

Visualization of the gestational sac or fetus The positive sign that can be elicited earliest in the pregnancy is visualization of the gestational sac or fetus. With transvaginal ultrasound, the gestational sac can be seen as early as 10 days after implantation.

A woman you care for in a prenatal clinic tells you that her pregnancy was unplanned and unwanted. At what point in pregnancy does the average woman change her mind about an unwanted pregnancy? After the seventh month When quickening occurs Around the third month After lightening happens

When quickening occurs Quickening, or feeling the baby move inside the body, is such a dramatic event that it can cause a woman's perceptions about the pregnancy to change.

The nurse is caring for a woman in a prenatal clinic who thinks she might be pregnant. Which assessment is a probable sign of pregnancy? a positive pregnancy test fatigue amenorrhea nausea and vomiting

a positive pregnancy test Most probable signs of pregnancy are objective signs; laboratory testing is probable, not positive, because error can occur.

During pregnancy, one of progesterone's actions is to allow sodium to be "wasted" or lost in the urine. The nurse would expect to see which hormone increased to help counteract this loss? cortisol glycogen ADH aldosterone

aldosterone Aldosterone is secreted by the adrenal glands, and it normally regulates the absorption of sodium in the kidney. During pregnancy, aldosterone is a key regulator of electrolyte and water homeostasis and plays a central role in blood pressure regulation. ADH (antidiuretic hormone) is secreted by the kidneys and aids in resorption of fluids in the kidneys. Glycogen assists in the balancing of blood glucose, breaking down to glucose when needed by the body. Cortisol is important in helping the body handle stress.

Place the following events in the sequence the pregnant woman would experience them, from first to last. All options must be used. uterine enlargement amenorrhea labor quickening Braxton Hicks contractions

amenorrhea uterine enlargement quickening Braxton Hicks contractions labor The correct sequence is amenorrhea, uterine enlargement, quickening, Braxton Hicks contractions, and labor.

The nurse is examining a woman who came to the clinic because she thinks she is pregnant. Which data collected by the nurse are presumptive signs of her pregnancy? Select all that apply. morning sickness ultrasound pictures hydatidiform mole fetal heartbeat amenorrhea breast changes

breast changes amenorrhea morning sickness Presumptive signs are possible signs of pregnancy that appear in the first trimester, often only noted subjectively by the mother (e.g., breast changes, amenorrhea, morning sickness). Probable signs are signs that appear in the first and early second trimesters, seen via objective criteria, but can also be indicators of other conditions (e.g., hydatidiform mole). Positive signs affirm that proof exists that there is a developing fetus in any trimester and are objective criteria seen by a trained observer or diagnostic study, (e.g., ultrasound.)

A nurse is caring for a pregnant client who has been diagnosed with lordosis. The nurse offers preventive measures for which consequence of lordosis when caring for this client? edema in lower extremities melasma (chloasma) chronic backache diastasis recti

chronic backache The nurse should provide preventive measures for chronic backache as a consequence of lordosis when caring for this client. Melasma (chloasma) is characterized by darkened areas on the face, particularly over the nose and cheeks. It is also known as the mark of pregnancy. Chloasma is not caused by lordosis. Diastasis recti occurs as the pregnancy progresses when the rectus muscle stretches to the point that it separates. It is not caused by lordosis. Edema in lower extremities occurs due to an impeded venous return caused by the pressure of the growing fetus on pelvic and femoral areas. It is not caused by lordosis.

During pregnancy a woman has many psychological adaptations that must be made. The nurse must remember that the baby's father is also experiencing the pregnancy and has adaptations that must be made. Some fathers actually have symptoms of the pregnancy along with the mothers. What is this called? couvade syndrome pseudo pregnancy pregnancy syndrome cretinism

couvade syndrome Some fathers actually experience some of the physical symptoms of pregnancy, such as nausea and vomiting, along with their partner. This phenomenon is called couvade syndrome.

Which assessment finding in the pregnant woman at 12 weeks' gestation should the nurse find most concerning? The inability to: detect fetal heart sounds with a Doppler. hear the fetal heartbeat with a stethoscope. feel fetal movements. palpate the fetal outline.

detect fetal heart sounds with a Doppler. Fetal heart sounds are audible with a Doppler at 10 to 12 weeks' gestation but cannot be heard through a stethoscope until 18 to 20 weeks' gestation. Fetal movements can be felt by a woman as early as 16 weeks of pregnancy and felt by the examiner around 20 weeks' gestation. The fetal outline is also palpable around 20 weeks' gestation.

Which effect would the nurse identify as a normal physiologic change in the renal system due to pregnancy? dilation of the renal pelvis reduction in kidney size shortening of the ureters decrease in glomerular filtration rate

dilation of the renal pelvis The renal pelvis becomes dilated during pregnancy, possibly due to the effect of progesterone on smooth muscle. The glomerular filtration rate increases during pregnancy. The kidneys enlarge during pregnancy. The ureters elongate, widen, and become more curved above the pelvic rim.

A woman is 10 weeks' pregnant and tells the nurse that this pregnancy was unplanned and she has no real family support. The nurse's most therapeutic response would be to: offer to meet with the client on a regular basis to provide her someone to talk to about her concerns. encourage her to identify someone that she can talk to and share the pregnancy experience. tell her to move home so her family will be nearby to help her. remind her that she is still early in the pregnancy and she will feel better about it as the pregnancy progresses.

encourage her to identify someone that she can talk to and share the pregnancy experience. A pregnant woman without social support needs to identify someone with whom she can share the experience of pregnancy because social support is a crucial part of adapting to parenthood. Telling her to move home and telling her that she will feel better as the pregnancy progresses do not address the issue of isolation. Also, moving home may not be a possibility for this woman. The nurse should maintain a professional relationship and not commit to a long-term relationship with a client.

A client is reporting shortness of breath. To ensure there are no developing complications, a tidal volume is obtained. Due to her pregnancy, the health care provider would except to see what type of results on the tidal volume? decrease of 20% increase of 20% decrease of 40% increase of 40%

increase of 40% Tidal volume or the volume of air inhaled increases by 40% (from 500 to 700 ml) as the pregnancy progresses.

The nursing instructor is presenting the basic physiologic changes in the woman that can occur during a pregnancy. The instructor determines the session is successful when the students correctly choose which change in the respiratory function during pregnancy as normal? increased tidal volume decreased oxygen consumption increased expiratory volume decreased respiratory rate

increased tidal volume A pregnant client breathes more deeply, which increases the tidal volume of gas moved in and out of the respiratory tract with each breath. The expiratory volume, residual volume, and respiratory rate decrease as the pregnancy progresses. The increased oxygen consumption in the pregnant client is 15% to 20% greater than in the nonpregnant state.

During a routine antepartal visit, a pregnant woman says, "I've noticed my gums bleeding a bit since I've become pregnant. Is this normal?" The nurse bases the response on the understanding of which effect of pregnancy? influence of estrogen and blood vessel proliferation effects of regurgitation from relaxation of the cardiac sphincter elevated progesterone levels increased venous pressure

influence of estrogen and blood vessel proliferation During pregnancy, the gums become hyperemic, swollen, and friable and tend to bleed easily. This change is influenced by estrogen and increased proliferation of blood vessels and circulation to the mouth. Elevated progesterone levels cause smooth muscle relaxation, which results in delayed gastric emptying and decreased peristalsis. Increased venous pressure contributes to the formation of hemorrhoids. Relaxation of the cardiac sphincter, in conjunction with slowed gastric emptying, leads to reflux due to regurgitation of the stomach contents into the upper esophagus.

The husband of a pregnant woman in her first trimester tells the nurse that his wife is increasingly preoccupied with herself and her fetus as more signs of the pregnancy present themselves. What should the nurse point out to the husband is probably occurring in this situation? ambivalence emotional lability introversion acceptance

introversion Introversion, or focusing on oneself, is common during early pregnancy, especially as more signs of the pregnancy become apparent. The woman may withdraw and become increasingly preoccupied with herself and her fetus. This is a normal psychological adaptation to upcoming motherhood. Ambivalence is an initial response that involves having conflicting feelings at the same time and is a universal feeling in pregnant women. It is considered normal when preparing for a lifestyle change and new role. In the stage of acceptance, the woman feels tangible signs that someone separate from herself is present. This response is common during the second trimester. Emotional lability involves experiencing mood swings (e.g., feeling great joy at one moment and then within a short time feeling shock and disbelief).

A client who is in her sixth week of gestation is being seen for a routine prenatal care visit. The client asks the nurse about changes in her eating habits that she should make during her pregnancy. The client informs the nurse that she is a vegetarian. The nurse knows that she has to monitor the client for which risks arising from her vegetarian diet? Select all that apply. iron-deficiency anemia constipation low gestational weight gain decreased mineral absorption epistaxis

iron-deficiency anemia decreased mineral absorption low gestational weight gain When caring for a pregnant client who follows a vegetarian diet, the nurse should monitor her for iron-deficiency anemia, decreased mineral absorption, and low gestational weight gain. Risk of epistaxis and increased risk of constipation are not reported to be associated with a vegetarian diet.

A 22-year-old primigravida comes to the office for a prenatal visit. She is in her second trimester and has had prenatal care since she was 8 weeks pregnant. Her only report is a new brownish line straight down her abdomen. Vital signs are unremarkable. Urine has no protein, glucose, or leukocytes. Fetal heart rate is 140; the client's uterus is palpated to the umbilicus. What physical finding is responsible for her new "brown line?" linea alba linea nigra diastasis recti corpus luteum

linea nigra The linea nigra is a hyperpigmented area of skin linear along the midline of the abdomen. It results from the hormonal changes of pregnancy and is considered an expected finding.

Many changes occur in the body of a pregnant woman. Some of these are changes in the integumentary system. What is one change in the integumentary system called? Chadwick sign linea rubria melasma (chloasma) ballottement

melasma (chloasma) The so-called mask of pregnancy, melasma (also known as chloasma) can appear as brown blotchy areas on the forehead, cheeks, and nose of the pregnant woman. This condition may be permanent, or it may regress between pregnancies.

A 39-year-old woman is pregnant with her first child and appears to be thrilled about it. Now in her second trimester, she talks enthusiastically with the nurse about the latest maternity clothes she has bought and models them for the nurse. She also discusses the latest trends in health foods, which she has adopted since learning of her pregnancy. The nurse interprets this information as reflecting which primary emotional response to pregnancy? stress emotional lability introversion narcissism

narcissism Self-centeredness (narcissism) may be an early reaction to pregnancy. A woman who previously was barely conscious of her body, who dressed in the morning with little thought about what to wear, suddenly begins to concentrate on these aspects of her life. She dresses so her pregnancy will or will not show. There is no evidence in this scenario of stress, introversion, or emotional lability.

A 28-year-old primigravida client with type 2 diabetes comes to the health care clinic for a routine first trimester visit reporting frequent episodes of fasting blood glucose levels being lower than normal, but glucose levels after meals being higher than normal. What should the nurse point out that these episodes are most likely related to? using too much insulin at this stage of the pregnancy tissue sensitivity to insulin increases normal response to the pregnancy insulin resistance is starting to decrease

normal response to the pregnancy This is a normal response to the pregnancy. During pregnancy, tissues become resistant to insulin to provide sufficient levels of glucose for the growing fetus. This can result in three normally occurring responses: blood glucose levels are lower than normal when fasting; blood glucose levels are higher than normal after meals; and insulin levels are increased after meals. The various hormones will prevent the mother from using most of the insulin produced to allow the extra glucose to get to the growing fetus.

The nurse teaches a pregnant woman about breast-feeding, stating that stimulation of the breast through sucking or touching stimulates the secretion of which hormone? oxytocin follicle stimulating hormone antidiuretic hormone cortisol

oxytocin Oxytocin is responsible for milk ejection during breast-feeding. Its secretion is stimulated by stimulation of the breasts via sucking or touching. Secretion of follicle-stimulating hormone is inhibited during pregnancy. The secretion of antidiuretic hormone has no effect on breastfeeding. Cortisol secretion regulates carbohydrate and protein metabolism and is helpful in times of stress.

A nurse is explaining how hormones affect the pregnancy. Which hormone would the nurse describe as being responsible for stimulating uterine contractions during labor and birth? progesterone oxytocin prolactin estrogen

oxytocin Oxytocin is responsible for stimulating the uterine contractions that bring about delivery. Progesterone and estrogen help maintain the pregnancy, and prolactin helps with stimulating milk production after the delivery.

The nurse is preparing to teach a community class to a group of first-time parents. Which information should the nurse include concerning what the pregnant woman's partner may experience as a normal response? desire to be the woman and give birth no changes, only the mother has changes during pregnancy physical symptoms similar to the mother feeling distanced from the mother

physical symptoms similar to the mother Couvade syndrome is the occurrence of physical symptoms by the partner, similar to the physical symptoms of the mother. Other emotional symptoms may occur, but they are typically on a person-to-person basis.

A new mother voices concerns about breastfeeding her infant. The nurse would explain to the mother the two hormones that control lactation and letdown are: luteinizing hormone and hCG follicle-stimulating hormone and thyroid hormone. estrogen and progesterone prolactin and oxytocin.

prolactin and oxytocin. Prolactin and oxytocin are both important hormones in regulation of breastfeeding. Prolactin helps in producing the breast milk and oxytocin stimulates letdown during breastfeeding. The other hormones do not play a role in breastfeeding or milk production.

A client who is entering her third trimester comes to the prenatal clinic for a follow-up examination. When assessing the breasts, which findings would the nurse expect? Select all that apply. pallor of the areolae prominent veins increased sensitivity warmth hyperpigmentation of the nipple

prominent veins hyperpigmentation of the nipple increased sensitivity Normal breast findings include prominent veins, nodular breasts, increased sensitivity to touch, and hyperpigmentation of the nipples and areolae. Warmth would suggest possible infection.

A 27-year-old female was just confirmed to be pregnant. She tells the nurse she just switched to a vegan diet. The nurse explains that she must pay special attention to her intake of which elements to ensure she is getting adequate nutrition for her and the baby? Select all that apply. calcium vitamin B12 protein folate iron

protein iron vitamin B12 calcium Vegan diets do not include any meat, eggs, or dairy products. Pregnant vegetarians must pay special attention to their intake of protein, iron, calcium, and vitamin B12.

The nurse is assessing a pregnant woman and noticing behavior changes that indicate she is beginning to accomplish the maternal tasks of becoming a mother. The client is in her third trimester. Which behavior would the nurse most likely assess? accepting the pregnancy but not yet the fetus questioning of her ability to become a good mother acknowledging the fetus as a separate entity identifying what must be given up to assume her new role

questioning of her ability to become a good mother During the third trimester, the woman often questions her ability to become a mother. Accepting the pregnancy but not the fetus and identifying what must be given up to assume new roles are characteristic of the first trimester. Learning how to delay own desires and acknowledging the fetus as a separate entity are characteristic of the second trimester.

A woman in the third trimester of her first pregnancy expresses fear about the birth canal being wide enough for her to push the baby through it during labor. She is a petite person, and the baby seems so large. She asks the nurse how this will be possible. To help alleviate the client's fears, the nurse should mention the role of the hormone that softens the cervix and collagen in the joints, which allows dilation (dilatation) and enlargement of the birth canal. What is this hormone? relaxin estrogen human placental lactogen progesterone

relaxin Relaxin, secreted by the corpus luteum of the ovary as well as the placenta, is responsible for helping to inhibit uterine activity and to soften the cervix and the collagen in joints. Softening of the cervix allows for dilation (dilatation) at birth; softening of collagen allows for laxness in the lower spine and so helps enlarge the birth canal. The effect of estrogen is to cause breast and uterine enlargement. Progesterone has a major role in maintaining the endometrium, inhibiting uterine contractility, and aiding in the development of the breasts for lactation. Human placental lactogen (hPL), also known as human chorionic somatomammotropin, serves as an antagonist to insulin, making insulin less effective and thereby allowing more glucose to become available for fetal growth.

A pregnant client who is beginning her third trimester asks the nurse why she feels like she is sometimes having labor contractions. The nurse would explain that: she needs to call her health care provider immediately to report the contractions. she may be beginning labor, so monitor for her water to break. she is having "practice" contractions called Braxton Hicks contractions and they are normal. if these contractions occur late in the day, she should be concerned.

she is having "practice" contractions called Braxton Hicks contractions and they are normal. Braxton Hicks contractions begin in the second trimester as painless, intermittent "practice" contractions and continue into the third trimester, when the mother may experience some discomfort. Braxton Hicks contractions are irregular and usually go away with rest. Braxton Hicks contractions normally occur later in the day, not early. It is thought that as the day slows down, the mother is more attuned to these mild, irregular contractions. There is no need to call the doctor unless the contractions become regular, which would be suggestive of labor.

A client who suspects she is pregnant asks the nurse about the accuracy of home pregnancy tests. The nurse would tell the client that: their reliability is only about 90%. home pregnancy tests often give a false positive result. some of the home pregnancy tests can detect the presence of hCG within 1 day of the woman's missed period. The test works best on a midday urine sample.

some of the home pregnancy tests can detect the presence of hCG within 1 day of the woman's missed period. Home pregnancy tests are 95% reliable if used according to the instructions on the kit. In fact, some can detect hCG within 1 day after a missed period. These tests often give a false negative, not false positive, reading. Results can be tested with the first voided specimen of the day.

A client who has just given a blood sample for pregnancy testing in the health care provider's office asks the nurse what method of confirming pregnancy is the most accurate. The nurse explains the difference between presumptive symptoms, probable signs, and positive signs. What should the nurse mention as an example of a positive sign, which may be used to diagnose pregnancy? visualization of the fetus by ultrasound absence of a period laboratory test of a urine specimen for hCG laboratory test of a blood serum specimen for hCG

visualization of the fetus by ultrasound There are only three documented or positive signs of pregnancy: 1) demonstration of a fetal heart separate from the mother's, 2) fetal movements felt by an examiner, and 3) visualization of the fetus by ultrasound. The absence of a period is an example of a presumptive symptom, which is a symptom that, when taken as a single entity, could easily indicate other conditions. Laboratory tests of either urine or blood serum for human chorionic gonadotropin (hCG) are examples of probable signs of pregnancy, which are objective and so can be verified by an examiner.