Chapter 12
A maternity nurse should be aware of which fact about the amniotic fluid? A. It serves as a source of oral fluid and as a repository for waste from the fetus. B. The volume remains about the same throughout the term of a healthy pregnancy. C. A volume of less than 300 ml is associated with gastrointestinal malformations. D. A volume of more than 2 L is associated with fetal renal abnormalities.
A Amniotic fluid also cushions the fetus and helps maintain a constant body temperature. Its volume changes constantly; too little fluid (oligohydramnios) is associated with renal abnormalities, and too much fluid (polyhydramnios) is associated with gastrointestinal and other abnormalities.
Many parents-to-be have questions about multiple births. Maternity nurses should be able to tell them that: A. Rates of twinning and other multiple births are increasing because of the use of fertility drugs and delayed childbearing. B. Dizygotic twins (two fertilized ova) have the potential to be conjoined twins. C. Identical twins are more common in Caucasian families. D. Fraternal twins are same gender, usually male.
A If the parents-to-be are older and have taken fertility drugs, they would be very interested in this information. Conjoined twins are monozygotic; they are from a single fertilized ovum in which division occurred very late. Identical twins show no racial or ethnic preference; fraternal twins are more common among African-American women. Fraternal twins can be different genders or the same gender. Identical twins are the same gender.
The nurse caring for a pregnant woman knows that her health teaching regarding fetal circulation has been effective when the woman reports that she has been sleeping: A. In a side-lying position. B. On her back with a pillow under her knees. C. With the head of the bed elevated. D. On her abdomen.
A Optimal circulation is achieved when the woman is lying at rest on her side. Decreased uterine circulation may lead to intrauterine growth restriction. Previously it was believed that the left lateral position promoted maternal cardiac output, thereby enhancing blood flow to the fetus. However, it is now known that either side-lying position enhances uteroplacental blood flow. If a woman lies on her back with the pressure of the uterus compressing the vena cava, blood return to the right atrium will be diminished. Although having a pillow under the knees is recommended and ideal for later in pregnancy, the woman must still maintain a lateral tilt to the pelvis to avoid compression of the vena cava. Many women will find lying on the abdomen uncomfortable as pregnancy advances.
The results of an amniocentesis show that the preg women lecithin-sphingomyelin (L-S) ratio is 2;1. This results indicates that; a) the women is in her second trimester of preg b)the newborn should be able to maintain effective respiration after birth c) the fetus most likely has developed a renal problem d) an open neural tub defect is preset
B
A woman is 8 months pregnant. She tells the nurse that she knows her baby listens to her, but her husband thinks she is imagining things. Which response by the nurse is most appropriate? A. "Many women imagine what their baby is like." B. "A baby in utero does respond to the mother's voice." C. "You'll need to ask the doctor if the baby can hear yet." D. "Thinking that your baby hears will help you bond with the baby."
B Fetuses respond to sound by 24 weeks. The fetus can be soothed by the sound of the mother's voice, and the nurse should instruct the mother so. Although statement A is accurate, it is not the most appropriate response. Statement D is not appropriate because it gives the mother impression that her baby cannot hear her and belittles her interpretation of her fetus's behaviors.
Which time span delineates the appropriate length for a normal pregnancy? A. 9 lunar months, 8.5 calendar months, 39 weeks, 272 days B. 10 lunar months, 9 calendar months, 40 weeks, 280 days C. 9 calendar months, 10 lunar months, 42 weeks, 294 days D. 9 calendar months, 38 weeks, 266 days
B Pregnancy lasts approximately 10 lunar months, 9 calendar months, 40 weeks, 280 days. Length of pregnancy is computed from the first day of the last menstrual period (LMP) until the day of birth. Nine lunar months is just short of a term pregnancy, and 294 days is longer than the average length of a pregnancy and would be considered postterm. Because conception occurs approximately 2 weeks after the first day of the LMP, the length described in D represents the postconception age of 266 days or 38 weeks. Postconception age is used in the discussion of fetal development.
In reviewing the history of a woman who wants to become pregnant, which medication profile would indicate a potential concern relative to toxic exposure? (Select all that apply.) A. Tylenol OTC occasionally for a headache; twice last week B. Anticonvulsant for seizure disorder C. Lithium for bipolar disorder D. Coumadin for atrial fibrillation E. Multivitamins once a day
B, C, D A patient being treated with an anticonvulsant or lithium is at risk for toxic effects during pregnancy. Warfarin (Coumadin) can put a patient at risk during pregnancy. Although acetaminophen (Tylenol) can have toxic effects on the liver, the reported frequency is not a concern at this time. Taking multivitamins is a healthy recommended option.
A pregnant woman has been diagnosed with oligohydramnios. Which presentation would the nurse suspect to find on physical examination? A. Fetus is in a breech position B. FHR baseline is within normal range C. Fetus with possible renal problems D. Increased fundal height
C Oligohydramnios reflects a decrease in the amount of amniotic fluid and is associated with renal abnormalities in the fetus and compromised fetal well-being. The position of the fetus is due to gestational age and the maternal uterine environment. FHR may be within normal range because it is affected by gestational age and fetal well-being. An increase in fundal height would be associated with polyhydramnios and/or gestational age assessment.
A woman at 35 weeks of gestation has had an amniocentesis. The results reveal that surface-active phospholipids are present in the amniotic fluid. The nurse is aware that this finding indicates that: A. The fetus is at risk for Down syndrome. B. The woman is at high risk for developing preterm labor. C. The lungs are mature. D. Meconium is present in the amniotic fluid.
C The detection of the presence of pulmonary surfactants, surface-active phospholipids, in amniotic fluid has been used to determine fetal lung maturity, or the ability of the lungs to function after birth. This occurs at approximately 35 weeks of gestation. This result is unrelated to Down syndrome and in no way indicates risk for preterm labor. Meconium should not be present in the amniotic fluid.
A woman's cousin gave birth to an infant with a congenital heart anomaly. The woman asks the nurse when such anomalies occur during development. Which response by the nurse is most accurate? A. "We don't really know when such defects occur." B. "It depends on what caused the defect." C. "They occur between the third and fifth weeks of development." D. "They usually occur in the first 2 weeks of development."
C The nurse would be aware of when such defects occur. Regardless of the cause, the heart is vulnerable during its period of development, the third to fifth weeks. The cardiovascular system is the first organ system to function in the developing human. Blood vessel and blood formation begins in the third week, and the heart is developmentally complete in the fifth week.
Which developmental finding is accurate with regard to fetal growth? A. Heart starts beating at 12 weeks. B. Lungs take shape by 8 weeks. C. Brain configuration is complete by 8 weeks. D. Main blood vessels form by 8 weeks.
D The heart starts beating by 4 weeks, the lungs take shape by 12 weeks, and brain configuration is complete by 12 weeks.
When caring for a preg women the nurse would recognize the women with what disorder has the greatest risk for giving birth to a macrosomic? a) diabetes b) anemia c)hyperthyroidism d) hypertension
a
when teaching a class of preg women, about fetal development the nurse would include which statements? (Select all) A)the sex of your baby is determined by the 9th week of preg B )Your baby will be able to suck and hiccup while in your uterus c )the baby heart begins to pump blood during the 10th week of preg d the baby heart beat will be audible using a special ultra sound stethoscope beginning at the 18th week of preg e You should be able to feel your baby move by week16 to 20 of preg f by the 24th week of your preg you will notice the baby responding to sounds in the environment, including music and your voice
b e f
If a preg women intake of iron is sufficient her newborn will have enough iron stored in its liver approx how many months after birth? a) 1 month b)3 month c) 5 month d) 9 months
c
