Chapter 12: Nursing Management During Pregnancy

The nurse is conducting a teaching session for breastfeeding mothers. Which statement by a mother requires further clarification by the nurse?

"I am glad I can have my two cups of coffee in the morning again."

The nurse is assigned to clients who are having the following procedures: Amniocentesis Fetal nonstress test Chorionic villus sampling Percutaneous umbilical blood sampling Doppler assessment of fetal heart rate For which clients will the nurse ensure that the informed consent is on the chart?

Amniocentesis, chorionic villus sampling, percutaneous umbilical blood sampling

During the first prenatal visit an extensive history is collected from the client. What is one part of this extensive history?

Social history

A client has been confirmed to be pregnant. She gives a history of two previous full-term normal pregnancies. How will the nurse classify the client's pregnancy history?

G3, P2

A nurse is teaching a client who is 30 weeks pregnant about ways to deal with heartburn. The nurse determines a need for additional teaching based on which client statement?

"I should lie down for 1/2 hour after eating."

After teaching the pregnant woman about ways to minimize flatulence and bloating during pregnancy, the nurse understands that which client statement indicates the need for additional teaching?

"I'll switch to chewing gum instead of using mints."

A gravid woman who is in her first trimester reports experiencing constipation. Which statement by the client indicates the need for further instruction?

"Taking gentle enemas no more frequently than once a week is acceptable."

The nurse is assessing a client at her first prenatal visit and notes that she is exposed to various chemicals at her place of employment. Which statement by the client would indicate she needs additional health education to protect her and her fetus?

"The gloves they provide irritate my hand, so I don't wear them"

A hospitalized client with hyperemesis gravidarium has been tolerating small amounts of clear fluids for the past 6 hours. What is the next step in the plan of care?

Add small quantities of dry toast every 2 to 3 hours.

The nurse discovers a new prescription for RhoGAM for a client who is about to undergo a diagnostic procedure. The nurse will administer the RhoGAM after which procedure?

Amniocentesis

A young couple are concerned that their fetus may be born with sickle cell anemia. The nurse explains that the recessive traits of sickle-cell anemia can be determined by using which test?

CVS

When measuring the diagonal conjugate of a woman's pelvis, the distance between which anatomic landmarks would be used?

Anterior surface of the sacral prominence and the anterior surface of the symphysis pubis

A young couple are very excited to discover they are pregnant and ask the nurse when to expect the baby. Based on a July 20 LMP, which day will the nurse predict for delivery?

April 27

What instruction should a nurse offer to a pregnant client or a client who wishes to become pregnant to help her avoid exposure to teratogenic substances?

Avoid medications.

A client with hyperemesis gravidarium is started on TPN. What parameter does the nurse need to assess at least twice a day?

Blood glucose

A nurse is assigned to care for a pregnant client as she undergoes a nonstress test. Place the steps involved in conducting the nonstress test in the correct order from first to last. All options must be used.

Client consumes a meal. Client placed in left lateral recumbent position. External electronic fetal-monitoring device applied. Client is handed an event marker. Fetal monitor strip marked for fetal movement.

A pregnant client arrives for her first prenatal appointment. She reports her previous pregnancy ended at 19 weeks, and she has 3-year-old twins born at 30 weeks' gestation. How will the nurse document this in her records?

G3 T0 P1 A1 L2

A nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a 4-year-old child who was delivered at 38 weeks' gestation and tells the nurse that she does have a history of a miscarriage within the first trimester. The nurse is correct to document the history as:

G = 3 T = 1 P = 0 A = 1 L = 1

A 28-year-old client who has just conceived arrives at a health care facility for her first prenatal visit to undergo a physical examination. Which intervention should the nurse perform to prepare the client for the physical examination?

Instruct the client to empty her bladder.

A teenager arrives in the emergency department in active labor having no prenatal care. Upon examination in L & D, the nurse notices a cluster of pinpoint vesicles with a red base on her vulva which the teenager asks the nurse to not touch "her rash" because it hurts when touched. At this point, which intervention should the nurse perform next?

Report this finding to the health care provider immediately so he or she can plan the birth route.

Which client immunization titer is most important to assess and document in the prenatal record of the pregnant woman?

Rubella

The health care provider has prescribed an over-the-counter antacid for a pregnant client in her first trimester who is having ongoing nausea, vomiting, and heartburn. Which instruction concerning the antacid should the nurse prioritize after noting the client is also prescribed a multivitamin supplement?

Take antacid 1 hour after the multivitamin.

A pregnant woman states that she would like to take a tub bath but has heard from her aunt that this could be dangerous to the baby. Which instruction should the nurse give to the client?

Tub baths are fine unless you are unstable on your feet or are experiencing vaginal bleeding.

A client in her third trimester reports to the nurse shortness of breath when sleeping. The nurse informs the client that this is normal and occurs because the growing fetus puts pressure on the diaphragm. Which measure should the nurse suggest to help alleviate this problem?

Use extra pillows

Which woman requires the most weight gain during pregnancy?

a woman carrying twins and a prepregnant BMI of 23

A pregnant client reports being unable to find snacks at work. Which snacks would the nurse recommend she prepare in advance for on-the-job snacks? Select all that apply.

carrot sticks cheese and crackers

A client is in her second trimester, and the health care provider has recommended she undergo an amniocentesis. The nurse explains that the procedure is used to diagnose which conditions? Select all that apply.

chromosomal abnormalities inborn errors of metabolism neural tube defects

The nurse is describing pregnancy danger signs to a pregnant woman who is in her first trimester. Which danger sign might occur at this point in her pregnancy?

excessive vomitting

The nurse is assisting a primigravid (pregnancy first-timer) on calculating the due date of her baby using Naegele's rule. The most important information provided by the mother is:

the first day of the last menstrual period.

A nurse is caring for a pregnant client in her second trimester of pregnancy. The nurse educates the client to look for which danger sign of pregnancy needing immediate attention by the primary care provider?

vaginal bleeding