Maternity
In the third week, three germ layers develop in the embryo. These layers are the ectoderm, mesoderm, and endoderm.
. The ectoderm, which is the outer layer of cells, develops to form skin, hair, nails, and the nervous system. The mesoderm is the middle layer, which will form the skeletal, muscular, and circulatory systems. Lastly, the endoderm, which is the inner layer, will form the glands, lungs, and urinary and digestive tracts
pregnant woman undergoing amniocentesis asks her nurse why the baby needs this fluid. What would be an accurate response from the nurse?
"Amniotic fluid cushions your baby to prevent injury." The amniotic fluid, kept inside the amnion, cushions the fetus against injury, regulates temperature, and allows the fetus to move freely inside it, which allows normal musculoskeletal development of the fetus. The woman's blood supplies food to—and carries wastes away from—the fetus. The placenta supplies the developing organism with food and oxygen; then the umbilical cord connects the fetal blood vessels contained in the villi of the placenta with those found within the fetal body.
A woman is going to have in vitro fertilization. When preparing her for this, you would tell her which of the following?
"It can be done with frozen donor sperm." Fresh or frozen sperm may be used. The success of in vitro fertilization is not related to the incidence of ovarian cancer in the family. Often more than one attempt is needed before successful implantation
A woman with epilepsy was on phenytoin (Dilantin) when she became pregnant. She is very worried that her baby will have a birth defect. Which reply by the nurse is most therapeutic?
"Yes, Dilantin increases the risk of certain defects in the fetus; however, overall the risk is low that your baby will be affected. Your doctor weighs the risk of untreated epilepsy on the fetus with the risk of the medication when making decisions about your treatment plan." Phenytoin (Dilantin) is therapeutic for preventing seizures in the mother but can cause cleft palate and other abnormalities in the fetus. In such a circumstance, the practitioner weighs the risk to the mother against the risk to the developing fetus before prescribing a potential teratogen
What is the main function of estrogen during the menstrual cycle
- Estrogen stimulates blood vessels to develop. -causes the ovum contained within the follicle to mature. -Causes endometrium to regenerate when high
A fetus is assessed at 2 cm above the ischial spines. The nurse would document fetal station as:
-2 Explanation: When the presenting part is above the ischial spines, it is noted as a negative station. Since the measurement is 2 cm, the station would be -2. A 0 station indicates that the fetal presenting part is at the level of the ischial spines. Positive stations indicate that the presenting part is below the level of the ischial spines.
Clomiphene citrate - Clomidis, a fertility drug to treat infertility, is used to
-Stimulate ovulation- women -Increase sperm production- in Men
The placenta
-acts as a barrier to some medications and hormones that are in the maternal blood supply. -secretes hormones that help to sustain the pregnancy. These include progesterone, estrogen, and hCG.
The Uterine cycle has 4 phases
1.Menstraul - Starts day 1 & ends day 5 2. Proliferative -ends w/ ovulation on day 14 3. Secretory- 15-26days 4. Ischemic- 28-29 days
Amniotic fluid serves four main functions for the fetus:
physical protection, temperature regulation, provision of unrestricted movement, and symmetrical growth.
When helping a woman locate her fertile days using the calendar method, you would teach her to subtract
18 from her shortest period and 11 from her longest. The days surrounding ovulation (3 days before and 3 days after) are the most fertile days.
A woman is in her early second trimester of pregnancy. The nurse would instruct the woman to return for a follow-up visit every:
4 weeks The recommended follow-up visit schedule is every 4 weeks up to 28 weeks, every 2 weeks from 29 to 36 weeks, and then every week from 37 weeks to birth.
(see full question) Utilize the GTPAL system to classify a woman who is currently 18 weeks pregnant. This is her 4th pregnancy. She delivered one baby vaginally at 26 weeks who died, experienced a miscarriage, and has one living child who was delivered at 38 weeks gestation.
4, 1, 1, 1, 1 The GTPAL system is used to classifying pregnancy status. G = gravida, T= term, P = preterm, A = number of abortions, L= number of living children.
Assessment reveals that a woman's cervix is approximately 1 cm in length. The nurse would document this as:
50% effaced A cervix 1 cm in length is described as 50% effaced. A cervix that measures approximately 2 cm in length is described as 0% effaced. A cervix 1/2 cm in length would be described as 75% effaced. A cervix 0 cm in length would be described as 100% effaced.
A woman has just learned that she is pregnant and would like to know how soon she can find out via ultrasound the sex of her fetus. The nurse should respond with which of the following?
At about 4 months Although fetal gender is usually determined by an ultrasound screen at about 4 months, it can be determined as early as 7 weeks by analysis of maternal serum.
A nursing student is explaining to a newly pregnant woman what happens during each stage of fetal development. At which stage does the nurse inform the woman that the lungs are fully shaped?
At the end of 16 weeks, the lungs are fully shaped, fetus swallows amniotic fluid, skeletal structure is identifiable, downy lanugo hair is present on the body, and sex can be determined using ultrasound
The nurse understands that the maternal uterus should be at what location at 20 weeks' gestation?
At the level of the umbilicus Correct Explanation: By 20 weeks' gestation, the uterus is at about the level of the umbilicus; by 36 weeks', it nears the bottom of the sternum.
A woman is 40 years old and a heavy smoker. She has a single sexual partner but has very irregular menstrual cycles. She wants a highly reliable contraceptive. Assuming that all of the following methods of birth control are acceptable to her, which of the following would be the best recommendation?
A diaphragm and spermicide Women over 40 who smoke should not take ovulation suppressants; irregular menstrual cycles make natural methods difficult; women over 40 may have vaginal dryness, so a spermicidal suppository would not be activated.
The mnemonic "ACHES" can help you recall warning signs related to using oral contraceptives.
A Abdominal pain C Chest pain, dyspnea, bloody sputum H Severe headache, weakness, or numbness in extremities E Eye problems such as blurred vision, double vision, or vision loss S Speech disturbance, severe leg pain, or edema
A woman uses a diaphragm for contraception. You would instruct her to return to the clinic to have her diaphragm fit checked after which of the following?
A weight gain of 10 lb. A substantial weight gain or weight loss of 10 pounds or more may shift the relationship of pelvic organs enough that the diaphragm no longer fits correctly.
A client at 16 weeks' gestation is scheduled for prenatal testing. Which of the following would the nurse anticipate as the most likely screening test for congenital anomalies based on the current age of this pregnancy?
Amniocentesis. Amniocentesis to screen for congenital anomalies can be done starting at 14 weeks' gestation. This procedure carries risks of spontaneous abortion, infection, and placental abruption. Cardocentesis is used less commonly to determine blood disorders. Chorionic villi sampling is performed at 8 to 12 weeks' gestation. Nuchal translucency testing is done between 11 and 13 weeks' gestation
What makes up the fetal membranes?
Amnion & chorion Amnion surrounds the amniotic cavity. The amnion is a thick fibrous lining made up of several layers that helps protect the fetus and forms the inner part of the sac in which the fetus grows. Amniotic fluid fills this sac. Lying against the amnion toward the exterior of the blastocyst is the chorion . The chorion is a second layer of thick fibrous tissue that surrounds the amnion.
(see full question) A terminally ill 15-year-old tells the nurse that she wants to stop all treatments and go home despite her parents' directives to provide extraordinary means to keep their child alive. What is the best resource available to this nurse to help solve this dilemma?
An institutional ethics committee Every institution has an Institutional Ethics Committee (IEC), which is required by The Joint Commission. The IEC should always be consulted in difficult or unusual cases when conflict and lack of agreement exists between parents and physicians or among the professional staff as to the course of action that is in the best interest of the child.
Question 5: (see full question) When reviewing the history of a woman in labor, the nurse notes that the client has a funnel-shaped pelvis. The nurse would identify this pelvic shape as which of the following?
Android The android pelvis is considered the male-shaped pelvis and is characterized by a funnel shape. The gynecoid pelvis is considered the true female pelvis and offers the optimal diameters in all three planes of the pelvic. An anthropoid pelvis has an oval pelvic inlet and long sacrum, producing a deep pelvis that is wider front to back than side to side. The platypelloid or flat pelvis has a shallow pelvic cavity that widens at the pelvic outlet
A nurse at the healthcare facility assesses a client in the 20 week of gestation. The client is healthy and progressing well, without any sign of complications. Where should the nurse expect to measure the fundal height in this client?
At the level of the umbilicus Explanation: In the 20 week of gestation, the nurse should expect to find the fundus at the level of the umbilicus. The nurse should palpate at the top of the symphysis pubis between 10 to 12 weeks' gestation. At 16 weeks' gestation, the fundus should reach halfway between the symphysis pubis and the umbilicus. With a full-term pregnancy, the fundus should reach the xiphoid process.
Why is the first prenatal visit usually the longest prenatal visit?
Baseline data is collected The first prenatal visit is usually the longest because the baseline data to which all subsequent assessments are compared are obtained at this visit.
(see full question) A pregnant woman who is 26 weeks pregnant arrives for a follow-up visit. Which of the following assessments, in addition to measuring fundal height and fetal heart rate, would the nurse expect to complete? Select all that apply.
Blood pressure • Weight • Urine testing • Blood glucose level Explanation: Up to 28 weeks' gestation, follow-up visits involve assessment of the client's blood pressure and weight, urine testing for protein and glucose, along with fundal height and fetal heart rate. Between weeks 24 and 28, a blood glucose level is obtained. Assessment for edema is typically done between 29 and 36 weeks' gestatio
Braxton Hicks contractions are termed "practice contractions" and occur throughout pregnancy. When the woman's body is getting ready to go into labor, it begins to show anticipatory signs of impending labor. Among these signs are Braxton Hicks contractions that are more frequent and stronger in intensity. What differentiates Braxton Hicks contractions from true labor?
Braxton Hicks contractions usually decrease in intensity with walking Explanation: Braxton Hicks contractions occur more frequently and are more noticeable as pregnancy approaches term. These irregular, practice contractions usually decrease in intensity with walking and position changes.
Lactation Amenorhea
Breast-feeding offers some level of contraceptive protection because elevated prolactin levels help suppress ovulation. The method works best during the first six months after childbirth. The woman must breast-feed frequently, every two to three hours without fail. Advantages of breast-feeding include promotion of weight loss, suppression of menses, and a more rapid return of the uterus to its prepregnant state. A major disadvantage is that the woman will not know for sure when fertility returns.
A fetus is in the LST position. The nurse interprets this as indicating which of the following as the presenting part?
Buttocks Explanation: The letter "S" indicates the sacrum or buttocks as the presenting part. The fetal head would be noted by the letter "O," indicating occiput. The fetal chin would be noted by the letter "M," indicating mentum. The fetal shoulder would be noted by the letter "A," indicating the acromion process
What are the 5 methods used anticipate the fertile window?
Calendar method BBT method Cervical mucus method Symptothermal method Standard days method (SDM)
There is no consensus of what actually happens to initiate the onset of labor. It is thought to be a combination of maternal and fetal factors that occur in such a way that labor begins. What is the term used to describe the way maternal and fetal factors interact to cause labor to begin?
Cascade effect Because a single causative factor of labor initiation has not yet been determined, the most likely answer seems to be that labor results from a combination of maternal and fetal factors working together in a cascade effect. During the cascade, factors that inhibit contractions, such as progesterone, are suppressed; and factors that promote contractions, such as prostaglandins, are engaged (Norwitz, 2006).
The nurse counseling a couple wishing to adopt a child explains to the couple that there has been a decline in the number of infants available for adoption, but an increase in the number of children with special needs, including: Select all answers that apply:
Children with abusive parents • Children whose parents have died • Children with chronic illness • Children who must be adopted with a sibling There has been an increase in the number of children with special needs available for adoption, as a result of parental abuse (including prenatal substance abuse), neglect, abandonment, or parental death. Special needs children also include certain minorities, children older than 6 years, children with chronic illnesses or psychological problems, and children who must be adopted with a sibling
By what processes do nutrients, oxygen, and wastes transfer between the pregnant woman's blood and fetal blood?
Circulation ?
After fertilization, the zygote begins the process of mitotic division known as
Cleavage
The names of pelvic support disorders correspond to the affected organs. Name 4
Cystocele Rectocele enterocele Uterine
Cystocele
Cystocele occurs when the bladder bulges into the front wall of the vagina.
Ovulation occurs when?
Day 14 of menstrual cycle
During pregnancy the endometrium is called the
Decidua
What is the name of the stage of development that occurs during weeks 3 to 8?
Embryonic
What is endometriosis?
Endometriosis is a disease in which tissue that normally grows inside the uterus grows outside it. The main symptoms are pelvic pain and infertility.
Enterocele
Enterocele occurs when the small intestine and peritoneum jut downward between the uterus and rectum.
Phases of sexual response :EPOR
Excitement Plateau Orgasm Resolution
2 Phases of the Ovarian cycle
FSH controls Follicular phase 1-14 days LH controls Luteal Phase 15-28 days
When describing the process of fertilization, the nurse would explain that it normally occurs in which structure?
Fallopian tube Fertilization normally occurs in the fallopian tube. Once fertilized the ovum proceeds down the uterus and attaches itself in the endometrium. The vagina and cervix are not involved in fertilization.
What term is used to describe the position of the fetal long axis in relation to the long axis of the mother?
Fetal lie Fetal lie describes the position of the long axis of the fetus in relation to the long axis of the pregnant woman.
EFFACEMENT
First, the cervix begins to get shorter and thinner, a process called effacement. Cervical effacement is recorded as a percentage. The cervical canal measures approximately 2 cm before effacement. At a length of 1 cm, the cervix is 50% effaced. When the cervix is paper thin, it is 100% effaced.
A client with a 28-day cycle reports that she ovulated on May 10. The nurse would expect the client's next menses to begin on:
For a woman with a 28-day cycle, ovulation typically occurs on day 14. Therefore, her next menses would begin 14 days later, on May 24.
A multigravida client is pregnant for the third time. Her previous two pregnancies ended in an abortion in the first and third month of pregnancy. How will the nurse classify her pregnancy history?
G3 P0020 Gravida (G) is the total number of pregnancies she has had, including the present one. Therefore she is G3 and not G2. Para (P), the outcome of her pregnancies, is further classified by the FPAL system as follows: F = Full term: number of babies born at 37 or more weeks of gestation, which is 0 and not 1 in this case. P = Preterm: number of babies born between 20 and 37 weeks of gestation, which is 0 in this case. A = Abortions: total number of spontaneous and elective abortions, which is 2 in this case. L = Living children, as of today. She has no living children; therefore, it is 0 and not 1.
A nurse is classifying the pregnancy history of a woman who has had five pregnancies: three full-term, one preterm, and one abortion. How would the nurse document this information on the patient chart?.
G5 P3114 Explanation: G = gravida or the total number of pregnancies, which in this case equals five. P = para is the outcome of the pregnancies in the following order: full term, preterm, abortions, and living as of today. In this case, P3114.
When is the Fertile Window?
Guidelines derive from the assumption that ovulation occurs exactly 14 days before the onset of the next menstrual cycle and that the fertile window extends three to four days before and after ovulation, or in other words, between days 10 and 17 of the menstrual cycle.
If a woman is trying to get pregnant she should have sex when
Have sex when the cervical mucus is thin, stretchy, and copious (alot) which is at the time of ovulation
The obstetrician is examining a woman who is in early labor to determine the positioning of the fetus. The nurse knows that which of the following fetal attitudes would be the most advantageous for birth?
Head flexed forward so much that the chin touches the sternum A fetus in good attitude is in complete flexion: the spinal column is bowed forward, the head is flexed forward so much that the chin touches the sternum, the arms are flexed and folded on the chest, the thighs are flexed onto the abdomen, and the calves are pressed against the posterior aspect of the thighs. This usual "fetal position" is advantageous for birth because it helps a fetus present the smallest anteroposterior diameter of the skull to the pelvis and also because it puts the whole body into an ovoid shape, occupying the smallest space possible. The other attitudes listed are not ideal, because larger diameters of the fetus' skull are presenting
Sonogram
If the date of the last menstrual period is unknown, a woman will be scheduled for a sonogram to confirm the pregnancy length and document healthy fetal growth at 7 to 11 weeks of pregnancy. A sonogram can also be scheduled between 16-20 weeks' gestation to verify healthy fetal structures and gender. Be certain women know a sonogram done under 8 weeks will show only the presence of a gestation sac, not a moving, kicking fetus so their expectations of what they will see is not disappointing
Infants in the U.S. are at highest risk for death statistically in comparison to other modernized countries.Which initiative, if implemented, would have the greatest impact on improving these numbers?
Improved accessibility to postnatal health care for infants Making postnatal health care available and affordable would have the greatest impact on improving infant health and reducing the number of infant deaths. Spending more money on healthcare has proven to not improve infant survival rates postnatally. Although provision of mothering classes and improving maternal nutrition would be a good idea, these measures will not positively impact infant survival rates.
Morning sickness is associated with rising levels of human chorionic gonadotropin (hCG) and progesterone
Known as morning sickness, nausea and vomiting begins to be noticed at the same time levels of hCG and progesterone begin to rise so these may contribute to its cause. Another reason may be a systemic reaction to increased estrogen levels or decreased glucose levels, because glucose is being used in such great quantities by the growing fetus
What is infertility?
Infertility is the failure to achieve conception after 1 year of unprotected intercourse. 12 months
Which of the following best explains the action of the lactational amenorrhea method (LAM) of fertility control?
LAM prevents pregnancy by suppressing the ovulation process. Withdrawal and barrier methods of contraception prevent the introduction of sperm into the vagina. The copper IUD, combined hormonal methods, and combined oral contraceptives prevent fertilization between the egg and the sperm. The Norplant system thickens the cervical mucus and blocks sperm
Determine Intensity of contraction
It is difficult for inexperienced nurses to determine the intensity of uterine contractions by palpation. If the fundus feels like the tip of your nose at the peak of a contraction, the contraction is mild. If the fundus feels firmer, as when you touch your chin, the contraction is of moderate intensity. A fundus that cannot be indented, one that feels like you are pushing on your forehead, is indicative of a strong contraction.
Assessment of a woman in labor reveals cervical dilation of 3 cm, cervical effacement of 30%, and contractions occurring every 7 to 8 minutes, lasting about 40 seconds. The nurse determines that this client is in:
Latent phase of the first stage The latent phase of the first stage of labor involves cervical dilation of 0 to 3 cm, cervical effacement of 0% to 40%, and contractions every 5 to 10 minutes lasting 30 to 45 seconds. The active phase is characterized by cervical dilation of 4 to 7 cm, effacement of 40% to 80%, and contractions occurring every 2 to 5 minutes lasting 45 to 60 seconds. The transition phase is characterized by cervical dilation of 8 to 10 cm, effacement of 80% to 100%, and contractions occurring every 1 to 2 minutes lasting 60 to 90 seconds. The perineal phase of the second stage occurs with complete cervical dilation and effacement, contractions occurring every 2 to 3 minutes and lasting 60 to 90 seconds, and a tremendous urge to push by the mother.
The nurse assesses a client in labor and finds that the fetal long axis is longitudinal to the maternal long axis. The nurse documents this finding as which of the following?
Lie The nurse is assessing fetal lie, the relationship of the fetal long axis to the maternal long axis. When the fetal long axis is longitudinal to the maternal long axis, the lie is said to longitudinal. Presentation is the portion of the fetus that overlies the maternal pelvic inlet. Attitude is the relationship of the different fetal parts to one another. Position is the relationship of the fetal denominator to the different sides of the maternal pelvis. (less)
Which hormone is responsible for ovulation?
Luteinizing hormone
(see full question) The nurse is explaining the events that lead up to ovulation. Which hormone would the nurse identify as being primarily responsible for ovulation?
Luteinizing hormone Correct Explanation: At ovulation, a mature follicle ruptures in response to a surge of luteinizing hormone. Estrogen is predominant at the end of the follicular phase, directly preceding ovulation. Progesterone peaks 5 to 7 days after ovulation. Follicle-stimulating hormone is highest during the first week of the follicular phase of the cycle.
Ovarian cycle has 2 main hormones that make cycle changes in the ovaries
Luteinizing hormone Follicle stimulating hormone
What physician is known as the "Father of Pediatrics"?
Many view Abraham Jacobi, a Prussian-born physician, as the father of pediatrics.
Gametogenesis occurs by which type of cellular division: mitosis or meiosis?
Meiosis
Low levels of estrogen and progesterone are at which 2 phases?
Menstrual and Ischemic
When narcotics are used in addition to anesthetics, pruritus is a common side effect. Most women tolerate the itching, particularly because the pain relief is generally excellent for the first 24 hours after surgery
Nalbuphine (Nubain), an opioid agonist-antagonist; naloxone (Narcan), an opioid antagonist; and diphenhydramine (Benadryl), an antihistamine, are medications that may be ordered to treat severe pruritus.
When caring for a client in the third stage of labor, the nurse notices that the expulsion of the placenta has not occurred within 5 minutes after delivery of the infant. What should the nurse do?
Nothing. Normal time for stage three is 5-30 minutes Following childbirth, the placenta is spontaneously expelled within 5-30 minutes so there is no problem with this patient. No further interventions are needed.
A woman reports that her LMP occurred on January 10, 2010. Using Nagele's rule, what is her due date?
October 17, 2010 To determine the due date using Nagele's rule, add seven days to the date of the first day of the LMP, then subtract three months
Question 4: (see full question) The nurse is advising a pregnant woman during her first prenatal visit regarding the frequency of future visits. Which of the following is the recommended schedule for prenatal care?
Once every 4 weeks for the first 28 weeks, then every 2 weeks until 36 weeks, and then weekly until the birth. The best health for mother and baby results when the mother has her first visit before the end of the first trimester (before the end of week 13) and then has regular visits until after she has delivered the baby. The usual timing for visits is about once every 4 weeks for the first 28 weeks, then every 2 weeks until 36 weeks, and then weekly until the birth.
A client's maternal serum alpha-fetoprotein (MSAFP) level was unusually elevated at 17 weeks. The nurse suspects which of the following?
Open spinal defects Elevated MSAFP levels are associated with open neural tube defects. Fetal hypoxia would be noted with fetal heart rate tracings and via nonstress and contraction stress testing. MSAFP in conjunction with marker screening tests would be more reliable for detecting Down syndrome. Maternal hypertension would be noted via serial blood pressure monitoring
A woman has just been prescribed clomiphene citrate to stimulate ovulation. Which of the following is an effect of the drug that the nurse should warn the woman about?
Overstimulation of the ovary resulting in potential multiple births Therapy with clomiphene citrate (Clomid, Serophene) may be used to stimulate ovulation. Administration of either clomiphene citrate or gonadotropins may overstimulate an ovary, causing multiple ova to come to maturity and possibly resulting in multiple births. Counsel women who receive these agents this is a possibility. None of the other answers is a common effect of clomiphene citrate use
Name five symptoms of PMS.c
Physical Symptoms Breast tenderness Abdominal bloating Headache, migraine Edema of the extremities Behavioral Symptoms Angry outbursts Confusion Depression Withdrawal from others Anxiety Irritable mood Feelings of "edginess"
A nurse is educating a group of nursing students about the molding of the fetal skull during the birth process. Which of the following would the nurse include as the usual cause of molding?
Poorly ossified cranial vault Molding is an adaptive process in which there is overriding and movement of the bones of the cranial vault to adapt to the maternal pelvis. The poorly ossified bones of the cranial vault, along with loosely attached membranous attachments, allow for the process of molding in the fetal skull. The bones of the face and the base of the skull are completely ossified and united. Hence they cannot allow for movement or overriding. The membranous attachments are loosely bound to the cranial vault and not tightly, which allows for molding of the fetal skull.
The nurse is assessing a woman who is pregnant for the first time. Which of the following terms applies to this client?
Primigravida Gravida refers to a woman who is or has been pregnant. Primigravida refers to a woman who is pregnant for the first time, which is the case in this scenario. Multigravida refers to a woman who has been pregnant previously. Nulligravida refers to a woman who has never been and is not currently pregnant. Para refers to the number of pregnancies that have reached viability, regardless of whether the infants were born alive. Primipara refers to a woman who has given birth to one child past age of viability.
Which two tests are generally performed on urine at a prenatal visit?
Protein and glucose Protein is assessed to help detect hypertension of pregnancy; glucose is assessed to help detect gestational diabetes.
A 32-year-old woman presents to the labor-and-delivery suite in active labor. She is multigravida, relaxed, and talking with her husband. When examined by the nurse, the fetus is found to be in a cephalic presentation. His occiput is facing toward the front and slightly to the right of the mother's pelvis, and he is exhibiting a flexed attitude. How does the nurse document the position of the fetus?
ROA Document the fetal position in the clinical record using abbreviations. The first letter describes the side of the maternal pelvis toward which the presenting part is facing ("R" for right and "L" for left). The second letter or abbreviation indicates the reference point ("O" for occiput, "Fr" for frontum, etc.). The last part of the designation specifies whether the presenting part is facing the anterior (A) or the posterior (P) portion of the pelvis, or whether it is in a transverse (T) position
During a nonstress test, when monitoring the fetal heart rate, the nurse notes that when the expectant mother reports fetal movement, the heart rate increases 15 beats or more above the baseline. The nurse interprets this as:
Reactive pattern A reactive nonstress test indicates fetal activity, as evidenced by acceleration of the fetal heart rate by at least 15 bpm for at least 15 seconds within a 20-minute recording period. If this does not occur, the test is considered nonreactive. An increase in the fetal heart rate does not indicate variable decelerations. Fetal tachycardia would be noted as a heart rate greater than 160 bpm.
Rectocele
Rectocele occurs when the rectum protrudes into the back wall of the vagina.
coitus
Sexual union between a male and a female involving insertion of the penis into the vagina.
Spermatogenesis is the process by which primary spermatocytes become mature sperm. When does spermatogenesis begin?
Spermatogenesis begins at puberty in the male.
The woman has just delivered a healthy baby boy, but the placenta has not yet delivered. What stage of labor does this scenario represent?
Stage 3 begins with the birth of the baby and ends with delivery of the placenta.
What is the main purpose of FSH?
Stimulates follicles to produces Estrogen causing ovum to mature and fill with estrogen on top of ovary
To decrease childhood mortality, pediatric nurses need to consistently engage in what activity throughout all age groups?
Teach injury prevention and proper safety practices. The leading cause of death throughout childhood is unintentional injury.
Which of the following interventions would be considered primary prevention in community-based health care?
Teaching women to take folic acid supplements to prevent neural tube defects Primary prevention involves preventing a disease or condition before it occurs, such as teaching women about the importance of taking folic acid supplements to prevent neural tube defects. Secondary prevention is the early detection of disease or conditions. Working with women who are victims of domestic violence, clients at an HIV clinic, or hypertensive clients are all examples of tertiary prevention, which is designed to reduce or limit the progression of a disease or condition. (l
Hormonal regulation of reproductive functions in both the male and the female are complicated processes. In the male where are the male sex hormones produced?
Testes The testes serve two important functions: production of male sex hormones, androgens, and formation and maturation of spermatozoa
What medication should the nurse advise a woman to discontinue prior to becoming pregnant because it will damage the developing dental and osseous tissue in the fetus?
Tetracycline may damage the developing dental and osseous tissue in the fetus.
At what point in the pregnancy is it possible for the fetus to survive outside the womb?
The end of the second trimester During the second trimester, fetal growth is significant. The fetus begins this trimester 3 inches long and weighing less than 1 oz (0.8 gm). By the end of the second trimester, the fetus is about 15 inches long and weighs more than 2 lbs (1000 gm). Major organs develop to the point that the fetus may survive (with help) outside the womb
The first phase of divorce is marked by quarreling, hurt feelings, and whispered conversations, as the parents realize they are no longer compatible.
The first phase is apt to be an antagonistic time as parents realize they are no longer compatible and is marked by quarreling, hurt feelings, and whispered conversations. This phase can be particularly upsetting for children because they usually haven't been told what is happening as yet. They may assume the quarreling is their fault (if they had behaved better, this wouldn't be happening). The second phase is the actual separation stage. The third phase involves reshaping lives.
Explain how the ductus arteriosus and foramen ovale aid the fetus in quickly getting oxygen-enriched blood to the tissues.
The majority of the blood in the right atrium flows into the left atrium via the . The foramen ovale is a hole that connects the right and left atria so the majority of oxygenated blood can quickly pass into the left side of the fetal heart and go to the brain and the rest of the fetal body. Blood entering the right atrium from the superior vena cava is mostly deoxygenated. In the right atrium, this blood mixes with some of the more oxygenated blood from the inferior vena cava. This mixed blood then enters the right ventricle, which pumps it to the fetal lungs via the pulmonary trunk. In utero, the fetus does not oxygenate its own blood in the lungs; therefore, blood supplied to the fetal lungs is for nourishment of the tissues only. The fetal lungs are collapsed and filled with fluid, which leads to high resistance. Because of this resistance, only 5% to 10% of the blood in the pulmonary artery enters the fetal lungs. The remainder of blood coming from the right ventricle enters the . The ductus arteriosus is a fetal shunt that links the pulmonary artery with the aorta and allows the oxygenated blood to flow to the body without having to reenter the heart.
A couple is considering vasectomy as a contraception option. However, the husband is nervous about how such a procedure would affect his sexual functioning. Which of the following statements that the nurse might mention to the man is true?
The man will still have full erection capacity Some men resist the concept of vasectomy because they are not sufficiently aware of their anatomy to know exactly what the procedure will involve. They can be assured vasectomy does not interfere with the production of sperm; the testes continue to produce sperm as always, but the sperm simply do not pass beyond the plugged vas deferens and are absorbed at that point. The man will still have full erection capacity and continue to produce testosterone. Because he also continues to form seminal fluid, he will ejaculate seminal fluid; it will just not contain sperm
A nurse assesses a primigravida client and observes darkening of the skin on the client's face. How should the nurse document this pigmentation?
The nurse should document the darkening of the skin on the client's face as chloasma, or the facial "mask of pregnancy." Linea nigra is a dark line extending from the umbilicus to the mons pubis. Spider nevi are tiny red angiomas occurring on the face, neck, chest, arms, and legs, and it may occur because of elevated estrogen levels. Palmar erythema is a pinkish color on the palms of the hands.
What would be the best response by a nursing student about the function of the uterus?
The uterus's functions are to receive the fertilized ovum and provide housing and nourishment for a fetus. The ovaries' functions are to produce female gametes or ova and secrete female sex hormones. The vagina's functions are to receive sperm, provide an exit for menstrual flow, and serve as the birth canal. The clitoris is a small erectile structure that responds to sexual stimulation
Vestibule
The vulval vestibule is a part of the vulva between the labia minora into which the urinary meatus and the vaginal opening open. Its edge is marked by Hart's line. It represents lower end of urogenital sinus from stage of embryo.
What is secondary infertility?
There are two main types of infertility: primary and secondary. A couple who has never been able to conceive has primary infertility; whereas, a couple who has been able to conceive in the past but is currently unable to do so has secondary infertility
Health promotion
This action is an example of health promotion, which may be defined as educating parents and children to follow sound health practices through teaching and role modeling. Health maintenance is intervening to maintain health when risk of illness is present. Health restoration is using conscientious assessment to be certain symptoms of illness are identified and interventions are begun to return client to wellness most rapidly. Health rehabilitation is helping prevent complications from illness, helping a client with residual effects achieve an optimal state of wellness and independence, and helping a client to accept inevitable death.
A woman's physician has suggested that she eat iodized salt during pregnancy. On which of the following would you base your explanation for this suggestion?
Thyroid activity, which depends on iodine intake, increases during pregnancy. Hypothyroidism is associated with pregnancy loss. Iodine is a necessary mineral for optimal thyroid function.
(see full question) During pregnancy the cardinal rule regarding taking medications and herbal remedies is that all drugs cross the placenta and have a potential impact on the fetus. What is one disease where treatment must continue during pregnancy?
Treatment, including medications, for certain diseases and conditions must continue during pregnancy. Examples include epilepsy, asthma, diabetes, and depression.
The placenta has three main functions:
To provide for the transfer and exchange of substances, to act as a barrier to certain substances, and to function as an endocrine gland by producing hormones.
A client has not received any medication during her labor. She is having frequent contractions every 1 to 2 minutes and has become irritable with her coach and no longer will allow the nurse to palpate her fundus during contractions. Her cervix is 8 cm dilated and 90% effaced. The nurse interprets these findings as indicating:
Transition phase of the first stage of labor The transition phase is characterized by cervical dilation of 8 to 10 cm, effacement of 80% to 100%, contractions that are strong, painful, and frequent (every 1 to 2 minutes) and last 60 to 90 seconds, and irritability, apprehension, and feelings of loss of control. The latent phase is characterized by mild contractions every 5 to 10 minutes, cervical dilation of 0 to 3 cm and effacement of 0% to 40%, and excitement and frequent talking by the mother. The active phase is characterized by moderate to strong contractions every 2 to 5 minutes, cervical dilation of 4 to 7 cm and effacement of 40% to 80%, with the mother becoming intense and inwardly focused. The pelvic phase of the second stage of labor is characterized by complete cervical dilation and effacement, with strong contractions every 2 to 3 minutes; the mother focuses on pushing.
A woman is in the second stage of labor and is crowning. Which diameter of the fetal skull, which is the smallest, should align with the anteroposterior diameter of the mother's pelvis, which is the narrowest diameter at the pelvic inlet?
Transverse (biparietal) Explanation: The anteroposterior diameter of the pelvis, a space approximately 11 cm wide, is the narrowest diameter at the pelvic inlet so the best presentation for birth is when the fetus presents a transverse (biparietal) diameter (the narrowest fetal head diameter, at 9.25 cm) to this. The other diameters of the fetal skull that are listed are all larger.
A nursing student studying reproduction identifies which of the following statements to be correct?
Twenty-two of the 23 pairs of chromosomes are autosomes and the remaining pair is the sex chromosomes. The nucleus of each soma cell contains 46 chromosomes, arranged in 23 pairs. Each parent donates one chromosome of every pair. Each chromosome is composed of genes, which are segments of DNA that control hereditary traits. Twenty-two of the 23 pairs of chromosomes are autosomes, and the remaining pair, the sex chromosomes, determines an individual gender
A primiparous client is being seen in the clinic for her first prenatal visit. It is determined that she is 11 weeks pregnant. The nurse develops a teaching plan to educate the client about what she will most likely experience during this period. Which of the following would the nurse include?
Urinary frequency The client is in her first trimester and would most likely experience urinary frequency as the growing uterus presses on the bladder. Ankle edema, backache, and hemorrhoids would be more common during the later stages of pregnancy
A pregnant woman has come to the clinic for her first prenatal visit. The nurse informs the woman that the physician will do a pelvic examination at this time and that she should go empty her bladder. What is the primary reason the nurse instructs the patient to empty her bladder?
Urinating now will allow easier identification of organs. Explanation: Before a pelvic examination, the nurse should instruct the patient to empty her bladder. Doing so makes the examination more comfortable, allows for easier identification of pelvic organs, and provides a urine specimen for laboratory testing
Uterine prolapse
Uterine prolapse occurs when the uterus drops down into the vagina.
The pregnant patient at 6 weeks' gestation asks the nurse if ultrasound will reveal the sex of the fetus yet. What is the best response by the nurse?
We will have to wait until the baby is 16 weeks' gestation to determine what the sex is." The sex of the baby can be determined by ultrasound at 16 weeks' gestation.
he nurse is caring for a premature infant and his mother who are scheduled for discharge even though the nurse feels the mother is not emotionally equipped to return home. When balancing the ethical components of this dilemma, the nurse identifies the problem and gathers more information. What would be the nurse's next step in this process?
Weigh the risks against the benefits Explanation: The pediatric nurse must balance these ethical components when dealing with families from a variety of cultural and religious backgrounds who are making health care decisions for their children. The process is as follows: (1) identify the problem, (2) gather information about the problem, (3) weigh the risks against the benefits, (4) choose a solution, (5) implement the solution, and (6) evaluate the outcome of the situation.
When should the nurse tell the patient she is fertile in relation to her mucus?
When it is thin, watery, and copious Explanation: The cervical mucus method relies on the changes that occur naturally with ovulation. Before ovulation, cervical mucus is thick and does not stretch when pulled. With ovulation, the mucus becomes thin, copious, watery, transparent, and stretch
What happens to the uterine lining during the ischemic phase?
Without these hormones to maintain the blood vessel network, the uterine lining becomes ischemic. When the lining starts to slough, the woman has come full cycle and is once again at day 1 of the menstrual cycle.
trying to have a bay
Women can analyze cervical mucus changes to help plan coitus so it coincides with ovulation if they want to increase their chance of becoming pregnant or plan to avoid coitus at the time of ovulation to prevent pregnancy by analyzing how thick or thin is cervical mucus. At the beginning of each cycle, when estrogen secretion from the ovary is low, cervical mucus is thick and scant. Sperm survival in this type of mucus is poor. At the time of ovulation, when the estrogen level has risen to a high point, cervical mucus becomes thin, stretchy (Spinnbarkeit), and copious. Sperm penetration and survival in this thin mucus are both excellent. Fernlike patterns on a microscope slide of cervical mucus do indicate ovulation, but this method is not nearly as practical as examining the consistency of the cervical mucus. The beginning of the cycle, just after the end of menstruation, is before ovulation, and thus not the best time to have coitus if the goal is conception.
A male fetus carries which two sex chromosomes?
XY
What is the name of the single cell that results from fertilization?
Zygote
A fertilized ovum is known as which of the following?
Zygote A fertilized ovum is known as a zygote and is the beginning of potential individual human development. The developing human organism is known as an embryo from the time it implants on the uterine wall until the eighth week after inception and as a fetus from the beginning of the ninth week after fertilization through birth. The chorion is the outermost cell layer that surrounds the embryo and fluid cavity.
What is corpus luteum?
a yellow body that forms after ovulation from the remnants of the follicle It produces estrogen & secrete progesterone
List three ways to prevent PID.
avoid sexual intercourse or to remain in a monogamous relationship, one in which both partners are sexually faithful to the other. The next best way is for the woman's partner to use latex condoms for all sexual acts.
The uterus is divides into 4 section
cervix uterine isthmus corpus fundus
What structure produces progesterone?
corpus luteum
There are four essential components of labor. These are known as the "four Ps" of labor:
passageway, passenger, powers, and psyche. A problem in any of these four areas will negatively influence the labor process.
Name the three fetal shunts.
ductus venosus, foramen ovale, and the ductus arteriosus. for fetal circulation
List the three germ layers in the embryo.
ectoderm mesoderm endoderm
What causes the ischemic phase to occur?
estrogen and progesterone levels fall because the corpus luteum is no longer producing them. Without these hormones to maintain the blood vessel network, the uterine lining becomes ischemic.
In Menstruation, the flow lasts how long
flow lasts four to six days, with a total blood loss of 25 to 60 mL of blood
The shape of the inlet determines the pelvic type. There are four basic pelvic shapes:
gynecoid, anthropoid, android, and platypelloid
Day 14 of menstraul cycle
ovulationbegins And proliferation phase ends
causes of pelvic support disorders?
pregnancy, vaginal birth, and aging-Most common obesity, chronic coughing, frequent constipation, and hysterectomy.
Which hormone is active only during the secretory phase of the uterine cycle?
progesterone
List three hormones produced by the placenta.
progesterone, estrogen, and hCG. Progesterone is necessary to maintain the nutrient-rich endometrial lining, the decidua. It also functions to keep the myometrium from having premature contractions. Estrogen functions to provide a rich blood supply to the decidua and placenta. The main function of hCG is to sustain the corpus luteum at the beginning of the pregnancy.
When using the contraceptive patch, a patient should understand that it
should be applied to the abdomen, buttocks, or back. The patch should be applied only to the buttocks, back, abdomen, or torso (never the breasts). The patch is safe for wearing during swimming and bathing. The patch requires application for 1 week before becoming effective.
What is spinnbarkeit?
stretchable quality of mucus
At the beginning of the fetal stage, how long is the fetus, and how much does it weight?
the fetus will be about 36 cm long and weigh approximately 3,400 g
What is a pessary?
which is a device that holds pelvic organs in place when inserted into the vagina
What is the thick membrane that surrounds the ovum? Hint: a single sperm has can penetrate it
zona pellucida,
The nurse is providing instruction to a woman who is 18 weeks pregnant. Which findings are expected at this time? Select all that apply:
• Fundal height of approximately 18 cm • Quickening Between 18 and 30 weeks' gestation, fundal height in centimeters is approximately the same as the number of weeks' gestation. In this case, the client is 18 weeks pregnant, so fundal height should measure approximately 18 cm. Quickening, which is typically described as light fluttering and is usually felt between 16 and 22 weeks' gestation, is caused by fetal movement. Insomnia, Braxton Hicks contractions, and leg cramps are common during the third trimester.