MATERNITY EXAM 2

The prenatal clinic nurse is designing a new prenatal intake information form for pregnant clients. Which question is best to include on this form?

"Do genetic diseases run in the baby's father's family?"

The nurse is most concerned if a client makes which statement?

"I clean the cat's litter box daily"

The primigravida at 22 weeks gestation has a fundal height palpated slightly below the umbilicus. Which of the following statements would best describe to the client why she needs to be seen by a physician today?

"Your baby might not be growing enough."

What are the THREE SIGNS of pregnancy? (The 3 P's)

1. Presumptive signs 2. Probable signs 3. Positive signs

When preparing nutritional instruction, which pregnant client would the nurse consider the highest priority?

15-year-old nulligravida

At the umbilicus

20 weeks

Women with eating disorders who become pregnant are at risk for a variety of complications, including which of the following? Select all that apply.

A) Premature birth C) Miscarriage E) Perinatal mortality

Which of the following is the most prevalent medical complication of pregnant adolescents?

B) Preeclampsia-eclampsia

What is Biophysical profile (BPP) ? (BATMN)

Breathing movement of fetus Amniotic fluid volume Tone of fetus Movement of fetus Non-stress test

While caring for a client in labor, the nurse notes the following persistent rhythm on the fetal heart rate monitor: Which action should the nurse take first?

Notify the provider

What is the Growth and repair of fetal tissue, placenta, uterus, breasts, and maternal blood volume?

Proteins

A client in the second trimester of pregnancy tells the nurse that she has developed a darkening of the line in the midline of her abdomen from the symphysis pubis to the umbilicus. What other expected changes during pregnancy might she also notice?

Reddish streaks called striae on her abdomen

The nurse begins a prenatal assessment on a 25-year-old primigravida at 20 weeks gestation and immediately contacts the healthcare provider because of which finding?

Respirations 30/minute

A 25-year-old primigravida is at 20 weeks gestation. Because of this finding, the nurse immediately takes her vital signs and notifies the healthcare provider.

Rhonchi in both bases

What does TORCH stand for?

T: toxoplasmosis O: other parvo- b 19, varicella zoster R: rubella C: cytomeglovirus (CMV) H: herpes

Which infection could be contracted through contact with a cat?

Toxoplasmosis

Vitamin A

• Recommended intake via beta-carotene • Too much can be toxic to the fetus • Too little can stunt fetal growth and cause impaired dark adaptation and night blindness

Polyhydramnios (Excessive amount)

◦ > 25 cm ◦Gastrointestinal and CNS anomalies ◦Multiple gestation

What is Chloasma?

" pregnancy mask " brown blotchy areas on the skin of the face, cheeks, nose, and forehead.

A pregnant client of average pre-pregnancy weight is now 30 weeks pregnant. She asks the nurse what the appropriate weight gain for her should be. What is the nurse's best response?

"25-35 pounds."

A pregnant client who is a lacto-vegetarian asks the nurse for assistance with her diet. What instruction should the nurse give? Select all that apply.

"A daily supplement of vitamin B12 is important."

A woman gave birth last week to a fetus at 18 weeks 'gestation after her first pregnancy. She is in the clinic for a follow-up and notices that her chart states she has had one abortion. The client is upset over the use of this word. How can the nurse best explain this terminology to the client?

"Abortion is the obstetric term for all pregnancies that end before 20 weeks."

The nurse is working with a pregnant 14-year-old. Which statement indicates that additional education is required?

"Because I don't eat breakfast, I'll have to eat more at supper."

A client at 16 weeks gestation has a hematocrit of 35%. Her pre-pregnancy hematocrit was 40%. Which statement by the nurse best explains this change?

"Because your blood volume has increased, your hematocrit count is lower."

The nurse is preparing a prenatal class about infant feeding methods. The maternal nutritional requirements for breastfeeding and formula feeding will be discussed. What statement should the nurse include?

"Breastfeeding requires a continued high protein and calcium intake."

The nurse has completed a community presentation about the changes of pregnancy and knows that the lesson was successful when a community member states.

"Enlargement of the uterus."

The pregnant client states she does not want "to take all these supplements." What recommendations could the nurse make for the client? Select all that apply. (2 answers)

"Folic acid is essential for minimizing the risk of neural tube defects." "Most women do not have an adequate intake of iron pre-pregnancy, and iron needs increase with pregnancy.

The prenatal clinic nurse cares for a 15-year-old client at eightweeks gestation. The client asks the nurse why she is supposed to gain so much weight. What is the best response by the nurse?

"Gaining 25-35 pounds is recommended for healthy fetal growth."

The nurse is providing care to a client entering the second trimester of pregnancy. Which client statement does the nurse anticipate when assessing this client?

"I am angry with my husband for not showing more interest in my pregnancy."

After teaching a pregnant client about the effects of smoking on pregnancy, the nurse knows that the client needs further education when she makes which statement?

"I am at increased risk for preeclampsia."

The breastfeeding mother is concerned that her milk production has decreased. The nurse knows that further client teaching is needed based on which statement?

"I have started cutting back on my protein intake."

The client is in the second stage of labor. The fetal heart rate baseline is 170, with minimal variability present. The nurse performs fetal scalp stimulation. The client's partner asks why the nurse did that. What is the best response by the nurse?

"I stimulated the top of the fetus's head to try to get his heart rate to accelerate."

A client presents to the antepartum clinic with a history of a 20-pound weight loss. Her pregnancy test is positive. She is concerned about gaining the weight back and asks the nurse if she can remain on her diet. What is the nurse's best response?

"I understand that gaining weight after such an accomplishment might not appeal to you but weight gain during pregnancy is important for proper fetal growth."

A pregnant woman ... reports exposure to a child with rubella. How would the nurse handle it?

"I will check your rubella titer results, and we can immediately identify whether interventions are needed"

The nurse is explaining "quickening" to a pregnant client for the first time. Which client indicates the need for further education on this topic?

"It indicates that I am experiencing preterm labor."

Which statement is best to include when teaching a pregnant adolescent about her nutritional needs in pregnancy?

"It is important to eat iron-rich foods like meat every day."

The nurse is teaching an early pregnancy class for clients in the first trimester of pregnancy. Which statement by a client requires immediate intervention by the nurse?

"It is normal for my vaginal discharge to be green."

The nurse is explaining to a new prenatal client that the certified nurse-midwife will perform clinical pelvimetry as a part of the pelvic exam. The nurse knows that teaching has been successful when the client makes which statement about the reason for the exam.

"It will help us know how big a baby I can deliver vaginally."

a client's partner at 16 weeks' gestation accompanies her to the clinic. The partner tells the nurse that the baby doesn't seem real to him and is having difficulty relating to his partner's fatigue and food aversions. Which statement would be best for the nurse to make?

"Many men feel this way. Feeling the baby move in a few weeks will help make it real to you."

The nurse teaches a pregnant client the clinical manifestations of preterm labor. Which client statement indicates the need for further education?

"Vomiting is a sign of preterm

While completing the medical and surgical history during the initial prenatal visit, the 16-year-old primigravida interrupts, "Why are you asking me all these questions? What difference does it make?" Which statement would best answer the client's questions?

"We ask these questions to detect anything that happened in your past that might affect the pregnancy."

The nurse provides prenatal care to an obese client who asks, "How much weight should I gain during my pregnancy?" Which response by the nurse is appropriate?

"You should gain 11 to 20 pounds."

Patient has a positive history of genital herpes but has not had lesions during this pregnancy. What should the nurse plan to tell the client?

"You will be evaluated at the time of delivery for genital lesions and if any are present, a cesarean delivery will be needed"

What is toxoplasmosis?

-Cat feces (litter box exposure) -Soil contaminated fruits & veggies (Educate clients who garden & eat homegrown vegetables) -Raw or undercooked meat NCLEX

Second Maneuver of Leopold's

-Determine location of fetal back based on whether head or buttocks occupies fundus -Steady one hand and move other, then switch

First Maneuver of Leopold's

-Face woman and palpate upper abdomen with both hands

Third Maneuver of Leopold's

-Grasp lower portion of abdomen with thumb, fingers of right hands -If fetal head not engaged, it may be gently pushed back and forth

What does GPTAL stand for?

-Gravidity (gravida) -Para (Deliveries after 20 weeks gestation) -Term (Over 37 weeks) -Preterm births (20-37 weeks) -Abortion (Abortion or Miscarriage, less than 20 weeks) -Living

Probable signs of pregnancy (objective)

-Uterine enlargement -Hegar's Sign -Chadwick's Sign -Goodell's Sign -Ballottement -Braxton Hick's Contractions -Positive Pregnancy Test

Contraction Stress Test (CST)

-nipple stimulation or oxytocin stimulation evaluates fetal response to stress -no deceleration with a min of 3 contractions lasting 40-60 seconds in 10 min -done at 28 wks

The nurse is assessing a pregnant client during a scheduled prenatal visit in the second trimester of pregnancy. Which questions are appropriate during the assessment process? Select all that apply.

1. "Do you feel bloated?" 2. "Do you have hemorrhoids?" 3. "Are you experiencing heartburn?" 4. "Are you experiencing constipation?"

The community nurse is preparing to visit the home of an adolescent who is 18 weeks pregnant. Which health problems should the nurse focus on when assessing this patient? Select all that apply.

1. Preeclampsia 2. Preterm birth 3. Low-birth-weight 5. Iron deficiency anemia

A patient asks if seafood is permitted during pregnancy. Which foods should the nurse encourage the patient to consume during this time? Select all that apply.

1. Shrimp 2. Catfish 3. Salmon 5. Canned light tuna

A patient in the first trimester of pregnancy is experiencing ptyalism. What should the nurse suggest to help this patient? Select all that apply.

1. Use chewing gum 2. Suck on hard candy 4. Use an astringent mouthwash

above the symphysis pubis

12 weeks

Underweight woman, B M I less than 18.5 Normal-weight woman, B M I 18.5-24.9 Overweight woman, B M I 25-29.9 Obese woman, B M I over 30

12.5-18 k g (28-40 l b) 11.5-16 k g (25-35 l b 7-11.5 k g (15-25 l b) 5-9.1 k g (11-20 l b)

half way between the symphysis pubis and umbilicus

16 weeks

A pregnant adolescent is scheduled for her first prenatal visit. For which sexually transmitted infections (STIs) should the nurse anticipate testing will occur? Select all that apply.

2. Candida 3. Gonorrhea 4. Chlamydia 5. Trichomonas

The nurse is instructing a pregnant patient on the importance of increasing her dietary intake of vitamin E. Which foods should the nurse recommend to meet this dietary need? Select all that apply.

2. Eggs 4. Greensalads 5. Wholegrain bread

Screening for gestational diabetes mellitus (GDM) is typically completed between which of the following weeks of gestation?

24 and 28 weeks

The nurse measures the fundal height of a patient who is at 28 weeks gestation using the following method. What would be considered a normal finding?

28 cm

A pregnant patient's first day of her last menstrual period was 6/14. What would be this patient's estimated date of birth?

3/21

at the xiphoid process

36 weeks

The fetus engages and the fundal height drops

38-40 weeks

In early-pregnancy class, the nurse emphasizes the importance of daily 8-10 glasses of fluid. How many of these should be water?

4 to 6

A patient weighing 80 kg with a body mass index of 29.8 is six weeks pregnant. What should be this patient's maximum weight at the time of delivery?

89kg (add 9kg to weight)

Intrauterine Pressure Catheter (IUPC)

A catheter that can be placed through the cervix into the uterus to measure uterine pressure during labor. Some types of catheters may be inserted for the purpose of infusing warmed saline to add additional intrauterine fluid when oligohydramnios is present.

The clinic nurse is compiling data for a yearly report. Which client would be classified as a primigravida?

A client at 15 weeks gestation who has never been pregnant before

The laboring client with meconium-stained amniotic fluid asks the nurse why the fetal monitor is necessary, as she finds the belt uncomfortable. Which response by the nurse is most important?

A) "The monitor helps us see how the baby tolerates labor."

The nurse is aware that a fetus that is not in any stress would respond to a fetal scalp stimulation test by showing which change on the monitor strip?

A) Accelerations

Postpartum nutritional status is determined primarily by assessing which of the following? Select all that apply.

A) Dietary history C) Mother's weight D) Hemoglobin levels

Upon assessing the FHR tracing, the nurse determines that there is fetal tachycardia. The fetal tachycardia would be caused by which of the following? Select all that apply.

A) Early fetal hypoxia B) Prolonged fetal stimulation C) Fetal anemia E) Infection

A laboring patient being monitored has the following rhythm strip: How should the nurse interpret this finding?

A) Episodic accelerations

What would the nurse do before performing Leopold's maneuvers? Select all that apply.

A) Have the client empty her bladder. C) Have the client lie on her back with her feet on the bed and her knees bent.

The nurse is caring for a client who has experienced premature rupture of membranes. For which maternal implication(s) should the nurse monitor? Select all that apply.

A) Infection B) Preterm labor

The nurse auscultates the FHR and determines a 112 beats/min rate. Which action is appropriate?

A) Inform the maternal client that the rate is average.

The nurse is caring for a client undergoing fetal heart rate monitoring, and the FHR is more significant than 162 beats/min for 12 minutes. For what cause(s) should the nurse anticipate treatment?

A) Maternal anxiety B) Fetal asphyxia C) Prematurity D) Fetal anemia

Fetal factors that possibly indicate electronic fetal monitoring include which of the following? Select all that apply.

A) Meconium passage B) Multiple gestations E) Decreased fetal movement

The nurse is reviewing the FHR monitor for a client in labor. The rhythm strip yields the following result: How should the nurse interpret this pattern?

A) Moderate variability (range of 6-25 bpm)

Remedies for back pain in pregnancy supported by research evidence and may safely be taught to any pregnant woman by the nurse include which of the following? Select all that apply

A) Pelvic tilt B) Water aerobics D) Proper body mechanics E) Good posture is essential because it allows more room for the stomach to function

The nurse is planning an early pregnancy class session on nutrition. Which information should the nurse include? Select all that apply.

A) Protein is essential for fetal development. B) Iron helps both mother and baby maintain the oxygen-carrying capacity of the blood. D) Zinc facilitates the synthesis of RNA and DNA. E) Vitamin A promotes the development of the baby's eyes.

. The nurse understands that a client's pregnancy is progressing normally when what physiologic changes are documented on the prenatal record of a woman at 36 weeks gestation?

A) The pelvis joints have relaxed, causing a waddling gait. C) The uterus vasculature contains one-sixth of the total maternal blood volume. D) Gastric emptying time is delayed, and the client complains of constipation andbloating. E) Supine hypotension occurs when the client lies on her back.

The charge nurse looks at laboring clients' charts. Which client is in greatest need of further intervention?

A) Woman at 7 cm, fetal heart tones auscultated every 90 minutes

The nurse is analyzing several fetal heart rate patterns. The pattern that would be of most concern to the nurse would be which of the following?

Accelerations

If a pregnant patient has herpes' how would the nurse handle it?

Active outbreak → painful genital lesions Interventions Immediate antiviral therapy: Acyclovir Active lesions before delivery → cesarean section

The student nurse will perform Leopold maneuvers on a laboring client. Which assessment requires intervention by the staff nurse?

After determining where the back is located, the cervix is assessed.

What signs indicate a pregnant client's urinalysis culture was abnormal?Select all that apply.

Alkaline urine Cloudy appearance Hemoglobinuria lab results

Which serum markers are assessed when conducting a quadruple screen?

Alpha-fetoprotein (AFP) Human chorionic gonadotropin (hCG) Unconjugated estriol (UE) Inhibin-A

A patient who is 12 weeks pregnant is counseled to increase her protein intake by an additional 40 grams per day. If each gram of protein is four calories, how many additional calories per day should this patient ingest to reach the recommended 300 calories daily during the pregnancy?

Answer: 140 calories (40 x 4= 160 , 300-160= 140)

Before becoming pregnant, a patient had a BMI of 28.5 and weighed 150 lbs. What should be the minimum weight of this patient upon delivery? (minimum weight add 15Lb)

Answer: 165 lbs.

A breastfeeding mother is instructed to increase her daily caloric intake by 500 calories daily. If her daily protein intake is 65 grams at four calories per gram, how many calories will this patient need to ingest to reach the recommended daily intake?

Answer: 240 calories (65 x 4= 260, 500-260= 240)

The nurse learns that a patient who is eight weeks pregnant continues smoking ten cigarettes daily. In which order should the nurse provide a 5-to-15-minute intervention about smoking with this patient?

Ask about tobacco use 1 Advise to quit smoking 2 Arrange for follow-up care 3 Assess willingness to quit 4 Assist in attempt to quit 5

What would the nurse do to assess a pregnant client's food intake accurately?

Ask her to complete a nutritional questionnaire.

The nurse is preparing to assess the pregnant client's fundal height during a routine prenatal visit. Which nursing action is appropriate in this situation?

Asking the client to empty her bladder before the procedure

Prevention of Torch infections?

Avoid consuming undercooked meat while pregnant

A patient at 28 weeks gestation asks the nurse why she has backaches. To help explain the changes, the nurse shows her a picture of the shape of her back. Which picture should the nurse use?

B) In the 28th week of gestation, the baby is becoming large enough that it is increasingly causing lordosis of the lumbosacral spine.

Absolute contraindications to exercise while pregnant include which of the following? Select all that apply.

B) Placenta previa after 26 weeks gestation C) Preeclampsia-eclampsia D) Cervical insufficiency (cerclage)

provide the body's primary source of energy as well as fiber necessary for proper bowel functioning. If the carbohydrate intake is not adequate, the body will use which of the following for energy?

B) Protein

A woman is in labor. The fetus is in the vertex position. When the client's membranes rupture, the nurse sees that the amniotic fluid is meconium-stained. What should the nurse do immediately?

Begin continuous fetal heart rate monitoring.

The nurse assesses an obese pregnant client during a routine prenatal visit. Which is the priority assessment for this client?

Blood pressure

Which foods ... avoid during pregnancy?

Brie cheese Unpasteurized milk Deli made egg salad

The nurse admits a client to the labor and delivery unit. Which aspect of the client's history requires notifying the physician?

C) Dark red vaginal bleeding

During an intrapartum vaginal examination, the nurse palpates the following: Based upon this information, which diagram best describes the fetal descent and station?

C) baby upside down face is not showing baby faced to the right

What is involved in; Nerve cell transmission, muscle contraction, bone building, and blood clotting

Calcium

Which drugs and drug categories can cause multiple fetal central nervous system (CNS), facial, and cardiovascular anomalies?

Category X: Isotretinoin

If a woman has the pre-existing condition of diabetes, the nurse knows that she would be prone to what high-risk factor when pregnant?

Cerebrovascular accident (CVA)

The nurse at the prenatal clinic has four calls to return. Which call should the nurse return first?

Client, at 32 weeks, reports headache and blurred vision.

Which of the following is common in many non-Western cultures and is increasing in the United States?

Co-sleeping

The nurse is conducting an initial prenatal assessment for a pregnant client. Which screenings should the nurse prepare the client for during this visit?Select all that apply.

Complete blood count (CBC) Glucose tolerance test (GTT) ABO and Rh typing HIV screening Urinalysis labor

A client in her third trimester of pregnancy reports frequent leg cramps. Whatstrategy would be most appropriate for the nurse to suggest?

D) Flex the foot to stretch the calf

The nurse is preparing for a postpartum home visit. The client has been home for a week, is breastfeeding, and experienced a third-degree perineal tear after vaginal delivery. The nurse should assess the client for which of the following?

Dietary intake of fiber and fluids

The nurse is teaching the pregnant client about the symptoms of preeclampsia. Which clinical manifestations will the nurse include in the teaching session?Select all that apply.

Dizziness Blurred vision

a pregnant client is not immune to rubella, how does the nurse hande it?

Do not provide the vaccine to a pregnant client. The client cannot receive the vaccine until after childbirth

Persistent early decelerations are noted. What would the nurse's first action be?

Do nothing. This is a benign pattern.

The laboring client's fetal heart rate baseline is 120 beats per minute. Accelerations are present to 135 beats/min. During contractions, the fetal heart rate gradually slows to 110 at 120 by the end of the contraction. What nursing action is best?

Document the fetal heart rate

The client delivered her first child at 37 weeks. The nurse would describe this to the client as what type of delivery?

Early term (37-38

The nurse is planning an educational session for pregnant vegans. What information should the nurse include?

Eating beans and rice provides complete protein needs.

The nurse assessing a pregnant African American woman in the first trimester understands that a cultural practice is which of the following?

Eating clay to supply dietary minerals

The pregnant client cannot tolerate milk or meat. What would the nurse recommend to the client to assist in meeting protein needs?

Eggs and tofu

Which of the following is essential for developing the fetus's central nervous system?

Essential fatty acids

Vitamin C

Essential in the formation of collagen, a necessary ingredient to wound healing

Leopold Maneuvers (Abdominal Palpation) First Maneuver

Face woman and palpate upper abdomen with both hands

What is a non-stress test (NST)?

Fetal heart rate monitoring used to check the baby's health

positive sign of pregnancy? (diagnostics)

Fetal heartbeat heard by Doppler device at 10 - 12 weeks Ultrasound visualization of the fetus Fetal movement (palpated or observed by HCP)

The nurse is presenting a preconception counseling class. The nurse instructs the participants to increase niacin intake during pregnancy to promote metabolic coenzyme activity. The nurse will know that teaching has been effective if a client suggests which food is a source of niacin??

Fish

What would the nurse include as part of a routine physical assessment for a second-trimester primiparous patient whose prenatal care began in the first trimester and is on going?

Fundal height measurement

The clinic nurse is assisting with an initial prenatal assessment. The following findings are present: spider nevi on lower legs; dark pink, edematous nasal mucosa; mild enlargement of the thyroid gland; mottled skin and pallor on palms and nail beds; heart rate 88 with murmur present. What is the best action for the nurse to take based on these findings?

Have the physician see the client today.

The nurse is caring for a client with fetal heart rate monitoring, and the fetus is discovered to have tachycardia. Which complication should the nurse anticipate in the fetus?

Infection

A nurse examining a prenatal client recognizes that a lag in the progression of fundal height measurements from week to week and month to month could signal what condition?

Intrauterine growth restriction

What promotes normal thyroid activity, preventing specific birth defects?

Iodine

What formation of hemoglobin is essential to the oxygen-carrying capacity of the blood?

Iron

A pregnant client tells the nurse she eats laundry starch daily. The nurse should assess the client for which of the following?

Iron deficiency anemia

The nurse is assessing a primiparous client who indicates that her religion is Judaism. Why is this information pertinent for the nurse to assess?

It provides a baseline to ask questions about the client's religious and cultural background.

The nurse receives a phone call from a client who claims she is pregnant. The client reports that she has regular menses that occur every 28 days and last five days. The first day of her last menses was April 10. What would the client's estimated delivery date (EDD) be if she is pregnant?

Jan. 17 (April 10 +7days-3 months)

During a pelvic examination of a pregnant patient, the following area is identified as being softened. How should the nurse document this finding?

Ladin sign (softened middle uterus)is a soft spot anteriorly in the middle of the uterus near

The labor and delivery nurse are assigned to four clients in early labor. Which electronic fetal monitoring findings would require immediate intervention?

Late decelerations with minimal variability

During a routine assessment of a pregnant patient, the nurse observes the following on the patient's abdomen. How should the nurse document this finding? (dark line down pt abdomen)

Linea nigra

The nurse is assessing the baseline fetal heart rate for a client in labor. What action should the nurse take first?

Measure the fetal heart rate for 10 minutes.

The fetus of a laboring patient is in the following position: What should the nurse expect when conducting the intrapartum vaginal examination?

Mercedes Sign looks like a "Y"

Meds used for hypertensive disorders in pregnancy?

Methyldopa Labetalol Nifedipine Hydralazine ACE Inhibitors/Angiotensin receptor blockers

What prevents deficiencies in the growing fetus and maternal stores?

Minerals

The nurse is caring for a pregnant client experiencing a high white, thick, and "cottage cheese-like" vaginal discharge. Based on this data, which diagnosis does the nurse anticipate for this client?

Moniliasis (Yeast infection)

Vitamin B12

Needed to maintain healthy nerve cells, RBCs, form DNA

Rubella key points

No rubella vaccine until AFTER childbirth If exposed: check rubella titer results immediately

Nurses interacting with expectant families from a different culture or ethnic group can provide more effective, culturally sensitive nursing care by doing what?

Obtaining a medical interpreter of the language the client speaks.

The school nurse is planning a class about nutrition for pregnant teens, several of whom have been diagnosed with iron-deficiency anemia. To increase iron absorption, the nurse would encourage the teens to consume more of what beverage?

Orange juice

The nurse is preparing to assess the fetus of a laboring client. Which assessment should the nurse perform first?

Perform Leopold maneuvers to determine fetal position.

What promotes strong bone growth?

Phosphorus

The kosher diet followed by many Jewish people forbids eating what foods?

Pig products and shellfish

Intercourse is contraindicated if the pregnancy is vulnerable because of which diagnosis?

Placenta previa

The nurse cares for a pregnant client diagnosed with a urinary tract infection (UTI) during a routine prenatal visit. What will the nurse educate the client about based on this data?

Preterm labor

The nurse has received a phone call from a multigravida who is 21 weeks pregnant and has not felt fetal movement yet. What is the best action for the nurse to take?

Schedule an appointment with her physician that same day.

The nurse evaluates the diet of a pregnant client and finds that it is low in zinc. The nurse knows that zinc intake should increase during pregnancy to promote protein metabolism. Which food should the nurse suggest to increase the intake of zinc?

Shellfish

the nurse notes purplish stretch marks on the pregnant client's breasts during the physical assessment. Which term will the nurse use when documenting this finding in the medical record?

Striae

The nurse has just palpated contractions and compares the consistency to that of the forehead to estimate the firmness of the fundus. What would the intensity of these contractions be identified as?

Strong

The nurse is assessing a client in the third trimester of pregnancy. What physiologic changes in the client are expected?Select all that apply.

The client's chest circumference has increased by 6 cm during the pregnancy. The client is using thoracic breathing. The client may have epistaxis (nose bleeds)

The fetus of a pregnant patient is in the right occiput anterior (ROA) position. Where should the nurse auscultate the fetal heart sounds?

The heart tones for the right occiput anterior position would be in the maternal lower right quadrant next to the symphysis pubis.

What is RhoGAM?

The shot of Rh+ anitbodies given to Rh- mothers who give birth to Rh+ children to avoid erythroblastosis fetalis in the next child.

What is syphilis?

This is a sexually transmitted infection that crosses the placenta & may cause birth defects.

While examining a pregnant patient for 24 weeks, the healthcare provider performs the maneuver in the diagram below. What is being measured on this patient?

Transverse diameter

After several hours of labor, the electronic fetal monitor (EFM) shows repetitive variable decelerations in the fetal heart rate. The nurse would interpret the decelerations as consistent with which of the following?

Umbilical cord compression

A client with an average pre-pregnancy weight asks why she has been told to gain 25- 35 pounds during her pregnancy while her underweight friend was told to gain more weight. What should the nurse tell the client about the recommended weight gain during pregnancy?

Up to 40 pounds for an underweight woman

A pregnant patient is lying in bed in the following position. Which health problem is this patient prone to developing?

Vena cavasyndrome

A pregnant teenage client is diagnosed with iron-deficiency anemia. Which nutrient should the nurse encourage her to take to increase iron absorption?

Vitamin C

What promotes fetal growth and maternal milk production?

Zinc

nulligravida

a woman who has never been pregnant

Presumptive signs of pregnancy? (Self Reported)

amenorrhea, nausea, vomiting, breast tenderness, deepening pigmentation, urinary frequency, quickening

McDonald sign

an ease in flexing the body of the uterus against the cervix

Chadwick sign

blue-purple discoloration of the cervix

primigravida

first pregnancy

A pregnant patient is having pelvic measurements made. Which approach should the examiner use to determine this patient's estimated length of the pubic ramus?

length of the pubic

The nurse performs Leopold maneuvers with a patient in the 3rd trimester of pregnancy. Which maneuver should the nurse perform first?

one hand on lower body (back/butt) other hand on legs. LOWER!

Goodell's sign

softening of the cervix

Hegar's sign

softening of the lower uterine segment

At 20 weeks gestation, the fundal height should be at the level of the patient's?

umbilicus

Multigravida

woman who has been pregnant more than once

Folic acid (Vitamin B9)

• Necessary for the formation of the nervous system • Prevents up to 70% of neural tube defects • Diet should include at least 400 mcg of folic acid per day

Vitamin B6

• Necessary for the healthy development of the fetus's nervous system

Oligohydramnios (decrease fluid)

◦< 5 cm ◦Congenital anomalies ◦PPROM

non-reactive stress test

◦Does not demonstrate at least two qualifying accelerations in a 20-minute window. Will need further assessment, BPP or CST

◦Reactive stress test?

◦FHR is at baseline, with moderate variability, accelerates at least 15/min (10/min prior to 32 weeks) for at least 15 seconds (10 seconds prior to 32 weeks) and occurs two or more times during a 20-min period

Nipple-stimulated contraction test

◦Patient lightly brushing her palm across nipple for 2 min. stopping when contractions begin and repeated after a 5 min rest period

Oxytocin-stimulated contraction test-(OCT)

◦Used if nipple stimulation fails ◦IV oxytocin used ◦Difficult to stop once contractions start ◦May lead to preterm labor