maternity exam three
oligohydramnios
too little amniotic fluid
A 14-year-old is brought to the clinic by her mother. She is determined to be seven months pregnant. The mother states, "we knew she was gaining weight, but she said she was not pregnant." The nurse understands that this typical behavior is: Low self-esteem. Anger Denial. Ignorance.
C
Types of placenta previa
total, partial, marginal, low lying
A primigravida woman at 42 weeks gestation received Prepidil (dinoprostone) for induction 12 hours ago. The Bishop score is now 3. Which of the following actions by the nurse is appropriate? Select one: a. Perform nitrazine analysis of the amniotic fluid. b. Report the lack of progress to the obstetrician. c. Place the woman on her left side. d. Ask the doctor for an order for oxytocin.
B. Little progress has taken place. The Bishop score of a primigravida will need to be 9 or higher before oxytocin will be effective.
A woman is suspected of having abruptio placentae. Which of the following would the nurse expect to assess as a classic symptom? A. Painless, bright-red bleeding B. "Knife-like" abdominal pain C. Excessive nausea and vomiting D. Hypertension and headache.
B. When the placenta separates from the uterine wall, it causes irritation and bleeding into the muscle fibers, which causes pain. Painless, bright-red bleeding indicates placenta previa symptomatology. Excessive nausea and vomiting would be characteristic of hyperemesis gravidarum. Hypertension and headache would be associated with gestational hypertension.
A 16-year-old patient is admitted to the hospital with a diagnosis of severe preeclampsia. The nurse must closely monitor the woman for which of the following? a. High leukocyte count b. Explosive diarrhea c. Fractured pelvis d. Low platelet count
D. Low platelet count is one of the signs associated with HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome.
When reviewing the medical record of a patient, the nurse notes that the client has a condition in which the fetus cannot physically pass through the maternal pelvis. The nurse interprets this as
Fetopelvic disproportion, defined as a condition in which the fetus is too large to pass through the maternal pelvis. Cervical insufficiency would lead to an abortion, typically in the second trimester, when the heavy gravid uterus would cause pressure on the weakened cervix. A contracted pelvis might cause passageway problems, but if the fetus was small, no problem might occur. Maternal disproportion doesn't indicate where the disproportion is located.
Placenta accreta
Improper implantation of placenta into the myometrium with little or no intervening decidua
The nurse is developing a care plan for a woman experiencing dystocia. Which of the following nursing interventions would be high priority?
Monitoring FHR patterns, because the health status of the fetus is paramount throughout the labor process to identify any deviations in a timely manner for decisive interventions to be initiated.
The perinatal nurse describes asynclitism to students as a presentation that occurs when the fetal head is turned toward the maternal sacrum or symphysis at an oblique angle. T/F
T. Face and brow presentations are examples of asynclitism (the fetal head is presenting at a different angle than expected). Face and brow presentations hyperextend the neck and increase the overall circumference of the presenting part. These presentations are uncommon and are usually associated with fetal anomalies.
placenta previa compared to abruptio placentae
insidious, always visible bright red bleeding, and becomes more profuse, painless, soft and relaxed uterine tone, normal FHR, presentation may be breech or transverse
After a vaginal examination, the nurse determines that the client's fetus is in an occiput posterior position. The nurse would anticipate that the client will have:
intense back pain. Having a fetus in a posterior position would cause intense back pain secondary to the fetal head facing the maternal vertebra and causing pressure. Leg cramps are common during pregnancy and not caused by an occiput posterior position, but rather pressure from the heavy gravid uterus toward term. Fetal position would not contribute to nausea and vomiting. Going through transition in labor might cause nausea and vomiting, not the fetal position. A precipitous birth occurs rapidly and is not associated with intense back pain.
multiple gestation
more than one fetus inside the uterus
placenta increta definition
penetrates INTO myometrium (INTO:INCRETA)
gestational hypertension
potentially life-threatening disorder that usually develops after the 20th week of pregnancy without proteinuria and resolves itself by the 12th week postpartum
cervical insufficiency
premature dilation of the cervix with absence of contractions
abruptio placentae
premature separation of the placenta from the uterine wall
abruptio placentae
premature separation of the placenta from the uterine wall, causes dark bleeding, sudden, can be concealed or visible bleeding, constant discomfort, firm to rigid, fetal distress or absent FHR.
Preterm Premature Rupture of Membranes (PPROM)
premature spontaneous rupture of membranes after 20 weeks of gestation and prior to 37 weeks of gestation.
PPROM
preterm premature rupture of membranes
low lying placenta previa
the placenta is implanted in the lower uterine segment and is near the internal os but does not reach it
Inevitable abortion
vaginal bleeding that is greater than slight, rupture of membranes, cervical dilation, strong abdominal cramping, and possible passage of products of conception.
Diagnosis of preeclampsia
The absolute blood pressure of 140/90 should be obtained twice 4-6 hours apart. Proteinuria > 300 mg per 24 hours or more than 1+ protein two times 4-6 hours apart with no UTI.
Bishop Scale Assesses Cervical Ripeness by 5 items
1-Dilation 2-Effacement % 3-Station 4-Consistency 5-Position of Cervix
The range for normal fetal heart rate is
110-160
cervical cerclage
a ring or loop used to hold the cervix closed, strengthens the cervix
incomplete abortion
An incomplete abortion involves intense abdominal cramping, heavy vaginal bleeding, and cervical dilation.
During labor, oxytocin is always administered __________.
Answer IV During labor, oxytocin can only be administered intravenously via an infusion pump to titrate and regulate the dose for safe administration. The correct answer is: intravenously with an infusion pump
A 16-year-old is making her first prenatal visit to the clinic in her fourth month of pregnancy. The nurse's first responsibility would be to? Contact the social worker. Develop a trusting relationship. Schedule the client for prenatal classes. Teach the client about proper nutrition.
B
Normal platelet count
150,000-400,000
Hydraminos
> 2,000 mL of amniotic fluid at term Associated with - maternal diabetes - neural tube defects - chromosomal deviations - malformations of CNS/GI that prevent fetus from swallowing amniotic fluid
calcium gluconate
Antidote for magnesium sulfate
Obstetric hemorrhage
heavy bleeding during pregnancy, labor, or right after birth; bleeding may be vaginal & external, or, less commonly but more dangerously, internal, into abdominal cavity
HELLP syndrome
hemolysis, elevated liver enzymes, low platelets. found in severe preeclampsia and eclampsia
Appropriate nursing strategies for the nursing diagnosis Family Coping, ineffective related to unanticipated pregnancy would include: Assess client and family reaction to pregnancy. Assess parenting skills of client and father of the baby. Discuss fears and concerns of body image. Discuss importance of regular prenatal care.
A
Following the first stage of labor/ the pregnant teenage pushes for two hours. The physician decides a cesarean is necessary. Which of the following physiologic risks may have contributed to this decision? Cephalopelvic disproportion Iron deficiency anemia Preeclampsia Low birth weight infant
A
The 19-year-old pregnant client begins a job to "save money for baby.' The nurse understands this statement to demonstrate partial accomplishment of which of the following developmental tasks? Gaining autonomy and independence Developing intimate relationships Developing a sense of achievement Developing a sense of identity
A
The nurse auscultates the FHR and determines a rate of 158 bpm. Which of the following actions is appropriate? A. inform the mother that the rate is normal B. Reassess the FHR in five minutes because the rate is high C. Report the FHR to the doctor immediately D. Tell the mother that she is having a boy with the FHR being that fast
A
The nurse determines fetal presentation and position by performing Leopold's maneuvers. The first maneuver in this procedure is used to determine: A. whether the fetal head or buttocks occupies the fundus. B. The location of the fetal back. C. Whether the head or buttocks lies in the pelvic inlet. D. The descent of the presenting part into the pelvis.
A
placenta previa
A bleeding condition in the last 2 trimesters of pregnancy. implantation of the placenta over the cervical opening or in the lower region of the uterus. risk increases with each C-section
Missed abortion
A missed abortion involves the absence of contractions and irregular spotting with possible progression to inevitable abortion.
The perinatal nurse describes for the new nurse the various risks associated with prolonged premature preterm rupture of membranes. These risks include: Select all answers that apply. Select one or more: a. Chorioamnionitis b. Abruptio placentae c. Operative birth d. Cord prolapse
A, B, D. Even though maintaining the pregnancy to gain further fetal maturity can be beneficial, prolonged PPROM has been correlated with an increased risk of chorioamnionitis, placental abruption, and cord prolapse.
Question text A pregnant woman who has a history of cesarean births is requesting to have a vaginal birth after cesarean (VBAC). In which of the following situations should the nurse advise the patient that her request may be declined? Select one: a. Transverse fetal lie b. Flexed fetal attitude c. Previous low flap uterine incision d. Positive vaginal candidiasis
A. A baby in the transverse lie is lying sideways in the uterus. This lie is incompatible physiologically with a vaginal delivery.
Question text Four women are close to delivery on the labor and delivery unit. The nurse knows to be vigilant to the signs of neonatal respiratory distress in which delivery? Select one: a. 42-week-gestation pregnancy complicated by intrauterine growth restriction b. 41-week-gestation pregnancy with biophysical profile score of 10 that morning c. 40-week-gestation pregnancy with estimated fetal weight of 3200 grams d. 39-week-gestation pregnancy complicated by maternal cholecystitis
A. A post-term baby with intrauterine growth restriction (IUGR) is high risk for meconium aspiration syndrome, cold stress syndrome, hypoglycemia, and acidosis. In each case, the baby may exhibit signs of respiratory distress.
For the patient with which of the following medical problems should the nurse question a physician's order for beta agonist tocolytics? a. Type 1 diabetes mellitus b. Cerebral palsy c. Myelomeningocele d. Positive group B streptococci culture
A. Beta agonists often elevate serum glucose levels. The nurse should question the order.
A woman is being discharged after receiving treatment for a hydatidiform molar pregnancy. The nurse should include which of the following in her discharge teaching?
A. Do not become pregnant for at least 1 year, use contraception to prevent it, because assessment of serum chorionic gonadotropin (hCG) is considered a specific tumor marker for gestational trophoblastic disease that isn't resolved. hCG levels are assayed at frequent intervals for up to a year. Pregnancy would obscure the evidence of choriocarcinoma by the normal secretion of hCG.
During the postpartum assessment, the perinatal nurse notes that a patient who has just experienced a forceps-assisted birth now has a large quantity of bright red bleeding. Her uterine fundus is firm. The nurse's most appropriate action is to notify the physician/certified nurse midwife and describe a: Select one: a. Need for vaginal assessment and repair b. Requirement for an oxytocin infusion c. Need for further information for the woman/family about forceps d. Requirement for bladder assessment and catheterization
A. In the presence of a firm fundus and bright red bleeding, after a forceps-assisted birth there is a need for vaginal assessment and there may be a need for repair.
A woman diagnosed with preeclampsia is to receive magnesium sulfate. The rationale for this drug is to:
A. Reduce CNA irritability to prevent seizures. Magnesium sulfate is a central nervous system depressant that interferes with calcium uptake in the cells of the myometrium, thus reducing the muscular ability to contract. Magnesium sulfate is not used as supplementation during pregnancy because most pregnant women do not have a deficiency of this mineral. Magnesium sulfate would not be effective against constipation in pregnant women. Magnesium sulfate does not stimulate musculoskeletal tone to augment labor contractions; rather, it has the opposite effect.
RhoGAM is given to Rh-negative women to prevent maternal sensitization. In addition to pregnancy, Rh-negative women would also receive this medication after which of the following?
A. Therapeutic or spontaneous abortion. Any time there is a pregnancy with the chance of maternal and fetal blood mixing, RhoGAM is needed to prevent sensitization or antibody production. Head injury resulting from a car crash is not a situation in which there would be mixing of fetal or maternal blood. The trauma would cause hemorrhage, but not a sensitization reaction. A blood transfusion after hemorrhage would require typing and cross-matching of the client's blood; thus, she would receive blood with her own Rh factor, not one with Rh-positive blood. Because the artificial insemination procedure was unsuccessful, no pregnancy occurred and RhoGAM would not be necessary.
Tocolytics
Act on uterine muscle to cease contractions. Used to stop preterm labor. Terbutaline sulfate (Brethine), ritodrine HCl (Yutopar), nifedipine (Procardia), magnesium sulfate
In order to give the pregnant teenager a role in her prenatal care, the nurse could allow her to: Choose the type of prenatal vitamin she takes. Measure and record her weight at each visit. Choose the schedule of her prenatal visits. Decide if she wants her labor to be induced.
B
During a nonstress test, the nurse notes that the fetal heart rate deceleration about 15 beats during a period of fetal movement. The decelerations occur twice during the test and last 20 seconds each. The nurse realizes these results will be interpreted as: A. A negative test. B. A reactive test. C. A nonreactive test. D. Equivocal test.
C
Which of the following conditions would most likely cause a pregnant woman with type 1 diabetes the greatest difficulty during her pregnancy?
B. Hyperemesis gravidarum. Extreme nausea and vomiting as part of hyperemesis gravidarum would cause fluid and electrolyte imbalances and would alter blood glucose levels tremendously. With placenta previa, the placenta is dislocated, not malfunctioning; it would not have as much of an impact on the pregnancy as would an imbalance of fluids and electrolytes. Abruptio placentae would place the mother at risk for hemorrhage, but the placenta does not govern the blood glucose levels of the mother. Rh incompatibility affects the fetus, not the mother, by causing hemolysis of the red blood cells in the fetus. This process would not influence the mother's glucose levels.
A pregnant woman, approximately 12 weeks gestation, comes to the emergency department after calling her health care provider's office and reporting moderate vaginal bleeding. Assessment reveals cervical dilation and moderately strong abdominal cramps. She reports that she has passed some tissue with the bleeding. THe nurse interprets these findings to suggest which of the following?
B. Inevitable abortion. An inevitable abortion is characterized by vaginal bleeding that is greater than slight, rupture of membranes, cervical dilation, strong abdominal cramping, and possible passage of products of conception. The threatened abortion involves slight vaginal bleeding, no cervical dilation and no change in cervical consistency, mild abdominal cramping, a closed cervical os, and no passage of fetal tissue. An incomplete abortion involves intense abdominal cramping, heavy vaginal bleeding, and cervical dilation. A missed abortion involves the absence of contractions and irregular spotting with possible progression to inevitable abortion.
One of the first indications of fetal compromise is: A. Meconium-stained amniotic fluid B. Oligohydramnios C. A nonreactive nonstress test D. A negative contraction stress test
C
The most common cause for late decelerations is A. cord compression B. head compression C. Placental oxygen transfer insufficiency D. prematurity
C
Which of the following would be considered a nonreassuring fetal heart rate (FHR) pattern? A. Early decelerations h each contraction B. Variable decelerations that recover to the baseline C. Late decelerations with minimal variability D. Accelerations
C
magnesium sulfate toxicity
C- cardiac dysrhythmia's O- Output less than 30mL R- Respirations less than 12/min A-Absent deep tendon reflexes (hyporeflexia*) L-LOC is decreased
Contraindications for induction of labor include: Select one or more: a. Abnormal fetal position b. Postdated pregnancy c. Pregnancy-induced hypertension d. Placental abnormalities
C. Contraindications for induction of labor include abnormal fetal position because of the risk of fetal injury and placental abnormalities because of the risk of hemorrhage. Pregnancy-induced hypertension and placental abnormalities are two of the common contraindications for induction of labor.
The perinatal nurse is providing care to Carol, a 28-year-old multiparous woman in labor. Upon arrival to the birthing suite, Carol was 7 cm dilated and experiencing contractions every 1 to 2 minutes which she describes as "strong." Carol states she labored for 1 hour at home. As the nurse assists Carol from the assessment area to her labor and birth room, Carol states that she is feeling some rectal pressure. Carol is most likely experiencing: a. Hypertonic contractions b. Hypotonic contractions c. Precipitous labor d. Uterine hyperstimulation
C. Contrary to both hypertonic and hypotonic labor, precipitate labor contractions produce very rapid, intense contractions. A precipitous labor lasts less than 3 hours from the beginning of contractions to birth. Patients often progress through the first stage of labor with little or no pain and may present to the birth setting already advanced into the second stage of labor.
After teaching a woman about hyperemesis gravidarum and how it differs from the typical nausea and vomiting of pregnancy, which statement indicates that the teaching was successful?
C. I need to avoid strong odors, perfumes, and flavors. The woman should avoid noxious stimuli such as strong flavors, odors, or perfumes because they might trigger nausea and vomiting.
A patient is receiving magnesium sulfate for severe preeclampsia. The nurse must notify the attending physician immediately of which of the following findings? a. Patellar and biceps reflexes of +4 b. Urinary output of 50 mL/hr c. Respiratory rate of 10 rpm d. Serum magnesium level of 5 mg/dL
C. The drop in respiratory rate may indicate that the patient is suffering from magnesium toxicity. The nurse should report the finding to the physician.
A woman who is admitted to labor and delivery at 30 weeks gestation, is 1 cm dilated, and is contracting q 5 minutes. She is receiving magnesium sulfate IV piggyback. Which of the following maternal vital signs is most important for the nurse to assess each hour? a. Temperature b. Pulse c. Respiratory rate d. Blood pressure
C. The respiratory rate is the most important vital sign. Respiratory depression is a sign of magnesium toxicity.
Question text After an education class, the nurse overhears an adolescent woman discussing safe sex practices. Which of the following comments by the young woman indicates that additional teaching about sexually transmitted infection (STI) control issues is needed? Select one: a. "I could get an STI even if I just have oral sex." b. "Girls over 16 are less likely to get STDs than younger girls." c. "The best way to prevent an STI is to use a diaphragm." d. "Girls get human immunodeficiency virus (HIV) easier than boys do."
C. This statement is untrue. The young woman needs further teaching. Condoms protect against STDs and pregnancy. In addition, condoms can be kept in readiness for whenever sex may occur spontaneously. Using condoms does not require the teen to plan to have sex. A diaphragm is not an effective infection-control method. Plus, it would require the teen to plan for intercourse.
Women who drink alcohol during pregnancy:
Can give birth to an infant with fetal alcohol spectrum disorder. Alcohol ingested by the woman during pregnancy is teratogenic to the fetus, and the newborn can be born with fetal alcohol spectrum disorder. Drinking alcohol would decrease production of dehydrogenase, an enzyme that mobilizes the hydrogen of a substrate so that it can pass it to a hydrogen acceptor. Becoming intoxicated faster during pregnancy is not the underlying problem associated with alcohol ingestion and pregnancy. The woman's genetic makeup, how much alcohol is ingested, her amount of body fat, metabolic rate, and ingestion of food are a few of the factors that determine the metabolism of alcohol. Alcohol contains calories and if enough is ingested along with food, weight gain would occur, not weight loss.
When assessing the following woman, the nurse assesses what for the highest risk of preterm labor?
Client with hx of previous preterm birth. Women with a history of preterm birth are at the highest risk for the same in subsequent pregnancies. Having had twins previously would have no bearing on this singleton pregnancy to influence preterm labor. Location of residence is not a risk for preterm labor. The woman's occupation as a computer programmer would not increase her risk of preterm labor. However, standing for long periods in a work environment might increase her risk.
Which of the following is a change in the baseline fetal heart rate? A. Acceleration B. Late deceleration C. Sinusoidal pattern D. Tachycardia
D
Question text A patient, G1 P0, is admitted to the labor and delivery unit for induction of labor. The following assessments were made on admission: Bishop score of 4, fetal heart rate 140s with good variability and no decelerations, TPR 98.6ºF, 88, 20, BP 120/80, negative obstetrical history. A prostaglandin suppository was inserted at that time. Which of the following findings, 6 hours after insertion, would warrant the removal of the Cervidil (dinoprostone)? Select one: a. Bishop score of 5 b. Fetal heart of 152 bpm c. Respiratory rate of 24 rpm d. Contraction frequency of every 2 minutes
D. Cervidil should be removed for tachysystole. Contraction frequency of every 2 minutes.
When providing prenatal education to a pregnant woman with asthma, which of the following would be important for the nurse to do?
D. Ensure she seeks treatment for any exacerbation. A pregnant woman with asthma who is having an acute exacerbation will be poorly oxygenated, and thus perfusion to the placenta is compromised. Immediate treatment is needed for her well-being as well as that of the fetus. Corticosteroids are used as a first-line drug therapy for asthma treatment and management because of their anti-inflammatory properties. Having asthma has no influence on the woman's glucose levels, unless she also has diabetes. Bronchodilators usually are inhaled, not given subcutaneously, so instruction about this route of administration would not be necessary.
Which of the following statements is most appropriate for the nurse to say to a patient with a complete placenta previa? a. "During the second stage of labor you will need to bear down." b. "You should ambulate in the halls at least twice each day." c. "The doctor will likely induce your labor with oxytocin." d. "Please promptly report if you experience any bleeding or feel any back discomfort."
D. Labor often begins with back pain. Labor is contraindicated for a patient with complete placenta previa.
It is critical for the perinatal nurse to learn, as part of the facility's policies and procedures, to immediately perform a vaginal examination on a woman who presents with vaginal bleeding after 24 weeks gestation. T/F
F. Placenta previa should be suspected in all patients who present with bleeding after 24 completed weeks of gestation. Because of the risk of placental perforation, vaginal examinations are not performed.
Which of the following laboratory values is most concerning in a client with pregnancy-induced hypertension? a. Total urine protein of 200 mg/dL b. Total platelet count of 40,000 mm c. Uric acid level of 8.0 mg/dL d. Blood urea nitrogen 24 mg/dL
The correct answer is: Total platelet count of 40,000 mm
Intrauterine growth restriction (IUGR)
Fetal undergrowth from any cause
Women who are obese have a greater risk of developing which of the following during pregnancy?
Gestational hypertension because excessive adipose tissue increases cardiac workload, coupled with increased circulatory demands of obesity increases risk for vasoconstriction leading to hypertension.
chorionic hypertension
HTN before the 20th week or pregnancy
The nurse would anticipate a c-section for a client who has which active infection present at the onset of labor?
Herpes simplex virus. Herpes exposure during the birth process poses a high risk for mortality to the neonate. If the woman has active herpetic lesions in the genital tract, a surgical birth is planned to avoid this exposure. Hepatitis is a chronic liver disorder, and the fetus if exposed would at most become a carrier; a surgical birth would not be expected for this woman. Toxoplasmosis is passed through the placenta to the fetus prior to birth, so a cesarean birth would not prevent exposure. HPV would be manifested clinically by genital warts on the woman, and a surgical birth would not be anticipated to prevent exposure unless the warts caused an obstruction.
When explaining to a pregnant woman about HIV infection and transmission, which of the following would the nurse include?
Most often is sexually transmitted. The highest percentage of HIV transmission results from sexual activity, followed by intravenous drug use. Transmission can occur despite a low viral load in the blood of the infected person. Pregnant women who take antiretroviral therapy during their gestation significantly reduce the chances of transmitting HIV to their newborn. The use of standard precautions will minimize the risk of transmission of HIV to health care workers. A very small percentage of nurses contract HIV through needle sticks if using appropriate precautions.
Maintenance on methadone or buprenorphine is the most common medical treatment for which of the following drug addictions?
Opiates
Diagnosis of preeclampsia
POST 20 WKS HTN WITH PROTEIN-URIA= BUT THIS IS NOT REQ FOR DIAGNOSIS PT CAN ALSO HAVE OTHER SX: LOW PLATELETS RENAL INSUFFICIENCY= HIGH CREATINE HIGH ALT, AST HEADACHE, VISION CHANGES ABD PAIN Severe preeclampsia is diagnosed with severely elevated blood pressures, defined as SBP >160 or DBP >110 or the presence of any of the above clinical findings.
The perinatal nurse recognizes that the laboring multiparous patient who is attempting a vaginal birth following a previous Cesarean birth (VBAC) needs frequent assessments to ensure that there is ___________ during her labor
Progress. Women with a previous history of cesarean birth may be offered a trial of labor, although a prompt cesarean birth is recommended at the earliest sign of maternal or fetal compromise.
The nurse is caring for a woman experiencing hypertonic uterine dystocia. The woman's contractions are erratic in their frequency, duration, and of high intensity. The priority nursing intervention would be
Provide pain relief measures as women with hypertonic uterine contractions experience a high level of pain related to the high intensity of contractions. Providing comfort measures along with pharmacologic agents to reduce would be a priority.
The rationale for using a prostaglandin gel for a client prior to the induction of labor is to:
Soften and efface the cervix. Prostaglandins soften and thin out the cervix in preparation for labor induction. Although they do irritate the uterus, they aren't as effective as oxytocin in stimulating contractions. Prostaglandin gel would stimulate cervical nerve receptors rather than numb them. Prostaglandins have no power to prevent cervical lacerations.
premature rupture of membranes
Spontaneous rupture of the amniotic membranes, 1 hr or more prior to the onset of true labor
A patient with hypertension who is receiving intravenous magnesium sulfate therapy has requested an epidural anesthetic. The perinatal nurse should first review the patient's complete blood count results for evidence of a decreased platelet count. T/F
T Baseline information, including complete blood count (CBC), clotting studies, serum electrolytes, and renal function tests, is used to alert the care providers to changes in the patient's condition as additional laboratory tests are obtained. Page: 115 The correct answer is: True
A client who was in active labor and whose cervix had dilated to 4 cm experiences a weakening in the intensity and frequency of her contractions and exhibits no further progress in labor. The nurse interprets this as a sign of
The correct response is C. Hypotonic labor typically occurs in the active phase; it involves ineffective contractions to evoke cervical dilation and causes secondary inertia. Hypertonic labor is characterized by painful, high-intensity contractions that usually occur in the latent phase. A precipitous labor occurs within 3 hours and cervical dilation is very fast secondary to effective, high-intensity contractions. Dysfunctional labor describes any pattern that doesn't produce dilation and effacement in a timely manner.
threatened abortion
The threatened abortion involves slight vaginal bleeding, no cervical dilation and no change in cervical consistency, mild abdominal cramping, a closed cervical os, and no passage of fetal tissue.
Which of the following would the nurse include when teaching a pregnant woman about the patho mechanisms associated with gestational diabetes?
There is progressive resistance to the effects of insulin. Levels of the hormone hPL (insulin antagonist) progressively rise throughout pregnancy, and additional insulin is needed to overcome its resistance. Having a carbohydrate craving is not associated with gestational diabetes. Hyperinsulinemia in the fetus develops in response to the mother's high blood glucose levels. Glucose levels are diverted across the placenta for fetal use, and thus maternal levels are reduced in the first trimester. This lower glucose level doesn't last throughout the gestation, just the first trimester. For the remaining two trimesters, the maternal glucose levels are high because of the insulin resistance caused by hPL.
Types of abortion
Threatened; Inevitable; Incomplete; Complete; Missed
VEAL CHOP
V- Variable C- Cord Compression E- Early Decels H- Head Compression A- Accelerations O - OK L-Late Decels P - Placental insufficiency
diagnosis of gestational trophoblastic disease
assessment of serum chorionic gonadotropin (hCG) is considered a specific tumor marker for gestational trophoblastic disease that isn't resolved. hCG levels are assayed at frequent intervals for up to a year. Pregnancy would obscure the evidence of choriocarcinoma by the normal secretion of hCG.
marginal placenta previa
edge of the placenta is at the margin of the internal os
gestational trophoblastic disease
condition in which trophoblastic tissue overtakes the pregnancy and propagates throughout the uterine cavity
placenta percreta
growth of the chorionic villi through the myometrium to the uterine serosa
hemolysis
destruction of red blood cells
dystocia
difficult labor