OB Chapter 10

A client at 39 weeks' gestation calls the OB triage and questions the nurse concerning a bloody mucus discharge noted in the toilet after an OB office visit several hours earlier. What is the best response from the triage nurse? "It might be nothing. If it happens again call your provider who is on-call." "Bloody mucus is a sign you are in labor. Please come to the hospital." "If the provider did an exam, it might be just normal vaginal secretions, so don't worry about it." "A one time discharge of bloody mucus in the toilet might have been your mucus plug."

"A one time discharge of bloody mucus in the toilet might have been your mucus plug." Bloody mucus can either be a mucus plug or bloody show. The one-time occurrence would be more likely to be the mucus plug. A bloody show would continue if her cervix was changing, but this usually does not occur until after contractions start. It is a sign that something is happening and should be reported to the health care provider. The bloody mucus is not a sign of labor, but it can be an early sign that labor is coming soon.

After delivery, a postpartum mother discusses nutritional needs with her nurse related to breastfeeding. Which statement by the mother demonstrates an understanding of the nurse's teaching on the subject? "I will need to eat more meat and whole grains to increase my zinc intake while I am nursing." "My iron intake will be adequate if I increase my intake of milk and vegetables." "The amount of milk I will produce is dependent upon my calcium intake while I am nursing." "My baby will take much of my protein through the breast milk, so I will supplement my diet with fruit and cheeses.

"I will need to eat more meat and whole grains to increase my zinc intake while I am nursing." Breastfeeding increases the daily requirements for zinc that were needed during the pregnancy. Increased intake of meat, seafood, and grains will increase the zinc in the nursing mother's diet. The other approaches will not benefit the nursing mother or the infant. The calcium intake does not determine the milk production.

The nurse is teaching the pregnant woman about nutrition for herself and her baby. Which statement by the woman indicates that the teaching was effective? "Because I am pregnant, I can eat anything I want and not worry about weight gain." "I can eat any seafood that I like because it contains phosphorus, which is a nutrient that pregnant women need." "Milk production requires higher levels of calcium; therefore, if I am going to breastfeed, I must take a calcium supplement during pregnancy." "I will need to take iron supplementation throughout my pregnancy even if I am not anemic."

"I will need to take iron supplementation throughout my pregnancy even if I am not anemic." Iron is recommended for all pregnant women because it is almost impossible for the pregnant woman to get what is required from diet alone, especially after 20 weeks' gestation when the requirements of the fetus increase. Pregnant women can get many nutrients from seafood including phosphorus, but there are specific recommendations about types of fish to avoid because of the risk of mercury poisoning. Milk production actually requires higher levels of zinc, which can be obtained from a healthy diet. Calcium requirements do not increase above prepregnancy levels during pregnancy because calcium absorption is enhanced during pregnancy. It can be unsafe for the pregnant woman to eat anything she wants and gain too much weight. A woman who gains too much weight during pregnancy is at risk for delivering a macrosomic baby.

The nurse is assessing a pregnant client at 20 weeks' gestation and obtains a hemoglobin level. Which result would be a cause for concern? 12.8 g/dl 10.6 g/dl 11.2 g/dl 11.9 g/dl

10.6 g/dl The average hemoglobin level at term is 12.5 g/dl. The hemoglobin level is considered normal until it falls below 11 g/dl.

A urinalysis is done on a client in her third trimester. Which result would be considered abnormal? Specific gravity of 1.010 2+ Protein in urine Trace of glucose Straw-like color

2+ Protein in urine During pregnancy, there may be a slight amount of glucose found in the urine due to the fact that the kidney tubules are not able to absorb as much glucose as there were before pregnancy. However, there should be minimal protein in the urine. A specific gravity of 1.010 and a straw- like color are both normal findings.

During a routine antepartal visit, a pregnant woman reports a white, thick vaginal discharge. What would the nurse do next? Tell the woman that this is entirely normal. Check the discharge for evidence of ruptured membranes. Ask the woman if she is having any itching or irritation. Advise the woman about the need to culture the discharge.

Ask the woman if she is having any itching or irritation. Although vaginal secretions increase during pregnancy, the nurse would need to ascertain if this discharge is the normal leukorrhea of pregnancy or if it is a monilial vaginitis, which is common during pregnancy. The nurse needs additional information to conclude that the woman's report is normal. A culture may or may not be necessary. There is no evidence to suggest that her membranes have ruptured.

A pregnant client in her third trimester, lying supine on the examination table, suddenly grows very short of breath and dizzy. Concerned, she asks the nurse what is happening. Which response should the nurse prioritize? Sympathetic nerve responses cause dyspnea when a woman lies supine. Blood is trapped in the vena cava in a supine position. Cerebral arteries are growing congested with blood. The uterus requires more blood in a supine position.

Blood is trapped in the vena cava in a supine position. Supine hypotension syndrome, or an interference with blood return to the heart, occurs when the weight of the fetus rests on the vena cava. Cerebral arteries should not be affected. Mean arterial pressure is high enough to maintain perfusion of the uterus in any orientation. The sympathetic nervous system will not be affected by the supine position.

During an exam, the nurse notes that the blood pressure of a client at 22 weeks' gestation is lower, and her heart rate is 12 beats per minute higher than at her last visit. How should the nurse interpret these findings? Combined, both of these findings are very concerning and warrant further investigation. Both findings are normal at this point of the pregnancy. The blood pressure should be higher since the cardiac volume is increased. The heart rate increase may indicate that the client is experiencing cardiac overload.

Both findings are normal at this point of the pregnancy. A pregnant woman will normally experience a decrease in her blood pressure during the second trimester. An increase in the heart rate of 10 to 15 beats per minute on average is also normal, due to the increased blood volume and increased workload of other organ systems. Hormonal changes cause the blood vessels to dilate, leading to a lowering of blood pressure.

Which information provided by a client would be considered a presumptive sign of pregnancy? Breast tenderness Ballottement Weight gain Reports of increased hunger

Breast tenderness Presumptive signs of pregnancy are things reported by the woman to the health care provider and occur early in pregnancy. Breast tenderness is a common sign reported by women in early pregnancy but is not a definitive sign. Reports of increased hunger and weight gain could be caused by any disorder or could be normal responses to eating cycles. Ballottement occurs late in the pregnancy and is a probable sign.

A new mother asks the postpartum nurse if her baby is getting enough nourishment from breastfeeding within the first 24 hours following birth. The nurse would provide her what information? Breast milk comes in within 12 hours after delivery and nourishment should not be a problem. Colostrum, which is the first milk produced, is rich in calories and protein that nourishes the infant well. Most infants need minimal nourishment for the first 24 hours, so the mother should not be concerned. The mother needs to supplement breastfeedings with formula until her milk comes in.

Colostrum, which is the first milk produced, is rich in calories and protein that nourishes the infant well. Colostrum is present prior to delivery and provides the infant with adequate nutrition for the first 3 days of life, at which time the mother's actual milk should come in. Formula is not recommended. Infants need nutrition shortly after birth to keep their blood glucose normal.

The nurse cares for a pregnant client at the first prenatal visit and reviews expected changes that will occur during pregnancy. Which information will the nurse include in the education? Pregnancy typically causes a decrease in respiratory rate. Blood pressure decreases in the third trimester. During pregnancy blood volume can increase by at least 40%. Hemoglobin levels rise significantly during pregnancy.

During pregnancy blood volume can increase by at least 40%. The pregnant woman can experience a blood volume increase by approximately 40% to 50% above prepregnancy levels by the end of the third trimester. Pregnancy results in an increased respiratory rate to provide oxygen to both the mother and fetus. Hemoglobin levels are usually low during pregnancy because of hemodilution of red blood cells, which is termed physiologic anemia of pregnancy. Blood pressure usually reaches a low point mid-pregnancy and, thereafter, increases to prepregnancy levels by the third trimester.

A client arrives to the clinic very excited and reporting a positive home pregnancy test. The nurse cautions that the home pregnancy test is considered a probable sign and will assess the client for which sign to confirm pregnancy? Positive office pregnancy test Hegar sign Chadwick sign Fetal movement felt by examiner

Fetal movement felt by examiner The positive signs of pregnancy are fetal image on a sonogram, hearing a fetal heart rate, and examiner feeling fetal movement. A pregnancy test has 95% accuracy; however, it may come back as a false positive. Hegar sign is a softening of the uterine isthmus. Chadwick sign may have other causes besides pregnancy.

A client at 16 weeks' gestation comes to the office for a routine exam. At what location within the abdomen would the nurse anticipate the uterus to be found? Below the symphysis pubis Halfway between the symphysis pubis and the umbilicus At the xiphoid process At the level of the umbilicus

Halfway between the symphysis pubis and the umbilicus As the pregnancy progresses, the uterus enlarges and enters the abdominal cavity. At 16 weeks, the nurse should be able to palpate the uterus halfway between the symphysis pubis and the umbilicus.

A 22-year-old client comes to the walk-in clinic complaining of fatigue, breast heaviness and extreme tenderness, and a clear vaginal discharge. What question would the nurse ask this client? Do you have a family history of breast cancer? Are you taking oral contraceptives? Do you have vaginal itching? Have you been sexually active in the past 2 months?

Have you been sexually active in the past 2 months? The client is presenting with presumptive or subjective symptoms of pregnancy. Given her symptoms and age, asking about sexual activity is the most appropriate question. Whether she is taking an oral contraceptive will not assist in identifying the cause of her symptoms. If she has vaginal itching, the underlying cause of her symptoms needs to be identified before treatment can be prescribed. Asking about family history is part of a comprehensive health history, but is not the priority based on the client's presentation.

During a vaginal exam, the nurse notes that the lower uterine segment is softened. The nurse documents this finding as: Ortolani sign. Hegar sign. Chadwick sign. Goodell sign.

Hegar sign. Hegar sign refers to the softening of the lower uterine segment or isthmus. Bluish coloration of the cervix is termed Chadwick sign. Goodell sign refers to the softening of the cervix. Ortolani sign is a maneuver done to identify developmental dysplasia of the hip in infants.

A client at 24 weeks' gestation is seen for a routine monthly check up. She reports concerns to the nurse about rest periods. She states that when she awakens she feels weak and lightheaded. What is the most appropriate initial action by the nurse? Request testing to assess the client's serum glucose levels. Assess the client for manifestations of preeclampsia. Inquire about the client's sleeping positions. Make a referral for a cardiac evaluation. Complete neurological assessment.

Inquire about the client's sleeping positions. When a pregnant woman lies on her back she can experience vena cava syndrome. This results when the weight of the pregnant uterus presses against the vena cava. Additional symptoms of this include weakens nausea and dizziness. To manage this condition, pregnant women are encouraged to assume side lying positions instead of lying on their backs. There is no indication that the client is experiencing cardiac, preeclamptic or diabetes-related manifestations.

The nurse is explaining the latest laboratory results to a pregnant client who is in her third trimester. After letting the client know she is anemic, which heme iron-rich foods should the nurse encourage her to add to her diet? Legumes Dairy Grains Meats

Meats Meats are the best source of heme-rich iron and should be included in her diet if she is not following a vegetarian diet. Grains and legumes are non-heme iron sources. Dairy products will add various vitamins and calcium to the diet.

The nurse is assessing a client who believes she is pregnant. The nurse points out a more definitive assessment is necessary due to which sign being considered a probable sign of pregnancy? Fatigue Nausea and vomiting Positive home pregnancy test Amenorrhea

Positive home pregnancy test A urine pregnancy test is considered a probable sign of pregnancy as the hCG may be from another source other than pregnancy. Fatigue, amenorrhea, and vomiting are presumptive or possible signs of pregnancy and can also have other causes.

The partner of a pregnant client in her first trimester asks the nurse about the client's behavior recently, stating that she is very moody, seems happy one moment and is crying the next and all she wants to talk about is herself. What response would correctly address these concerns? What you are describing may be normal but we need to talk to her more in depth. Pregnant women often experience mood swings and self-centeredness but this is normal. Moodiness and irritability are not usual responses to pregnancy. Her body is changing and she may be angry about it.

Pregnant women often experience mood swings and self-centeredness but this is normal. During the first trimester of pregnancy, the woman often has mood swings, bouts of irritability and is hypersensitive. The partner needs to know that these are all normal behaviors for a pregnant woman.

The community nurse is preparing a presentation for a health fair illustrating successful pregnancies. Which component should the nurse prioritize as the most critical to ensure a positive psychological experience with the pregnancy by the mother? Having a planned pregnancy Social support Early prenatal care Age at the time of pregnancy

Social support All options are correct and play a role pregnancy, but the most critical for a positive psychological experience is for the woman to have a social support system. Early care, maternal age, and planned pregnancy all affect fetal and maternal health, but are not necessarily linked to positive psychological experiences.

A pregnant client at 24 weeks' gestation calls the clinic crying after a prenatal visit, where she had a pelvic exam. She states that she noticed blood on the tissue when she wiped after voiding. What initial statement by the nurse would explain this finding? It is possible she is losing her mucus plug, which can cause bloody show. Some bleeding during pregnancy is not uncommon and this finding is expected. The cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual. She may have a bleeding disorder so she needs to come back to the clinic for blood work.

The cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual. Slight bleeding after a pelvic exam in a pregnant woman is common due to the vascularity of her cervix during pregnancy. Suggesting a bleeding disorder is frightening and not substantiated by the data. Bleeding is not a normal finding during pregnancy and losing the mucus plug occurs at the end of pregnancy, just prior to labor.

The primigravid client at 18 weeks' gestation states, "I feel a fluttering sensation, kind of like gas." What change in the client typically follows this experience? The client acknowledges the fetus's existence as a separate identity. The client will begin to notice changes in body appearance. The client will bond with one's partner and build a family unit. The client will begin to experiences stretching pains and discomforts from fetal movement.

The client acknowledges the fetus's existence as a separate identity. The fluttering sensation that can be confused with gas is called "quickening." In the 2 weeks leading up to the 20-week mark, the pregnant client may feel "flutters" that may be confused with gas. At this time the client experiences for oneself that the fetus is alive and real. The client may begin calling it by a human pronoun. The client begins to see one's role as a parent. The client previously noticed changes in the body. Discomforts of pregnancy vary between pregnant client. The client may feel discomfort from abdominal growth and typically feels little discomfort at this time from fetal movement. There is no relationship between this experience and directly bonding with one's partner.

Which of the following changes, with highest priority, should the nurse teach a pregnant client to report to the health care provider as soon as possible? heartburn awakening her at night during the first trimester vomiting 2 to 3 times a day during first trimester abdominal pain coming and going during the third trimester frequent urination, every 1 to 2 hours, during the first trimester

abdominal pain coming and going during the third trimester Any abdominal pain needs to be reported to the health care provider ASAP. This could be a sign of preterm labor and needs to be addressed. Vomiting during the first trimester is normal. Heartburn is caused by the shifting of abdominal organs. Frequent urination is the result of increased pressure on the bladder.

Place the following events in the sequence the pregnant woman would experience them, from first to last. All options must be used.

amenorrhea uterine enlargement quickening Braxton hicks labor

The nurse is assessing several pregnant women in a clinic setting. Which assessment finding would alert the nurse to notify the health care provider? increased skin pigment blood pressure measured at 170/88 mm Hg increased nasal congestion increased urination and fatigue

blood pressure measured at 170/88 mm Hg During pregnancy, women may expertise increased nasal stuffiness, increased urination, fatigue, and skin pigment increases. Elevated blood pressure is a concern during pregnancy and would be reported.

The nurse is examining a woman who came to the clinic because she thinks she is pregnant. Which data collected by the nurse are presumptive signs of her pregnancy? Select all that apply. hydatidiform mole ultrasound pictures fetal heartbeat breast changes amenorrhea morning sickness

breast changes amenorrhea morning sickness Presumptive signs are possible signs of pregnancy that appear in the first trimester, often only noted subjectively by the mother (e.g., breast changes, amenorrhea, morning sickness). Probable signs are signs that appear in the first and early second trimesters, seen via objective criteria, but can also be indicators of other conditions (e.g., hydatidiform mole). Positive signs affirm that proof exists that there is a developing fetus in any trimester and are objective criteria seen by a trained observer or diagnostic study, (e.g., ultrasound.)

During a prenatal visit, the nurse inspects the skin of the client's abdomen. Which would the nurse identify as an abnormal finding? darkening of the umbilicus striae bruising linea nigra

bruising Bruising would not be a normal finding. Evidence of bruising might suggest domestic violence. Linea nigra, striae, and darkening of the umbilicus are normal findings.

During pregnancy a woman has many psychological adaptations that must be made. The nurse must remember that the baby's father is also experiencing the pregnancy and has adaptations that must be made. Some fathers actually have symptoms of the pregnancy along with the mothers. What is this called? cretinism pregnancy syndrome couvade syndrome pseudo pregnancy

couvade syndrome Some fathers actually experience some of the physical symptoms of pregnancy, such as nausea and vomiting, along with their partner. This phenomenon is called couvade syndrome.

Which assessment finding in the pregnant woman at 12 weeks' gestation should the nurse find most concerning? The inability to: feel fetal movements. detect fetal heart sounds with a Doppler. palpate the fetal outline. hear the fetal heartbeat with a stethoscope.

detect fetal heart sounds with a Doppler. Fetal heart sounds are audible with a Doppler at 10 to 12 weeks' gestation but cannot be heard through a stethoscope until 18 to 20 weeks' gestation. Fetal movements can be felt by a woman as early as 16 weeks of pregnancy and felt by the examiner around 20 weeks' gestation. The fetal outline is also palpable around 20 weeks' gestation.

Which effect would the nurse identify as a normal physiologic change in the renal system due to pregnancy? reduction in kidney size decrease in glomerular filtration rate dilation of the renal pelvis shortening of the ureters

dilation of the renal pelvis The renal pelvis becomes dilated during pregnancy, possibly due to the effect of progesterone on smooth muscle. The glomerular filtration rate increases during pregnancy. The kidneys enlarge during pregnancy. The ureters elongate, widen, and become more curved above the pelvic rim.

During a routine visit to the clinic, a client tells the nurse that she thinks she may be pregnant. The physician prescribes a pregnancy test. The nurse should know the purpose of this test is to determine which change in the client's hormone level? decrease in human chorionic gonadotropin (hCG) increase in luteinizing hormone (LH) increase in human chorionic gonadotropin (hCG) decrease in LH

increase in human chorionic gonadotropin (hCG) Human chorionic gonadotropin (hCG) increases in a woman's blood and urine to fairly large concentrations until the 15th week of pregnancy. The other hormone values are not indicative of pregnancy.

The nursing instructor is presenting the basic physiologic changes in the woman that can occur during a pregnancy. The instructor determines the session is successful when the students correctly choose which change in the respiratory function during pregnancy as normal? increased tidal volume increased expiratory volume decreased respiratory rate decreased oxygen consumption

increased tidal volume A pregnant client breathes more deeply, which increases the tidal volume of gas moved in and out of the respiratory tract with each breath. The expiratory volume, residual volume, and respiratory rate decrease as the pregnancy progresses. The increased oxygen consumption in the pregnant client is 15% to 20% greater than in the nonpregnant state.

The nurse is assessing a client during a prenatal visit. While listening to fetal heart tones, the client tells the nurse, "I have been itching pretty much all over my body." The rest of the client's assessment is unremarkable. The nurse suspects that the client's report is the result of which body change? increasing immune response increasing levels of estrogen rising levels of progesterone increasing reabsorption of bilirubin into the maternal bloodstream

increasing reabsorption of bilirubin into the maternal bloodstream Because of the gradual slowing of the gastrointestinal tract, decreased emptying of bile from the gallbladder may result. This can lead to reabsorption of bilirubin into the maternal bloodstream, giving rise to a symptom of generalized itching (subclinical jaundice). A rising level of progesterone would contribute to nausea. Typically, the immune response during pregnancy is decreased. Increased levels of estrogen cause gingival hypertrophy.

Increased pigmentation on the face of some pregnant women is called: melasma (chloasma) melanotropin nigra striae gravidarum (stretch marks)

melasma (chloasma) Melasma (chloasma), or "mask of pregnancy," is a blotchy brown discoloration on the face. In some women, a darkened line up the abdomen appears, which is called linea nigra. Striae gravidarum are "stretch marks. Melanotropin is the hormone responsible for melasma (chloasma).

A 39-year-old woman is pregnant with her first child and appears to be thrilled about it. Now in her second trimester, she talks enthusiastically with the nurse about the latest maternity clothes she has bought and models them for the nurse. She also discusses the latest trends in health foods, which she has adopted since learning of her pregnancy. The nurse interprets this information as reflecting which primary emotional response to pregnancy? introversion emotional lability narcissism stress

narcissism Self-centeredness (narcissism) may be an early reaction to pregnancy. A woman who previously was barely conscious of her body, who dressed in the morning with little thought about what to wear, suddenly begins to concentrate on these aspects of her life. She dresses so her pregnancy will or will not show. There is no evidence in this scenario of stress, introversion, or emotional lability.

A pregnant woman who is a vegetarian asks the nurse, "What would you suggest to make sure that I get enough protein in my diet while I am pregnant?" Which food(s) would be appropriate for the nurse to suggest? Select all that apply. nuts green leafy vegetables beans orange juice lentils

nuts beans lentils

The nurse is preparing to teach a community class to a group of first-time parents. Which information should the nurse include concerning what the pregnant woman's partner may experience as a normal response? physical symptoms similar to the mother no changes, only the mother has changes during pregnancy desire to be the woman and give birth feeling distanced from the mother

physical symptoms similar to the mother Couvade syndrome is the occurrence of physical symptoms by the partner, similar to the physical symptoms of the mother. Other emotional symptoms may occur, but they are typically on a person-to-person basis.

In a client's seventh month of pregnancy, she reports feeling "dizzy, like I'm going to pass out, when I lie down flat on my back." The nurse explains that this is due to: pressure of the gravid uterus on the vena cava. a 50% increase in blood volume. physiologic anemia due to hemoglobin decrease. pressure of the presenting fetal part on the diaphragm.

pressure of the gravid uterus on the vena cava The client is describing symptoms of supine hypotension syndrome, which occurs when the heavy gravid uterus falls back against the superior vena cava in the supine position. The vena cava is compressed, reducing venous return, cardiac output, and blood pressure, with increased orthostasis. The increased blood volume and physiologic anemia are unrelated to the client's symptoms. Pressure on the diaphragm would lead to dyspnea.

A client's menstrual period is two weeks late. She has been feeling tired and has had episodes of nausea in the morning. What classification of pregnancy symptoms is this client experiencing? probable presumptive no classification positive

presumptive The most common presumptive sign of pregnancy is a missed menstrual period, or amenorrhea. Other presumptive signs include nausea, fatigue, swollen, tender breasts, and frequent urination.

A new mother voices concerns about breastfeeding her infant. The nurse would explain to the mother the two hormones that control lactation and letdown are: estrogen and progesterone prolactin and oxytocin. follicle-stimulating hormone and thyroid hormone. luteinizing hormone and hCG

prolactin and oxytocin. Prolactin and oxytocin are both important hormones in regulation of breastfeeding. Prolactin helps in producing the breast milk and oxytocin stimulates letdown during breastfeeding. The other hormones do not play a role in breastfeeding or milk production.

A woman in the third trimester of her first pregnancy expresses fear about the birth canal being wide enough for her to push the baby through it during labor. She is a petite person, and the baby seems so large. She asks the nurse how this will be possible. To help alleviate the client's fears, the nurse should mention the role of the hormone that softens the cervix and collagen in the joints, which allows dilation (dilatation) and enlargement of the birth canal. What is this hormone? human placental lactogen relaxin progesterone estrogen

relaxin Relaxin, secreted by the corpus luteum of the ovary as well as the placenta, is responsible for helping to inhibit uterine activity and to soften the cervix and the collagen in joints. Softening of the cervix allows for dilation (dilatation) at birth; softening of collagen allows for laxness in the lower spine and so helps enlarge the birth canal. The effect of estrogen is to cause breast and uterine enlargement. Progesterone has a major role in maintaining the endometrium, inhibiting uterine contractility, and aiding in the development of the breasts for lactation. Human placental lactogen (hPL), also known as human chorionic somatomammotropin, serves as an antagonist to insulin, making insulin less effective and thereby allowing more glucose to become available for fetal growth.

The nursing instructor is teaching students about normal changes of pregnancy. The instructor talks about diastasis recti. What is the instructor presenting? separation of the muscles of the abdominal wall relaxation of the kidneys movement of the bladder to the rear of the pelvis behind the uterus raising of the uterus into the abdomen

separation of the muscles of the abdominal wall By 20 weeks' gestation, muscles of the abdominal wall may begin to separate (diastasis recti) and not return to normal approximation until several weeks after childbirth. The term diastasis recti does not refer to the raising of the uterus into the abdomen, relaxation of the kidneys, or movement of the bladder.

A pregnant client is visiting the clinic and complains about the tiny, blanched, slightly raised end arterioles on her face, neck, arms, and chest. The nurse should explain that these are normal during pregnancy and are referred to as: striae gravidarum. epulis. linea nigra. telangiectasias.

telangiectasias. The dilated arterioles that occur during pregnancy are due to the elevated level of circulating estrogen and are called telangiectasias. An epulis is a red raised nodule on the gums that may develop at the end of the first trimester and continue to grow as the pregnancy progresses. The linea nigra is a pigmented line extending from the symphysis pubis to the top of the fundus during pregnancy. Striae gravidarum (stretch marks) are slightly depressed streaks that commonly occur over the abdomen, breast, and thighs during the second half of pregnancy.

The nurse teaches a primigravida client that lightening occurs about 2 weeks before the onset of labor. The mother will most likely experience which of the following at that time? dyspnea constipation dysuria urinary frequency

urinary frequency Lightening refers to the descent of the fetal head into the pelvis and engagement. With this descent, pressure on the diaphragm decreases, easing breathing, but pressure on the bladder increases, leading to urinary frequency. Dysuria might indicate a urinary tract infection. Constipation may occur throughout pregnancy due to decreased peristalsis, but it is unrelated to lightening.

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 possible effect would the nurse include? backache ankle edema hemorrhoids urinary frequency

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 client in her third trimester reports sleeping poorly: sleeping on her back results in lightheadedness and dizziness and lying on her side results in no sleep. Which suggestion for sleeping should the nurse prioritize for this client? without a pillow with a pillow under her shoulders with a pillow under her right hip with a pillow under both hips

with a pillow under her right hip Pregnancy places strain on the cardiovascular system with increased fluid in the lungs and heart. The use of one pillow under the right hip will help displace the uterus and fetus off the major blood vessels, allowing the circulation to flow appropriately and provide relief to the client. When the woman lies flat on her back the uterus and contents can compress the vena cava and aorta and reduce blood flow, resulting in the light-headedness and dizzy spells. Removal of the pillow would not alter the effects on the vena cava. A pillow under the shoulders would hurt the neck, and a pillow under both hips would exacerbate the light-headedness.