prepU ch 12 Nursing Management During Pregnancy

A client comes to the clinic for her usual prenatal check up. The nurse measures the fundal height at 24 cm. What is the estimated length of her gestation?

24 weeks

At which gestational age will the nurse no longer associate fundal height directly with week's gestation?

36 weeks

The nurse is providing care for a pregnant client who has been given the necessary requisitions for laboratory work by the primary care provider. The client notices that the lab tests include testing for HIV and other sexually transmitted infections, and expresses alarm, stating, "I don't understand why the doctor would suspect that I've got these diseases." What is the nurse's most therapeutic statement?

"Every pregnant client is tested for these diseases; it doesn't necessarily suggest that the doctor suspects that you have them."

A pregnant client reports frequent urination and tells the health care provider that she has stopped drinking water during the day since she cannot take many breaks during work. Which statement by the nurse is most appropriate at this time?

"Fluids are necessary so your blood volume can double, which is normal in pregnancy."

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

"The gloves they provide irritate my hands, so I don't use them."

The diagonal conjugate of a pregnant woman's pelvis is measured. Which measurement would the nurse interpret as presenting a potential problem?

12.0 cm

Why is the first prenatal visit usually the longest prenatal visit?

Baseline data is collected.

A nurse is teaching a group of primigravida women who are in their first trimester. One of the women asks the nurse about sexual activity during pregnancy. Which information would the nurse most likely incorporate into the response?

Because of pelvic congestion, women may experience increased clitoral sensitivity.

The client states that the first day of her last menstrual period is March 23. The nurse is most correct to calculate using Naegele rule that the estimated date of delivery is:

December 30

A client at 27 weeks' gestation still walks daily but reports "terrible" heartburn at night. Which action should the nurse point out will best address this situation?

Elevate the head of the bed.

A multigravida client is pregnant for the third time. Her previous two pregnancies ended in an abortion in the first and third month of pregnancy. How will the nurse classify her pregnancy history?

G3 P0020

A pregnant woman comes to the clinic for a prenatal visit for her third pregnancy. She reveals she had a previous miscarriage at 12 weeks and her 3-year-old son was born at 32 weeks. How should the nurse document this woman's obstetric history?

G3, T0, P1, A1, L1

The nurse is educating a woman about the importance of folic acid before conception and during pregnancy, to prevent neural tube defects in the fetus. The client plans to take prenatal vitamins and minerals. What food source would the nurse recommend to add to the woman's diet?

Green leafy vegetables

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

Instruct the client to empty her bladder.

A nurse is caring for a client who is 8 months pregnant. Which instruction is the nurse mostlikely to give her?

Rest on the left side for at least 1 hour in the morning and afternoon.

The nurse is assessing a client at her first prenatal visit and reports her LMP started December 1. Which date will the nurse predict for the EDD?

September 8

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

Take antacid 1 hour after the multivitamin.

The client is 32 weeks' pregnant and has been referred for a biophysical profile (BPP) after a nonreassuring nonstress test (NST). Which statement made by the client indicates that the nurse's explanation of the procedure was effective?

The BPP is an ultrasound that measures breathing, body movement, tone, and amniotic fluid volume.

The nurse is planning a class for nurses learning to teach early prenatal classes. Which statement indicates that teaching has been effective?

The goal of early prenatal care is to optimize the health of the woman and the fetus.

The nurse is reinforcing health care provider education on the technique for an amniocentesis. Which piece of equipment will the nurse have ready?

Ultrasound equipment

A pregnant client in her second trimester informs the nurse that she needs to travel by air the following week. Which precaution should the nurse instruct the client to take during the flight?

Wear support hose.

A woman in her second trimester of pregnancy is beginning to experience more headaches. In addition to suggesting holding an ice pack to the forehead, the health care provider recommends which medication to provide some relief from the pain?

acetaminophen

A nurse is taking a history during a client's first prenatal visit. Which assessment finding would alert the nurse to the need for further assessment?

history of diabetes for 4 years

During pregnancy, the cardinal rule concerning medications and herbal remedies is that all drugs cross the placenta and have a potential impact on the fetus. What is one disease where treatment must continue during pregnancy?

asthma

A woman is 20 weeks pregnant. The nurse would expect to palpate the fundus at which location?

at the umbilicus

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

avoid medications

A nurse is reading a journal article about the use of real-time ultrasonography, which allows the health care provider to obtain information about the fetus. The nurse would expect the article to describe which type of information?

biophysical profile

While assessing a client's breast during the third trimester, which finding would the nurse expect?

colostrum from the nipples

A woman calls the prenatal clinic and says that she thinks she might be in labor. She shares her symptoms over the phone with the nurse and asks what to do. The nurse determines that she is likely in true labor and that she should head to the hospital. Which symptom is an indicator of true labor?

contractions beginning in the back and sweeping forward across the abdomen

Which disease process would the nurse screen for under potential genetic disorders?

cystic fibrosis

Some pregnant women hire a trained professional to provide support during pregnancy and birth, to provide emotional support during labor and birth, and to aid in establishing breastfeeding. What is the name of the woman who takes this role?

doula

A young woman with scoliosis has just learned that she is pregnant. Several years ago, she had stainless-steel rods surgically implanted on both sides of her vertebrae to strengthen and straighten her spine. However, her pelvis is unaffected by the condition. What does the nurse anticipate in this woman's pregnancy?

potential for greater than usual back pain

Which two tests are generally performed on urine at a prenatal visit?

protein and glucose

The nurse is preparing to administer a prescribed medication to the pregnant client. Which order should the nurse question?

rubella

If constipation is a problem for a woman during pregnancy, which measure would be best to recommend?

stopping prenatal vitamins temporarily

The nurse is assisting a primigravida on calculating the due date of her baby using Naegele rule. The most important information provided by the mother is:

the first day of the last menstrual period.

A client who is 28 weeks' pregnant asks the nurse if it is safe to use mineral oil to relieve constipation. What is the best response by the nurse?

"No, mineral oil may interfere with the absorption of fat-soluble vitamins from your diet."

The nurse advises a pregnant client to keep a small high-carbohydrate, low-fat snack at the bedside. The nurse should point out this will assist with which condition?

Nausea and vomiting

The nurse understands that the maternal uterus should be at what location at 20 weeks' gestation?

at the level of the umbilicus

What anatomic area should be examined when assessing Montgomery glands (Montgomery tubercles)?

breasts

A nurse is providing education to a client who is 8 weeks' pregnant. The client stated she does not like milk. What is a source of calcium that the nurse can recommend to the client?

dark, leafy green vegetables

A pregnant client has come to a health care provider for her first prenatal visit. The nurse needs to document useful information about the past health history. What are goals of the nurse in the history-taking process? Select all that apply.

to develop a trusting relationship with the client to prepare a plan of care that suits the client's lifestyle to prepare a plan of care for the pregnancy