271 PrepUs - Week 9 (Reproduction)

Pleural Effusions

Defined as abnormal fluid in the pleural cavity

Dystocia

Defined as difficult labor

Mastitis

Defined as inflammation of the breast (mammary gland)

Tachypnea

Defined as rapid breathing

The client will demonstrate the ability to differentiate between perceptual disturbances and reality. (inability to differentiate perceptual disturbances from reality is a hallmark of psychosis, and the ability to do so should be a priority goal in the care of a client with postpartum psychosis.)

A 29-year-old first-time mother has been diagnosed with postpartum psychosis after her partner reported the client was hearing voices and told the partner she "saw someone trying to steal the baby." In the planning of this client's care, which outcome should the nurse prioritize?

Will be prescribed Tocolytics

A 7 months' pregnant woman is experiencing contractions. She is admitted to the hospital in preterm labor. What will be prescribed to stop the labor?

headache following anesthesia

A client in active labor is given spinal anesthesia. Which information would the nurse include when discussing with the client and family about the disadvantages of spinal anesthesia?

Use a warm moist compress over the painful area. (This will reduce inflammation and edema of the infected breast tissue. The woman with mastitis should wear a proper fitting bra with good support. Breast-feeding does not have to be interrupted. The client will also need to pump the breast to keep the breast empty of milk and to ensure an adequate milk supply. Adequate emptying of the affected breast helps prevent more bacteria from collecting in the breast and may shorten the duration of the infection. Antibiotics must be taken for the full course of therapy and not stopped when symptoms subside.)

A client is 9 days postpartum and breast-feeding her neonate. The client experiences pain, redness, and swelling of her left breast and is diagnosed with mastitis. The nurse teaching the client how to care for her infected breast should include which information?

Progesterone (increases smooth muscle relaxation, thereby decreasing peristalsis. This slowed movement of contents through the gastrointestinal system can lead to firmer stools and constipation.)

A client who is 14 weeks' pregnant mentions that she has been having difficulty moving her bowels since she became pregnant. Which hormone is responsible for this common discomfort during pregnancy?

G3 P0020 (-Gravida (G) is the total number of pregnancies she has had, including the present one. Therefore she is G3 and not G2. -Para (P), the outcome of her pregnancies, is further classified by the FPAL system as follows: -F = Full term: number of babies born at 37 or more weeks of gestation, which is 0 and not 1 in this case. -P = Preterm: number of babies born between 20 and 37 weeks of gestation, which is 0 in this case. -A = Abortions: total number of spontaneous and elective abortions, which is 2 in this case. -L = Living children, as of today. She has no living children; therefore, it is 0 and not 1.)

A 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?

Embryonic stage and teratogens

A nurse is counseling pregnant women about the detrimental effects of smoking and drinking on a fetus. During what stage of development is the fetus most susceptible to these teratogens?

Mercury attacks the nervous tissue. (Lead and mercury attack and disable nervous tissue.)

A nurse is giving a prenatal class on teratogens that have an affinity for specific body tissues. Which teratogen is accurately paired with the specific body tissue affected?

-Holds new child and breastfeeds without prompting -Expresses a strong interest in taking care of her child

A postpartum client is experiencing thoughts and behaviors common to the taking-hold phase. Which items are characteristic of this phase?

Monophasic

A postpartum client visits her physician to discuss contraception. After a thorough discussion, the client decides to use hormonal contraceptives. The healthcare professional orders ethinyl estradiol-ethynodiol diacetate, one tablet by mouth daily, followed by 7 days without a dose before beginning the next cycle of tablets. Which type of combination hormonal contraceptive is ethinyl estradiol-ethynodiol diacetate?

Ectopic pregnancy

A pregnancy outside of the womb, usually in a fallopian tube (A fertilized egg in any site other than the normal uterine location)

Long axis of fetus is perpendicular to that of client

A pregnant client is admitted to a maternity clinic for birth. Which assessment finding indicates that the client's fetus is in the transverse lie position?

Hemorrhoids (displacement of the intestines and possible slowed motility of the intestines can lead to constipation in the pregnant woman. This, along with elevated venous pressure, can lead to development of hemorrhoids.)

A pregnant mother may experience constipation and the increased pressure in the veins below the uterus can lead to development of what problem?

Occurring about every 5 minutes (True labor contractions are commonly felt in the lower back, in contrast to Braxton Hicks contractions that typically last about 30 seconds and occur primarily in the abdomen and groin and are relieved by walking, voiding, eating, increasing fluid intake, or changing positions.)

A pregnant woman at 37 weeks' gestation calls the clinic to say she thinks that she is in labor. The nurse instructs the woman to go to the health care facility based on the client's report of contractions that are:

Administer oxygen by mask (An amniotic embolism quickly becomes a pulmonary embolism. The woman needs oxygen to compensate for the sudden blockage of blood flow through her lungs.)

A woman experiences an amniotic fluid embolism as the placenta is delivered. The nurse's first action would be to:

Providing a comfortable environment with dim lighting

A woman is experiencing dystocia that appears related to psyche problems. Which intervention would be most appropriate for the nurse to initiate?

She has a family history of thromboembolism. (The estrogen content of birth control pills may lead to increased blood clotting, leading to an increased incidence of thromboembolism. Women who already are prone to this should not increase their risk further.)

A woman visits the family planning clinic to request a prescription for birth control pills. What factor would indicate that an ovulation suppressant would not be the best contraceptive method for her?

Assess the amount of cervical dilation (dilatation).

During an admission assessment of a client in labor, the nurse observes that there is no vaginal bleeding yet. What nursing intervention is appropriate in the absence of vaginal bleeding when the client is in the early stage of labor?

Embryonic stage (a period of such rapid growth and change, the embryo is especially vulnerable to any factor that might cause congenital anomalies)

At which stage of pregnancy is the developing fetus most at risk for developing congenital anomalies?

-Women should take their temperature for 5 minutes at the same time every morning on awakening, before arising or starting any activity. -Doing so prevents other factors, such as eating or moving, from possibly influencing body temperature. The temperature reading should be recorded on a graph. -In some women, a slight drop in body temperature occurs just before ovulation. However, a woman cannot determine exactly when ovulation occurs until it has actually happened. Typically, ovulation occurs when the slight drop in body temperature is followed by temperature rise. This temperature rise is maintained for the remainder of the menstrual cycle. -Taking the basal body temperature at times other than on awakening, such as before bedtime, may result in inaccurate readings because the client's temperature may be affected by numerous factors, causing fluctuations. -Basal body temperature can be an effective fertility management method if the client is motivated and able to perform the procedure correctly. Unfortunately it is one of the least reliable methods. -Generally clients who choose this method do not wish to use other chemical or barrier methods for a variety of reasons.

Basal body temperature method and benefits

Lung and ovarian cancers (Lung cancers, breast cancers, and lymphomas account for about 75% of malignant pleural effusions.)

In some cancers, the presenting factor is an effusion, or fluid, in the pleural, pericardial, or peritoneal spaces. Research has found that almost 50% of undiagnosed effusions in people not known to have cancer turn out to be malignant. Which cancers are often found because of effusions?

PID

Known as pelvic inflammatory disease and more likely to have an ectopic pregnancy

Birth Canal

The cervix and vagina are soft tissues that form the part of the passageway known as this

amnion

The fluid-filled, inner membrane sac surrounding the fetus is which structure?

1 cm below the umbilicus (The fundus of the uterus may be palpated through the abdominal wall halfway between the umbilicus and the symphysis pubis within a few minutes after birth. Within 6-12 hours, it rises to the level of the umbilicus. By 24 hours after birth, the fundus will decrease one fingerbreadth (1 cm) and therefore should be found at 1 cm below the umbilicus. The fundus should continue to descend at a rate of 1 cm per day and no longer be palpable by day 10 postpartum (once it descends into the pelvis).)

The nurse assesses the fundus of a woman who gave birth to a baby 24 hours ago. Where would the nurse expect the fundus to be located at this time?

"Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)." (Ovulation is controlled by FSH and LH, with the follicle-stimulating hormone encompassing days 1 to 14 of a 28-day cycle and the luteinizing hormone controlling the luteal phase, which is days 15 to 28.)

The nurse educates a client who is confused about her ovarian cycle. Which client statement would best validate her understanding of the education?

Monitor the client's vital signs and bleeding. (monitor vitals (peritoneal or vaginal) to identify hypovolemic shock that may occur with tubal rupture)

The nurse is caring for a pregnant client with fallopian tube rupture. Which intervention is the priority for this client?

Cleft lip with or without cleft palate.

The nurse is explaining congenital defects to a newly pregnant client. She explains that one of the most common birth defects is:

Lack of thoracic compressions during birth (A baby born by cesarean birth does not have the same benefit of the birth canal squeeze as does the newborn born by vaginal birth. This may result in the fluid in the lungs being removed too slowly or incompletely. Research findings support the need for thoracic compression to assist with the removal of the fluid and facilitate adequate breathing in the newborn.)

The nurse is explaining to new parents that a potential complication of a cesarean birth is transient tachypnea of the newborn. The nurse explains that this is due to which occurrence?

Bladder distention (Ask the client to void and then reassess the uterus.)

The nurse is performing an assessment on a 2-day postpartum client and discovers a boggy fundus at the umbilicus and slightly to the right. The nurse determines that this is most likely related to which situation?

1 cm above the ischial spines. (Station refers to the relationship of the presenting part to the level of the maternal pelvic ischial spines. Fetal station is measured in centimeters and referred to as a minus or plus, depending on its location above or below the ischial spines.)

The nurse is providing care to a client in labor. On examination, the nurse determines the fetus is at -1 station. The nurse interprets this as indicating that the fetus is:

Condoms or not having sex.

The nurse should inform a young female client that the barrier method providing the best protection against sexually transmitted infections (STIs) is:

-Microcephaly -Skeletal malformations -Intellectual disability (Heavy doses of ionizing radiation are teratogenic and mutagenic and have the capacity to effect inheritable changes in genetic material.)

The nurse teaches the pregnant radiation technologist that excessive levels of radiation have been shown to cause which conditions?

The fallopian tubes (Once fertilized, the fertilized egg moves to the uterus for implantation.)

The typical site of ovum fertilizations

Oral contraceptive pills (OCPs)

These drugs need to be taken on a daily basis to prevent breakthrough ovulation. Oral contraceptive pills do not protect against STIs, and clients still need to use STI protection such as condoms.

Tocolytics

These, are uterine relaxants that are used to stop labor contractions that occur before the completion of the 37th week of gestation.

Oxytocics

These, are uterine stimulants used to initiate or augment a contractile pattern of labor.

Vernix Caseosa

This is a whitish, waxy, or cheesy, substance that serves as a protective covering over the fetal body throughout the pregnancy and usually disappears by term gestation

Meconium aspiration

This is defined as fetal aspiration of amniotic fluid containing meconium

Cryptorchidism

This is defined as undescended testicles

Enterocele

This occurs when the small intestine bulges through the posterior vaginal wall.

Uterine prolapse

This occurs when the uterus descends through the pelvic floor and into the vaginal canal.

The letting-go phase

This phase, begins when the mother accepts her real child and incorporates the neonate into the family unit. (Focuses on family and individual roles)

The taking-in phase

This phase, occurs in the first 24 hours after birth. The mother is concerned with her own needs and requires support from staff and relatives. She holds her new child with a sense of wonder and rests to gain her physical strength and calm her thoughts. 24-48 hours after birth: dependent, passive; focuses on own needs; excited, talkative

The taking-hold phase

This phase, occurs when the mother is ready to take responsibility for her care, as well as her neonate's care. (focuses on maternal role and care of the newborn; eager to learn; may develop blues)

The third stage of labor

This stage of labor begins with the documented time of birth and is completed with the delivery of the placenta

Incomplete miscarriage

This, is when a miscarriage begins, but the pregnancy doesn't completely come away from the womb. Some pregnancy tissue will remain in the uterus. Vaginal bleeding and lower abdominal cramping may continue as the uterus continues trying to empty itself.

Cystocele

This, occurs when the posterior bladder wall protrudes downward through the anterior vaginal wall.

Rectocele

This, occurs when the rectum sags and pushes into or against the posterior vaginal wall.

Advise the woman that this is a normal occurrence after stopping breast-feeding (a woman may have leakage for 3 months to 1 year.)

What should the nurse do when a woman who stopped breast-feeding her infant 3 months ago complains of occasional milk leakage from her breasts?

-BRCA1 gene -menarche at age 11 -being a 52-year-old female

When preparing for a class on breast cancer, the nurse should explain which nonmodifiable risk factors?

Should be applied to the abdomen, buttocks, or back. ((never the breasts). The patch is safe for wearing during swimming and bathing. The patch requires application for 1 week before becoming effective.)

When using the contraceptive patch, a client should understand that it:

Estrogen Progesterone (have the principal effects of promoting secondary sexual characteristics and preparing the female body for pregnancy.)

Which hormones are produced by the ovaries?

Dilation and curettage (D & C)

Which of the following diagnostic tests is used as a therapeutic measure for incomplete miscarriage?

Using a reliable method of contraception for several weeks. (It may take several weeks or more after surgery before the ejaculatory fluid is free of sperm, and the client is informed to use a reliable method of contraception until sperm no longer are present.)

Which of the following would be most important to include in a teaching plan for a client who has had a vasectomy?

Vaginal examination (contraindicated in a client with bright red vaginal bleeding until placenta previa is ruled out.)

Which procedure is contraindicated in an antepartum client with bright red, painless bleeding?

Low T4 level and high TSH level

Which results would indicate to the nurse the possibility that a neonate has congenital hypothyroidism?

Meconium stained fluids followed by tachypnea

Which symptom would most accurately indicate that a newborn has experienced meconium aspiration during the birth process?