Adaptive quizzing
Estimated delivery date can be determined by
-adding one year -subtracting 3 months -adding 7 days
What are the signs of infection for a woman who is pregnant?
-chills -fever -diarrhea -flank pain -burning on urination These findings would be reported to the health care provider for additional testing.
Lochiah would be considered excessive if the pad were saturated in ______ minutes 1 day after delivery
15
Mild preeclampsia the systolic blood pressure is below _____ mm Hg and diastolic BP is below _____ mm Hg. Proteinuria is present, but there is no evidence of organ dysfunction.
160, 110
When can a fetoscope pick up a fetal heart beat?
17 weeks
Saturating the pad in __ hours is considered heavy bleeding.
2
At what gestational age is a 1 hour glucose tolerance test completed?
24-28 weeks
The following are risk factors for women over _____ -Preterm labor -Multiple gestation -Chromosomal anomalies -Bleeding in the first trimester
35
Severe preeclampsia is a systolic blood pressure of greater than 160 mm Hg or diastolic blood pressure of at least 110 mm Hg and proteinuria of ___ g or more per 24-hour specimen.
5
Between contractions that are 2 to 3 minutes apart and last about 45 seconds the internal fetal monitor shows a fetal heart rate (FHR) of 100 beats/min. Which is the priority nursing action?
Contact the physician
____________ paper will turn dark blue if amniotic fluid is present.
Nitrazine
What are signs of thrombophlebitis?
Pain, warmth, redness in the calf
T/f? In the first trimester when fluid fills the bladder, the uterus is pushed up toward the abdominal cavity for optimum ultrasound viewing. The bladder must be full, not empty, for better visualization of the uterus.
True
What can help expel excess gas after a cesarean birth? The client also may be advised to lie on the left (not right) side and rock in a rocking chair. The client should avoid using a straw when drinking water or other fluids. Supporting the incision when moving relieves incisional pain, but does not promote expulsion of gas.
Walking around the room, not drinking from a straw, laying on the LEFT not right side
A client at 36 weeks' gestation presents with severe abdominal pain, heavy vaginal bleeding, a drop in blood pressure, and an increased pulse rate. Which complication of pregnancy is suggested by these signs and symptoms?
abruptio placentae
The separation of a normally implanted placenta before a fetus is born is called
abruptio placentae
When does the external cervical os appears as a jagged slit?
after delivery
During respiratory _______________, breathing into a paper bag or into the hands promotes the rebreathing of exhaled carbon dioxide.
alkalosis
artificial rupture of the membranes is also called
amniotomy
Carbamazepine is used as an
anticonvulsant
Which is the immediate nursing action when a client's membranes rupture spontaneously, releasing clear, odorless fluid?
assess FHR
A vertex presentation in the occiput posterior position usually causes __________ pain.
back
Involution progresses rapidly during the next few days after ________.
birth
The second stage of labor begins with full cervical dilation and ends with the ________ of the infant.
birth
___________ show may occur before or after true labor begins.
bloody
Which instruction would the nurse give to a client in labor who begins to experience dizziness and tingling of her hands?
breathe into her cupped hands
Once the membranes have ruptured, an active herpes infection ascends and can infect the fetus; because herpes does not cross the placenta, a _____________ birth prevents transfer of the virus to the fetus.
cesarean
If a patient has a positive tuberculosis screening test, a ____________ is required after 20 weeks.
chest xray
Early decelerations are associated with fetal head compression during a ___________ stress test (CST) or during labor.
contraction
Variable decelerations are associated with _______ compression during a CST or during labor.
cord
Stimulation of the fetal sympathetic nervous system is evidenced by:
decreased heart rate
Artificial rupture of the membranes (amniotomy) allows more effective exertion of pressure of the fetal head on the cervix, enhancing _________ and _______________.
dilation, effacement
Are pulses affected by thrombophlebitis?
no, it occurs in veins not arteries
Involution is the return of the uterus to a _______________ state after birth
nonpregnant
Why is hemorrhage a potential complication related to spontaneous abortion?
placental fragments could be retained or uterine atony can occur
Which action provides support for the fetal head as it is being delivered?
placing fingers around the fetal head
The nurse teaches a client who is about to undergo an amniocentesis that ultrasonography will be performed just before the procedure to determine the location of
the placenta, fetus, and pockets of amniotic fluid
Cramping and vaginal spotting occurring at 12 weeks' gestation in conjunction with a closed cervix is characteristic of which problem?
threatened abortion
Varicose veins predispose the client to ______________
thrombophlebitis
By the beginning of the 6th week of pregnancy, the cervical ____ softens.
tip
The _________________ position is used when the cord is prolapsed or the client is in shock.
trendelenberg
The major difference between true and false labor is that __________ labor can be confirmed by the presence of dilation and effacement of the cervix.
true
Which factor will increase the risk for hypotonic uterine dystocia in a postpartum client?
twin gestation because the uterine wall is overstretched and contractions are less efficient
Which test is used to confirm cephalopelvic disproportion?
ultrasound NOT DIGITAL PELVIMETRY
What causes variable decelerations?
umbilical cord compression
When a patient delivers a large infant, the uterine musculature has been stretched and impairs the ability for the ________ to contract after birth.
uterine
Late decelerations during a CST or during labor are associated with
uteroplacental insufficiency
What causes late decelerations>?
uteroplacental insufficiency
Immediately after birth, the risk for cardiac decompensation occurs when extravascular fluid is remobilized in to the __________ space.
vascular
If the first twin is in the ___________ presentation, a vaginal birth will be attempted with a double setup; if possible, the birth of the second twin also will be attempted vaginally.
vertex
T/f? breastfeeding lessens the chance of postpartum hemorrhage because it stimulates uterine contractions.
True
Nitrazine paper is utilized to determine if __________ rupture has occurred
membrane
Aortic stenosis has a high risk of maternal ___________.
mortality
During pregnancy, the cervical _________ and its collagen-rich connective tissues increase in volume and become loose and highly elastic. Cervical tissue fragility also INCREASES.
muscle
Carbamazepine is associated with ________ tube defects.
neural
Is blood pressure affected by spontaneous membrane rupture?
no
Can a fetal heart beat be heard at 4 weeks with a stethoscope?
no it is too early
With an occiput ___________ position the labor may be longer, but usually the mother can give birth vaginally.
posterior
A (prolonged/short) third stage of labor is a risk factor for postpartum hemorrhage.
prolonged-30 minutes
A primigravida who is at 40 weeks' gestation arrives at the birthing center with abdominal cramping and a bloody show. Her membranes ruptured 30 minutes before arrival. A vaginal examination reveals 1 cm of dilation and the presenting part at -1 station. Which action would the nurse take after obtaining the fetal heart rate and maternal vital signs?
promote relaxation techniques since the patient is in the first stage of labor
Does amniotic fluid provide protection or nutrition>?
protection
What two cardiac conditions have the highest risk for mortality?
pulmonary hypertension and endocarditis
At the moment of birth, the pressure on the veins is ____________, the intra-abdominal pressure decreases dramatically, and the blood flow to the heart is significantly increased.
removed
The priority assessment for a client with marginal abruptio placentae includes fetal status, vital signs, skin color, and urine output. Which additional assessment is essential?
Assessment of the fundal height; an increase in fundal height can indicate a concealed hemorrhage.
Which descriptor would the nurse use when explaining to a client how to time the frequency of contractions?
From the beginning of one contraction to the beginning of the next contraction
Why would a patient who is experiencing dizziness and tingling in the hands not pant 3x before the next contraction?
It could further worsen the respiratory alkalosis and hyperventilation
The membranes may ____________ before or after labor begins.
rupture
A ____________ presentation in a multipara is indicative of a transverse lie, and this necessitates a cesarean birth.
shoulder; it indicates a transverse lie
Bleeding in the first trimester is more common to mature gravitas (>35 years) and is called
spontaneous abortion
What is useful to for a woman with a history of preterm labor who is sent home on bedrest?
Placing herself in a side lying position with a head raised by a small pillow; this keeps the gravid uterus from impeding blood flow through major vessels, thus maintaining uterine perfusion.
The nurse applies fetal and uterine monitors to the abdomen of a client in active labor. When the client has contractions, the nurse notes a 15 beats/min deceleration of the fetal heart rate below the baseline lasting 15 seconds. Which is the next nursing action?
Reposition the mother since the fetus is probably experiencing cord compression. `
A nonstress test (NST) is scheduled for a client with mild preeclampsia. During an NST, the client asks what it means when the fetal heart rate goes up every time the fetus moves. Which is an appropriate response?
The accelerations indicate fetal well being
Why are mature gravidas more prone to having multifetal pregnancies?
The consumption of fertility medication or in vitro fertilization
A cesarean birth may be performed when the fetus is in the ______________ presentation because the risk of morbidity and mortality is increased.
breech
Labor is usually longer with a fetus in the ___________ presentation because the buttocks are not as effective as the head as a dilating wedge.
breech
For which reason is an ultrasound done during the first trimester?
determine fetal age
A fetal heartbeat can be obtained at 10 to 12 weeks with electronic ____________ ultrasound.
doppler
A client with patient _________ _________ has the lowest risk for maternal mortality.
ductus arteriosus
___________ is the gentle stroking of the abdomen in rhythm with her breathing during a contraction.
effleurage
The third stage of labor begins after birth, continues until the separation of the placenta from the uterine wall, and ends with the _____________ of the placenta.
expulsion
A FHR is decelerates to 100bpm when contractions are 2-3 minutes apart and last 45 seconds. What does this indicate>
fetal compromise is evident; medical intervention needs to occur
The transition phase of labor is the last phase of the ________ stage of labor. The onset of strong contractions occurs during the active phase of the first stage of labor.
first
During the initial prenatal visit, a cervical culture for _________________ is obtained.
gonorhhea
Vaginal and anal cultures for ___________` are obtained at 35 to 37 weeks of gestation.
group B streptococcus (GBS)
What is a likely complication of spontaneous abortion?
hemorrhage
________________ and consequent hypovolemic shock are dangers for the woman with a placental abruption/abruptio placentae.
hemorrhage
The nurse teaching a prenatal class is asked why infants of diabetic mothers are larger than those born to women who do not have diabetes. On which information about pregnancy and diabetes would the nurse base the response?
hyperglycemia crosses over to the fetus and causes an increase in fatty deposits
Subinvolution is the self-destruction of excess _________________ tissue; this process may be caused by retained placental fragments or infection.
hypertrophied
Dizziness and tingling of the hands are signs of respiratory alkalosis, most likely the result of _________________________.
hyperventilating
At the end of the second trimester and the beginning of the third trimester, insulin needs ___________ because of an increase in maternal resistance to insulin.
increase
Which complication is the result of type 1 diabetes in a pregnant client?
increased risk for hypertensive states
Placing the fingers around the head will prevent a rapid change in ______________ pressure while the head is being born and keeps the head from "popping out," which could result in maternal perineal trauma.
intracranial
The contraction of muscle fibers, catabolism, and the regeneration of the uterine epithelium describes the process of
involution
Why is FHR assessed after spontaneous membrane rupture?
it indicates how well the fetus tolerated it
Postpartum hemorrhage is greater with delivery of ____________ infants.
large
___________ is a common finding in the amniotic fluid of a client whose fetus is in a breech presentation, because contractions compress the fetal intestinal tract, causing its release.
meconium
