Before conception and Pregnancy (14+15)

Phases of Menstrual cycle

I. Follicular phase II. Ovulation III. Luteal phase

Intrauterine development

I. Preembryonic II. Embryonic III. Fetal

During pregnancy, does the bladder increase or decrease?

Decrease

A student nurse is concerned about learning enough about different cultures to deliver competent care. The preceptor responds by saying: A. "Responding effectively to different cultures means always using an interpreter to communicate." B. "You will never know everything so focus on cultural sensitivity for people born in other countries." C. "You will never know everything but keeping an open mind and communicating effectively will help." D. "You only need to be concerned about knowing about the main cultures in our community."

C. "You will never know everything but keeping an open mind and communicating effectively will help." Communicating effectively and keeping an open mind will help the nurse better understand patients' perspectives and needs. Providing culturally competent care is more than using an interpreter. Attempts to better understand a patient's perspectives should be made with all patients, not just specific culture groups.

"AVA"

1 vein delivers oxygenated blood to the fetus and 2 arteries deliver deoxygenated blood to placenta

During the first and second trimester, what is the expected weight gain?

1-4 lbs

Low risk maternal age

20 - 34 y.o.

Average maternal age

26.3 y.o.

A nurse is caring for a pregnant client with heart disease in a labor unit. Which intervention is most important in the first 48 hours postpartum?

Assessing for cardiac decompensation

A patient is 37 weeks pregnant and exposed to a teratogen that can impede neural tube fusion. The nurse says: A. There is little risk because the pregnancy is now in the embryonic stage. B. There is little risk because neural tube fusion is complete in the embryonic stage. C. There is little risk to any pregnancy when the mother is exposed to a teratogen. D. The pregnancy is at risk because the neural tube fuses during the fetal stage of development.

B. There is little risk because neural tube fusion is complete in the embryonic stage.

Chadwick's sign

Blue discoloration of genitalia

Presumptive signs of pregnancy

Breast tenderness Amenorrhea Nausea

Chloasma

Brown patches of hyperpigmentation on facial skin

A mother is talking to the nurse and is concerned about managing her asthma while she is pregnant. Which response to the nurse's teaching indicates that the woman needs further instruction?

I need to begin taking allergy shots like my friend to prevent me from having an allergic reaction this spring A pregnant woman with a history of asthma needs to be proactive, taking her inhalers and other asthma medications to prevent an acute asthma attack

A pregnant client with sickle cell anemia is admitted in crisis. Which nursing intervention should the nurse prioritize?

IV fluids

The fundus level begins at 12. The umbilicus is reached at 20. What is the increments in which the fundus increases in height?

Increments of 4

A nursing instructor is teaching students about anemia during pregnancy. Which type of anemia does the instructor teach students is most prevalent during pregnancy?

Iron-deficiency anemia

A nurse has written the note (above) and is concerned the client has had a relapse of depression or has developed generalized anxiety disorder (GAD). Which symptom(s) is more closely associated with GAD? Select all that apply. Fatigue Irritability Weight loss Excessive worry Insomnia

Irritability and excessive worrying

In the embryonic stage, what two major systems begin to form?

Neural tubes fuse and heart is formed

A client at 28 weeks' gestation is admitted for an exacerbation of asthma. Which test(s) will the nurse monitor to determine the severity of the exacerbation? Select all that apply. Pulse ox Hemoglobin level Arterial blood gases Peak flow measurements Serum carbon dioxide level

Pulse ox Arterial blood gases Peak flow measurements

Luteinizing hormone (LH)

Regulate length and order of menstrual cycle and can assist with implantation

A client who has had type 1 diabetes since childhood has just given birth. The client asks the nurse if giving birth will alter the need for insulin. What response will the nurse give?

Your insulin requirements will decrease, but will still be needed

What female hormone is produced on early implantation of the egg?

hCG

BMI calculation

lbs/in2 x 703

A pregnant woman with cardiac disease tells the nurse, "I want to have a healthy baby and know heavier babies are more healthy." What would be the nurse's best response to this client?

Too much weight gain could overburden your heart and circulatory system A client with cardiac disease may need closer supervision of nutrition during pregnancy than the average person, because the client must gain enough weight to ensure a healthy pregnancy and baby, but not so much that the client has to supply additional cells with nutrients

Which factor would contribute to a high-risk pregnancy?

Type 1 diabetes

What week of gestation does the embryo's final heart form?

Week 6

Can HPL lead to gestational diabetes, and why?

Yes because of the elevated maternal glucose levels

Is the following statement true or false? The purpose of obtaining a health history during pregnancy is to understand a patient's physical ailments.

False.

Ovarian cycle

Activity of ovaries to release eggs

Ductus venosus

Allows blood to bypass the liver

What female hormone can assist with egg implantation in the uterus?

LH

Embryonic stage

Lasts from Week 2 - 8

Goodell's sign

Softening of cervix

Probable signs of pregnancy

+ Pregnancy test Braxton Hick's ctx Goodell's sign Chadwick's sign

High risk maternal age

- 20 y.o. + 35 y.o.

A nursing instructor is teaching students about preexisting illnesses and how they can complicate a pregnancy. The instructor recognizes a need for further education when one of the students makes which statement?

A pregnant woman does not have to worry about contracting new illnesses during pregnancy Woman enters a pregnancy with a chronic illness, it can put both her and the fetus at risk, be cautious about developing a new illness during her pregnancy as well as having an accident during the pregnancy

A pregnant woman with a history of mitral valve stenosis is to be prescribed medication as treatment. Which medication class would the nurse expect the client to be prescribed?

Anticoagulant

A nurse is preparing a postpartum client for discharge who was diagnosed with new-onset peripartum cardiomyopathy. Related to the client's diagnosis, what information will the nurse include in the discharge instructions? Select all that apply. A. Information regarding dietary restrictions B. Follow-up appointment to see a cardiac surgeon C. Directions on how to take prescribed vasodilators D. Education on signs/symptoms of worsening condition E. Screening for newborn congenital anomalies

A. Information regarding dietary restrictions C. Directions on how to take prescribed vasodilators D. Education on signs/symptoms of worsening condition

Human placental lactogen (HPL)

Acts on maternal metabolism causing insulin resistance in cells to promote glucose circulation to fetus and lactation

Ductus arteriosus

Allows blood to bypass the lungs

The inner layer of the embryo is the amnion, and the outer layer of the embryo is the chorion. What do these fuse together to make?

Amniotic sac

A woman's obstetrician prescribes vitamin K supplements for a client who is on antiepileptic medications beginning at 36 weeks' gestation. The mother asks the nurse why she is taking this medication. The nurse's best response would be:

Anti-epileptic therapy can lead to vitamin K-deficient hemorrhage of the newborn

Umbilical cord

Conduit for blood from mother to fetus surrounded by Wharton's jelly containing "AVA"

Foramen ovale

Connects the two atria in fetus in order to bypass the lungs

A patient who is 10 weeks pregnant complains of nausea, vomiting, fatigue, and breast tenderness. Recommendations by the nurse should include: A. Looking for over-the-counter medications to help with nausea and fatigue during pregnancy. B. Notifying the provider if the patient experiences severe headache or vision changes such as blurred or double vision after 20 weeks. C. Letting the doctor know if the patient is unable to keep any food down, experiences weight loss, and is dehydrated. D. Eating small, frequent meals; napping frequently; and wearing a supportive, well-fitting bra.

D. Eating small, frequent meals; napping frequently; and wearing a supportive, well-fitting bra.

Nevi

Darkening of existing mole

A woman at 30 weeks' gestation reports to the nurse that she has been monitoring fetal movement counts (kick counts) several times a day. She states the fetus has been kicking 10 to 12 times per hour, on average. Which nursing action is indicated?

Document finding in clients chart

The nurse is assessing a pregnant client with a known history of congestive heart failure who is in her third trimester. Which assessment findings should the nurse prioritize?

Dyspnea, crackles, and irregular weak pulse The nurse should be alert for signs of cardiac decompensation due to congestive heart failure, which include crackles in the lungs from fluid, difficulty breathing, and weak pulse from heart exhaustion

Menstrual cycle

Endometrial change of the uterus

During Week 28 - 36, a mother should attend how many prenatal care visits?

Every 2 weeks

During the first and second trimester, a mother should attend how many prenatal care visits?

Every 4 weeks

What female hormone assists with the production of eggs?

FSH

Is the following statement true or false? Health outcomes improve with the amount of money spent on care.

False.

Positive signs of pregnancy

Fetal heartbeat Visualization of fetus on ultrasound

A pregnant client with deep vein thrombosis has been diagnosed as having systemic lupus erythematosus (SLE). The nurse would monitor the client closely for the development of which complication?

Fetal malnutrition Clients with SLE who become pregnant are at an increased risk of fetal malnutrition due to decreased placental circulation

What is the earliest form of an embryo to be seen on an ultrasound?

Fetal pole

Naegele's rule

First day of LMP - 3 months + 7 days = EDD

What prenatal supplements can a mother take?

Folic acid, iron, vitamin-minerals supplements

Placenta

Functions as circulation, protection, hormone production

A client with systemic lupus erythema (SLE) wants to have a baby. Which response will the nurse make after learning the client had an exacerbation of SLE 3 months ago?

It is best to wait until you have not had an exacerbation for 6 months

A pregnant client asks why a maternal serum alpha-fetoprotein level has been ordered. What should the nurse explain to the client about this test?

It may reveal chromosomal abnormalities Produced by fetal liver, can be found in amniotic fluid and maternal serum

Fetal stage

Lasts from Week 9 - birth

Preembryonic stage

Lasts from fertilized ovum to implantation

In the third trimester prenatal appointments, what is performed by the nurse?

Leopold's manuever, Group B Strep test, labs, and weekly weight gain

During ovulation, the corpus luteum degenerates to become corpus albicans. What results after corpus albicans?

Menstrual period

When does HPL present in pregnancy, early, mid, or late gestation?

Mid to late gestation

Operculum

Mucus plug in the cervix

A client who is 18 weeks' pregnant has a history of depression. For which potential effect should the nurse plan care for this client?

Preterm birth

Human chorionic gonadotropin (hCG)

Produced early implantation and doubled every 48-72 hrs and promotes continued progesterone

Progesterone

Produced from ovaries to support menstruation, lactation, and metabolic change

Follicle stimulating hormone (FSH)

Secreted from pituitary and supports menstrual cycle and production of eggs

What pregnancy test can be used for hCG?

Serum hCG pregnancy test

A woman who has sickle cell anemia asks the nurse if her infant will develop sickle cell disease. The nurse would base the answer on which information?

Sickle cell anemia is recessively inherited Sickle cell anemia is an autosomal recessive disease requiring that the person have two genes for the disease, one from each parent

Hegar's sign

Softening of uterus at 6 - 12 weeks gestation

Estrogen

Steroid hormone to support lactation, uterine ctx, attachment to placenta

A nurse expects a patient's hemoglobin and hematocrit to be lower at the end of pregnancy than they were at her initial prenatal visit. True or false.

True. Decrease in hemoglobin and hematocrit lowers from increased plasma in blood.

What hormone in the embryonic stage is important for neural development?

Thyroid hormone

A client with a body mass index (BMI) of 32 states their last menstrual period was "about 3 months" ago. Which method will the nurse anticipate being used initially to help determine the week of gestation?

Ultrasound

What week is the placenta formed?

Week 20

If a mother's gestation advances past Week 36, how often should the mother attend prenatal care visits?

Weekly

A client presents to the prenatal clinic for a first trimester visit. The client has a history of Class A pregestational diabetes. The client asks the nurse how the disease will be managed during their pregnancy. How will the nurse respond?

Your diabetes will be managed based on your glucose levels