Ch1 -1
The nurse is conducting a women's health class at the community center. A participant asks what is the most effective form of contraception. Which response by the nurse is most accurate?
Implants Implants and reversible long-acting contraceptives are the most effective. They have a very low failure rate, similar to permanent sterilization procedures.
The nurse is teaching a female to take her basal body temperature daily to assess the time of ovulation. What will the patient's body temperature reflect at the day of ovulation?
Increase a degree. At the time of ovulation, the basal body temperature can be seen to dip slightly (about 0.5ºF); it then rises to a level no higher than normal body temperature; it then stays at that level until 3 or 4 days before the next menstrual flow. This increase in basal body temperature marks the time of ovulation because it occurs immediately after ovulation. Upon ovulation, the basal body temperature will not decrease a degree, fluctuate, or spike and then drop.
A client has been receiving depot medroxyprogesterone acetate (DMPA) for the past 4 years. She shares with the nurse that it is time for another baby. Which response by the nurse is most accurate?
"It may take as long as 18 months for you to become pregnant." When the DMPA injections are stopped, the effects of cervical mucus thickening begin to reverse. As the progestin levels fall, ovulation is restored. While it may take up to 18 months to become pregnant, the woman can begin trying to conceive as soon as the medication is stopped.
A client comes to the clinic for her depot medroxyprogesterone acetate (DMPA) injection. However, her injection was due 4 weeks' ago. After administering the medication, what is the priority teaching the nurse should provide to this client?
"You need to use an alternative form of birth control for the next 7 days." Because the client is 4 weeks late in getting the injection the effectiveness of the contraceptive properties are decreased. Therefore, the client needs to use backup birth control for the next 7 days until the progestin levels are reestablished in her system. The most important need to address is prevention of pregnancy during the next week. More information is needed about whether or not the client is taking responsibility for her health and whether or not she has a healthy lifestyle. Reminding the client to get her injection on time is part of the discharge teaching, but preventing pregnancy is a higher priority.
A pregnant woman with gestational diabetes comes to the clinic for a fasting blood glucose level. When reviewing the results, the nurse determines that the woman is achieving good glucose control based on which result?
88 mg/dL For a pregnant woman with diabetes, the ADA and ACOG recommend maintaining a fasting blood glucose level below 95 mg/dL, with postprandial levels below 140 mg/dL at 1 hour, below 120 mg/dL at 2 hours.
Identify the abnormal portion of the fetal heart rate tracing.
Fetal bradycardia or a heart rate below 100 beats per minute is an abnormal pattern on the fetal monitoring tracing.
During a postpartum hemorrhage, the nurse anticipated administering which medication to cause vasoconstriction of the uterine vessels?
Methylergonovine Oxytocin, methylergonovine and misoprostol all stimulate the uterine muscle to contract. Methylergonovine is the only medication that also stimulates vasoconstriction of the uterine vessels, thereby decreasing bleeding. Fentanyl is a pain medication. Magnesium sulfate is a smooth muscle relaxant.
A pregnant woman comes to the clinic with a head injury. She tells the nurse that her partner came home drunk and she made him angry by not having dinner ready. He lashed out, she got in the way, and her head hit the corner on the table. What action should the nurse take in this situation?
Provide the client with contact information for a 24-hour shelter and social worker on discharge. The nurse should empower the client by making her aware of the resources and options available to her. The client cannot be forced to leave her situation, stay at a friend's home, or to report the abuse.
Identify the transducer recording the fetal heart rate.
The transducer recording is placed over the fetal back. If the fetus is in a vertex position, the transducer is on the lower portion of the abdomen.
During an ultrasound, the client's placenta is visualized low in the uterus and covers the cervix. The nurse explains to the client that this finding is a characteristic of:
placenta previa. A placenta previa is when the placenta implants in the lower uterine segment and covers the all or part of the cervix. If the placenta is covering a significant portion of the cervix, the fetus must be born by a cesarean delivery. A placental abruption is when the placenta separates from the uterine wall before the birth of the baby. A placenta accreta is when blood vessels and other parts of the placenta grow too deeply into the uterine wall. Placental insufficiency when the placenta is unable to deliver an adequate supply of nutrients and oxygen to the fetus.
