Nursing 317: Intrapartal and Antepartal Care NCLEX questions and Review

What does the first letter in the fetal position abbreviation signify?

-The first letter describes the side of the maternal pelvis toward which the presenting part is facing ("R" for right and "L" for left).

Engagement occurs when...

-The greatest transverse diameter of the head passes through the pelvic inlet.

What is the presenting part of a cephalic/vertex fetal presentation?

-The head

A woman's husband expresses concern about risk of paralysis from an epidural block being given to his wife. What sort of statement would be the most appropriate response by the nurse?

-The injection is given in the space outside the spinal cord.

What does the Third letter in the fetal position abbreviation signify?

-The last part of the designation specifies whether the presenting part is facing the anterior (A) or the posterior (P) portion of the pelvis, or whether it is in a transverse (T) position.

Crowning occurs when...

-The top of the fetal head appears at the vaginal orifice and no longer regresses between contractions.

What are the 6 major concepts that make labor and birth as natural as possible?

1) labor should begin on its own, not be artificially induced 2) women should be able to move about freely throughout labor, not be confined to bed 3) women should receive continuous support from a caring other during labor; 4) no interventions such as intravenous fluid should be used routinely 5) women should be allowed to assume a nonsupine position such as upright and side-lying for birth 6) mother and baby should be housed together after the birth, with unlimited opportunity for breastfeeding.

Marked FHR fluctuation range...

>25 beats per minute.

How can you find the EDD from the LMP or the LMP from the EDD?

According to Naegele rule, to find the EDD; take the LMP and add 7 days and subtract 3 months. If finding the LMP from the EDD, subtract 7 days and add 3 months.

What is Fundal height?

Fundal height is an approximation of the number of weeks of gestation. Between 20 to 32 weeks, SFH = gestation in weeks + or - 2 cm.

During the inital obstetrical clinic visit, the nurse shares with a client that several blood studies will be drawn. What screening is performed for Black women because of the ethnically inherited nature of the disease?

Sickle-cell trait or disease

What is the most common cause of uteroplacental insufficiency?

-Compression of the vena cava

When caring for a client in labor, the nurse should monitor for an increase in the heart rate by ___ to ___ bpm

-10 to 20

The diagonal conjugate, which indicates the anteroposterior diameter of the pelvic inlet is usually...

-12.5 cm or greater

Between weeks ____ and ____ the fundal height in centimeters should match the gestational age of the pregnancy.

-18 and 32

The nurse is teaching a pregnant client some nonpharmacologic ways to handle common situations encountered during pregnancy. The nurse determines the session is successful when the client correctly chooses which condition that can be minimized if she avoids drinking fluids with her meals? -Nosebleeds -Heartburn -Blood clots -Constipation

-Heartburn

Controlled chest breathing is a technique used in ______ breathing.

-Lamaze

Increasing levels of _________ cause relaxation of ligaments and joints.

-Progesterone

the FPAL system

F=Full Term: number of babies born at 37 or more weeks of gestation P=Preterm: number of babies born between 20 and 37 weeks of gestation A=Abortions: total number of spontaneous and elective abortions L=Living children, as of today

A nurse is classifying the pregnancy history of a woman who has had five pregnancies: three full-term, one preterm, and one abortion. How would the nurse document this information on the patient chart?

G5 P3114

How might a pregnant woman lessen nausea or vomiting?

-Nausea and vomiting can be lessened by limiting intake of fatty and greasy foods and eating small frequent meals every 2 to 3 hours.

A primigravidia client at 38 weeks' gestation calls the clinic and reports, "My baby is lower and it is more difficult to walk." Which response should the nurse prioritize? -"The baby has dropped into the pelvis; your body and baby are getting ready for labor in the next few weeks." -"This is not normal unless you are in active labor; come to the hospital and be checked." -"That is something we expect with a second or third baby, but because it is your first, you need to be checked." -"The baby moved down into the pelvis; this means you will be in labor within 24 hours, so wait for contractions then come to the hospital."

-"The baby has dropped into the pelvis; your body and baby are getting ready for labor in the next few weeks." The baby can drop into the pelvis, an event termed lightening, and can happen for up to 2 weeks before the woman goes into labor. This is normal and does not require intervention.

A woman, who has been in labor for a few hours, is now complaining of being hungry. Which response by the nurse would be best if the client asks for some food to eat? -"You could have some hard candy to suck on." -"What would you like to eat?" -"You can have a protein supplement." -"I can get you something soft and easy to digest, like pudding."

-"You could have some hard candy to suck on." The woman can be encouraged to sip fluid, ice chips, or suck on hard candy if they become thirsty or nauseated by labor. It also helps to supply extra fluid. Although many hospital protocols dictate that women who present in labor should not partake of oral nutrition, there is little evidence to support this restrictive practice. However, if women are kept NPO during labor, they can be administered anesthesia safely in an emergency.

At ___ weeks' the fundal height should be at the umbilicus.

-20

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? -28 weeks, 24 weeks, or 30 weeks?

-24 weeks

When caring for a client in labor, the nurse should monitor for an increase in blood pressure by as much as ___ mm Hg

-35

Moderate (normal) FHR fluctuation range from...

-6 to 25 beats per minute

The ____is the peak intensity of a contraction.

-Acme

Which anti-viral drugs may be safely administered to pregnant women with HSV who develop lesions during pregnancy as well as to their newborns at birth?

-Acyclovir or Valacyclovir

A client in labor has requested the administration of narcotics to reduce pain. At 2 cm cervical dilatation, she says that she is managing the pain well at this point but does not want it to get ahead of her. What should the nurse do? -Advise the client to hold out a bit longer, if possible, before administration of the drug, to prevent slowing labor. -Agree with the client, and administer the drug immediately to keep the pain manageable. -Explain to the client that narcotics should only be administered an hour or less before birth. -Refuse to administer narcotics because they can develop dependency in the client and the fetus.

-Advise the client to hold out a bit longer, if possible, before administration of the drug, to prevent slowing labor. The timing of administration of narcotics in labor is especially important as, if given too early (before 3 cm cervical dilatation), they tend to slow labor. If given close to birth, because the fetal liver takes 2 to 3 hours to activate a drug, the effect will not be registered in the fetus for 2 to 3 hours after maternal administration. For this reason, narcotics are preferably given when the mother is more than 3 hours away from birth. This allows the peak action of the drug in the fetus to have passed by the time of birth.

Restitution or External Rotation occurs...

-After the head is born and free of resistance. It untwists, causing the occiput to move about 45 degrees back to its original left or right position.

After which week might the uterus be palpated above the umbilical?

-After week 20

What is the difference between Analgesia and Anesthesia?

-Analgesia only reduces pain, but anesthesia partially or totally blocks all pain in a particular area.

How can anxiety affect the labor process?

-Anxiety can slow down labor and decrease oxygen to the fetus.

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? -Monitor vital signs. -Assess amount of cervical dilation. -Obtain urine specimen for urinalysis. -Monitor hydration status.

-Assess amount of cervical dilation. If vaginal bleeding is absent during admission assessment, the nurse should perform vaginal examination to assess the amount of cervical dilation. Hydration status is monitored as part of the physical examination. A urine specimen is obtained for urinalysis to obtain a baseline. Vital signs are monitored frequently throughout the maternal assessment.

What should a pregnant woman avoid to lessen nausea and vomitting?

-Avoid drinking liquids with meals; avoid coffee, tea, and spicy foods; and eliminate individual food intolerances.

Before which week is the uterus too low to be palpated?

-Before week 20

What is a Doula?

-Birth coaches who provide one-on-one support in labor and throughout birth. -Does not take the place of a nurse or client's partner but is there to assist in the process. -There would be no need to print off any instructions for them to sign off.

Braxton Hicks contractions are termed "practice contractions" and occur throughout pregnancy. When the woman's body is getting ready to go into labor, it begins to show anticipatory signs of impending labor. Among these signs are Braxton Hicks contractions that are more frequent and stronger in intensity. What differentiates Braxton Hicks contractions from true labor?

-Braxton Hicks contractions occur more frequently and are more noticeable as pregnancy approaches term. These irregular, practice contractions usually decrease in intensity with walking and position changes.

What are the three main fetal presentations?

-Cephalic/Vertex -Breech -Shoulder

What is the normal color of amniotic fluid?

-Clear to straw-colored

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

-Colostrum from the nipples

The nurse is admitting a client who is in labor who reports her husband and doula will be arriving shortly. Which action should the nurse prioritize in response? -Determine what activities the doula is qualified to handle -Ask the client who she wants to come in first -Continue with the admission assessment -Print a copy of the instructions for the doula to sign off

-Continue with the admission assessment The nurse should continue with the assessment to establish a baseline for the client and determine her status. This could include asking any personal questions which might be inappropriate to ask in front of the doula. Doulas are birth coaches who provide one-on-one support in labor and throughout birth. A doula does not take the place of a nurse or client's partner but is there to assist in the process. There would be no need to print off any instructions for the doula to sign off.

The nurse is preparing a young couple for the upcoming birth of their child, and the mother expresses concern for needing pain medications and the effects on the fetus. When counseling the couple about pain relief, the nurse would incorporate which information in the teaching about measures to help to decrease the requests for pain medication? -Continuous support through the labor process helps decrease the need for pain medication. -Sitting in a hot tub helps decrease the need for pain medication. -A quick epidural can replace the need for pain medication. -Lying on an ice pack can help decrease the need for pain medication.

-Continuous support through the labor process helps decrease the need for pain medication.

The six cardinal movements of the fetus are...

-Descent, flexion, internal rotation, extension, external rotation, expulsion.

A 39-week-gestation client presents to the labor and birth unit reporting abdominal pain. What should the nurse do first? -Determine if the client is in true or false labor. -Ask if this is the client's first pregnancy. -Notify the healthcare provider. -Assess to see if the client has any drug allergies.

-Determine if the client is in true or false labor.

______ refers to the relaxation phase of a contraction.

-Diastole

A nurse is caring for a pregnant client in labor in a health care facility. The nurse knows that which sign marks the termination of the first stage of labor in the client? -Diffuse abdominal cramping -Rupturing of fetal membranes -Start of regular contractions -Dilation of cervix diameter to 10 cm

-Dilation of cervix diameter to 10 cm The first stage of labor terminates with the dilation of the cervix diameter to 10 cm. Diffused abdominal cramping and rupturing of the fetal membrane occurs during the first stage of labor. Regular contractions occur at the beginning of the latent phase of the first stage; they do not mark the end of the first stage of labor.

Descent is the...

-Downward movement of the fetal head until it is within the pelvic inlet.

Softening, thinning, and shortening of the cervical canal occurring during the first stage of labor is...

-Effacement

How often should the FHR be assessed during the second stage of labor for a low-risk woman?

-Every 15 minutes

How often should the FHR be assessed during the second stage of labor for a high-risk woman and during the pushing stage?

-Every 5 minutes.

When providing preconception care to a client, the nurse would identify which medication as being safe to continue during pregnancy? -Isotretinoin -Lithium -Warfarin -Famotidine

-Famotidine Famotidine is a category B drug that has been used frequently during pregnancy and does not appear to cause major birth defects or other fetal problems. Isotretinoin and warfarin are category X drugs and should never be taken during pregnancy. Lithium is a category D drug with clear health risks for the fetus and should be avoided during pregnancy.

The nurse is admitting a client in early labor and notes: FHR 120 bpm, blood pressure 126/84 mm Hg, temperature 98.8oF, contractions every 4 to 5 minutes lasting 30 seconds, and greenish-color fluid in the vaginal vault. Which finding should the nurse prioritize? -Fetal heart rate -Possible maternal infection -Meconium in the fluid -Irregular contractions

-Meconium in the fluid Green tinted fluid with ROM is indicative of meconium in the amniotic sac, or the infant having a bowel movement in utero.

The nurse is admitting a client who is in early labor. After determining that the birth is not imminent, which assessment should the nurse perform next? -Risk factors -Maternal status -Fetal status -Maternal obstetrical history

-Fetal status The woman may present to the birthing suite at any phase of the first stage of labor. Therefore, it is important to assess birth imminence, fetal status, risk factors, and maternal status immediately. If birth is not imminent and the fetal and maternal conditions are stable, perform additional data collection, including the full admission health history, a complete maternal physical assessment, the status of labor and any labor, birth, and cultural preferences the woman may have.

Pregnant women should avoid hot tubs, saunas, whirlpools, and tanning beds because the heat may cause...

-Fetal tachycardia -Additionally, exposure to bacteria is a risk factor

Generally, painful urination, severe/ persistent vomiting, and lower abdominal and shoulder pain are the danger signs that the client has to monitor for during the ______ trimester of pregnancy.

-First

A client is in active labor. Checking the EFM tracing, the nurse notes variables that are abnormal. What would be the nurse's first nursing intervention?

-First, the nurse should assist the woman to change positions and try to find a position that is comfortable for the woman that relieves the compression. If the variables stop after the position change, the nurse will know that the compression has been relieved. However, if the variables continue, the nurse should try a variety of position changes, including the knee-chest position.

What is a Tocometer used for?

-For Cardiotocography (CTG); to monitor the fetal heart rate and maternal contractions

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 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 -G2 P0020 -G2 P1020 -G3 P0021

-G3 P0020

Which nursing action is a priority when the fetus is at the +4 station? -Have a blue bulb suction and an infant warmer ready -Have a tocometer and a patient gown ready -Provide lubricating jelly and an internal monitor -Prepare for an immediate cesarean section

-Have a blue bulb suction and an infant warmer ready At the station +4, the fetus is being born. The priority nursing action is to have a blue bulb or suction device for airway clearance and an infant warmer ready.

To give birth to her infant, a woman is asked to push with contractions. Which pushing technique is the most effective and safest? -Lying supine with legs in lithotomy stirrups -Squatting while holding her breath -Head elevated, grasping knees, breathing out -Lying on side, arms grasped on abdomen

-Head elevated, grasping knees, breathing out An important point is to be certain the woman does not hold her breath, as this puts pressure on the vena cava, reducing blood return.

During the initial clinic visit for a primapara woman, the nurse reviews the topic of constipation during pregnancy when the woman interjects that she has been "straining forcefully" almost on a daily basis. The nurse offers some measures that may help to prevent the occurrence of which complication?

-Hemorrhoid development that may eventually need surgical repair

The nurse is teaching a prenatal class on the difference between true and false labor contractions. The nurse determines the session is successful when the class correctly chooses which factor as an indication of true labor contraction? -Increase even if relaxing and taking a shower -Remain irregular with the same intensity -Subside when walking around and use the lateral position -Cause discomfort over the top of uterus

-Increase even if relaxing and taking a shower

A nurse is caring for a pregnant client who is in labor. Which maternal physiologic responses should the nurse monitor for in the client as the client progresses through birth? Select all that apply. -Increase in heart rate -Increase in blood pressure -Increase in respiratory rate -Slight decrease in body temperature -Increase in gastric emptying and pH

-Increase in heart rate -Increase in blood pressure -Increase in respiratory rate

A pregnant client is admitted to a maternity clinic for birth. The client wishes to adopt the kneeling position during labor. The nurse knows that which to be an advantage of adopting a kneeling position during labor? -It helps the woman in labor to save energy. -It facilitates vaginal examinations. -It facilitates external belt adjustment. -It helps to rotate fetus in a posterior position.

-It helps to rotate fetus in a posterior position.

Why is a Papanicolau test done at the first prenatal visit?

-It identifies abnormal cervical cells; tests for cervical cancer. Should abnormal cells be present, the woman may need to make a decision about her priorities of therapy for cervical disease or continuing the pregnancy.

What is a gynecoid pelvis and how does it relate to the birthing process?

-It is rounded in shape and allows ample room for the neonate to fit through the passageway -Most favorable for a vaginal birth

The student nurse is preparing to assess the fetal heart rate (FHR). She has determined that the fetal back is located toward the client's left side, the small parts toward the right side, and there is a vertex (occiput) presentation. The nurse should initially begin auscultation of the fetal heart rate in the mother's: (Quadrant)

-Left lower quadrant

A client calls the clinic asking to come in to be evaluated. She states that when she went to bed last night the fetus was high in the abdomen, but this morning the fetus feels like it has dropped down. After asking several questions, the nurse explains this is probably due to:

-Lightening

Teratogenic effects of Thalidomide are...

-May cause limb defects

General anesthesia is not used frequently in obstetrics because of the risks involved. There are physiologic changes that occur during pregnancy that make the risks of general anesthesia higher than it is in the general population. What is one of those risks? -The client is more sensitive to preanesthetic medications. -The client is less sensitive to inhalation anesthetics. -Neonatal depression is possible. -Fetal hypersensitivity to anesthetic is possible.

-Neonatal depression is possible. General anesthesia is not used frequently in obstetrics because of the risks involved. The pregnant woman is at higher risk for aspiration. It requires more skill to intubate a pregnant woman because of physiologic changes in the trachea and thorax. In addition, general anesthetic agents cross the placenta and can result in the birth of a severely depressed neonate who requires full resuscitation.

A 37-year-old primigravida client at 40 weeks' gestation is seen in the clinic for a scheduled prenatal visit. The nurse predicts the woman is close to labor based on which assessment finding? -Nesting or Effacement?

-Nesting

What is Nesting?

-Nesting is the activity or burst of energy women often experience prior to the onset of labor. The client could express this in her words or by what her activities had been at home.

Assessment reveals that the fetus of a client in labor is in the vertex presentation. The nurse determines that which part is presenting?

-Occiput

What is the best position to auscultate fetal heart tones?

-On the fetus back

How often should a pregnant woman schedule prenatal care visits?

-Once every 4 weeks for the first 28 weeks -Then every 2 weeks until 36 weeks -And then weekly until the birth

P=Para which is the...

-Outcome of the pregnancies in the following order: Full Term, preterm, abortions, and living as of today.

The nurse is preparing an educational event for pregnant women on the topic of labor pain and birth. The nurse understands the need to include the origin of labor pain for each stage of labor. What information will the nurse present for the first stage of labor? -Pain originates from the cervix and lower uterine segment. -It is reported as the worst pain a woman will ever feel. -Pain is focal in nature. -Diffuse abdominal pain signals a complication with progression of labor.

-Pain originates from the cervix and lower uterine segment.

The nurse is preparing an educational event for pregnant women on the topic of labor pain and birth. The nurse understands the need to include the origin of labor pain for each stage of labor. What information will the nurse present for the first stage of labor? -Pain originates from the cervix and lower uterine segment. -It is reported as the worst pain a woman will ever feel. -Pain is focal in nature. -Diffuse abdominal pain signals a complication with progression of labor.

-Pain originates from the cervix and lower uterine segment. Pain sensations associated with labor originate from different places depending on the stage of labor. During the first stage of labor, the stretching required to efface and dilate the cervix stimulates pain receptors in the cervix and lower uterine segment.

A nurse is auscultating the fetal heart rate of a woman in labor. To ensure that the nurse is assessing the FHR and not the mother's heart rate, which action would be most appropriate for the nurse to do? -Palpate the mother's radial pulse at the same time. -Ask the woman to hold her breath while assessing the FHR. -Have the woman lie completely flat on her back while auscultating. -Instruct the woman to bend her knees and flex her hips.

-Palpate the mother's radial pulse at the same time.

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 -Cesarean birth -Increased risk of miscarriage -Increased risk of fetal trauma

-Potential for greater than usual back pain

A pregnant woman comes to the emergency department stating she thinks she is in labor. Which assessment finding concerning the pain will the nurse interpret as confirmation that this client is in true labor? -Radiates from the back to the front -Slows when the woman changes position -Occurs in an irregular pattern -Lasts about 20 to 25 seconds

-Radiates from the back to the front

What is the presenting part of a shoulder fetal presentation?

-Scapula

__________ stage of labor is the pushing stage; this is typically identified by the woman's urge to push or a feeling of needing to have a bowel movement.

-Second

The nurse is discussing options to provide relief of labor pain when the client states, "Why can't the health care provider provide a sedative during labor?" Which disadvantages are common with providing a sedative as pain management? Select all that apply. -The client feels restless and unable to focus. -Sedatives allow the client to sleep through the delivery. -Sedatives will not provide pain relief. -The sedation effect can cross to the fetus. Sedatives are only used in early labor

-Sedatives will not provide pain relief. -The sedation effect can cross to the fetus. -Sedatives are only used in early labor Sedatives are used in the early stage of labor to promote sleep, not restlessness. Sedation does not extend to the delivery period as other medications are used in active labor. Disadvantages of using sedatives are sedatives do not provide pain relief, it can pass to the fetus and is not used throughout the labor process.

A pregnant client reports chewing on ice throughout the day. Which laboratory value would the nurse evaluate? -Serum iron level -Serum potassium level -Serum glucose Level -Serum sodium level

-Serum iron level Pregnant clients who crave ice often have an iron deficiency. A low serum iron level needs to be checked. The client's electrolyte values are not associated with cravings for ice.

Naegele's Rule

-Subtract 3 months and add 7 days from the first day of the last menstrual period to determine an expected due date

While waiting for the placenta to deliver during the third stage of labor the nurse must assess the new mother's vital signs every 15 minutes. What signs would indicate impending shock?

-Tachycardia and a falling blood pressure

To assess the frequency of a woman's labor contractions, the nurse would time: -The beginning of one contraction to the beginning of the next. -The end of one contraction to the beginning of the next. -The interval between the acme of two consecutive contractions. -How many contractions occur in 5 minutes.

-The beginning of one contraction to the beginning of the next. Measuring from the beginning of one contraction to the next marks the time between contractions. If you measured from the end to the next beginning it could be inaccurate; the contractions themselves could be different lengths.

What is Brow presentation?

-The brow or sinciput is the presenting part when a fetus is in a brow presentation.

What is the presenting part of a breech fetal presentation?

-The buttocks, and/or the leg(s) or foot.

What is Molding?

-The cartilage between the bones allows the bones to overlap during labor, a process called molding that elongates the fetal skull, thereby reducing the diameter of the head.

A pregnant client wants to know why the labor of a first-time-pregnant woman usually lasts longer than that of a woman who has already given birth once and is pregnant a second time. What explanation should the nurse offer the client?

-The cervix takes around 12 to 16 hours to dilate during first pregnancy.

The nurse is caring for a client at 39 weeks' gestation and whose fetal station is noted as a 0 (zero). The nurse is correct to document which? -The client is fully effaced. -The fetus is floating high in the pelvis. -The fetus is in the true pelvis and engaged. -The fetus has descended down the birth canal

-The fetus is in the true pelvis and engaged. When the fetus is at a 0 (zero) station, it is at the level of the ischial spines and said to be engaged.

What does the sedond letter in the fetal position abbreviation signify?

-The second letter indicates the reference point ("O" for occiput, "Fr" for frontum, etc.)

Why are the pauses between contractions during labor importnat?

-They allow the restoration of blood flow to the uterus and the placenta.

Teratogenic effects of Lead and mercury are..

-They attack and disable nervous tissue

Teratogenic effects of Tetracycline include...

-Tooth enamel deficiencies -Long bone deformities

G=Gravida which is the...

-Total number of pregnancies

If the monitor pattern of uteroplacental insufficiency were present, which action would the nurse do first?

-Turn her or ask her to turn to her side.

A nurse caring for a pregnant client in labor observes that the fetal heart rate (FHR) is below 110 beats per minute. Which interventions should the nurse perform? Select all that apply. -Turn the client on her left side. -Reduce intravenous (IV) fluid rate. -Administer oxygen by mask. -Assess client for underlying causes. -Ignore questions from the client.

-Turn the client on her left side. -Administer oxygen by mask. -Assess client for underlying causes.

During the second stage of labor, a woman is generally: -Very aware of activities immediately around her. -Anxious to have people around her. -No longer in need of a support person. -Turning inward to concentrate on body sensations.

-Turning inward to concentrate on body sensations. Second-stage contractions are so unusual that most women are unable to think of things other than what is happening inside their body.

The relaxation technique of __________ is used in hypnobirthing or focused meditation.

-Visualization

By which week does the uterus expand to reach the height of the umbilicus?

-Week 20

Is it safe for a pregnant woman to engage in sexual intercourse?

-Yes, as long as the pregnancy is normal and there is no abnormal bleeding or rupture of membranes.

A pregnant client tells the nurse that she has a 2-year-old child at home who was born at 38 weeks; she had a miscarriage at 9 weeks; and she gave birth to a set of twins at 34 weeks. Which documentation would be appropriate for the nurse? -gravida 2, para 1 -gravida 4, para 2 -gravida 5, para 4 -gravida 5, para 4

-gravida 4, para 2 Gravida (G) indicates the number of PREGNANCIES; not children birthed (Set of twins does not count as Gravida 2, just Gravida 1). When a nurse calculates the GTPA of a pregnant client, the current pregnancy counts and the three other pregnancies count for a total of four pregnancies. Para (P) indicates the number of pregnancies carried to viable gestational age. This client has had two viable pregnancies so far.

The student nurse is learning about normal labor. The teacher reviews the cardinal movements of labor and determines the instruction has been effective when the student correctly states the order of the cardinal movements as follows: -Internal rotation, flexion, descent, extension, external rotation, expulsion. -Descent, flexion, external rotation, extension, internal rotation, expulsion. -Descent, flexion, internal rotation, extension, external rotation, expulsion. - Internal rotation, flexion, descent, extension, external rotation, expulsion.

Descent, flexion, internal rotation, extension, external rotation, expulsion.