Nursing Care: During Pregnancy

The nurse reinforces with Amy that she must consume enough nutrients in order to maintain a healthy pregnancy. How many calories should Amy consume per day? 3450-3500 kcals/day​ 2450-2500 kcals/day​ 1500-2000 kcals/day​ 3000-3500 kcals/day​

2450-2500 kcals/day

A normal pregnancy lasts ________ weeks from the ________ day of the last menstrual period (LMP).​

40 First

Which finding is a presumptive sign of pregnancy?​ Presence of fetal heartbeat ​ Goodell's sign​ Amenorrhea Positive pregnancy test​

Amenorrhea

Click to indicate which findings are consistent with normal pregnancy and which are abnormal or indicative of danger signs in pregnancy. ​

Danger signs during pregnancy that Amy is exhibiting include swelling of the face and fingers and signs of infection (fever, diarrhea, pain or burning with urination). Also, it is normal for the heart rate to increase 10-15 beats per minute in pregnancy, but Amy's is 30+ over her baseline. Amy should also gain 25-35 pounds in pregnancy but has only gained 5 pounds so far. Orthostatic hypotension with a normal baseline BP is typical in pregnancy, as is edema and tingling in the feet, elevated platelets, trace amounts of protein and negative glucose in the urine (higher levels would be abnormal), and hirsutism (male pattern excessive hair growth).

A woman who is pregnant for the 3rd time, has had a miscarriage, and has one living child who was born prematurely. Select the correct number for each component of GTPAL below.

G3: she has been pregnant 3 times​ T0: none of the pregnancies resulted in the delivery of term newborns (37 weeks or greater) P1: of the 3 pregnancies, one of them resulted in the delivery of a preterm newborn​ A1: of the 3 pregnancies, one resulted in either a spontaneous abortion (miscarriage) or an elective abortion​ L1: of the 3 pregnancies, one resulted in a living child (and was preterm as indicated by the "P1") ​

Click to indicate if each finding requires follow-up by the nurse or does not require follow-up.​

Hyperemesis gravidarum is severe vomiting that can lead to dehydration (dark urine with an odor, lightheadedness), fluid and electrolyte imbalance, acid-base imbalance, kidney and cardiac dysfunction, and even fetal death. All of these symptoms require follow-up. Anxiety should also be followed up on to see if symptoms are worsening and to ensure the client has coping mechanisms. The following does not require follow up: Amy's current vital signs are stable. Mucousy vaginal discharge, tender breasts, fatigue, and human chorionic gonadotropin (HCG) in the urine are all normal symptoms of pregnancy. A reddened cervix is indicative of Chadwick's sign (increased vascularity noted upon pelvic exam). A softened cervix is indicative of Goodell's sign (cervical softening), which are all expected during the pregnancy.

Which of the following nursing diagnoses should the nurse select for Amy? Select all that apply.​ Imbalanced nutrition: less than body requirements​ Imbalanced nutrition: more than body requirements​ Knowledge deficit Risk for overweight Activity intolerance

Imbalanced nutrition: less than body requirements Knowledge deficit

The nurse is speaking with Amy's healthcare team about her condition and treatment plan. For each potential action (healthcare provider order or nursing intervention), click to specify whether it is anticipated, unrelated, or contraindicated for Amy's care.​

Low protein and sugar-free diets in normal pregnancy are contraindicated, and the amount of protein and glucose in Amy's urine is normal in pregnancy. Fluid restriction is also contraindicated in a normal pregnancy. Amy's increased heart rate is probably due to the infection and is not cardiac related. Medication to lower her heart rate would be contraindicated. Amy's elevated platelets and hirsutism are normal for pregnancy. Meeting with an endocrinologist would be unrelated, as her symptoms do not necessitate a visit with that specialty. Daily intake diary, frequent weight measurements, and education related to nutrition are anticipated.

Select the correct structure for each description. Each item will fit only one structure.

Placenta ​ secretes the hormones that maintain the pregnancy​ exchanges nutrients, oxygen, and waste products between the fetus and the maternal circulation​ blocks the transfer of certain substances to the fetus​ Fetal Membranes ​ amniotic sac that contains the fetus​ Umbilical Cord ​ connects the placenta to the fetus​ cushioned to protect it from compression​ carries deoxygenated blood away from the fetus and carries oxygenated blood to the fetus​ Amniotic Fluid​ surrounds the fetus in the uterus​ cushions the fetus from compression​ regulates fetal temperature​ provides for fetal lung development ​

Identify whether each of the following is a presumptive, probable, or positive sign of pregnancy. ​

Presumptive signs of pregnancy: subjective indicators that the woman may be pregnant but may also be caused by other non-pregnancy-related conditions. These may include: amenorrhea (absence of menstruation), nausea, vomiting breast changes (swelling, tenderness, darkening areolae) Probable signs of pregnancy: objective indicators confirmed upon examination but may also be caused by other non-pregnancy-related conditions. These may include: uterine enlargement Goodell's sign (cervical softening) ballottement (upon abdominal palpation a rebound is felt) positive pregnancy test (detects presence of HCG in blood or urine) Chadwick's sign (increased vascularity noted upon pelvic exam) Positive signs of pregnancy: these signs only occur in pregnancy and confirm the presence of the fetus. These include: palpation of the fetal outline visualization of the pregnancy on ultrasound presence of the fetal heartbeat

A nurse is reinforcing teaching a pregnant woman about the danger signs during pregnancy. For which occurrences should the nurse advise the client to contact her health care provider? Select all that apply.​ Frequent urination​ Severe epigastric pain Pedal edema ​ A mild headache​ Mucous, odorless vaginal drainage​ Muscular convulsions Decreased fetal movement​ Increasing fetal movement​ Blurred vision

Severe epigastric pain Muscular convulsions Decreased fetal movement​ Blurred vision

Based on Amy's obstetric and gynecological history, Amy is a G2 T1 P0 A0 L1. Which statements explain what this notation means? Select all that apply. She has not had any spontaneous or elective abortions.​ She has had one elective abortion. She has one living child who was born prematurely. She has one living child who was born at term.​ This is her second pregnancy, and she has delivered one other child.​

She has not had any spontaneous or elective abortions.​ She has one living child who was born at term.​ This is her second pregnancy, and she has delivered one other child.​

A sexually active woman of childbearing age states that she began her menses 3 days ago, but the bleeding is lighter than usual. What would lead her provider to order a pregnancy test even though she states she began her menses? ​Select all that apply. She may be pregnant and experiencing implantation bleeding rather than her menses​. It could determine whether she is experiencing menses or early pregnancy bleeding, which is abnormal​. It would not be ordered because bleeding never occurs in pregnancy, only in labor. She may be having a miscarriage even though she didn't realize she was pregnant​. It would not be ordered unless she has been bleeding heavily, which is normal early in pregnancy​.

She may be pregnant and experiencing implantation bleeding rather than her menses​. She may be having a miscarriage even though she didn't realize she was pregnant​.

Which two healthcare provider orders should the nurse address first?​ Fetal heart tones auscultation Side lying position Reinforce education regarding the signs of labor​ Assess cardiac status for further signs of cardiac distress​ Repeat urinalysis to assess fluid status ​

These are the danger signs of pregnancy (other answers are normal in pregnancy):​ Absence or decrease in fetal movement may indicate fetal distress Visual disturbances: diplopia (double vision), blurring, or spots ​ Headaches: severe, sudden, or continuous ​ Edema: swelling of the face, presacral area, or fingers ​ Rapid weight gain in excess of normal gain for gestation ​ Pain: severe abdominal or epigastric pain ​ Signs of infection: fever, chills, diarrhea, changes in vaginal drainage, pain or burning with urination ​ Vaginal bleeding (no matter how slight) ​ Vaginal drainage (aside from normal mucus) ​ Persistent vomiting ​ Muscular irritability or convulsions ​

All major organs and systems develop simultaneously, approximately 8 weeks after fertilization. Why is this a very critical stage of pregnancy? Select all that apply. ​ This is when the mother starts taking prenatal vitamins. This is the time when birth defects develop. The developing embryo is vulnerable to teratogenic agents. All major body organs develop. This is the time when the embryo becomes a fetus.

This is the time when birth defects develop. The developing embryo is vulnerable to teratogenic agents. All major body organs develop.