OB chapter 25
April 27th
a 25 year old woman comes to the clinic and says she thinks she is pregnant. Her last period was July 20th. Based on this fact, what is the expected date of delivery
progesterone
a leading hormone of pregnancy that is secreted by the corpus luteum and later the placenta. This hormone has properties that enable it to relax the organs. It is frequently referred to as the maintenance hormone of pregnancy because it is responsible for the normal contractility of the uterus being halted, which enables implantation to take place without interruption
quantity of amniotic fluid, femur length
a patient is scheduled for an ultrasound scan. She is at 22 weeks gestation. The patient asked how they will be able to tell the gestational age of her fetus. When planning the response, the nurse correctly recognizes that which measurements will be used in this determination
16 and 20 weeks
a pregnant client asks the nurse in the clinic when she will be able to start feeling the fetus move. The nurse responds by telling the mother that fetal movement will be noted between which weeks of gestation
tell the client that these are common and they may occur throughout the pregnancy
a pregnant client is seen in the health care clinic for a regular prenatal visit. The client tells the nurse that she is experiencing irregular contractions. The nurse determines that the client is experiencing Braxton Hicks contractions. Based on this finding, which nursing action is appropriate
That is linea nigra, a darkened line from the pubis to the umbilicus, as a result of increased hormones
a pregnant patient asks the nurse about a darkened line that is seen on her abdomen. What would be the best response
extends her leg and dorsiflexes her foot during the cramp
a pregnant patient at her third office visit asked the nurse, what can I do when my leg goes into a cramp? The patient demonstrates understanding of the nurses instruction regarding relief of leg cramps if she
I can stop taking my vitamins if I have hemorrhoids
a pregnant patient comes into the clinic complaining of constipation. Which statement by the patient indicates the need for further teaching
10wks
a pregnant patient comes to the clinic for a prenatal visit. At how many weeks gestation would a patient need to be to hear fetal heart tones using a Doppler scan
you may find that you need to modify your exercising to walking later in your pregnancy, around the seventh month
a pregnant woman at 10 weeks of gestation drugs 3 or 4 times per week. She is concerned about the effect of exercise on the fetus. What information can be provided by the nurse
turn the woman on her side
a pregnant woman at 32 weeks of gestation and reports feeling dizzy and lightheaded while her fundal height is being measured. Her skin is pale and moist. What should the nurses initial action be
estrogen
a primary hormone of pregnancy that is secreted by the corpus luteum and later the placenta. It is responsible for the increased vascularity needed in the developing pregnancy
fetal heart rate of 180 beats per minute
a primipara is being evaluated and they Clinic during her second trimester of pregnancy. Which indicates and abnormal physical finding that necessitates further testing
fetal movement causes an increase in maternal heart rate
a test that may be done in late pregnancy to determine fetal well-being is the non-stress test. This test is based on which phenomenon
come to the office right away
a woman at 23 weeks of gestation cost to tell the nurse she thinks she is leaking fluid from her vagina. What information should be included in the nurses response to the patient
1-2-1-3
a woman is admitted in labor has an obstetric history that indicates that she has had three children, all of whom are living. One was born at 39 weeks gestation, another at 34 weeks of gestation, and another at 35 weeks of gestation. She had a miscarriage at 16 weeks gestation. What are her gravida and para de for the TPAL system
the movement is flutter like and is called quickening
a woman who is in her first trimester is talking with the nurse. The patient has inquired about the feelings she will have when she first feels her baby move. What information can be provided by the nurse
planning
after admitting a new patient to the maternity unit, the nurse writes a care plan. This process of determining outcomes and interventions is which stage of the nursing process
intactness of the placenta
after delivery, the nurse is examining the placenta. What is the most important observation that the nurse should note and document
used to detect biochemical or chromosomal abnormalities. Later in pregnancy, amniocentesis is primarily used to determine fetal lung maturity. It may also be performed to detect intrauterine infection and Fetal distress and to assist fetal laboratory values
an amniocentesis is performed to identify what conditions
this is called emotional liability and is related to hormone changes and anxiety during pregnancy. The mood swings will subside as she adjust to being pregnant
an expectant father confides in the nurse that his pregnant wife is driving him crazy. 1 minute she seems happy, and the next minute she seems unhappy, and the next she is crying over nothing at all. Is there something wrong with her? What is the most appropriate response by the nurse
number of fetuses, gestational age of fetuses, congenital anomalies, placement of the placenta
at one of her prenatal visits, the patient is scheduled for a sonogram. Sonographic can be used to assess
gravida 3 para 2
based on the definitions of gravida and para, what documentation best describes a woman in the clinic who is currently pregnant and has had to prior children
have you been vomiting? If yes, how frequently?
big pregnant woman reports frequently feeling ill in the morning with bouts of nausea throughout the day. What question is most important to differentiate between morning sickness and the more serious condition of hyperemesis gravidarum
slight decrease in the second trimester
blood pressure changes during pregnancy
increase by 15 mL or 40% to 50% above pregnancy level
blood volume changes during pregnancy
increase is 30 to 50%
cardiac output changes during pregnancy
Zygote
cell formed by the union of two reproductive cells
drink six to eight glasses of water daily
constipation is a frequent symptom as a pregnancy progresses. Which measure is best to recommend for relief of constipation
great abdominal distention that gives the pelvis a forward tilt, decreased abdominal muscle tone, and increased weight-bearing creates a realignment of the spinal curvature, the woman center of gravity shifts Ford, lordosis develops, and increased curvature in the cervicodorsal region is also seen, the expectant mother may also be noted with an exaggerated anterior flexion of the head, enlarging breast and a stoop shoulder since further accentuates the lumbar and dorsal curves
describe the musculoskeletal changes that women may experience during pregnancy
Morula
developmental stage of the fertilized ovum in which there is a solid mass of cells resembling a mulberry
implantation
embedding of the fertilized ovum in the uterine mucosa
implantation bleeding
enzymes allow the blastocyst to enter the endometrium and implant, may cause slight bleeding in some individuals
the placenta function as an endocrine gland that secretes HCG and the steroidal hormones estrogen and progesterone, which maintain the pregnancy. In addition, the placenta is the site of the exchange of nutrients, oxygen, and waste products between the fetus and the maternal circulation. The puss in it allows transfer of oxygen and nutrients through such processes as diffusion and active transport, and it also blocks the transfer of certain substances
explain the function of the placenta
Dick-Read Method
focuses on Progressive relaxation techniques and avoidance of analgesics
increases 10 to 15 beats per minute
heart rate during pregnancy
decreases
hemoglobin and hematocrit changes during pregnancy
human chorionic gonadotropin, human placental lactogen, estrogen, progesterone, relaxin
hormone secreted during pregnancy
how to calculate, start with the first day of the woman's last normal menstrual period and count back 3 months then at 7 days
how do you estimate the date of birth using the Nagele's rule
to hear the fetal heart tones, place the instrument in the midline, just above the symphysis pubis, and apply firm pressure. Some difficulty may be seen in locating heart tones in obese women during the early stages. Fetal heart tones are to be assessed for a full minute
how would you assess the fetal heart tones
human placental lactogen
impax maternal metabolism, resulting in the maintenance of energy sources for the fetus
ectopic pregnancy
implantation of the fertilized egg outside of the uterine cavity
HCG
initially secreted by the trophoblast in the developing pregnancy. It is responsible for simulation of the corpus luteum to promote production of estrogen and progesterone until the placenta is functioning. This is the hormone assist with a pregnancy test
relaxin
it is secreted by the corpus luteum in later the decidua of the uterine lining and the placenta. This hormone is linked to the softening of the cervix and pubic symphysis and preparation for labor and delivery
common methods of prepared childbirth include Dick-Read, Bradley, Leboyer, Lamaze
list common methods of prepared childbirth
abortion
medical term used to refer to the loss of a pregnancy prior to 20 weeks gestation
increase 18%
red blood cell mass changes during pregnancy
villi
short vascular processes or protrusions growing on certain membranous surfaces
Bradley method
stresses control of environmental factors, such as lighting, temperature, and noise to provide a calm, supportive environment for childbirth
conception
takes place when the sperm joins or fuses with the ovum
mechanical injury, temperature, musculoskeletal
the amniotic fluid acts as a cushion against___________ _________ , helps regulate fetal_________ , allows the developing embryo or fetus room for growth promoting______________ development, and provides for fetal lung development
July 27th 2017
the client arrives at the prenatal clinic for her first prenatal assessment. The client tells the nurse that the first day of her last period was October 20th 2016. Using the naegele's rule, the nurse determines the estimated date of birth is which
Blastocyst
the embryonic form, a spherical mass of cells having a central fluid-filled cavity surrounded by two layers of cells
8wks, fetus
the embryonic stage last for________. after this initial stage, the embryo is called the_______
reassure the mother that crying with relief and joy is an understandable response
the mother has diabetes and is at risk for placental insufficiency. The results of the non-stress test shows three fetal movements accompanied by 2 increases of 15 beats per minute in a 20 minute period. the mother is so relieved that she starts crying. What should the nurse be prepared to do for the patient
if excessive leakage is a problem, breast pads can be useful
the mother is in her second trimester and reports free milk is leaking from her breast. What should the nurse tell the mother
severe headaches
the nurse explains to the patient that she should contact her healthcare provider if she experiences any of the danger signs of pregnancy. Which symptom is a danger sign during pregnancy
place the Doppler just above the symphysis pubis and apply firm pressure
the nurse is assessing fetal heart tones on a woman who is 12 weeks pregnant. What is the correct method for this procedure
gravida 2 para 1
the nurse is collecting data from a client who is pregnant with triplets. The the client also has a three-year-old child who was born at 39 weeks gestation. The nurse should document which gravida and para status on this client
G2, T1,P0,A0, L1
the nurse is collecting data from a client who is pregnant with twins. The client has a healthy five year old child who was delivered at 38 weeks comment tells the nurse that she does not have his history of any type of abortion or fetal demise. The nurse should document the GTPAL for this client as witch
Ballottement, Chadwick's sign, Uterine enlargement, Braxton Hicks contractions
the nurse is collecting data from a client who suspect she is pregnant. The nurse is checking the clot for probable signs of pregnancy. Which are the probable signs of pregnancy that the nurse should note
28 cm
the nurse is collecting data from a pregnant mother who is 28 weeks gestation. The nurse measures the fundal height in centimeters and should expect which finding
possible intrauterine growth restriction
the nurse is comparing today's fundal height measurement with the previous recording taken 5 weeks ago. What is the significance of a stable or decrease measurement
the cord has two vessels, two artery and one vein
the nurse is examining the umbilical cord immediately after delivery. Which finding should be reported to the healthcare provider for further investigation of fetal anomalies
you and your partner can watch the images on the screen if you would like to
the nurse is helping a woman prepare for an abdominal ultrasound. Which information is correct
family will have additional stress related to finances if there is no insurance coverage
the nurse is interviewing a woman who has just found out that she is pregnant. From a nursing standpoint, what is the best rationale for asking about insurance coverage for maternity and newborn care
a softening of the cervix
the nurse is reviewing the record of a client who has just been told that her pregnancy test is positive. The nurse knows that the healthcare provider has documented the presence of Goodell sign. the nurse determines that this is a sign indicatives of which
have you ever had rubella or have you had the vaccination
the nurse is taking a health history and the information is likely to be used later during genetic counseling. Which question is the most appropriate in the initial data collection
suck on hard candy
the nurse notes in the healthcare providers documentation that the patient is experiencing ptyalism. what should the nurse instruct the patient to do
facial swelling is something that has to be reported to your health care provider for follow-up care and evaluation
the nurse notices the patient has facial swelling. What is the nurses best response
fetal movement palpated by the primary caregiver, presence of fetal heart tones
the nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. Which are positive signs of pregnancy
it is the fetal movement that is felt by the mother
the nursing instructor as a nursing student to describe the process of quickening. Which statement indicates an understanding of this term
instructs a patient to lie supine on the examination table
the nursing student is preparing to measure fundal height. At which Step would the nurse intervene
prolonged or repeated Beetle temperature evaluation may result in birth defects
the patient in the first trimester is advised to avoid exercising for more than 35 minutes in hot, humid weather. What is the best rationale for this advice
declining levels of quantitative human Chorionic gonadotropin
the patient is at risk for miscarriage. Which diagnostic test result is consistent with a miscarriage
presumptive
the patient reports experiencing nausea, vomiting, and breast tenderness along with missing her period. these symptoms are considered to be what type of signs of pregnancy
my baby should move at least 10 times in a one to two hour period
the pregnant patient has been instructed to count fetal movements. Which statement demonstrates that the patient understands the procedure
pain in burning sensation with urination
the pregnant patient phones the clinic and reports having some symptoms that are causing discomfort and worry. Which symptom is the most serious and warrants immediate evaluation by the healthcare provider
preterm delivery with low birth weight
the pregnant woman is a heavy smoker and she feels that it is unlikely that she will be able to quit. Because of the oxygen deprivation in the utero, which outcome should the healthcare team be prepared to deal with
check the patient's blood pressure
the pregnant woman reports bleeding or diplopia. Which assessment should the nurse immediately perform
10 weeks
the very first fetal movements, characterized as bubbling through a straw in the stomach, maybe experienced at
Chadwicks sign
the vulva have a violet or purple discoloration
formed all organs and structures
the woman has entered her 16th week of pregnancy and ask the nurse how is the baby growing the nurse provides accurate information by informing the mother that the baby will have
will you have to travel to areas where the water is untreated, have you checked the policies of the airline that you usually fly, are you planning to travel to a foreign country, when you drive, do you use the lap belt or shoulder harness
the woman with a low risk pregnancy tells the nurse that she frequently has to travel for her job. Which questions are most relevant
Leboyer method
uses a warm water bath to reduce the trauma of birth
Lamaze method
uses breathing, distraction, and focusing techniques to mentally control pain and requires discipline training throughout the pregnancy
visual disturbances, headaches, edema, rapid weight gain, pain, signs of infection, vaginal bleeding, vaginal drainage, persistent vomiting, muscular irregularity or convulsions, absence or decrease in fetal movement once felt
what are the danger signs during the pregnancy that may indicate the need for immediate medical attention
amenorrhea, nausea and vomiting, frequent urination, breast changes, changing in the shape of the abdomen, quickening, skin changes, Chadwicks sign
what are the presumptive signs that can indicate that a woman is pregnant
breast changes begin early in pregnancy. Many women report tingling and a feeling of fullness. Increased sensitivity is also common. Generally, the breast grows in preparation for lactation. Nipples and areola darken. Colostrum may be secreted by the nipple in second half of pregnancy
when do the changes in breasts occur during pregnancy
use only acceptable medical terminology when referring to body parts and functions
when obtaining a reproductive health history from a female patient. What should the nurse do
review the woman's dietary intake
when planning a diet with a pregnant woman. What should the nurses initial action be
increase in the platelet count
which laboratory results should be reported to the healthcare provider because pregnancy increases the risk for blood clots
amenorrhea, breast changes, Chadwick sign
which of the following maternal changes are presumptive signs of pregnancy
the exercises are most beneficial if they are done 10 times in a row at least 3 times a day
which patient response indicates that she understands how to perform kegel exercises
vaginal bleeding
which symptom is considered a first trimester warning sign and should be reported immediately to the healthcare provider
no alcohol
while giving a health history to the nurse, the patient reports that she usually has a glass of wine with dinner. What is the safe level of alcohol intake for her during her pregnancy
14 to 16 weeks gestation
while in the clinic, a first-time pregnant patient asks the nurse when she should be able to feel the fetus move. What is the nurses best response
flagellation
whip like movements of sperm traveling through the mucus of the cervical canal
increases in second and third trimester
white blood cell count changes during pregnancy