prepU ch 15

The nurse is conducting a teaching session for breastfeeding mothers. Which statement by a mother requires further clarification by the nurse?

"I am glad I can have my two cups of coffee in the morning again." Breastfeeding mothers should avoid caffeine because it delays iron absorption and passes through the milk and can slow infant weight gain

A nurse is teaching a client who is 30 weeks pregnant about ways to deal with heartburn. The nurse determines a need for additional teaching based on which client statement?

"I should lie down for 1/2 hour after eating."

A pregnant woman at her first prenatal visit asks the nurse if it is safe to have sex during her pregnancy. Which client statement alerts the nurse to the need for further teaching?

"I should substitute intercourse with nonsexual touch to avoid harming the fetus."

When questioned about alcohol consumption at her first prenatal visit, a client says that she drinks occasionally. What should the nurse urge her to do?

Abstain from alcohol completely during the remainder of her pregnancy.

The nurse is assigned to clients who are having the following procedures: Amniocentesis, Fetal nonstress test, Chorionic villus sampling, Percutaneous umbilical blood samplin, Doppler assessment of fetal heart rate. For which clients will the nurse ensure that the informed consent is on the chart?

Amniocentesis, chorionic villus sampling, percutaneous umbilical blood sampling

A client at 16 weeks' gestation is scheduled for prenatal testing. Which of the following would the nurse anticipate as the most likely screening test for congenital anomalies based on the current age of this pregnancy?

Amniocentesis. -can be done at 14 weeks -chronic villi is performed at 8-12 wks

Which precaution should the nurse take with a pregnant woman following an amniocentesis?

Assess fetal heart rate and possible uterine contractions. Because amniocentesis is an invasive procedure, there is a risk that it might initiate uterine contractions. Assessing for contractions postprocedure is important to safeguard the pregnancy.

During her first prenatal visit, a woman 18 weeks pregnant reports she did not realize she was pregnant and continued to take her birth control pills. She is concerned about their effects on her baby. Which of the following would be the best response to her concerns?

Because of concerns about the estrogen exposure to the baby, we will monitor the fetal development."

A pregnant client in her third trimester, lying supine on the examination table, suddently grows very short of breath and dizzy. Concerned, she asks the nurse what is happening. Which response should the nurse prioritize?

Blood is trapped in the vena cava in a supine position.

Assessment for surfactant level via LS ratio in the amniotic fluid is a primary estimation of fetal maturity. The purpose of surfactant is to:

Prevent alveoli from collapsing on expiration.

A client comes to the clinic with concerns about her pregnancy. She is in her first trimester and is now experiencing moderate abdominal pain on the right side. What would be the nurse's first action?

Recommend an abdominal ultrasound to the doctor since this may be ectopic pregnancy.

A client the nurse meets in a prenatal clinic states that she has a vaginal discharge and asks about douching. Which rule is safe regarding douching during pregnancy?

Routine douching is not advised.

To screen for chromosomal disorders, a 39-year-old woman is scheduled for a circulating cell-free DNA test. What type of test is this?

blood specimen collection Women over the age of 35 may be offered a more accurate, noninvasive blood test, circulating cell-free DNA (cfDNA) testing, to screen for chromosomal disorders.

When preparing a class for a group of pregnant women about nicotine use during pregnancy, the nurse describes the major risks associated with nicotine use including:

decreased birth weight in neonates. Spontaneous abortion is associated with caffeine use. Increased risks of stillbirth and placenta abruptio are associated with mothers addicted to cocaine.

During an assessment, a patient who is 5 months pregnant tells the nurse that she has to change her diet because she is just becoming too fat. Which nursing diagnosis should the nurse use to guide interventions for the patient at this time?

disturbed body image

A nurse is asked to auscultate the fetal heart sounds in a pregnant client. Which of the following equipment is most appropriate when auscultating fetal heart sounds at the 12th week?

doppler

Nondisjunction of a chromosome results in which diagnosis?

downsyndrome

A client who has just found out that she is pregnant comes to the healthcare facility for a visit. Which of the following instructions should the nurse give the client during this visit?

eat sour, salty foods to prevent nausea.

A normal umbilical cord contains two veins and one artery.

false

Levels of hCG continue to rise during pregnancy, returning to normal after delivery.

false

blood pressure during pregnancy typically increases r/t increased blood volume

false

A nurse overhears a colleague tell a client that based on the genetic testing results she should terminate the pregnancy. Which action is most appropriate for the nurse to take?

immediately stop the nurse

White blood cell productions typically ________________ during pregnancy.

increase

An 18-year-old pregnant woman asks the nurse why she has to have a routine alpha-fetoprotein serum level drawn. The nurse explains that this:

may reveal chromosomal abnormalities. An alpha-fetoprotein analysis is a cost-effective screening test to detect chromosomal and open-body-cavity disorders.

A 29-week-gestation client is admitted with moderate vaginal discharge. The nurse performs a nitrazine test to determine if the membranes have ruptured. The nitrazine tape remains yellow to olive green, with pH between 5 and 6. What should the nurse do next?

notify the provider

The nurse is planning care for several pregnant patients. Which patient is at the greatest risk for nutritional deficiency while pregnant? You Selected:

patient with a 1 yr old son A pregnant woman with high parity or a short interval between pregnancies such as having a 1-year-old son may enter pregnancy with depleted nutritional reserves that she has little to draw on during the first part of pregnancy.

The ________________ is responsible for three important functions: circulation, protection, and hormone production.

placenta

What is the organ with a rich blood supply that supplies the developing organism with food and oxygen and carries away waste for excretion by the mother?

placenta The placenta is an organ with a rich blood supply that supplies the developing organism with food and oxygen, carries waste away for excretion by the mother, slows the maternal immune response so that the mother's body does not reject the fetal tissue, and produces hormones that help maintain the pregnancy.

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

In a client's seventh month of pregnancy, she reports feeling "dizzy, like I'm going to pass out, when I lie down flat on my back." The nurse explains that this is due to:

pressure of the gravid uterus on the vena cava. The client is describing symptoms of supine hypotension syndrome

To help alleviate the patient's fears, the nurse should mention the role of the hormone that softens the cervix and collagen in the joints, which allows dilation and enlargement of the birth canal. This hormone is which of the following?

relaxin

A nurse is working with a pregnant woman to schedule follow-up visits for her pregnancy. Which statement by the woman indicates that she understands the scheduling?

"From now until I'm 28 weeks, I'll be coming once a month." -every 4 wks up to 28 wks -every 2 wks from 29-36 -every week from 37 to birth

A community health nurse is visiting a 16-year-old new mother. The nurse explains to the client and her mother the genetic screening that is required by the state's law. The client asks why it is important to have the testing done on the infant. What is the nurse's best response?

"PKU, congenital hypothyroidism, and galactosemia are conditions that could result in disability or death if untreated."

A client calls the nurse in a panic after a home pregnancy test indicates she is pregnant. She reports that that she consumed a lot of alcohol on the night that she thinks the pregnancy occurred. The next day she had taken several acetaminophen. For the past 3 weeks, she has had her usual nightly glass of wine with dinner but no other alcohol. What is an appropriate response for the nurse to make when the client questions if she has caused irreversible damage to the fetus?

"The fetus is not exposed to the mother's blood until after it implants about 6 days after fertilization, so the first night is not an issue. But it is best to avoid alcohol while you are pregnant."

A woman in labor has chosen to use hydrotherapy as a method of pain relief. Which statement by the woman would lead the nurse to suspect that the woman needs additional teaching?

"The temperature of the water should be at least 105℉ (40.5℃)."

During a physical assessment, the nurse palpates a pregnant patient's fundus at the level of the umbilicus. What statement should the nurse make to the patient about this assessment finding?

"You are at 20 weeks of your pregnancy."

After teaching a woman how to perform Kegel exercises, the woman states the steps. Which steps would the nurse determine as reflecting the correct components of Kegel exercises? Select all that apply.

- Squeeze the rectal muscles as if trying to prevent the passage of flatus. - Stop and start urinary flow to identify pubococcygeus muscle. - Tighten the pubococcygeus muscle for a count of three, then relax. - Contract and relax the pubococcygeus muscle rapidly 10 times.

A client with hyperemesis gravidarum is on a clear liquid diet. Which foods would be appropriate for the nurse to serve? Select all that apply:

- Tea and gelatin - Ginger ale and apple juice - Cranberry juice and chicken broth

A woman's prepregnant weight is within the normal range. During her second trimester, the nurse would determine that the woman is gaining the appropriate amount of weight when her weight increases by which amount per week?

1 lb (.45 kg) Underweight women should gain slightly more than 1 lb (.45 kg) per week. Overweight women should gain about 2/3 lb (.30 kg) per week.

The nurse is caring for a neonate whose mother received no medical care for either of her pregnancies. When assessing the neonate's status, which would indicate a potential A, B, and O incompatibility?

Hemolytic anemia mothers antibodies cross the placenta and attack the fetus's rbc's

The nurse assesses a 20-week gestational client at a routine prenatal visit. What will the nurse predict the fundal height to be on this client experiencing an uneventful pregnancy?

20 cm

A pregnant patient scheduled for an amniocentesis asks the nurse how the placenta is not punctured during the procedure. What should the nurse respond to the patient?

A sonogram to locate it will be done first."

A pregnant woman tells you that she wants to avoid saturated fat by using vegetable oil. What is another advantage of vegetable oil?

Contains linoleic acid Linoleic acid is a fat important for skin integrity in the mother and for fetal growth.

A nurse is caring for a client who has just been told that her unborn baby carries a genetic disorder associated with significant health related issues. The client asks, "Should I kill the baby?" What is the most appropriate nursing diagnosis for this client?

Decisional conflict related to continuation of pregnancy The client is unsure as to whether to continue the pregnancy or terminate it as evidenced by the question she asked the nurse.

A woman who is 6 weeks pregnant is concerned because she is nauseated every morning. Which measure should the nurse suggest the patient use to help relieve nausea?

Delay breakfast until midmorning. The traditional solution for preventing nausea is for the pregnant patient to keep dry crackers, such as saltines, by the bedside and eat a few before rising because increasing carbohydrate intake seems to relieve nausea better than any other nutrition remedy. The patient can then eat a light breakfast or delay breakfast until 10 or 11 AM, which is past the time nausea seems to persist.

A patient who is 4 months pregnant is experiencing pyrosis. Which suggestion should the nurse make to the patient to help with this health problem?

Eat small meals and do not lie down after mea

A 41-year-old pregnant woman and her husband are anxiously awaiting the results of various blood tests to evaluate the fetus for potential Down syndrome, neural tube defects, and spina bifida. Client education should include which information?

Further testing will be required to confirm any diagnosis. Nursing management related to marker screening tests consists primarily of providing education about the tests. Remind the couple that a definitive diagnosis is not made without further tests such as an amniocentesis.

After teaching a pregnant woman how to count fetal movements, the nurse determines that the teaching was successful when the client makes which statement?

I'll sit comfortably in a recliner or lie on my side when I do the counts. The client should perform the counts in a relaxed environment and a comfortable position, such as a semi-Fowler's or side-lying position. The woman needs to do fetal movement counts consistently, at approximately the same time each day. A woman should report a count of less than three fetal movements in an hour. A relaxed environment, a comfortable position, and consistency in performing the counts are important to identify changes.

The nurse is assessing a pregnant client at her 12 weeks' gestation and the client reports some new bumps on the dark part of her nipples. What is the best response from the nurse when questioned by the client as to what they are?

Montgomery tubercles; secrete lubricant for the nipples

The nurse has identified the diagnosis of imbalanced nutrition for a pregnant patient. Which assessment data did the nurse use to identify this diagnosis for the patient?

Patient does not want to gain any weight while pregnant.

The exaggerated curve to the lumbar spine that is commonly seen in pregnant women is known as ________________.

lordosis

Which of these cardiac variations, if found in the client who is pregnant, should the nurse recognize as a normal finding in pregnancy?

Soft systolic murmur

A pregnant patient is concerned that orgasm will be harmful to the developing fetus. What should the nurse include when responding to this patient's concern?

Some women experience orgasm intensely during pregnancy.

The nurse is reviewing the signs of labor with a patient entering the last phase of the third trimester of pregnancy. What should the nurse include as an indication that the labor is beginning?

Sudden gush of clear fluid from the vagina Labor may begin with rupture of the membranes, experienced either as a sudden gush or as scanty, slow seeping of clear fluid from the vagina

A mutligravida client is concerned that she may deliver early. When asking the nurse what is the earliest her baby can be delivered and survive, which time frame would the nurse point out?

The end of the second trimester

A client reports occasional headaches. She wants to know what she can take to alleviate the discomfort. What would be the best response by the nurse?

The safest medication to take for your headaches during your pregnancy would be acetaminophen."

A client in her third trimester is scheduled for a nonstress test. What is the purpose of the nonstress test for the client?

To determine the well-being of the fetus

A woman is only 30 weeks pregnant, but the physician determines that the fetus must be delivered for the safety of the mother. The physician orders a glucocorticosteroid injection to be given. Why does the physician order this injection?

To promote the formation of surfactant in the fetal lungs key task of the third trimester is maturation of the fetal lungs. If a fetus must be delivered between 28 and 34 weeks, a glucocorticosteroid injection is given to the mother to promote the formation of surfactant.

A woman is scheduled to undergo fetal nuchal translucency testing. Which statement would the nurse include when describing this test?

You'll have an intravaginal ultrasound to measure fluid in the fetus."

Which pregnant woman should consult with her obstetric provider before continuing an exercise program?

a 33-year-old G5 P1 with a history of incompetent cervix

The fetal-assessment technique of a rhythm strip refers to:

a tracing of fetal heart rate and pattern.

A 17-year-old client arrives for an annual examination and reports no changes since the last exam; however, the nurse assesses a postive Chadwick sign, slightly enlarged uterus, and subsequent positive urine pregnancy test. Which task should the nurse prioritize to assist this client who is denying any possibility that she is pregnant?

accepting the pregnancy

The nurse discovers a new prescription for RhoGAM for a client who is about to undergo a diagnostic procedure. The nurse will administer the RhoGAM after which procedure?

amniocentesis

When assessing newborns for chromosomal disorders, which assessment would be mostsuggestive of a problem?

low set ears pg 279

he first system to develop in the embryo is the ________________ system

cardiovascular

Pigmentation changes often seen on the face during pregnancy are called ________________.

chloasma

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

colostrum from the nipples

A nurse is discussing fetal development with a pregnant woman. The woman is 12 weeks pregnant and asks, "What's happening with my baby?" Which information would the nurse integrate into the response? Select all that apply.

continued sexual differentiation digestive system becoming active

A woman calls the prenatal clinic and says that she thinks she might be in labor. She shares her symptoms over the phone with the nurse and asks what to do. The nurse determines that she is likely in true labor and that she should head to the hospital. Which symptom is an indicator of true labor?

contractions beginning in the back and sweeping forward across the abdomen Explanation:

After teaching a class on the stages of fetal development, the nurse determines that the teaching was successful when the group identifies which stages? Select all that apply.

fetal embryonic pre-embryonic

The nurse is creating an educational pamphlet for pregnant mothers. Which is the best description of fetal development for the nurse to emphasize?

gestational age, length, weight, and systems developed

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?

heartburn

A nurse assesses a 32-year-old primigravida client with twin gestation in her second trimester. The client reports constipation from iron supplements. Which condition should the nurse assess for in this client as a result of the constipation?

hemmoroids

A nurse is assessing a woman in labor. Which finding would the nurse identify as a cause for concern during a contraction?

respiratory rate of 10 breaths/minute

The placenta is the site where antibodies in the mother's blood pass into the fetal circulation. These antibodies give passive immunity to the fetus for several common childhood diseases. There are some infections for which the mother does not provide antibodies to the fetus. What infection is the fetus not protected from?

rubella The fetus does not receive immunity to rubella, cytomegalovirus (CMV), varicella, or measles. If the woman encounters these pathogens during her pregnancy, fetal infection may ensue.

A pregnant client is planning a vacation to a different state and questions the nurse concerning precautions. Which suggestion should the nurse prioritize for this client who will be traveling by automobile? You Selected:

stop and walk every 2 hrs

The uterus

the cavity in the abdominal region within which the embryo and fetus develop, along with the placenta.

The nurse is assisting a primigravid on calculating the due date of her baby using Naegele's rule. The most important information provided by the mother is:

the first day of the last menstrual period.

the ovary

the organ that produces the ova. A morula is a ball of about 16 identical cells and is the result of the zygote dividing rapidly.

A nurse urges a pregnant client at the first prenatal office visit to begin taking iron supplements immediately. What is the rationale for this intervention?

to avoid anemia

Striae gravidarum is a normal occurrence during pregnancy that affects skin pigmentation and vasculature.

true

The embryo stage of development occurs from day 10 to week 8.

true

The nurse is assessing a primigravida woman at a routine prenatal visit. Which assessment finding is reinforcing to the client that she is definitely pregnant?

ultrasound picture of her uterus

A woman you care for in a prenatal clinic tells you that her pregnancy was unplanned and unwanted. At what point in pregnancy does the average woman change her mind about an unwanted pregnancy?

when quickening occurs -feeling the baby move inside the body, is such a dramatic event that it can cause a woman's perceptions about the pregnancy to change.

A fertilized ovum is known as which structure?

zygote