Ch. 30: The Pregnant Woman

Striae gravidarum

"stretch marks" that may be seen in areas of weight gain during pregnancy

Corpus luteum

"yellow body"; a structure on the surface of the ovary that is formed by the remaining cells in the follicle; acts as a short-lived endocrine organ that produces progesterone to help maintain the pregnancy in its early stages

35. A woman in her second trimester of pregnancy states, "I'm so glad the morning sickness is gone,but I feel so tired!" What action by the nurse is appropriate at this time? Select all that apply. A. Order a test of the woman's vitamin D level. B. Instruct her to get more rest during the day. C. Order a complete blood count. D. Order thyroid function studies. E. Offer HIV screening.

ANS: A (Order a test of the woman's vitamin D level.), C (Order a complete blood count.), D (Order thyroid function studies.) Vitamin D is essential for maternal response to the calcium demands of the fetus for growth and bone development. Maternal anorexia and malaise are often associated with Vitamin D deficiency. In addition, iron deficiency is a common cause of anemia in pregnancy; a complete blood count will indicate whether this is present. Thyroid function should be done to check for maternal hypothyroidism, which can cause symptoms of lethargy in the mother and also have severe effects on the developing fetus. HIV screening should have been offered at the onset of her pregnancy. Instructing her to get more rest will not help in finding a possible cause of her tiredness.

15. Which of these is considered a normal and expected finding when the nurse is performing a physical examination on a pregnant woman? A. A palpable, full thyroid B. Edema in one lower leg C. Significant diffuse enlargement of the thyroid D. Pale mucous membranes of the mouth

ANS: A) A palpable, full thyroid The thyroid may be palpable during pregnancy. It should feel full, but smooth. Significant diffuseenlargement occurs with hyperthyroidism, thyroiditis, and hypothyroidism. Pale mucous membranes may indicate anemia. Bilateral lower extremity edema is common in pregnancy, but edema with pain in only one leg occurs with deep vein thrombosis

13. The nurse knows that the best time to assess a woman's blood pressure during an initial prenatal visit is: A. At the end of the examination when she will be the most relaxed. B. At the beginning of the interview as a non threatening method of gaining rapport. C. During the middle of the physical examination when she is the most comfortable. D. Before beginning the pelvic examination because her blood pressure will be higher after the pelvic examination.

ANS: A) At the end of the examination when she will be the most relaxed. Assess the woman's blood pressure at the end of the examination, when it is hoped that she will be most relaxed. The other options are not correct.

18. When performing an examination of a woman who is 34 weeks pregnant, the nurse notices that as the woman raises her head and shoulders off of the bed there is a midline linear protrusion in the abdomen over the area of the rectus abdominis muscles. Which response by the nurse is correct? A. Document the presence of diastasis recti. B. Discuss this condition with the physician because it will most likely need to be surgically repaired. C. Suspect that the woman has a hernia from the increased pressure within the abdomen from pregnancy. D. Tell the woman that she may have a difficult time with delivery because of the weakness in her abdominal muscles.

ANS: A) Document the presence of diastasis recti. The separation of the abdominal muscles is called diastasis recti. It frequently occurs during pregnancy. The rectus abdominis muscles will return together after pregnancy with abdominal exercise. This condition is not a true hernia

31. During auscultation of fetal heart tones (FHTs), the nurse determines that the rate is 136 beats per minute. The nurse's next action should be to: A. Document the results, which are within normal range. B. Take the maternal pulse to verify these findings as the uterine souffle. C. Have the patient change positions and count the FHTs again. D. Notify the physician immediately for possible fetal distress.

ANS: A) Document the results, which are within normal range. The normal FHT rate is between 120 and 160 beats per minute. The nurse should document the results as within the normal range. The other options are not correct

27. A patient who is 24 weeks pregnant asks about wearing a seatbelt while driving. Which response by the nurse is correct? A. "Seat belts should not be worn during pregnancy." B. "Place the lap belt below the uterus and use the shoulder strap at the same time." C. "Place the lap belt below the uterus but omit the shoulder strap during pregnancy." D. "Place the lap belt at your waist above the uterus and use the shoulder strap at the same time."

ANS: B) "Place the lap belt below the uterus and use the shoulder strap at the same time." For maternal and fetal safety, the nurse should instruct the woman to place the lap belt below the uterus and to use the shoulder strap. The other instructions are incorrect.

5. A patient is being seen at the clinic for her 10-week prenatal visit. She asks when she will be able to hear the baby's heartbeat. The nurse should reply: A. "The baby's heartbeat is not usually heard until the second trimester." B. "The baby's heartbeat may be heard anywhere from the ninth to the twelfth week." C."It is often difficult to hear the heartbeat at this point, but we can try." D. "It is normal to hear the heartbeat at six weeks. We may be able to hear it today."

ANS: B) "The baby's heartbeat may be heard anywhere from the ninth to the twelfth week." Fetal heart tones can be heard by use of the Doppler device between 9 and 12 weeks. The other responses are incorrect.

17. When the nurse is assessing the deep tendon reflexes (DTRs) on a woman who is 32 weeks pregnant, which of these would be considered a normal finding on a 0 to 4+ scale? A. Absent DTRs B. 2+ C. 4+ D. Brisk reflexes and the presence of clonus

ANS: B) 2+ Normally during pregnancy the DTRs are 1+ to 2+ and equal bilaterally. Brisk or greater than 2+DTRs and the presence of clonus are abnormal and may be associated with an elevated blood pressure and cerebral edema in the preeclamptic woman

21. During a prenatal visit at 30 weeks of gestation, the patient mentions to the nurse, "The baby has not moved very much since yesterday." The nurse notices that fetal movement is not as active as it was the last visit, and notifies the physician. What should the nurse prepare to do next? A. Admit the woman to a hospital. B. Administer a nonstress test for fetal monitoring. C. Start an intravenous infusion. D. Have the patient walk around the hallways and then check fetal movement again.

ANS: B) Administer a nonstress test for fetal monitoring. A decrease in fetal movement should be reported and followed by a nonstress test (fetal monitoring). Cessation of fetal movement may be indicative of fetal distress or impending fetal death

14. When examining the face of a woman who is 28 weeks pregnant, the nurse notices the presence of a butterfly-shaped increase in pigmentation on the face. The proper term for this finding in the documentation is: A. Striae. B. Chloasma. C. Linea nigra. D. The mask of pregnancy

ANS: B) Chloasma Chloasma is a butterfly-shaped increase in pigmentation on the face. It is known as the mask of pregnancy, but when documenting, the nurse should use the correct medical term, "chloasma." "Striae" is the term for stretch marks. The linea nigra is a hyperpigmented line that begins at the sternal notch and extends down the abdomen through the umbilicus to the pubis

29. A 25-year-old woman is in the clinic for her first prenatal visit. The nurse will prepare to obtain which laboratory screening test at this time? A. Urine toxicology B. Complete blood cell count C. Alpha-fetoprotein D. Carrier screening for cystic fibrosis

ANS: B) Complete blood cell count At the onset of pregnancy, a routine prenatal panel usually includes a complete blood cell count, serology, rubella antibodies, hepatitis B screening, blood type and Rhesus factor, and antibody screen. A clean-catch urine sample is collected for urinalysis to rule out cystitis. Urine toxicologyis beneficial for women if active substance abuse is suspected or known, but it not routinely done. In the second trimester, maternal serum is analyzed for alpha-fetoprotein. Carrier screeningfor cystic fibrosis is offered to check whether a person carries the abnormal gene that causes cystic fibrosis but is not part of routine testing

12. When assessing a woman who is in her third trimester of pregnancy, the nurse looks for the classic symptoms associated with preeclampsia, which include: A. Edema, headaches, and seizures. B. Elevated blood pressure and proteinuria. C. Elevated liver enzymes and high platelet counts. D. Decreased blood pressure and edema.

ANS: B) Elevated blood pressure and proteinuria. The classic symptoms of preeclampsia are hypertension and proteinuria. Headaches may occur with worsening symptoms, and seizures may occur if preeclampsia is untreated and leads to eclampsia. A serious variant of preeclampsia, the HELLP syndrome, involves hemolysis, elevated liver enzymes, and low platelet counts, and it is an ominous picture. Edema is a common occurrence in pregnancy.

16. When auscultating the anterior thorax of a pregnant woman, the nurse notices the presence of a murmur over the second, third, and fourth intercostal spaces. It is continuous but can be obliterated by pressure with the stethoscope or finger on the thorax just lateral to the murmur. The nurse interprets this finding to be: A. The murmur of aortic stenosis. B. Most likely a mammary souffle. C. Associated with aortic insufficiency. D. An indication of a patent ductus arteriosus.

ANS: B) Most likely a mammary souffle. Often blood flow through the blood vessels, specifically the internal mammary artery, can be heard over the second, third, and fourth intercostal spaces. This is called a mammary souffle, but it may be mistaken for a cardiac murmur. The other options are incorrect

30. A woman in her 25th week of gestation comes to the clinic for her prenatal visit. The nurse notices that her face and lower extremities are swollen, and her blood pressure is 154/94 mm Hg. She states that she has had headaches and blurry vision but thought she was just tired. What should the nurse suspect? A. Eclampsia B. Preeclampsia C. Diabetes type 1 D. Preterm labor

ANS: B) Preeclampsia Classic symptoms of preeclampsia include elevated blood pressure (greater than 140 systolic or 90 diastolic mm Hg in a woman with previously normal blood pressure) and proteinuria. Onset and worsening symptoms may be sudden, and subjective signs include headaches and visual changes. Eclampsia is manifested by generalized tonic-clonic seizures. These symptoms are not indicative of diabetes mellitus (type 1 or 2) or preterm labor.

28. During a history interview, a 38-year-old woman shares that she is thinking about having another baby. The nurse knows that which statement is true regarding pregnancy after age 35 years? A. Fertility does not start to decline until age 40 years. B. The occurrence of Down syndrome is much more frequent after age 35 years. C. Genetic counseling and prenatal screening are not routine until after age 40 years. D. Women older than 35 years who are pregnant have the same rate of pregnancy-related complications as those who are younger than 35 years.

ANS: B) The occurrence of Down syndrome is much more frequent after age 35 years. The risk of Down syndrome increases as the woman ages, from about 1 in 1250 at age 25 to 1 in 400 at age 35. Fertility declines with advancing maternal age. Women 35 years and older, or with a history of a genetic abnormality, are offered genetic counseling and the options of prenatal diagnostic screening tests. Because the incidence of chronic diseases increases with age, women older than 35 years who are pregnant more often have medical complications such as diabetes, obesity, and hypertension.

34. During a group prenatal teaching session, the nurse teaches Kegel exercises. Which of these statements would be appropriate for this teaching session? Select all that apply. A. "Kegel exercises help to keep your uterus strong during the pregnancy." B. "Kegel exercises should be performed twice a day." C. "Kegel exercises should be performed 50 to 100 times a day." D. "To perform Kegel exercises, squeeze slowly to a peak at the count of eight, and then release slowly to a count of eight." E. "To perform Kegel exercises, perform rapidly alternating squeeze-release exercises up to the count of eight."

ANS: C ("Kegel exercises should be performed 50 to 100 times a day."), D ("To perform Kegel exercises, squeeze slowly to a peak at the count of eight, and then release slowly to a count of eight.") Kegel exercises can be done to prepare for and to recover from birth. The nurse should direct the woman to squeeze slowly to a peak at the count of eight and then to release slowly to the count of eight. The nurse can prescribe this exercise to be performed 50 to 100 times a day.

6. A patient who is in her first trimester of pregnancy tells the nurse that she is experiencing significant nausea and vomiting and asks when it will improve. The nurse should reply: A. "Did your mother have significant nausea and vomiting?" B. "Many women experience nausea and vomiting until the third trimester." C. "Usually, by the beginning of the second trimester, the nausea and vomiting improve." D. "At about the time you begin to feel the baby move, the nausea and vomiting will subside."

ANS: C) "Usually, by the beginning of the second trimester, the nausea and vomiting improve." The nausea, vomiting, and fatigue of pregnancy improve by weeks 12 to 16. Quickening, when the mother recognizes fetal movement, occurs at approximately 18 to 20 weeks.

19. The nurse is palpating the fundus of a pregnant woman. Which of these statements about palpation of the fundus is true? A. It should be hard and slightly tender to palpation during the first trimester. B. Fetal movement may not be felt by the examiner until the end of the second trimester. C. After 20 weeks of gestation, the number of centimeters should approximate the number of weeks of gestation. D. Fundal height is usually less than the number of weeks of gestation, unless there isan abnormal condition such as too much amniotic fluid present

ANS: C) After 20 weeks of gestation, the number of centimeters should approximate the number of weeks of gestation. After 20 weeks, the number of centimeters should approximate the number of weeks of gestation. Also, at 20 weeks of gestation the examiner may feel fetal movement and the head can be balloted

3. When performing the examination of a woman who is 8 weeks pregnant, the nurse notices that the cervix is a bluish color. The nurse would document this finding as _____ sign. A. Hegar's B. Homans' C. Chadwick's D. Goodell's

ANS: C) Chadwick's During pregnancy, the uterus becomes globular in shape, softens, and flexes over the cervix (Hegar's sign). The cervix softens (Goodell's sign) and becomes bluish or cyanotic in color (Chadwick's sign). Homans' sign is pain in the calf upon dorsiflexion of the foot and is not related to signs of pregnancy

4. A woman who is 8 weeks pregnant is visiting the clinic for a checkup. Her systolic blood pressure is 30 mm Hg higher than her prepregnancy systolic blood pressure. The nurse should: A. Consider this a normal finding. B. Expect the blood pressure to decrease as the estrogen levels increase throughout the pregnancy. C. Consider this an abnormal finding because blood pressure is typically lower at this point in the pregnancy. D. Recommend that she decrease her salt intake in an attempt to decrease her peripheral vascular resistance

ANS: C) Consider this an abnormal finding because blood pressure is typically lower at this point in the pregnancy. During the seventh gestational week, blood pressure begins to drop as a result of falling peripheral vascular resistance. Early in the first trimester, blood pressure values are similar to those of pre pregnancy measurements. In this case, the woman's blood pressure is higher than it should be.

10. The nurse auscultates a functional systolic murmur, grade II/IV, on a woman in week 30 of her pregnancy. The remainder of her physical assessment is within normal limits. The nurse would: A. Consider this an abnormal finding and refer her for additional consultation. B. Ask the woman to run in place briefly and then assess for an increase in intensity of the murmur. C. Know that this is a normal finding resulting from the increase in blood volume during pregnancy. D. Ask the woman to restrict her activities and return to the clinic in 1 week for re-evaluation.

ANS: C) Know that this is a normal finding resulting from the increase in blood volume during pregnancy. Because of the increase in blood volume, a functional systolic murmur, grade II/IV or less, can be heard in 95% of pregnant women. The other actions are not appropriate

25. A patient's pregnancy test is positive, and she wants to know when the baby is due. The first day of her last menstrual period was June 14, and that period ended June 20. Using Nägele's rule, what is her expected date of delivery? A. March 7 B. March 14 C. March 21 D. March 27

ANS: C) March 21 Using Nägele's rule, add 7 days to the first day of the last menstrual period and then subtract 3 months. Therefore, adding 7 days to June 14 would be June 21, then subtracting 3 months makes it March 21

7. During the examination of a woman in her second trimester of pregnancy, the nurse notices the presence of a small amount of yellow drainage from the nipples. The nurse knows that this is: A. An indication that the woman's milk is coming in. B. A sign of possible breast cancer in a pregnant woman. C. Most likely colostrum and considered a normal finding at this stage of the pregnancy. D. Too early in the pregnancy for lactation to begin, and refers the woman to a specialist.

ANS: C) Most likely colostrum and considered a normal finding at this stage of the pregnancy. During the second trimester, colostrum, the precursor of milk, may be expressed from the nipples. Colostrum is yellow and contains more minerals and protein but less sugar and fat than mature milk. The other options are incorrect.

9. A patient who is 20 weeks pregnant tells the nurse that she feels more shortness of breath as her pregnancy progresses. The nurse recognizes that which of these statements is true? A. High levels of estrogen cause shortness of breath. B. Feelings of shortness of breath are abnormal during pregnancy. C. The hormones of pregnancy cause an increased respiratory effort. D. She should get more exercise in an attempt to increase her respiratory reserve.

ANS: C) The hormones of pregnancy cause an increased respiratory effort. Progesterone and estrogen cause an increased respiratory effort during pregnancy by increasing tidal volume. Increased tidal volume causes a slight drop in partial pressure of arterial carbon dioxide (PaCO2), causing the woman to occasionally have dyspnea. The other options are not correct.

11. A woman who is 28 weeks pregnant has edema in her lower legs bilaterally after working 8 hours a day as a cashier at a local grocery store. She is worried about her legs. What is the nurse's best response? A. "You will be at risk for development of varicose veins when your legs are edematous." B. "I would like to listen to your heart sounds. Edema can indicate a problem with your heart." C. "Edema is usually the result of too much salt and fluids in your diet. You may need to try to cut down on salty foods." D. "As your baby grows, it slows blood return from your legs, causing the swelling. This often occurs with prolonged standing."

ANS: D) "As your baby grows, it slows blood return from your legs, causing the swelling. This often occurs with prolonged standing." Edema of the lower extremities occurs because of the enlarging fetus, which impairs venous return. Prolonged standing worsens the edema. Typically, the bilateral, dependent edema experienced with pregnancy is not the result of cardiac pathology

24. Which of these correctly describes the average length of pregnancy? A. 38 weeks B. 9 lunar months C. 280 days from the last day of the last menstrual period D. 280 days from the first day of the last menstrual period

ANS: D) 280 days from the first day of the last menstrual period The average length of pregnancy is 280 days from the first day of the last menstrual period, which is equal to 40 weeks, 10 lunar months, or roughly 9 calendar months

33. During an internal examination of a woman during her first prenatal visit, the nurse finds that thecervix is soft. This is known as _____ sign. A. Hegar's B. Chadwick's C. Homans' D. Goodell's

ANS: D) Goodell's Increased vascularity, congestion, and edema cause the cervix to soften (Goodell's sign) and become bluish purple (Chadwick's sign). The uterus becomes globular in shape, softens, and flexes easily over the cervix (Hegar's sign). This causes compression of the bladder, which results in urinary frequency. Homans' sign is pain in the calf upon dorsiflexion of the foot and is not related to signs of pregnancy

22. The nurse is palpating the uterus of a woman who is 8 weeks pregnant. Which of these findings would be considered to be most consistent with this stage of pregnancy? A. The uterus seems slightly enlarged and softened. B. It reaches to the pelvic brim and is about the size of a grapefruit. C. It rises above the pelvic brim and is about the size of a cantaloupe. D. It is about the size of an avocado, approximately 8 cm across the fundus.

ANS: D) It is about the size of an avocado, approximately 8 cm across the fundus. The 8-week pregnant uterus is approximately the size of an avocado, approximately 7 to 8 cm across the fundus. The 6-week pregnant uterus is slightly enlarged and softened. The 10-week pregnant uterus is about the size of a grapefruit and may reach to the pelvic brim. The 12-week pregnant uterus will fill the pelvis. At 12 weeks, the uterus is sized from the abdomen

1. Which of these statements best describes the action of the hormone progesterone during pregnancy? A. It produces the hormone human chorionic gonadotropin. B. It stimulates duct formation in the breast. C. It promotes sloughing of the endometrial wall. D. It maintains the endometrium around the fetus.

ANS: D) It maintains the endometrium around the fetus. Progesterone prevents the sloughing of the endometrial wall and maintains the endometrium around the fetus. Progesterone increases the alveoli in the breast and keeps the uterus in a quiescent state. The other options are not correct

20. The nurse is palpating the abdomen of a woman who is 35 weeks pregnant and notices that the fetal head is facing downward toward the pelvis. The nurse would document this as fetal: A. Lie. B. Variety. C. Attitude. D. Presentation.

ANS: D) Presentation Fetal presentation describes the part of the fetus that is entering the pelvis first. Fetal lie is orientation of the fetal spine to the maternal spine. Attitude is the position of fetal parts in relation to each other, and fetal variety is the location of the fetal back to the maternal pelvis.

2. A female patient has nausea, breast tenderness, fatigue, and amenorrhea. Her last menstrual period was 6 weeks ago. The nurse interprets that this patient is experiencing _____ signs of pregnancy. A. Positive B. Possible C. Probable D. Presumptive

ANS: D) Presumptive Presumptive signs of pregnancy are those that the woman experiences, and they include amenorrhea, breast tenderness, fatigue, nausea, and increased urinary frequency. Probable signs are those that are detected by the examiner, such as an enlarged uterus or changes in the cervix. Positive signs of pregnancy are those that document direct evidence of the fetus such as fetal heart tones or positive cardiac activity on ultrasound.

8. A woman in her second trimester of pregnancy complains of heartburn and indigestion. When discussing this with the woman, the nurse considers which explanation for these problems? A. Tone and motility of the gastrointestinal tract increase during the second trimester. B. Sluggish emptying of the gallbladder, resulting from the effects of progesterone, often causes heartburn. C. Lower blood pressure at this time decreases blood flow to the stomach and gastrointestinal tract. D. The enlarging uterus and altered esophageal sphincter tone predispose the woman to have heartburn.

ANS: D) The enlarging uterus and altered esophageal sphincter tone predispose the woman to have heartburn. Stomach displacement from the enlarging uterus plus altered esophageal sphincter and gastric tone as a result of progesterone predispose the woman to heartburn. The tone and motility of the gastrointestinal tract are decreased, not increased, during pregnancy. Emptying of the gallbladder may become more sluggish during pregnancy, but it is not related to indigestion. Instead, some women are predisposed to gallstone formation. A lower blood pressure may occur during the second semester, but it does not affect digestion.

32. During a woman's 34th week of pregnancy, she is told that she has preeclampsia. The nurse knows that which of these statements about preeclampsia is true? A. Preeclampsia has little effect on the fetus. B. Edema is one of the main indications of preeclampsia. C. Eclampsia only occurs before delivery of the baby. D. Untreated preeclampsia may contribute to restriction of fetal growth.

ANS: D) Untreated preeclampsia may contribute to restriction of fetal growth. Untreated preeclampsia may progress to eclampsia, which is manifested by generalized tonic-clonic seizures. Eclampsia may develop as late as 10 days postpartum. Before the syndrome becomes clinically manifested, it is affecting the placenta through vasospasm and a series of small infarctions. The placenta's capacity to deliver oxygen and nutrients may be seriously diminished, and fetal growth may be restricted. Edema is common in pregnancy and is not an indicator of preeclampsia

26. During the assessment of a woman in her 22nd week of pregnancy, the nurse is unable to hear fetal heart tones with the fetoscope. The nurse should: A. Notify the physician immediately, then wait 10 minutes and try again. B. Ask the woman if she has felt the baby move today. C. Wait 10 minutes and try again. D. Use ultrasound to verify cardiac activity

ANS: D) Use ultrasound to verify cardiac activity If no fetal heart tones are heard during auscultation with a fetoscope, then the nurse should verify cardiac activity using ultrasonography. This should be done before notifying the physician immediately or causing the woman distress by asking about fetal movement.

23. A woman in the 15th week of pregnancy has had bouts of severe vomiting for 3 weeks. She comes to the clinic today, and the nurse notices that she is showing signs of dehydration. Her blood pressure is lower than usual, and she is extremely fatigued. The nurse recognizes that this patient is experiencing: A. Preeclampsia. B. Polyhydramnios. C. Proteinuria. D. Hyperemesis

ANS: D) hyperemesis Nausea and vomiting are not uncommon in pregnancy and usually resolve between weeks 16 and 20 and may be controlled with dietary and lifestyle changes or oral antiemetics. Hyperemesis is the extreme of vomiting and may require home infusions or hospitalization for fluid replacement. See Table 29-2 for a description of preeclampsia. Polyhydramnios is a condition where there is excessive amniotic fluid. Proteinuria is the presence of protein in the urine, which is not a normalfinding

You palpate the maternal abdomen at approximately 35 weeks. Your left hand is on the maternal right, and your right hand on the maternal left. What maneuver is this?

Leopold's second maneuver

Approximately 2-3 weeks before labor, the woman will experience which sign that the baby has "dropped" to the pelvis?

Lightening

Multigravida

a pregnant woman who has previously carried a fetus to the point of viability

Umbilical cord

a ropelike structure containing blood vessels that connect the fetus to the placenta, carrying oxygen and nutrients from the mother and waste products away from the fetus

Nägele Rule

a rule for calculating estimated delivery date; add seven days to first day of LPM and subtract 3 months

Primigravida

a woman pregnant for the first time

Primipara

a woman who has had one pregnancy and delivery

Multipara

a woman who has had two or more viable pregnancies and deliveries

Presumptive signs of pregnancy include:

amenorrhea and fatigue.

Fetal heart tones are best ausculated over the fetus's:

back

Chadwick sign

bluish purple discoloration of the cervix during pregnancy due to venous congestion

Women older than 35 years who desire a pregnancy are at possible risk for:

congenital defects, infertility, diabetes, hypertension

Antenatal testing

consists of monitoring fetal growth, amniotic fluid volume, umbilical cord Dopper blood flow, and fetal monitoring via non-stress or contraction stress testing using a fetal monitor

Leopold maneuver

external palpation of the maternal abdomen to determine fetal lie, presentation, attitude, and position

What findings can be assessed with an obstetric ultrasound?

fetal position, placental location, amniotic fluid volume

Amniotic fluid

fluid in the sac surrounding the fetus in the mother's uterus

A pregnancy test measures levels of:

human chorionic gonadotropin.

Cardiac output in a pregnant woman:

increases along with stroke volume

Sexually transmitted infections place the pregnant woman at risk for:

infertility, premature rupture of membranes, preterm labor, postpartum maternal infections

Position

location of a fetal part to the right or left of the maternal pelvis

Anemia

low RBC count

Linea nigra

median line of the abdomen that becomes darker during pregnancy

Mucus plug

mucus that forms a thick barrier in the cervix that is expelled at various times before or during labor

Morning sickness

nausea and vomiting of pregnancy that usually begins between weeks 4 and 6, peaks bewtween weeks 8 and 12, and resolves between weeks 14 and 16

Hegar sign

occurs when the uterus becomes globular in shape, softens, and flexes easily over the cervix

Fetal lie

orientation of the fetal spine in relation to the maternal spine

A pregnant adolescent is medically at risk for:

poor weight gain, preeclampsia, sexually transmitted infections

A woman reports nausea, fatigue, breast tenderness, urinary frequency, and amenorrhea. These are:

presumptive signs of pregnancy

Abdominal pain in the first trimester may be indicative of:

preterm labor, ectopic pregnancy, or appendicitis

Signs of pregnancy identified by the clinician are considered:

probable signs.

Engagement

refers to when the widest diameter of the presenting part has descended into the pelvic inlet

Diastasis recti

separation of the abdominal muscle during pregnancy, returning to normal after pregnancy

Loss of the mucus plug is a:

sign of impending labor.

A woman at approximately 20 weeks' gestation reports lower right and/or left quadrant pain. What may be the cause?

stretching go the round ligament

Chloasma

the "mask of pregnancy"; butterfly-shaped pigmentation of the face

Nuchal translucency

the amount of fluid behind the neck of the fetus; also known as the nuchal fold. Fetuses at risk for down syndrome tend to have a higher amount of fluid

Blastocyst

the fertilized ovum; a specialized layer of cells around the blastocyst that becomes the placenta

Bloody show occurs with:

the onset of labor.

Presentation

the part of the fetus that is entering the pelvis first

Postpartum

the period occurring after delivery

Antepartum

the period occurring before childbirth

Colostrum

the precursor to milk that contains minerals, proteins, and antibodies

Goodell sign

the softening of the cervix due to increased vascularity, congestion, and edema

Ultrasound (US) image

the sound of waves to examine the fetus, amniotic fluid, and placenta in the uterus

Amniocentesis

the transabdominal perforation of the amniotic sac for the purpose of obtaining a sample of amniotic fluid; helps identify genetic disorders, such as Down syndrome or sickle cell anemia

Chorionic villi smapling

transabdominal or transvaginal sampling of trophoblastic tissue surrounding the gestational sac

VBAC

vaginal birth after cesarean delivery