Ch1 -2

A client comes to the clinic after a positive home pregnancy test. The health care provider performs an ultrasound examination and determines the client is 8 weeks' pregnant. The client asks the nurse if the provider will disclose the baby's gender. What is the nurse's best response?

"No, the gender can't be determined until the second trimester ultrasound." Fetal gender cannot be seen until the second trimester fetal survey ultrasound. The first trimester ultrasound is to confirm the presence of a viable pregnancy and establish gestational age. A second trimester ultrasound can visualize fetal gender and structural characteristics of the fetus.

A client asks about a child inheriting an autosomal recessive disorder. What must occur for an offspring to demonstrate signs and symptoms of the disorder with this type of inheritance?

Both parents must be carriers. Autosomal recessive inheritance occurs when two copies of the mutant or abnormal gene in the homozygous state are necessary to produce the phenotype. In other words, two abnormal genes are needed for the individual to demonstrate signs and symptoms of the disorder. Both parents of the affected person must be carriers of the gene, either clinically normal or expresses the disorder.

Select the bradycardic episode on the fetal monitor tracing.

Bradycardia is when the fetal heart rate drops below 100 beats per minute.

The father of a stillborn infant tells the nurse he wants to hold the child. What is the nurse's best response?

Dress the infant in a T-shirt and diaper and let him hold the infant. Fathers need to grieve the loss of an infant. Seeing and holding the infant is helpful to many parents. Providing photographs is a long-term keepsake, but does not replace the opportunity to hold and view his infant. Optimally, parents will grieve as a couple, but if the mother is unable to hold the infant because of medical condition or personal choice, the father still needs the opportunity to see and say goodbye to his child.

The nurse encourages a woman with gestational diabetes to maintain an active exercise period during pregnancy. Prior to this exercise period, the nurse would advise her to take which action?

Eat a sustaining-carbohydrate snack. Because exercise uses up glucose, women with diabetes should take a sustaining-carbohydrate snack before hard exercise to prevent hypoglycemia.

A client complaining of right-sided abdominal pain and intermittent vaginal bleeding over the past 2 hours comes to the urgent care center. Based on her last menstrual period and a home pregnancy test she is 8 weeks' pregnant. A blood test confirms the pregnancy but the hCG level is low for 8 weeks' gestation. This client's presentation is consistent with what condition?

Ectopic pregnancy These symptoms are consistent with an ectopic pregnancy. In addition to the cramping and intermittent bleeding, the low levels of hCG from the blood test are a sign that the pregnancy is not growing (as happens when the embryo is developing in the confined space of the fallopian tube). With implantation bleeding or a threatened abortion, the hCG level would be consistent with an 8 week gestation pregnancy. At 8 weeks' gestation, the placenta is not adequately formed to prematurely separate.

A client with symptoms of pregnancy is having an ultrasound is to determine the gestation of the pregnancy. The nurse explains that the visualization of different developmental milestones correlates with the gestation of the pregnancy. Place the following developmental milestones in order, from earliest to latest, as they appear during the first trimester. Use all options.

Gestational sac Cardiac pulsation Spine formation Formation of limb buds

A pregnant client arrives in triage reporting sudden, intense abdominal pain and vaginal bleeding. The nurse assesses the client's abdomen and finds it is firm with frequent contractions. Based on this presentation and the assessment data, what condition does the nurse prepare for?

Placental abruption Sudden, intense abdominal pain with or without vaginal bleeding is characteristic of a condition called placental abruption. Preeclampsia is characterized by elevated blood pressure, protein in the urine, and edema. Placenta previa is characterized by painless vaginal bleeding. A ruptured uterus also has intense abdominal pain, but uterine contractions are not palpable.

The parent is going to do skin-to-skin contact with a premature infant. Place in order the steps the nurse should take. Use all options.

Position parent in comfortable chair. Expose parent's chest skin. Undress infant, except for diaper. Position baby on parent's chest. Cover parent and baby with warmed blanket.

The nurse cared for a client who gave birth. The duration of labor from the onset of contractions until the birth of the baby was 2 hours. How will the nurse document the client's labor in the health record?

Precipitous labor A labor that is less than 3 hours in duration is a precipitous labor. Prolonged labor, also known as failure to progress, occurs when labor lasts for approximately 20 hours or more in a first-time mother. Prodromal labor is labor that starts and stops before fully active labor begins. The contractions are real, but they come and go, and labor does not progress. False labor is intermittent nonproductive or practice contractions, which most commonly occur in the last 2 months before a full-term delivery.