OB Chapter 11 Prepu

The nurse is caring for a client at 8 weeks' gestation who states, "I did not plan for this right now and I am not happy or excited about this pregnancy. I am not sure what to do." Which response by the nurse is best?

"Many women feel this way during the first trimester."

A client is about 16 weeks' pregnant and is concerned because she feels her "abdomen" contracting. She calls the primary care provider's office and speaks to the nurse. What is the nurse's most appropriate response to this client's concern?

"What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy."

Before becoming pregnant, a woman's heart rate averaged 72 beats per minute. The woman is now 15 weeks' pregnant. The nurse would expect this woman's heart rate to be approximately:

85 beats per minute.

A 17-year-old client arrives for an annual examination and reports no changes since the last exam; however, the nurse assesses a positive 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

A pregnant client in her third trimester, lying supine on the examination table, suddenly 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.

A pregnant client at 24 weeks' gestation calls the clinic crying after a prenatal visit, where she had a pelvic exam. She states that she noticed blood on the tissue when she wiped after voiding. What initial statement by the nurse would explain this finding?

The cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual.

The nurse is examining a woman who came to the clinic because she thinks she is pregnant. Which data collected by the nurse are presumptive signs of her pregnancy? Select all that apply.

breast changes amenorrhea morning sickness

Which information provided by a client would be considered a presumptive sign of pregnancy?

breast tenderness

A nurse is explaining how hormones affect the pregnancy. Which hormone would the nurse describe as being responsible for stimulating uterine contractions during labor and birth?

oxytocin

The nurse is preparing to teach a community class to a group of first-time parents. Which information should the nurse include concerning what the pregnant woman's partner may experience as a normal response?

physical symptoms similar to the mother

A new mother voices concerns about breastfeeding her infant. The nurse would explain to the mother the two hormones that control lactation and letdown are:

prolactin and oxytocin.

The nurse is assessing a pregnant woman and noticing behavior changes that indicate she is beginning to accomplish the maternal tasks of becoming a mother. The client is in her third trimester. Which behavior would the nurse most likely assess?

questioning of her ability to become a good mother

The client at 18 weeks' gestation states, "I feel a fluttering sensation, kind of like gas." The nurse understands that the client is describing what occurrence?

quickening

A client who has just given a blood sample for pregnancy testing in the health care provider's office asks the nurse what method of confirming pregnancy is the most accurate. The nurse explains the difference between presumptive symptoms, probable signs, and positive signs. What should the nurse mention as an example of a positive sign, which may be used to diagnose pregnancy?

visualization of the fetus by ultrasound

A client in her 39th week of gestation reports swelling in the legs after standing for long periods of time. The nurse recognizes that this factor increases the client's risk for which condition?

venous thrombosis

The nurse is teaching a prenatal class about preparing for their expanding families. What is helpful advice from the nurse?

"The hormones of pregnancy may cause anxiety or depression postpartum."

A pregnant client reports an increase in a thick, whitish vaginal discharge. Which response by the nurse would be most appropriate?

"This discharge is normal during pregnancy."

A client in her second trimester of pregnancy is anxious about the blotchy, brown pigmentation appearing on her forehead and cheeks. She also reports increased pigmentation on her breasts and genitalia. Which statement by the nurse is most appropriate?

"This is called facial melasma (chloasma) and should fade after the birth."

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 (0.45 kg)

The nurse is teaching a pregnant woman with a prepregnancy body mass index (BMI) of 26 about recommended weight gain. The nurse determines that the teaching was successful when the woman states that she should gain approximately how much during her pregnancy?

15 to 25 pounds (7 to 11 kilograms)

The nurse is assessing a pregnant client at her 20-week visit. Which breast assessment should the nurse anticipate documenting?

Darkened breast areolae

Which interventions would a pregnant client be taught regarding dietary restrictions during pregnancy? Select all that apply.

Discard foods that have been left out at room temperature for more than 2 hours. Wash raw fruits and vegetables with hot water and a mild soap. Do not drink raw or unpasteurized milk

A nurse is assessing a pregnant client. The nurse understands that hormonal changes occur during pregnancy. Which hormones would the nurse most likely identify as being inhibited during the pregnancy?

FSH and LH

What is a positive sign of pregnancy?

Fetal movement felt by examiner

A client in her 39th week of gestation arrives at the maternity clinic stating that earlier in her pregnancy, she experienced shortness of breath. However, for the past few days, she has been able to breathe easily, but she has also begun to experience increased urinary frequency. A nurse is assigned to perform the physical examination of the client. Which observation is most likely?

Fundal height has dropped since the last recording.

What physical changes take place when a woman becomes pregnant? Select all that apply.

Heart rate increases 10 to 15 beats per minute. The areolae become more prominent. Nasal congestion increases due to edema.

A 28-year-old client in her first trimester of pregnancy reports conflicting feelings. She expresses feeling proud and excited about her pregnancy while at the same time feeling fearful and anxious of its implications. Which action should the nurse do next?

Inform the client this is a normal response to pregnancy that many women experience.

A client calls to cancel an appointment for the first prenatal visit after reporting a home pregnancy test is negative. Which instruction should the nurse prioritize?

Keep the appointment.

In preparing for a prenatal class to discuss the hormonal changes during pregnancy, which information would the nurse most likely include?

Over-the-counter antacids can be used to treat acid reflux with the health care provider's knowledge.

A client in her 29th week of gestation reports dizziness and clamminess when assuming a supine position. During the assessment, the nurse observes there is a marked decrease in the client's blood pressure. Which intervention should the nurse implement to help alleviate this client's condition?

Place the client in the left lateral position.

During late pregnancy, the nurse teaches a pregnant woman to lay on her left side to avoid what condition?

Supine hypotension syndrome

During a routine prenatal visit, a pregnant woman reports a white, thick, vaginal discharge. She denies any itching or irritation. Which action would the nurse take next?

Tell the woman that this is entirely normal.

A client takes a home pregnancy test. While she is waiting to read the results, her phone rings. When she gets off the phone 15 minutes have passed. The package instructions are to read the pregnancy test result at 3 minutes and warn that waiting longer may result in a false positive. What is a false positive?

The test reads positive but the client is not pregnant.

During a prenatal visit, the nurse inspects the skin of the client's abdomen. Which would the nurse identify as an abnormal finding?

bruising

What is the major concern for a lactose intolerant woman who is pregnant?

calcium deficiency

During pregnancy a woman has many psychological adaptations that must be made. The nurse must remember that the baby's father is also experiencing the pregnancy and has adaptations that must be made. Some fathers actually have symptoms of the pregnancy along with the mothers. What is this called?

couvade syndrome

The husband of a pregnant woman in her first trimester tells the nurse that his wife is increasingly preoccupied with herself and her fetus as more signs of the pregnancy present themselves. What should the nurse point out to the husband is probably occurring in this situation?

introversion

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 fetus