Prenatal Labor and Delivery Final

During the initial prenatal visit of a woman at 23 weeks' gestation, the nurse discovers that she has a history of pica. What is the most appropriate nursing action? Seeking referral to a psychologist or psychiatrist Explaining the danger this poses to the fetus Obtaining a prescription for an iron supplement Determining whether the diet is nutritionally adequate

Determining whether the diet is nutritionally adequate

A nurse is teaching a young primigravida regarding expected body changes during pregnancy. The nurse explains that most prenatal clients experience urinary frequency in the first trimester due to an increase in what? Estrogen level Extracellular fluid volume Kidney glomerular filtration Bladder pressure from the enlarged uterus

Bladder pressure from the enlarged uterus

When discussing dietary needs during pregnancy, a client tells the nurse that milk causes her to be constipated at times. What should the nurse teach the client? A.Substitute a variety of cheeses for the milk. B. Replace fat-free or low-fat milk for whole milk. C. Increase intake of prenatal supplements and omit the milk. D. Treat constipation when it occurs and continue drinking milk.

D. If not lactose intolerant should drink milk for nutrients

A client measuring at 18 weeks' gestation visits the prenatal clinic stating that she is still very nauseated and vomits frequently. Physical examination reveals a brown vaginal discharge and a blood pressure of 148/90 mm Hg. What condition does the nurse suspect the client is experiencing? Dehydration Choriocarcinoma Hydatidiform mole Threatened abortion

Hydatiform Mole Rationale:A hydatidiform mole, in which chorionic villi degenerate into grapelike vesicles, is most often the cause of these signs and symptoms. Although vomiting may cause dehydration, this conclusion ignores the vaginal discharge and hypertension. Choriocarcinoma is a sequel to a hydatidiform mole; the blood level of human chorionic gonadotropin (hCG) is monitored for 1 year after removal of the mole. If the level of hCG blood decreases to the expected range and remains there for 1 year, the client may safely plan another pregnancy. Although vaginal discharge is related to threatened abortion, an increased blood pressure and severe nausea and vomiting are not.

A client asks the nurse at the prenatal clinic whether she may continue to have sexual relations while pregnant. What is one indication that the client should refrain from intercourse during pregnancy? Fetal tachycardia Presence of leukorrhea Premature rupture of membranes Imminence of the estimated date of birth

Premature rupture of membrane Rationale: Ruptured membranes leave the products of conception exposed to bacterial invasion. Intact membranes act as a barrier against organisms that may cause an intrauterine infection. Fetal tachycardia may occur during sex, but there is no evidence that it is harmful for the fetus. Leukorrhea is common because of increased production of mucus containing exfoliated vaginal epithelial cells; intercourse is not contraindicated by leukorrhea. Intercourse is not contraindicated near the estimated date of birth if the membranes are intact; modification of sexual positions may be needed because of the enlarged abdomen

A pregnant woman at 6 weeks' gestation tells the nurse at her first prenatal visit that she uses an over-the-counter herbal product as a health supplement. What should the nurse recommend to the client? Select all that apply. Select all that apply Stop taking the supplement immediately. Discuss the use of the supplement with the practitioner. Increase the dosage of the supplement as pregnancy progresses. Ask the pharmacist whether the supplement is safe for use during pregnancy. Discuss the use of any over-the-counter products with the practitioner.

Stop taking the supplements immediatley Discuss the use of supplements with practitioner Discuss the use of an OTC products with the practitioner Rationale:Stopping the supplement is appropriate until more instructions are received from the practitioner. It is the practitioner's responsibility to counsel the client regarding all prescriptions, over-the-counter medications, and supplements. Continuing or increasing the dose of the supplement is unsafe; it may be detrimental to both the client and the fetus. The nurse may not prescribe medications of any kind, and to do so is functioning outside of the legal definition of nursing practice. It is the practitioner's responsibility, not the pharmacist's, to counsel the client regarding all prescriptions, over-the-counter medications, and supplements.

A primigravida client with type 1 diabetes is attending her first prenatal visit. While discussing changes in insulin needs during pregnancy and after birth, the nurse explains that in light of the client's blood glucose readings she should expect to increase her insulin dosage. Between which weeks of gestation is this expected to occur? Tenth and twelfth weeks of gestation Eighteenth and twenty-second weeks of gestation Twenty-fourth and twenty-eighth weeks of gestation Thirty-sixth and fortieth weeks of gestation

Twenty fourth and twenty eighth weeks of gestation

A 37-year-old woman agrees to have a prenatal test done in order to diagnose fetal defects. There is a history of Down syndrome in her family. Which invasive prenatal test provides the earliest diagnosis and rapid test results? Nonstress test Amniocentesis Chorionic villus sampling Percutaneous umbilical blood sampling

chorionic villus sampling

A client at 38 weeks' gestation is admitted to the high-risk prenatal unit with a diagnosis of severe preeclampsia. The nurse obtains the vital signs, performs a health history and physical assessment, and reviews the client's laboratory results. What is the priority nursing intervention at this time? Monitoring intake and output Providing a dark private room Measuring the extent of edema Preparing for an immediate cesarean birth

Providing a dark private room Rationale: Increasing cerebral edema may predispose the client to seizures; therefore, stimuli of any kind should be minimized. Although intake and output should be monitored to identify oliguria, this will not limit the occurrence of a seizure. Although edema should be measured, it will not limit the occurrence of a seizure. A cesarean birth may not be necessary.

A client has been taking methadone 40 mg/day for treatment of an opioid addiction. During a methadone clinic visit she tells the counselor that she is 3 months pregnant and receiving prenatal care. The counselor notifies the nurse in the prenatal clinic about the client's addiction history. What should the nurse in the prenatal clinic recommend that the client do? A. Withdraw the methadone slowly over the next several weeks. B. Continue the prescribed methadone to prevent withdrawal symptoms. C. Temporarily discontinue the methadone to improve maternal and neonatal outcome. D. Leave the methadone maintenance program during the pregnancy and reenter it after the birth.

B. continue the prescribed methadone to prevent withdrawl symptoms Rationale: Methadone is the only medication approved for the treatment of pregnant women with opioid addiction. Although methadone crosses the placenta, it is considered safer for the newborn than the acute opioid detoxification that would result if the methadone was not administered.

A nurse is teaching a prenatal class regarding the physiologic alterations that occur during the second trimester of pregnancy. What cardiovascular changes should the nurse include? Select all that apply. Cardiac output increases. Blood pressure decreases. The heart is displaced upward. The blood plasma volume peaks. The hematocrit level is lowered

Cardiac output increases during the second trimester due to an increasing plasma volume. The blood pressure decreases because of the enlarged intravascular compartment and hormonal effects on peripheral resistance. As the fetus grows and the enlarging uterus outgrows the pelvic cavity, it displaces the heart upward and to the left A,B,C

The nurse is teaching a prenatal breathing and relaxation class. What intervention does the nurse suggest to ease back discomfort during labor? Alternating lying on the back and side Having support persons use back massage techniques Using distraction techniques such as abdominal effleurage Maintaining the knee-chest position before and after assessments of the fetal heart rate

Having support persons use back massage techniques Rationale:The fetus exerts pressure against the spine during labor; back massage provides counterpressure, which eases the discomfort. The back-lying position is contraindicated because the weight of the fetus compresses the vena cava, decreasing the flow of blood to the placenta. Although abdominal effleurage can serve as a distraction during labor, it will not relieve back discomfort. The knee-chest position will also not relieve back pain during labor.