sex/repro prepu questions
A primigravid client at 24 weeks' gestation has received permission from the primary care provider to make a 6-hour automobile trip to visit her parents. After the nurse teaches the client about precautions to take during the trip, which client statement indicates the need for further instruction?
"I'll sleep for 1 hour at the halfway point of the trip."
A client is at an ideal weight when she conceives. During a prenatal visit 2 months later, the client asks the nurse how much weight she should gain during pregnancy. What is the nurse's best response?
"You should gain 25 to 35 lb (11.3 to 15.9 kg)."
When can fetal heart tones be heard?
10-12 weeks: doppler >18 weeks: fetoscope
normal FHR
110-160 bpm
drug used for syphilis
Benzathine with penacillin if allergic to penicillin --> doxycycline
A client is admitted to the labor area for induction with intravenous oxytocin because she is 42 weeks pregnant. What should the nurse include in the induction teaching plan for this client?
Continuous fetal heart rate monitoring will be implemented.
Prenatal Visits (Frequency)
Every 4 weeks for the first 28 weeks Every 2 weeks from 29 weeks until 36 weeks After week 36: every week until childbirth
The nurse assesses a client during the third stage of labor. Which assessment findings indicate that the client is experiencing postpartum hemorrhage?
Heart rate 120 beats/minute, respiratory rate 28 breaths/minute, blood pressure 80/40 mm Hg 9 (low bp)
While a 31-year-old multigravida at 39 weeks' gestation in active labor is being admitted, her amniotic membranes rupture spontaneously. The client's cervix is 5 cm dilated, the presenting part is at 0 station, and the electronic fetal heart rate pattern is reassuring. What should the nurse do first?
Note the color, amount, and odor of the amniotic fluid.
A woman's breasts undergo anatomic and physiologic changes during pregnancy and lactation. Which of the following is true?
The alveolar cells being to secrete colostrum.
A primigravid client gave birth vaginally 2 hours ago with no complications. As the nurse plans care for this postpartum client, which postpartum goal would have the highest priority?
The client will demonstrate self-care and infant care by the end of the shift.
para/parity
The number of babies born after 20 weeks gestation does not include current pregnancy twins= one pregnancy
Ballottement
a sharp upward pushing against the uterine wall with a finger inserted into the vagina for diagnosing pregnancy by feeling the return impact of the displaced fetus
The health care provider (HCP) plans to perform an amniotomy on a multiparous client admitted to the labor area at 41 weeks' gestation for labor induction. After the amniotomy, what should the nurse do first?
assess fetal heart rate for a full minute
A primigravid client has just completed a difficult, forceps-assisted birth of a 9-lb (4.08-Kg) neonate. Her labor was unusually long and required oxytocin augmentation. The nurse who's caring for her should stay alert for uterine
atony
drug used for chlamydia
azithromycin #1 STI in america
In which maternal locations would the nurse place the ultrasound transducer of the external electronic fetal heart rate monitor if a fetus at 34 weeks' gestation is in the left occipitoanterior (LOA) position?
below the umbilicus on the left side
used for pain management during delivery
butorphanol (stadol) - narcotic - can cause withdraw in physical opiate addiction
For a primigravid client with the fetal presenting part at -1 station, what would be the nurse's priority immediately after a spontaneous rupture of the membranes?
check fetal heart rate
vertex fetal presentation
chin to chest (ideal position)
client education for contraceptives
danger signs to report: -blood clotting --> pain/redness at site -pulmonary blood clot --> shortness of breath
The nurse is caring for expectant and new mothers. The nurse would encourage breastfeeding for the client who is:
diagnosed with mastitis
While performing continuous electronic monitoring of a client in labor, the nurse should document which information about uterine contractions?
duration, frequency, and intensity
A client who's 19 weeks pregnant comes to the clinic for a routine prenatal visit. In addition to checking the client's fundal height, weight, and blood pressure, what should the nurse assess for at each prenatal visit?
edema
gestational diabetes when
end of 2nd trimester, 24-28 weeks
A 25-year-old woman who is in the first stage of labor receives a continuous lumbar epidural block when the cervix is 6 cm dilated. After administration of this anesthesia, which assessment would be most important?
fetal heart rate
optimal/most common pelvic shape
gynecoid (50%)
hormone responsible for gestational diabetes
hPL
hormone responsible for morning sickness
hcG - also detected in pregnancy tests
During the initial assessment of a laboring client, the nurse notes the following: blood pressure 160/110 mm Hg, pulse 88 beats/minute, respiratory rate 22 breaths/minute, reflexes +3/+4 with 2 beat clonus. Urine specimen reveals +3 protein, negative sugar and ketones. Based on these findings, a nurse should expect the client to have which complaints?
headache, blurred vision, and facial and extremity swelling
which STI is lifelong
herpes
A 19-year-old primigravida at 38 weeks' gestation, in active labor for the past 8 hours, is admitted to the hospital accompanied by her mother. On admission, the client's cervix is 5 cm dilated, her blood pressure is 120/84 mm Hg, and she is breathing rapidly, feeling dizzy and light-headed. The nurse determines that the client is most likely experiencing effects of which factor?
hyperventiliation
A 31-year-old multigravid client at 39 weeks' gestation admitted to the hospital in active labor is receiving intravenous lactated Ringer's solution and a continuous epidural anesthetic. During the first hour after administration of the anesthetic, the nurse should monitor the client for which adverse reaction?
hypotension
Which behavior should cause the nurse to suspect that a client's labor is moving quickly and that the physician should be notified?
increased sense of rectal pressure
During the fourth stage of labor, a nurse notes that the client's fundus is boggy and located above the umbilicus. What is the nurse's priority intervention?
massage fundus
What assessment data of a laboring woman would require further intervention by the nurse?
maternal heart rate 125 bpm
During labor, a primigravid client receives an epidural anesthetic, and the nurse assists in monitoring maternal and fetal status. Which finding suggests an adverse reaction to the anesthesia?
maternal hypotension
drug used for bacterial vagninosis
metronidazole (flagyl) no alcohol!
A nurse assesses a 1-day-old neonate. Which finding indicates respiratory distress?
nasal flaring
The membranes of a multigravid client in active labor rupture spontaneously, revealing greenish-colored amniotic fluid. How does the nurse interpret this finding?
passage of meconium by the fetus
A client in her 34th week of pregnancy presents with sudden onset of bright red vaginal bleeding. Her uterus is soft, and she's experiencing no pain. Fetal heart rate is 120 beats/minute. Based on this history, what should the nurse suspect?
placenta previa (placenta covers the opening in the mother's cervix)
The nurse is caring for a primigravida client who has been admitted to the labor and birth unit. Assessment reveals fetal malpresentation, green amniotic fluid, and a fetal heart rate (FHR) of 98 beats/minute. What is the nurse's priority intervention?
prepare for emergency c-section
A nurse is developing a care plan for a client in her 34th week of gestation who's experiencing premature labor. What nonpharmacologic intervention should the plan include to halt premature labor?
promoting adequate hydration
hormone responsible for waddling gait in third trimester
relaxin
contradicted in males with acute uncontrolled hypertension
sildenafil (viagra)
The health care provider (HCP) has prescribed prostaglandin gel to be administered vaginally to a newly admitted primigravid client. Which finding indicates that the client has had a therapeutic response to the medication?
softening of the cervix and beginning effacement
When the nurse is working in the mother-baby unit, which client would the nurse anticipate giving Rho(D) immune globulin (human) to?
the Rh-negative mother with an Rh-positive baby
quickening.... when?
the first movement of the fetus in the uterus that can be felt by the mother 16-20 weeks
A nurse is teaching a pregnant client how to distinguish prelabor contractions from true labor contractions. Which statement about prelabor contractions is accurate?
they're usually felt in abdomen
A client with gestational hypertension receives magnesium sulfate, 4 g in 50% solution I.V. over 20 minutes. What is the purpose of administering magnesium sulfate to this client?
to prevent seizures
The nurse is caring for a multigravid client in active labor when the nurse detects variable fetal heart rate decelerations on the electronic monitor. The nurse interprets this as the compression of which structure?
umbilical cord
A primigravid client is admitted to the labor and delivery area, where the nurse evaluates her. Which assessment finding may indicate the need for cesarean birth?
umbilical cord prolapse
BMI for under, normal, over, obese
underweight: <18.5 normal: 18.5-24.9 over: 25- 29.9 obese: >30
Accompanied by her partner, a client seeks admission to the labor and delivery area. She states that she's in labor and says she attended the facility clinic for prenatal care. Which question should the nurse ask her first?
what is your EDD
first, second and third trimester
1st: weeks 1-13 2nd: weeks 14-26 3rd: weeks 27-40
Chadwick's sign
Bluish-purple coloration of the vaginal mucosa and cervix
drug used for gonorrhea
Ceftriaxone (rocephin) in combination with azithromycin #2 STI in america
A 32-year-old primigravida at 39 weeks' gestation is admitted to the hospital in active labor. While the nurse performs Leopold's maneuvers, the client asks why these maneuvers are being done. The nurse explains that the major purpose of these maneuvers is to determine which factor?
fetal presentation
The nurse is caring for a client at 36 weeks' gestation with a temperature of 101.2° F (38.4° C). Examination indicates that the client is leaking amniotic fluid. The nurse understantds that what is the probable cause of the client's fever?
intrauterine infection
After the nurse explains about the second stage of labor, which client statement would indicate to the nurse that the client understands the information discussed?
"I should try to push with each contraction"
A primigravid client in a preparation for parenting class asks how much blood is lost during an uncomplicated vaginal birth. What should the nurse should tell the client?
"The maximum blood loss considered within normal limits is 500 ml."
A client in the fourth stage of labor asks to use the bathroom for the first time since giving birth. The client has oxytocin infusing. What is the nurse's best response?
"Let me help you sit up on the side of the bed."
antepartum; intrapartum; postpartum
-prenatal, conception to onset of labor -onset of labor to delivery of placenta -delivery of placenta to 6 weeks after
Ultrasound (when)
20 weeks
when is glucose test done
28 weeks
gtpal
Gravida, Term, Preterm, Abortions, Living
A multigravid client at 34 weeks' gestation who is leaking amniotic fluid has just been hospitalized with a diagnosis of preterm premature rupture of membranes and preterm labor. The client's contractions are 20 minutes apart, lasting 20 to 30 seconds. Her cervix is dilated to 2 cm. The nurse reviews prescriptions (see chart). Which prescription should the nurse initiate first?
Initiate fetal and contraction monitoring.
What data indicates to the nurse that placental detachment is occurring?
abrupt lengthening of cord
A multigravid client is receiving oxytocin augmentation. When the client's cervix is dilated to 6 cm, her membranes rupture spontaneously with meconium-stained amniotic fluid. Which action should the nurse perform first?
assess fetal heart rate
When measuring the fundal height of a primigravid client at 20 weeks' gestation, the nurse will locate the fundal height at which point?
at about the level of the client's umbilicus
A client at term arrives in the labor unit experiencing contractions every 4 minutes. After a brief assessment, she's admitted and an electric fetal monitor is applied. Which finding should most concern the nurse?
blood pressure of 146/90 mm Hg
Assessment of a client in active labor reveals meconium-stained amniotic fluid and fetal heart sounds in the upper right quadrant. What is the most likely cause of this situation?
breech position
when to avoid narcotics
during transition labor
A client in labor is attached to an electronic fetal monitor (EFM). Which finding by an EFM indicates adequate uteroplacental and fetal perfusion?
fetal heart rate variability within 5 to 10 beats/minute
A postpartum client's husband calls the nurse and says, "My wife feels funny." The nurse enters the room and notes blood gushing from the client's vagina, pallor, and a rapid, thready pulse. What should be the nurse's first intervention?
massage fundus
A 16-year-old unmarried client visiting the prenatal clinic at 32 weeks' gestation and currently weighing 140 lb (63.5 kg) is being closely monitored for early signs of preeclampsia. The client is 5 feet, 2 inch (158 cm) tall and weighed 120 lb (54.4 kg) before the pregnancy. Which factor would be most important to assess?
proteinuria
Recommended weight gain during pregnancy for each BMI
under: 28-40 normal: 25-35 over: 15-25 obese: 11-20