1230 Maternal/Neonatal Nursing Chapter 65

A pregnant client states to the nurse, "I have a darkening of the skin on my face since I got pregnant and I don't know what it is." What is the best response by the nurse?

"This is melasma and is caused by hormonal changes during pregnancy."

Normal fetal heartbeat

120-160 bpm

Time needed for the morula to go down the Fallopian tube and into the uterus.

7- 9 days.

A nurse is caring for a pregnant client and will need to teach her about dietary changes that will need to be made. Which is a recommended dietary need for the pregnant client?

>Increase Fluid intake to 10 glasses daily. Rationale: Increasing fluid intake to 10 glasses daily during pregnancy will assist in kidney and bowel function. Caloric intake during pregnancy should be increased by approximately 300 calories, not just 100 calories, daily. The recommend folic acid intake during pregnancy should increase to 600 mcg rather than 200 mcg daily. Iodized salt should be used, as it promotes proper functioning of the thyroid gland. It should not be avoided.

A client is demonstrating presumptive signs of pregnancy . Which symptoms described by the client should the nurse document as presumptive? SATA

>Nausea, Frequent urination, Breast fullness and tenderness.

A fertilized ovum is known as:

A Zygote

The delivery of an infant by spontaneous or therapeutic means.

Abortion

Which term is used for the fluid-filled, inner membrane sac surrounding the fetus?

Amnion

Fluid that suspends the fetus within the amnion, cushioning the fetus from injury, regulating temperature, and allowing the fetus to move freely.

Amniotic fluid (page 1020)

Occurring before childbirth (referring to pregnant women) : antepartal

Antepartum (Page 1014)

A client reports her last menstrual period was on July 1, 2015. When calculating the estimated due date of confinement using the Naegele rule, what will the nurse document?

April 8, 2016

The nurse is providing instruction to the client with recently confirmed pregnancy at 5 weeks gestation. What should the nurse be sure to include in the instructions to prevent congenital anomalies in the embryo?

Avoid consumption of alcohol.

A specific Palpation to test for a floating object, such as a fetus

Ballottement (page 1016)

Maternal serum alpha-fetoprotein (MSAFP)

Between weeks 15 - 19; Screening for fetal neural tube defects (down syndrome, spina bifida); AKA triple marker screen

Layer surrounding a fluid-filled space

Blastocyst (page1016)

Literally head to toe (used to denote developmental progression in infants)

Cephalocaudal (page 1018)

A cervix that looks blue or purple which may occur as early as the sixth week of pregnancy

Chadwick sign (page 1022)

Functions of Amniotic Fluid:

Cushions the fetus against injury; Regulates temperature; Allows the fetus to move freely inside it, which allows normal musculoskeletal development of the fetus.

Nagele Rule

Determine date of LNMP, add 7 days, subtract 3 = estimated date of delivery

Supine Hypertension Syndrome

Do not sleep or lie on her back because the weight of the uterus can interfere with the circulation in the aorta and vena cava.

Detect fetal heartbeat as early as 10 weeks

Doppler

Pregnancy Danger Signs in the First Trimester:

Excessive Vomiting

Use of Hot tubs during pregnancy is considered safe and may ease lower back pain.

False

The major systems in a fetus do not develop until the last full month of pregnancy.

False.

Postive sign of pregnancy

Fetal heartbeat.

In pregnant woman, for which condition does the maternal serum alpha fetoprotein blood test screen?

Fetal neural tube defects.

Special manual stethoscope used to detect fetal heartbeat; can hear as early as 18-20 weeks

Fetoscope

A client arrives at the clinic stating to the nurse, "I have a positive urine pregnancy test and a set of twins at home that were born 32 weeks gestation." Using the G-P system, how will the nurse document these findings.

G2 P1

A client has been confirmed to be pregnant. she gives a history of two previous full-term normal pregnancies. How will the nurse classify the client's pregnancy history?

G3, P2

The period of time that occurs from the moment a man's sperm fertilizes a woman's egg until the birth of the newborn.

Gestation

GTPAL

Gestations, term pregnancies, preterm pregnancies, abortions, live births

Morning sickness that results in a weight loss of 8lbs or more.

Hyperemesis

Pregnancy Danger Signs Late in pregnancy

Leaking or gushing of amniotic fluid; swelling in the woman's extremities of face; dyspnea, blurred vision or spots before the eyes; severe headaches; abdominal, epigastric, or severe back pain; decreased fetal movement; lower abdominal pressure

The total number of children who have survived birth but may have died any time later. Often confused with reference to "living children"

Live births

The number of children living as of today (does not include live births who have died previously.) Can be confused with reference to "live birth"

Living children

Post term

Longer than 42 weeks gestation

A nurse is caring for a client who is 8 months pregnant. Which instruction is the nurse most likely to give her?

Maintain a side-lying position when resting or sleeping to avoid aortocaval compression.

RH Immune Globulin

Microdose: 50 mcg/ Full dose: 300 mg at 28 weeks gestation/ Adverse side effects: Pain, sore at injection site.

The branch of medicine concerned with pregnancy and birth is termed:

Obstetrics.

Outline the pathway of fetal blood circulation

Oxygenated blood from the placenta through umbilical cord → Fetus → Liver → Receives deoxygenated blood from the portal vein → through ductus venous → inferior vena cava → right atrium of the heart → through foramen ovale → left atrium of the heart → left ventricle of the heart

Abbreviation- P

P = number of deliveries

Abnormal Craving for nonfood items, such as clay, dirt, cornstarch

Pica

Which organ has a rich blood supply that supplies the developing organism with food and oxygen while also carrying away waste for excretion by the mother?

Placenta

The client tells the nurse shes suspects she may be pregnant. Which probable signs may be assessed to determine if the client is pregnant? SATA

Positive urine pregnancy test; Basal Body Temperature elevation; Enlargement of the abdomen

Gravida =

Pregnancy

Classification for a baby born between 20 - 37 weeks of gestation.

Preterm

Fetal movements that can be felt as early as 18- 20 weeks of gestation are known as:

Quickening

A pregnant client is excited that she is beginning to feel her baby move within her. How would the nurse document this information?

Quickening.

Sports that are safe during pregnancy

Racquet sports (Tennis, racquetball) ; Golf ; Slow pitch softball; Cross- Country skiing

Toxoplasmosis

Should not handle cat litter; and should cook all meats well, especially poultry.

Functions of the placenta:

Supplies the developing organism with food and oxygen; Carries waste away from excretion by the mother; Slows he maternal immune response so that the mother's body does not reject the fetal tissue

Abbreviation: T

T= Term

A client who is considering becoming pregnant asks the nurse about the safety of sports during pregnancy. The nurse would include which in the list of safe sports to participate in while pregnant?

Tennis.

TPAL

Term births, Premature births, Abortions, Living Children

2,500 - 3,500 calories needed per day

True

Consuming adequate amounts of folic acid during pregnancy is crucial to prevent neural tube defects.

True

Environmental factors such as tobacco or alcohol use can cause congenital anomalies or birth defects.

True

The amniotic fluid provides a cushion for the fetus and helps to regulate temperature in the womb.

True

Using its chorionic villi within the placenta, the fetus secures its oxygen and food directly from the mothers blood, instead of using its own lungs. and digestive system.

True

Gravida is the term used in the classification of pregnancy history, indicating total number of pregnancies.

True.

The period of the fetus lasts from the beginning of the 9th week after fertilization through birth

True.

Pregnancy Danger Sign at any time of pregnancy

Vaginal bleeding, excessive or irritating vaginal discharge, dizziness or fainting, decrease in urine output, burning with urination, persistent vomiting, chills or fever, and chest pain.

First Trimester

Weeks 1-12

Second Trimester

Weeks 13 - 28

Third Trimester

Weeks 29 to delivery

Fertilized Ovum (_____________) is the beginning of potential individual human development. When it divides into 16 cells, it is called a ______________.

Zygote; Morula

At least 5 pregnancies or more =

grand multipara

Other births =

multigravida

First Pregnancy =

primigravida

Preterm

pregnancy of 20 - 37 weeks, or more than 500 g or less than 2500 g

puerperium

time between birth and 42 days of delivery.

Although the exact cause of fatigue is unknown, tiredness is probably caused by the body's increased use of energy because it works harder than normal during this time.

true