Ch15-1

A pregnant client states, "I am only 6 weeks pregnant, but the morning sickness is awful. When is it going to stop?" What is the best response by the nurse?

"Usually after 12 weeks, when the placenta starts managing the production of progesterone, morning sickness ends." By 12 weeks' gestation, the placenta has grown sufficiently to take over production of progesterone and the corpus luteum is absorbed. Most women who have morning sickness start feeling better once the placenta takes over.

The client states that the first day of her last menstrual period is March 23. The nurse is most correct to calculate using Naegele rule that the estimated date of delivery is:

December 30

A nurse is asked to auscultate the fetal heart sounds in a pregnant client. Which of the following equipment is most appropriate when auscultating fetal heart sounds at the 12th week?

Doppler Fetal heart sounds are best heard with the Doppler from the 10th week onward. They can be heard with the fetoscope by about the 18th to 20th week only. A tocodynometer is used to record uterine contractions and not to auscultate fetal heart tones. Fetal heart tones may not be audible with an ordinary stethoscope at the 12th week.

A client's last menstrual period was April 11. Using the Naegele rule, her estimated date of delivery (EDD) would be:

January 18. To use the Naegele rule, subtract 3 months and then add 7 days to the first day of the client's LMP (April 11): April minus 3 months is January, plus 7 days is 18. Thus, her estimated date of delivery (EDD) would be January 18 of the next year.

A pregnant client reports difficulty sleeping well. Which suggestion for sleeping should the nurse prioritize to assist this client?

On her side with the weight of the uterus on the bed Resting on the side prevents pressure from the uterus against the vena cava and therefore allows blood to return to the uterus. Other positions may be more uncomfortable or may exacerbate the problems associated with pressure on the vena cava.

A nurse is counseling a pregnant client about Maternal Serum Marker Screening. She wants to go ahead with the test to rule out anencephaly. The client understands the risks associated with the test and is worried about what to do if the test shows a positive result even if the child is completely healthy. Which of the following nursing diagnoses would be most appropriate?

Risk for Anxiety related to false-positive test results The most appropriate nursing diagnosis will be Risk for Anxiety related to false-positive test results. The client understands the risks associated with the test so the diagnosis should not be deficient knowledge. As the client wants to have a Maternal Serum Marker Screening test done despite her apprehensions, there is no decisional conflict. The test involves a blood specimen so the risk for infection is extremely minute.

A woman has a positive pregnancy test and comes to the nurse with left lower quadrant pain. Bimanual examination reveals a tender mass. Which of the following is suspected?

Tubal pregnancy Lower quadrant pain in a young woman could represent any of these possibilities. A positive HCG test and left, not right-sided, pain make appendicitis less likely. Presence of an extrauterine mass makes threatened abortion less likely.

A nurse is discussing fetal development with a pregnant woman. The woman is 12 weeks pregnant and asks, "What's happening with my baby?" Which information would the nurse integrate into the response? Select all that apply.

continued sexual differentiation digestive system becoming active At 12 weeks, sexual differentiation continues and the digestive system shows activity. Eyebrows form and startle reflex is present between weeks 21 and 24. Lanugo on the head appears about weeks 13 to 16.

Pregnancy tests (both urine and blood) measure levels of which hormone to validate the existence of pregnancy?

human chorionic gonadotropin (hCG) The outer layer of the developing embryo produces hCG. Pregnancy tests (both urine and blood) measure levels of this hormone, whose presence validates the existence of a pregnancy and initiates a feedback loop that preserves the corpus luteum for longer than the normal 14 days.

A nurse is assessing a woman in labor. Which finding would the nurse identify as a cause for concern during a contraction?

respiratory rate of 10 breaths/minute During labor, the mother experiences various physiologic responses including an increase in heart rate by 10 to 20 bpm, a rise in blood pressure by up to 35 mm Hg during a contraction, an increase in white blood cell count to 25,000 to 30,000 cells/mm3, perhaps as a result of tissue trauma, and an increase in respiratory rate with greater oxygen consumption due to the increase in metabolism. A drop in respiratory rate would be a cause for concern.