ob exam #2 ch 12

The most common method of kick counting is

"Count to 10," whereby a woman focuses her attention on her fetus's movement and records how long it takes to document 10 movements.

A nurse is teaching a client who is 30 weeks pregnant about ways to deal with heartburn. The nurse determines a need for additional teaching based on which client statement?

"I should lie down for 1/2 hour after eating."

After teaching the pregnant woman about ways to minimize flatulence and bloating during pregnancy, the nurse understands that which client statement indicates the need for additional teaching?

"I'll switch to chewing gum instead of using mints."

A client at 10 weeks gestation comes to the clinic for a prenatal follow-up. The client reports experiencing morning sickness. She states, "It happens at any time of the day. Is there anything I can do?" Which suggestions by the nurse would be most helpful? Select all that apply.

"Try eating some dry crackers before you getting out of bed in the morning." "Avoid any strong food odors as much as possible." "Limit your intake of fluids when you eat your meals."

The diagonal conjugate of a pregnant woman's pelvis is measured. Which measurement would the nurse interpret as presenting a potential problem?

12.0 cm

pelvic inlet should be ?

12.5 or greater

A client who is in her first trimester is anxious to have an ultrasound at each visit. The nurse explains that it is not necessary and schedules a second ultrasound to be performed when she is about:

18 to 20 weeks pregnant.

A nurse is teaching a pregnant woman how to perform fetal kick counts. The nurse determines that the teaching was successful when the client states that she will call her healthcare provider if it takes longer than what time frame to reach 10 kicks?

2 weeks

women should be tested for gestational diabetes between ?

24-28 weeks

first week check up schedule is every 4 weeks up to

28 weeks

Assessment for edema is typically done between

29-36 weeks

check up every 2 weeks from

29-36 weeks

Backache and leg cramps are more common in

2nd trimester

. A woman should report a count of less than

3

A pregnant woman comes to the clinic for a visit. This is her third pregnancy. She had a miscarriage at 12 weeks and gave birth to a son, now 3 years old,at 32 weeks. Using the GTPAL system, the nurse would document this woman's obstetric history as:

30111

check up every week from

37 weeks to birth

A woman is in her early second trimester of pregnancy. The nurse would instruct the woman to return for a follow-up visit every:

4 weeks

At the first prenatal visit of all clients who come to the clinic appropriate blood screenings are obtained. The nurse realizes that a hemoglobin A1c above which level is concerning for diabetes and warrants further testing?

6.5%

The triple marker screens for

AFP, hCG, and unconjugated estriol

At the first prenatal visit, the client reports her LMP was November 16, 2017. The nurse determines the estimated due date to be

August 23, 2018

At her prenatal visit a client reports that she cannot find any shoes that are comfortable. Assessment of her legs reveals dependent edema. The nurse suggests that the client attempt which actions to help reduce the edema? Select all that apply.

Elevate feet and legs when sitting or lying. Avoid foods high in sodium, sugar, and fats. Drink 6 to 8 glasses of water each day.

A 41-year-old pregnant woman and her husband are anxiously awaiting the results of various blood tests to evaluate the fetus for potential Down syndrome, neural tube defects, and spina bifida. Client education should include which information?

Further testing will be required to confirm any diagnosis

After teaching a pregnant woman how to count fetal movements, the nurse determines that the teaching was successful when the client makes which statement?

I'll sit comfortably in a recliner or lie on my side when I do the counts."

know this

Nagele's rule can be used, which involves subtracting 3 months and then adding 7 days to the first day of the LMP.

When describing the role of a doula to a group of pregnant women, the nurse would include which information?

The doula primarily focuses on providing continuous labor support

Alpha-fetoprotein

a substance produced by the fetus. AFP enters the maternal circulation by crossing the placenta. If there is a developmental defect, more AFP escapes into amniotic fluid from the fetus. The optimal time for AFP screening is 16 to 18 weeks

The nurse is concerned that a client is not obtaining enough folic acid. Which test would the nurse anticipate being used to evaluate the fetus for potential neural tube defects?

alpha-fetoprotein analysis

Chromosomal abnormalities are detected via

amniocentesis

A potential complication for the mother and fetus is Rh incompatibility; therefore, assessment should include blood typing. If the mother is Rh negative, her antibody titer should be evaluated. If treatment with RhoGAM is indicated, the nurse would expect to administer it at which time?

at 28 weeks

A woman is 20 weeks pregnant. The nurse would expect to palpate the fundus at which location?

at the umbilicus

Leading a discussion among couples who are thinking about getting pregnant, the nurse stresses that preconception counseling helps to identify risks and encourages modification by the couple before conception. The nurse considers the discussion successful when the couples realize that the greatest risk to the embryo is:

between 17 and 56 days after conception.

Encouraging routine prenatal visits is an important function for nurses to ensure the clients avoid complications or difficulties throughout the pregnancy and delivery. The nurse would prepare to screen clients for gestational diabetes at which time during the pregnancy?

between 24 and 28 weeks' gestation

A nurse is reading a journal article about the use of real-time ultrasonography, which allows the health care provider to obtain information about the fetus. The nurse would expect the article to describe which type of information?

biophysical profile

A pregnant woman who is 26 weeks pregnant arrives for a follow-up visit. Which assessments, in addition to measuring fundal height and fetal heart rate, would the nurse expect to complete? Select all that apply.

blood pressure weight urine testing blood glucose level

s. Rh incompatibility and HIV status are both evaluated by

blood tests

Lithium

category D drug with clear health risks for the fetus and should be avoided during pregnancy

Isotretinoin and warfarin

category X drugs and should never be taken during pregnancy.

A young couple are concerned that their fetus may be born with sickle cell anemia. The nurse explains that the recessive traits of sickle-cell anemia can be determined by using which test?

chorionic villus sampling

A client is in her second trimester, and the health care provider has recommended she undergo an amniocentesis. The nurse explains that the procedure is used to diagnose which conditions? Select all that apply

chromosomal abnormalities inborn errors of metabolism neural tube defects

Urinary frequency in the third trimester, nausea and vomiting during the first trimester, and backache during the second trimester are common ?

discomforts of pregnancy.

Measures to help alleviate nausea and vomiting of pregnancy include

eating small, frequent meals that are bland and low in fat, eating dry crackers, Cheerios, or cheese before getting out of bed, avoiding any strong food odors, limiting the intake of fluids and soups during meals, and eating a high-protein snack before going to bed

A nurse is providing care to a pregnant client who is 9 weeks gestation. The client reports that her breasts have become quite tender. She says, "I know my breasts are going to get bigger, but I didn't think that it would be uncomfortable." The nurse offers suggestions to address this discomfort, based on the understanding that this change is the result of which hormones? Select all that apply.

estrogen and progesterone

When providing preconception care to a client, the nurse would identify which medication as being safe to continue during pregnancy?

famotidine

During a follow-up visit to the prenatal clinic, a pregnant client asks the nurse about using a hot tub to help with her backache. The nurse recommends against the use based on the understanding that what can occur?

fetal tachycardia

Eating mints can help reduce

flatulence

The nurse is preparing a teaching plan for a pregnant woman about the signs and symptoms to be reported immediately to her health care provider. Which signs and symptoms would the nurse include? Select all that apply.

headache with visual changes in the third trimester sudden leakage of fluid during the second trimester lower abdominal pain with shoulder pain in the first trimester

Pregnant women should avoid

hot tubs, saunas, whirlpools, and tanning beds.

Amniocentesis

is used to evaluate for neural tube defects, chromosomal disorders, and inborn errors of metabolism.

At 36 weeks' gestation, the fundus can be palpated

just below the ensiform cartilage.

Part of the initial prenatal assessment should include the client's immunization history. The nurse informs the client to avoid which type of vaccines while she is pregnant?

live virus vaccine

A nurse is conducting a class with group of pregnant women who are all in their first trimester of pregnancy. During the class, the women are discussing the various discomforts that they are experiencing. The nurse would expect to hear complaints about which discomforts? Select all that apply.

nausea urinary frequency breast tenderness

Chorionic villus sampling (CVS)

procedure for obtaining a sample of the chorionic villi for prenatal evaluation of chromosomal disorders, enzyme deficiencies, fetal gender determination, and to identify sex-linked disorders such as hemophilia, sickle cell anemia, and Tay-Sachs disease

Percutaneous umbilical blood sampling allows for ?

rapid chromosomal analysis.

famotidine

s a category B drug that has been used frequently during pregnancy and does not appear to cause major birth defects or other fetal problems.

At 16 weeks' gestation, the fundus is

s midway between the symphysis pubis and umbilicus.

chewing gum increases the amount of air that is

swallowed

A fundus of 12 weeks' gestation is palpated

symphis pubis

Doppler flow study evaluates

the blood flow, and amniocentesis evaluates the contents of the amniotic fluid looking for chromosomal defects

Amniocentesis is performed

the second trimester, usually between 15 and 18 weeks gestation

In preparing for a preconception class, the nurse plans to include a discussion of potential risk factors. Which risk factor would be most important to include?

the use of OTC drugs with teratogens

The client should remain sitting for 1 to 3 hours after eating and avoid lying down within 3 hours of eating. true or false?

true

Blood typing

via blood sample