prepU ch 11 maternal adaptation during pregnancy

The nurse is teaching a prenatal class about preparing for their expanding families. What is helpful advice from the nurse?

"The hormones of pregnancy may cause anxiety or depression postpartum."

A client in her second trimester of pregnancy is anxious about the blotchy, brown pigmentation appearing on her forehead and cheeks. She also reports increased pigmentation on her breasts and genitalia. Which statement by the nurse is most appropriate?

"This is called facial melasma (chloasma) and should fade after the birth."

A client is about 16 weeks' pregnant and is concerned because she feels her "abdomen" contracting. She calls the primary care provider's office and speaks to the nurse. What is the nurse's most appropriate response to this client's concern?

"What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy."

A woman's prepregnant weight is within the normal range. During her second trimester, the nurse would determine that the woman is gaining the appropriate amount of weight when her weight increases by which amount per week?

1 lb (0.45 kg)

Before becoming pregnant, a woman's heart rate averaged 72 beats per minute. The woman is now 15 weeks' pregnant. The nurse would expect this woman's heart rate to be approximately:

85 beats per minute

A 17-year-old client arrives for an annual examination and reports no changes since the last exam; however, the nurse assesses a positive Chadwick sign, slightly enlarged uterus, and subsequent positive urine pregnancy test. Which task should the nurse prioritize to assist this client who is denying any possibility that she is pregnant?

Accepting the pregnancy

A woman tells the nurse that she is going to use a home pregnancy test to determine whether she is pregnant. Which precautions should the nurse give her?

Arrange for prenatal care if the test is positive

A pregnant client in her third trimester, lying supine on the examination table, suddenly grows very short of breath and dizzy. Concerned, she asks the nurse what is happening. Which response should the nurse prioritize?

Blood is trapped in the vena cava in a supine position

During an exam, the nurse notes that the blood pressure of a client at 22 weeks' gestation is lower, and her heart rate is 12 beats per minute higher than at her last visit. How should the nurse interpret these findings?

Both findings are normal at this point of the pregnancy

Which information provided by a client would be considered a presumptive sign of pregnancy?

Breast tenderness

A client arrives to the clinic very excited and reporting a positive home pregnancy test. The nurse cautions that the home pregnancy test is considered a probable sign and will assess the client for which sign to confirm pregnancy?

Fetal movement felt by examiner

What is a positive sign of pregnancy?

Fetal movement felt by examiner

A client in her 39th week of gestation arrives at the maternity clinic stating that earlier in her pregnancy, she experienced shortness of breath. However, for the past few days, she has been able to breathe easily, but she has also begun to experience increased urinary frequency. A nurse is assigned to perform the physical examination of the client. Which observation is mostlikely?

Fundal height has dropped since the last recording

A 22-year-old client comes to the walk-in clinic complaining of fatigue, breast heaviness and extreme tenderness, and a clear vaginal discharge. What question would the nurse ask this client?

Have you been sexually active in the past 2 months?

The nurse is explaining the latest laboratory results to a pregnant client who is in her third trimester. After letting the client know she is anemic, which heme iron-rich foods should the nurse encourage her to add to her diet?

Meats

In preparing for a prenatal class to discuss the hormonal changes during pregnancy, which information would the nurse most likely include?

Over-the-counter antacids can be used to treat acid reflux with the health care provider's knowledge

A client in her 29th week of gestation reports dizziness and clamminess when assuming a supine position. During the assessment, the nurse observes there is a marked decrease in the client's blood pressure. Which intervention should the nurse implement to help alleviate this client's condition?

Place the client in the left lateral position

The nurse is assessing a client who believes she is pregnant. The nurse points out a more definitive assessment is necessary due to which sign being considered a probable sign of pregnancy?

Positive home pregnancy test

What effect does progesterone have on normal gallbladder function?

Progesterone interferes with gallbladder contraction, leading to stasis of bile

During a routine prenatal visit, a pregnant woman reports a white, thick, vaginal discharge. She denies any itching or irritation. Which action would the nurse take next?

Tell the woman that this is entirely normal

A pregnant client at 24 weeks' gestation calls the clinic crying after a prenatal visit, where she had a pelvic exam. She states that she noticed blood on the tissue when she wiped after voiding. What initial statement by the nurse would explain this finding?

The cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual

During an examination, a client at 32 weeks' gestation becomes dizzy, lightheaded, and pale while supine. What should the nurse do first?

Turn the client on her left side

After teaching a woman about the importance of folic acid in pregnancy, the nurse determines that the teaching was successful when the woman identifies which food(s) as being high in folic acid? Select all that apply.

broccoli spinach oranges

During a prenatal visit, the nurse inspects the skin of the client's abdomen. Which would the nurse identify as an abnormal finding?

bruising

A nurse is caring for a pregnant client who has been diagnosed with lordosis. The nurse offers preventive measures for which consequence of lordosis when caring for this client?

chronic backache

Which assessment finding in the pregnant woman at 12 weeks' gestation should the nurse find most concerning? The inability to:

detect fetal heart sounds with a Doppler

Which effect would the nurse identify as a normal physiologic change in the renal system due to pregnancy?

dilation of the renal pelvis

A nurse assessing the laboratory results of a pregnant client in her second trimester notes that she has a hemoglobin level of 11 gm/dl. What will the nurse interpret this finding to most likely indicate?

hemodilution of pregnancy

A client comes to the clinic and tells the nurse, "I think I might be pregnant." After completing the history and physical examination, the nurse obtains a blood specimen for pregnancy testing. When explaining this test to the client, which hormone will the nurse identify as being measured by this test?

human chorionic gonadotropin

The nurse is examining a woman who came to the clinic because she thinks she is pregnant. Which data collected by the nurse are presumptive signs of her pregnancy? Select all that apply.

morning sickness amenorrhea breast changes

The nurse is teaching a pregnant woman about breastfeeding. The nurse determines that the teaching was successful when the woman identifies which hormone as being released when the newborn sucks at the breast?

oxytocin

The nurse is preparing to teach a community class to a group of first-time parents. Which information should the nurse include concerning what the pregnant woman's partner may experience as a normal response?

physical symptoms similar to the mother

The nurse is assessing a primigravida woman at a routine prenatal visit. Which assessment finding is reinforcing to the client that she is definitely pregnant?

ultrasound picture of her fetus

A client in her 39th week of gestation reports swelling in the legs after standing for long periods of time. The nurse recognizes that this factor increases the client's risk for which condition?

venous thrombosis