T3 Self set

A healthy 28-year-old female client who has a sedentary lifestyle and is a chain smoker is seeking information about contraception. The nurse informs this client of the various options available and the benefits and the risks of each. Which should the nurse recognize as contraindicated in the case of this client?

combination oral contraceptives Considering the client's smoking habit, combination oral contraceptives may be contraindicated. Oral contraceptives are highly effective when taken properly, but can aggravate many medical conditions, especially in women who smoke.

Variable decelerations are associated with ______ and recommendation?

compression of the umbilical cord The nurse should alter the client's position and increase the IV fluid rate.

What is the gold standard for HSV diagnosis?

culture

postpartum

delivery of placenta 6 weeks

The nurse explains Leopold's maneuvers to a pregnant client. For which purposes are these maneuvers performed? Select all that apply.

determining the presentation of the fetus determining the position of the fetus determining the lie of the fetus

A nurse is evaluating the external fetal monitoring strip of a client who is in labor. She notes decreases in the fetal heart rate (FHR) that start with the beginning of the client's contraction and return to baseline before the end of the contraction. What term does the nurse use to document this finding?

early decelerations A deceleration is a decrease in the FHR below the baseline. When decelerations occur at the same time as uterine contractions, they are called early decelerations. Early decelerations result from head compression during normal labor and do not indicate fetal distress.

heart burn, indigestion, flatulence recommendation

eat slow frequent meals, fresh dired fruit daily, 6-8 glasses water, exercise, increase fiber in diet, sitz bath, witchhazel compresses, avoid prolong standing, avoid chochalte, coffee, peppermint, alcohol, soda, spicy food. limit heavy lifting

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

Nurses are expected to know how to use the first genetic test. What is it?

family hx

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 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 presention

what period with the highest vulnerability to effects of teratogens

first trimester

what does a nonreactive nonstress test result in

further surveillance for a biophysical profile BPP

A client who is 37 years of age presents to the health care clinic for her first prenatal checkup. Due to her advanced age, the nurse should prepare to talk with the client about her increased risk for what complication?

genetic disorders Women over the age of 35 are at increased risk of having a fetus with an abnormal karyotype or other genetic disorders. Gestational diabetes, cervical insufficiency, and preterm labor are risks for any pregnant woman.

anurse is explaining to a client about monthly hormonal changes. Starting with day 1 of the menstrual cycle, place the hormones in the chronological order in which they elevate during the menstrual cycle. All options must be used.

gonadotropin-releasing hormone (GnHR) estrogen follicle-stimulating hormone (FSH) luteinizing hormone (LH) progesterone Bartholin glands, when stimulated, secrete mucus that supplies lubrication for intercourse. Endocrine glands secrete hormones for various bodily functions. The pituitary gland releases follicle-stimulating hormones to stimulate the ovary to produce follicles. Skene glands secrete a small amount of mucus to keep the opening to the urethra moist and lubricated for the passage of urine.

cause of morning sickness

hCG

rH postitive

have this factor have the antigens

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

hCG

human chorionic gonadotropin basis of pregnancy test, seen 8-10 days after fertilization 50-70 days than decreases Maintains CORPUS LUTEUM until placenta functions more fully Higher levels will be detected in mult pregnancies with mult placentas

A group of students is reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which cause of condylomata?

human papillomavirus Genital warts or condylomata are caused by the human papilloma virus (HPV). Herpes virus causes genital herpes. Treponema pallidum is the cause of syphilis. Haemophilus ducreyi bacillus is the cause of chancroid.

Severe compression of the fetal chest, such as during the process of vaginal birth, may result

in transient bradycardia

The nurse is reviewing the laboratory test results of a client in labor. Which finding would the nurse consider normal?

increase wbc increase plasma fibrogen levels decrease blood coagulation time

Pediatric nurses are developing more home care and community-based services for children with chronic illnesses because:

increasing numbers of children live with chronic disabilities due to advances in health care that allow children with formerly fatal diseases to survive.

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

Primipara

made it to 20 weeks at least once

multipara

made it to 20 weeks more than once

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 funduse

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 the fundus! Postpartum hemorrhage results in excessive vaginal bleeding and signs of shock, such as pallor and a rapid, thready pulse. Placental separation causes a sudden gush or trickle of blood from the vagina, rise of the fundus in the abdomen, increased umbilical cord length at the introitus, and a globe-shaped uterus. Uterine involution causes a firmly contracted uterus, which cannot occur until the placenta is delivered. Cervical lacerations produce a steady flow of bright red blood in a client with a firmly contracted uterus. The priority measure to correct postpartum hemorrhage is to massage the fundus. Packing the uterus with sterile gauze is contraindicated. The physician will have to be called but the nurse must first intervene.

Contraindication vaccines

mmr varicella

bottom half of the NST strip

monitors moms uterus for contraction

A full-term neonate delivered an hour after the mother received IV meperidine is showing signs of respiratory depression. The nurse should be prepared to administer which medication?

naloxone

By the time a woman is 36 weeks' gestation, where would the nurse expect to find the uterus?

near the bottom of the sternum By 20 weeks' gestation, the uterus is at about the umbilicus; by 36 weeks, it nears the bottom of the sternum

Nullipara

never pregnant

What is non reactive

no accelerations that last 15 seconds and increase 15 bpm in relation to contractions or fetal movement

what do you tell a Client in 15th week states she has increased white vaginal discharge.

normal leukorrhea

preterm labor risk factors

onset between 20-38 weeks Previous hx of preterm labor an delivery Multiple gestation 50% twins are delivered preterm >90% of higher multiples are delivered preterm Young maternal age <17, advanced maternal age >35 Genitourinary infection (BV,STI), Periodontal disease, Late or lack of prenatal care Premature rupture of membrane PROM. Chronic health problems such as HTN, DM, clotting problems Poor nutritionDehydration

Intrapartum

onset of labor to delivery of placenta

A nurse is explaining how hormones affect the pregnancy. Which hormone would the nurse describe as being responsible for stimulating uterine contractions during labor and birth?

oxytocin Oxytocin is responsible for stimulating the uterine contractions that bring about delivery. Progesterone and estrogen help maintain the pregnancy, and prolactin helps with stimulating milk production after the delivery.

What is the medication of choice for early syphilis?

penicillin G benzathine

A nursing student correctly identifies that a person's outward appearance or expression of genes is referred to as the:

phenotype Phenotype refers to a person's outward appearance or the expression of genes. Alleles are two like genes. Genotype refers to his or her actual gene composition. Genome is the complete set of genes present in a person.

what is concerning for a women 32nd week states her Rings are tight and her eyes are puffy. Nurse tells the patient fluid overload edema.

pre-elcampsia

Abortion

pregnancies ending <20 weeks

Premature

pregnancy made it PAST 20 weeks but it was less than 38 weeks so a baby born between 20-37 weeks

Tabacco causes

premature small babies, skinny cords, smaller placenta, higher risk for allergies/asthma

Antepartum

prental, conception to onset of labor

A new mother voices concerns about breastfeeding her infant. The nurse would explain to the mother the two hormones that control lactation and letdown are:

prolactin and oxytocin

The nurse would monitor clients with which conditions for fetal demise? Select all that apply.

prolonged pregnancy hypertension others are infection, advanced maternal age, Rh disease, uterine rupture, diabetes, congenital anomalies, cord accident, abruption, premature rupture of membranes, or hemorrhage.

true labor contractions are

regular, start in the back and radiate to the abdomen, and become more intense during walking.

What hormone is responsible for relaxation of ligaments in hip and pelvis by 3rd trimester

relaxin

Compression or damage to the placenta, typically from abruptio placentae, results in

severe, late decelerations.

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

Polyhydramnios/Hydramnios and related to

too much amniotic fluid R/T GI malfunction or gestation DM

True or false 300 cal per day during pregnancy is the most that is ever needed by 3rd trimester.

true

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 nurse is teaching personal hygiene care techniques to a client with genital herpes. Which statement by the client indicates the teaching has been effective?

wear loose cotton pantys

inadequate nutritional intake associated

with preterm birth, low weight, congenital anomalies

The decrease in fetal heart rate begins at the end of the contraction and doesn't return to baseline until the contraction is over. Late decelerations are associated

with uteroplacental insufficiency, shock, or fetal metabolic acidosis.

As part of a presentation on breast cancer being given to a local woman's group, the nurse describes the need for early detection through screening. Applying the guidelines from the American Cancer Society, the nurse would emphasize which recommendation?

yearly mammograms for women starting at age 40 Clinical breast examinations are recommended every year starting at age 40

A fertilized ovum is known as which structure?

zygote the developing human organism is known as an embryo from the time it implants on the uterine wall until the eighth week after inception and as a fetus from the beginning of the ninth week after fertilization through birth. The chorion is the outermost cell layer that surrounds the embryo and fluid cavity.

A parent at an educational session on sexually transmitted infections (STIs) asks the nurse if there are vaccines available to prevent STIs. How should the nurse respond?

"A vaccine has been approved to prevent the human papillomavirus." Vaccine-preventable STIs can be effectively prevented through preexposure vaccination. Vaccines are under development or are undergoing clinical trials for certain STIs, including HIV and HSV. The only vaccines currently available are for prevention of hepatitis A virus, hepatitis B virus, and HPV infection. Vaccination efforts focus largely on integrating the use of these available vaccines into STI prevention and treatment activities.

A pregnant woman undergoing amniocentesis asks her nurse why the baby needs this fluid. What would be an accurate response from the nurse?

"Amniotic fluid cushions your baby to prevent injury."

The nurse is assessing a primipara's fundal height at 36 weeks' gestation and notes the fundus is now located at the xiphoid process of the sternum. The client asks if this is normal. Which response to the client would be best?

"At 36 weeks' gestation, the fundus is in the normal expected location." Explanation: The fundus grows to reach the umbilicus at 20 to 22 weeks and the xiphoid process of the sternum at 36 weeks. Therefore, this fundus is in the normal, expected location. After 36 weeks' gestation, lightening occurs and the fundus will drop ~4 cm below the xiphoid process. Once the fundus reaches the xiphoid process, it cannot go higher without severely compromising maternal respiratory efforts.

The nurse is assessing a male client who is concerned about his ability to produce enough sperm to have a child. He tells the nurse, "I have had some issues in my younger years." What questions would be important for the nurse to ask this client? Select all that apply.

"Do you use drugs or use alcohol excessively? "Are you exposed to X-rays or other radioactive substances?" "Have you ever had any type of trauma or surgery on or near your testicles?" Conditions that may inhibit sperm production are trauma to the testes, surgery on or near the testicles that results in impaired testicular circulation, and endocrine imbalances, particular of the thyroid, pancreas, or pituitary glands. Drug use or excessive alcohol use and environmental factors such as exposure to X-rays or radioactive substances have also been found to negatively affect spermatogenesis. Men exposed to radioactive substances in their work environments should be provided adequate protection for the testes.

A nurse is caring for a client who is anxious to know her baby's due date. The nurse instructs the client on how to determine the baby's due date according to Naegele's rule. The client is correct to state which comment when discussing the use of the rule?

"Naegele's rule provides a good approximation of the due date." "I will add 7 days to the first day of my last menstrual period and count back 3 months." "Naegele's rule may be used in conjunction with other assessment findings."

A recently licensed nurse is orienting to a pediatric unit in an acute care facility. The nurse is discussing causes of infant mortality with the preceptor. Which statement by the preceptor most accurately addresses this problem?

"The most common cause of infant deaths is chromosomal abnormalities and congenital anomalies, which we have no control over." Congenital anomalies and chromosomal abnormalities are the leading cause of infant mortality in the United States. Violence and neglect can be contributory to infant deaths but are not major predictors of infant mortality. SIDS is a cause of infant mortality, but it is not the greatest cause. Infant mortality statistics go from age one month to one year of age, not starting at birth.

Gravida

# of times one has been pregnant regardless of outcome

Ptyalism

(Excess saliva / spitting and increased sensitivity of gums may occur during pregnancy, proper hygiene important

genetic screening test test for

(Identify risk for trisomies like T21 (Down syndrome) and neural tube defects (anencephaly, spina bifida)

Fundal height:

+ or -2 weeks from 20-37 weeks. Have patient empty bladder first -Measured from the symphyses pubis to top of uterine fundus-At umbilicus around week 20-22 -Drops after week 36-38 lightening

effects on prematurity

- Maturational deficiencies -Decrease muscle tone -Small amount of subcutaneous fat and thin skin -Immature hypothalamic thermoregulation Respiratory distress -Inadequate surfactant Poor glucose regulation -Inadequate glycogen stores Poor sucking reflex Immature living and kidneys Immature immune system (HIGH risk for secondary infections)

Routine monitoring at antepartal visit:

-BP, Weight, Fundal height, Fetal heart tones, Fetal activity, Urine for protein, glucose, edema, psychosocial assessmentSharing of questions and or concernsAnticipatory guidance provided

Braxton hicks

-Irregular in intensity -Infrequent, unpredictable, non-rhythmic -More uncomfortable than painful -Don't increase in intensity, or frequency -Side lying position, increase fluids -Lamaze breathing techniques, effleurage -Client education regarding "false" labor vs true labor to alleviate stress, fear

Danger signs 2nd trimester

-Regular uterine contraction - Preterm labor -Pain or dorsiflexion of foot- DVT -Leakage of fluid from vagina - PROM -Lack of fetal movement for 12 hours - fetal distress or demise

Danger signs 1st trimester

-Spotting, bleeding -Painful urination- possible UTI -Severe persistent vomiting - hyperemesis gravidarum-Fever 100.4 - Infection-Lower abdominal pain, dizziness, (referred) shoulder pain-possible ectopic pregnancy

Third trimester danger

-Sudden weight gain - PIH/Pre-eclampsia-Non-dependent edema, especially facial - PIH -Headache and visual changes - PIH -Epigastric pain/discomfort - PIH -Any previous warning signs-Lack of fetal movement for 12 hours - fetal distress or demise

Positive signs of pregnancy

-Visualization of fetus on U/S -Fetal movement detected by practitioner-Auscultation of fetal HR (10-12 weeks by doppler)

Non-stress test (NST)

-ultra sound record movement, doppler measures fetal HR, assess fetal well being -2 or more acceleration with 15bpm lasting 15 seconds for 20 min with return to baseline -done after 28 wks

diagnosis of preterm labor**

1. Gestational age between 20-37 weeks 2. 6+ Uterine contractions in 1 hour 3. Progressive cervical change (effacement 80%, OR cervical dilation of 2cm or greater)

benefits of oxytocin

1.The posterior pituitary gland is allowing release of milk so baby is able to drink2.Causes uterine contraction - to prevent hemorrhage but main benefit is PREVENTS HEMORRHAGE

Fetal HR heard

10-12 weeks

a pregnant client is scheduled to undergo chorionic villi sampling (CVS) to rule out any birth defects. Ideally, when should this testing be completed?

10-12 weeks gestation

normal fetal HR

110-160s

A fundal height measurement between umbilicus and symphysis pubis wound suggest a fetus with gestational age between

12 and 20 weeks.

The fundus typically is over the symphysis pubis at

12 weeks.

3 trimester ranges

1st: 1-13 weeks 2nd: 14-26 weeks 3rd: 27-40

Umbilica cord has

2 arteries, 1 vein AVA wharton jelly

1 liter of water =

2.2lb or 1kg

A fundal height between the umbilicus and the xiphoid process would suggest a fetus with a gestational age between

20 and 36 weeks. The fundus then commonly returns to about 4 cm below the xiphoid owing to lightening at 40 weeks. Additionally, pressure on the diaphragm occurs late in pregnancy. Therefore, a fundal height measurement near the xiphoid process with diaphragmatic compression suggests a fetus near the gestational age of 36 weeks or older.

anatomy u/s is done

20 weeks

avarage fetal age of viability is

23 weeks

Diabetes is screened at

24-28 weeks

Gestational diabetes occurs around the 24th week of gestation. When should every woman be screened for gestational diabetes?

24-28 weeks

weight gain in pregnancy

25-35lb

first trimester approx gain

3.5-5lbs and 1lb PER week after

Group B strep is screened at

35-37 weeks

The fundus typically reaches the xiphoid process at approximately

36 weeks' gestation

Term is considered

38 weeks or more

Cardiovascular system affects during pregnancy

50% increase in blood volume and cardiac output Increased clotting factors produced causing hypercoaguable state (risk for dvt/pe/cva) venous stasis occurs which can lead to DVT Hemodilution or physiologic anemia - 50% increase in plasma volume due to hormonal factors, water retention.

By what week is it critical for embryonic development?

8 weeks

The nurse is noting a collection of blood under the scalp on a newborn being discharged to home. The nurse is correct to prepare teaching instructions of which topic?

A cephalohematoma

Vena cava syndrome and recommendation

Abdominal weight compresses vena cava and aorta while client is in supine position. Blood return to R atrium is reduced Symptoms: Clamminess, dizziness, hypotension. L side laying: Recommended to increase uteroplacental blood flow.

Relaxin

Acts with progesterone to maintain pregnancy -causes relaxation of pelvic ligaments, soften cervix and allows pelivc to expand so fetus can fit through RESPONSIBLE FOR WADDLING GAIT

Presumptive pregnancy signs

Amenorrhea, Fatigue, N/V, Urinary frequency, Breast tenderness, tingling, fullness, enlargement, abdominal enlargement, Quickening (16-20 weeks), Skin changes hyperpigmentation

Embryonic membrane

Amnion Chorion

Vitamin C deficiency can lead to what adverse effects for the gestating mother?

Blood disorders such as easy bruising

Braxton Hicks contractions are termed "practice contractions" and occur throughout pregnancy. When the woman's body is getting ready to go into labor, it begins to show anticipatory signs of impending labor. Among these signs are Braxton Hicks contractions that are more frequent and stronger in intensity. What differentiates Braxton Hicks contractions from true labor?

Braxton Hicks contractions usually decrease in intensity with walking.

Which body system is most affected throughout the embryonic and fetal period by teratogens?

CNS

Class X and cause

Cytotec, Estrogen, DES, Prosom, Accutane, Retinols cause fetal abnormalities

Respiratory system changes in pregnancy and recommendation

Decreased airway resistance allows for increased air intake. Deeper respirations to oxygenate the extra RBCs. Diaphragm shifts up and rib cage shifts out In order to absorb increased air, the respiratory tract becomes more vascular than it already is. Woman c/o nasal congestion, nosebleeds, bleeding gums. Interventions: Saline nasal spray, humidifier, good hydration, blow nose gently to prevent epistaxis, warm saline mouthwash, soft toothbrush, no OTC meds

Human placental lactogen HPL

Decreases maternal insulin sensitivity (mom will have more free glucose in the blood. Insulin tells the body to store glucose so it says no, keep it in the blood so the babies body can pick it up and let it grow) Responsible for gestational diabetes

What physiological changes would be noted in a pregnant woman? Select all that apply

Enlarged pituitary gland Lordosis Delayed gastric emptying and decreased peristalsis

Placenta

Exchange nutrients, O2, CO2 exchange. Immunologic properties: transfer of maternal antibodies immune globulin g igG bacteria, virsues. Stores glycogen, iron Produces hormones

Ovulation and menstruation are suppressed how?

FSH and LH (sends signal to rupture cyst and release egg) suppressed by progesterone

True or False Placenta produces nutrients for the developing fetus

False

Fetal circulation

Fetal blood leaves placenta and enters the fetus through the umbilical vein. After circulating through the fetus, the blood returns to the placenta through the umbilical arteries.

Early decelerations are associated with

Fetal head compression is associated with early decelerations.

Which consideration is a priority when caring for a mother with strong contractions 1 minute apart?

Fetal heart rate in relation to contractions

A nursing instructor is explaining the stages of fetal development to a group of nursing students. The instructor determines the session is successful after the students correctly choose which time period as representing the pre-embryonic stage?

From fertilization to the end of the second week after fertilization The pre-embryonic stage begins at fertilization and lasts through the end of the second week after fertilization. The embryonic stage begins approximately 2 weeks after fertilization and ends at the conclusion of the eighth week after fertilization. The fetal stage begins at 9 weeks after fertilization and ends at birth. There is no distinct stage recognized approximately 6 to 8 weeks after fertilization. This is part of the embryonic stage period.

A multigravida client is pregnant for the third time. Her previous two pregnancies ended in an abortion in the first and third month of pregnancy. How will the nurse classify her pregnancy history?

G3 P0020 Gravida (G) is the total number of pregnancies she has had, including the present one. Therefore she is G3 and not G2. Para (P), the outcome of her pregnancies, is further classified by the FPAL system as follows: F = Full term: number of babies born at 37 or more weeks of gestation, which is 0 and not 1 in this case. P = Preterm: number of babies born between 20 and 37 weeks of gestation, which is 0 in this case. A = Abortions: total number of spontaneous and elective abortions, which is 2 in this case. L = Living children, as of today. She has no living children; therefore, it is 0 and not 1.

Determine GTPAL Alicia just delivered a healthy term infant. Her history states that she has a miscarriage at 22 weeks, a child born at 32 weeks who only lived 2 days, and another child born at 38 weeks who is currently at home and healthy.

G4, T2, P2, A0, L2

Determine GTPAL A client is 39 weeks pregnant and in labor. She has a 10-year-old son that was born at 35 weeks, an 8-year-old daughter that was born at 40 weeks, and 5-year-old twins that were born at 37 weeks. She had a miscarriage 2 years ago at 9 weeks.

G5 T1 P2 A1 L4

The nurse is teaching a client the advantages and disadvantages of self-care. The nurse determines the session is successful when the client correctly chooses which point as best describing self-care?

Gaining information about and taking an active role in wellness

when else would you give rhogam

Give it at 28 weeks of pregnant after amniocentesis, abortion, ectopic pregnancy and 72 hours after delivery of an Rh positive baby to prevent antibody formation for future pregnancies.

Hormone thought to be responsible for gestational DM

HPL

Fetal stage begins at 9 weeks characterics

Head is x2 size, HR heard at 10-12 weeks, urine is produced and excreted, face and neck are well formed- more human resemblence

What physical changes take place when a woman becomes pregnant? Select all that apply.

Heart rate increases 10 to 15 beats per minute. The areolae become more prominent. Nasal congestion increases due to edema. The pregnant uterus is globular shaped, not pear-shaped. The heart rate usually increases 10 to 15 beats per minute over the prepregnancy rate of 60 to 100 beats per minute. The respiratory rate is essentially unchanged. The areolae of the breasts become more prominent with a deepened pigmentation. Mothers report that they experience more nasal congestion during pregnancy that occurs secondary to edema found in the nasal passages.

immunizations recommended

Hep B Influenza Tetanus, Diptheria, Pertussia, TDAP Meningococcal

causes of umbilical cord prolapse

Hydramnios, multifetal gestation, and malpresentation

if group b strep goes untreated than what can happen

If untreated, newborn may need sepsis workup and treatment

normal breast changes in pregnancy with recommendation

Increase in vascularity and size, areolas darken, nipples enlarge, prominence of the tubercles of Montgomery Good hygiene, no soap -Supportive bra, wide straps

The nurse is instructing a client with dysmenorrhea on how to manage her symptoms. Which suggestions should the nurse include in the teaching plan? Select all that apply.

Increase water consumption. Use heating pads or take warm baths. Increase exercise and physical activity.

renal / urinary system changes in preg

Increased urine output and nocturia due to increased kidney function, increased renal perfusion in side lying position Increased GFR by 40 6

leukorrhea, what is it and what are recommendations

Increased white or clear mucoid discharge is normal during pregnancy, unless accompanied by itching or burning, other s/s Maintain good perineal hygieneAvoid tight clothing, panty hose, use undergarments with cotton

A nurse is describing the development of the fetus to a group of pregnant women. When describing the function of the placenta, which information would the nurse most likely include? Select all that apply.

It supplies oxygen and nutrients to the fetus. It produces hormones that help maintain the pregnancy. It carries waste away for excretion by the mother. The placenta supplies the developing organism with food and oxygen, carries waste away for excretion by the mother, slows the maternal immune response so that the mother's body does not reject the fetal tissues, and produces hormones that help maintain the pregnancy. Wharton's jelly protects the umbilical cord and the foramen ovale permits most of the blood to bypass the right ventricle. The amniotic fluid cushions the fetus against injury.

The nursing instructor is teaching a class on the menstrual cycle. The instructor determines the class is successful when the class correctly chooses which hormone that is responsible for imitating ovulation?

LH At the beginning of each menstrual cycle, a follicle on one of the ovaries begins to develop in response to rising levels of FSH from the pituitary gland. The follicle produces estrogen, which causes the ovum contained within the follicle to mature. When the pituitary gland detects high levels of estrogen from the mature follicle, it releases a surge of LH. This sudden release of LH causes the follicle to burst open, releasing the mature ovum into the abdominal cavity in a process called ovulation. This follicle then becomes the corpus luteum, which continues to secrete estrogen and progesterone, preparing the endometrium for possible implantation of a fertilized ovum. If the ovum is not fertilized, the hormone levels subsequently fall and menstruation occurs

Calculating delivery date EDD

LMP 1st day of last mensural periodEDD= LMP + 7 days - 3 months or 9 months plus 1 week (7 days)

A client in her second trimester of pregnancy arrives at a health care facility reporting heartburn. What instructions should the nurse offer to help the client deal with heartburn? Select all that apply.

Limit consumption of food before bedtime. Avoid overeating. Sleep in a semi-Fowler position.

Which instruction should be given to a woman newly diagnosed with genital herpes?

Limit stress and emotional upset as much as possible.

A woman in labor is having very intense contractions with a resting uterine tone >20 mm Hg. The woman is screaming out every time she has a contraction. What is the highest priority fetal assessment the health care provider should focus on at this time?

Look for late decelerations on monitor, which is associated with fetal anoxia.

A nurse is preparing a presentation for a health fair about preventing breast cancer. Which of the following would the nurse include?

Maintaining an ideal weight decreases the risk of breast cancer. Having no children or having children after age 30 is associated with an increased risk for breast cancer. Some breast tumors are hormone dependent, such that estrogen (or progesterone) enhances tumor growth. Women are advised to avoid the consumption of alcohol, not caffeine, because alcohol correlates with an increased risk of breast cancer

An infant was born at term but has intrauterine growth restriction (IUGR). What findings in the infant's history would contribute to this problem? Select all that apply.

Maternal smoking Intrauterine infection of the fetus

A nurse is giving a prenatal class on teratogens that have an affinity for specific body tissues. Which teratogen is accurately paired with the specific body tissue affected?

Mercury attacks the nervous tissue. Explanation: A factor determining the effects of a teratogen is the teratogen's affinity for specific body tissues. Lead and mercury, for example, attack and disable nervous tissue. Thalidomide, originally used to treat nausea in pregnancy, is now prescribed for cancer therapy, and it may cause limb defects. Tetracycline, a common antibiotic, causes tooth enamel deficiencies, and possibly, long bone deformities.

The nurse is assessing a pregnant client at 12 weeks' gestation and the client reports some new bumps on the dark part of her nipples. What is the best response from the nurse when questioned by the client as to what they are?

Montgomery glands (Montgomery tubercles); secrete lubricant for the nipples

Probable signs of pregnancy

More objective so -Abd enlargement-Braxton-Hicks contraction-Post preg test-Ballottment-Cervix/Fetus rebounds after being pushed-Hegars sign- softening of the lower uterine segment-Goddells sign- Softening of cervix-Chadwicks sign- Bluish discoloration of cervix

The nurse is preparing to administer a prescribed medication to the pregnant client. Which order should the nurse question?

Most vaccines are contraindicated during pregnancy and are considered teratogenic, such as rubella. Penicillin and acetaminophen may be taken under provider supervision. Folic acid supplementation should be encouraged.

Is a significant rise in BP normal in pregnancy ?

NO

Para or partiy

Number of LIVE births of 20 weeks gestational or more

Anterior pituitary gland secretes

Oxytocin MILK LET DOWN REFLEX && UTERINE CONTRACTION

what do you tell Client in 34th week c/o INCREASING low back pain and cramping that isnt relieved with walking or rest?

Pre labor

what does rhogam do

Prevents formation of antibodies

Prostaglandins

Produced by all bodily tissues, increased during maturation of follicle, large amounts found in menstrual secretions Play a role in onset of labor CRAMPING

Estrogen

Proliferative function (Enlargement of uterus and breast) Expands blood supply Contributes to myometrial uterine contractility at term

At a follow-up visit, the client is informed that her breast cancer has recurred. The nurse knows that which situation places the client at risk for developing bone metastases?

Recurrence within 2 years of the original diagnosis

A nurse should instruct a client who has premenstrual syndrome (PMS) to make which of these lifestyle modifications?

Reduce caffeine, walk several times a week, use relaxation techniques, and maintain a regular sleep schedule.

rH factor

Refers to the presence or absence of the Rh antigen on red blood cells. If placenta separates from wall of uterus, some of the blood can leak into the moms blood which would say this is a foreign invader. Moms immune system will create AB to kill it. AB can cross the placenta and attack fetus RBC. If it happens late in pregnancy or at delivery. For the rest of her life, she is unable to get pregnant or stay pregnant. SO, RH negative but first pregnancy was RH Positive, they had mixing of blood at delivery that was not treated. The mom developed AB so now that body knows how to fight off RH + blood, so next time she gets pregnant with a RH+ blood baby, it will immediately attack the baby and cause major problems with the baby up to death.

A nurse notices repetitive late decelerations on the fetal heart monitor. What is the best initial actions by the nurse?

Reposition the client, apply oxygen, and increase IV fluids.

A nurse is teaching a sex education class and is discussing sexual response. She describes a 30-minute period during which external and internal genital organs return to an unaroused state. What is this phase of sexual response known as?

Resolution, the fourth and final phase of sexual response, is a 30-minute refractory period during which the external and internal genital organs return to an unaroused state. Excitement, the first phase, occurs with physical and psychological stimulation (sight, sound, emotion, or thought) that causes parasympathetic nerve stimulation. The plateau stage, which is the second phase, is reached just before orgasm. Orgasm, the third phase, occurs when stimulation proceeds through the plateau stage to a point at which a vigorous contraction of muscles in the pelvic area expels or dissipates blood and fluid from the area of congestion.

what is given to moms that are rh negative

Rhogam

client teaching for pre term labor symptoms

Rhythmic lower abdominal cramping and pain Low backache Pelvic pressure Leaking of amniotic fluid Vaginal spotting or bleeding

Progesterone

Secreted by corpus luteum first 7 weeks RELAXES SMOOTH MUSCLE EARLY IN PREGNANCY TO PREVENT PRE TERM LABOR, INCREASE VASODIALTION Prepares mamory gland for lactation Supports nourishment of endometrium

GI system changes in pregnancy

Smooth muscle relaxation Decreased paristalisis because of progesterone causing relaxation bloating, constipation, hemorrhoids, acid reflux, heart burn from slower gastric emptying time and relaxation of cardiac sphincter (Relaxin), prolonged emptying of GB, morning sickness.

Week 28 characterics

Surfactant produced, fetus begins to assume head down see intracoastal and sternal retractions and hear pleural rub

T or F After delivery: If mom is negative and baby's blood is tested and is positive then the mom gets another shot of Rhogam.

TRUE

The nurse is caring for a client with a G=5, T=0, P=3, A=1, L=3 obstetric history. The nurse is most correct to state which interpretation?

The client has had difficulty reaching full term.

The nurse is caring for a client at 39 weeks' gestation who is noted to be at 0 station. The nurse is correct to document which?

The fetus is in the true pelvis and engaged.

What should the nurse explain to the pregnant client about the importance of the fetal stage of development?

There is additional growth and development of the organs and body systems. The fetal stage is from the beginning of the ninth week after fertilization and continues until birth. At this time, the developing human is called a fetus. During the fetal stage, there is additional growth and maturation of the organs and body systems.

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 Magnesium sulfate is given to prevent and control seizures in clients with gestational hypertension. Beta-adrenergic blockers (such as propranolol, labetalol, and atenolol) and centrally acting blockers (such as methyldopa) are used to lower blood pressure. Magnesium sulfate has no effect on labor or dopamine receptors.

Teratogen substances

Toxoplasmosis (cat poop) Other: Syphilis, Varicella-zoster (chicken pox), Parovirus B12, Rubella, Cytomegalovirus,Herpes infection(MOST CONERNING)

true or false Reactive is when you WANT 2 accelerations of 15 beats for at least 15 seconds within 20 minutes of recording

True

T or F rhogam is given to all negative women

True We do not test babies blood. We just assume the mom needs it. Give it at 28 weeks of pregnancy because it can last for 12 weeks.

what is screened at EVERY antepartal visit

V/S, Weight, UA, fundus measurement, fetal HR, fetal movement

what do you do if you think you are going into pre term labor

VOID Drink 3-4 cupsRest 30 minutes If contractions persist are 10 mins apart of closer notify pcp

umbilical cord compression would indicate what kind of deceleration

Variable decelerations which are decreases in fetal heart rate that aren't related to the timing of contractions. Characteristic of umbilical cord compression, variable decelerations generally occur as drops of 10 to 60 beats/minute below the baseline.

Week 20 characterics

Vernix and lanugo are seen, brown fat develops, fetal heart tones can be heard with fetoscope, rapid brain growth, quickening may be felt

dependent edema recommendation

Very common during pregnancy Elevate legs Support hose when standing for long periods Change position frequently throughout the day When standing, rock from balls of toes to foot Left side-lying position Avoid high sodium food, avoid high sugar Avoid restrict clothing Drink 6-8 glasses water daily

True or false Pregnant woman have different H&H values

Yes. 10 is acceptable. Increased needs for iron due to demands of fetus and increased RBC production

PICA

a craving for unusual substances clay, ice, baby powder, starch

The nurse prepares a couple to have a karyotype performed. What describes a karyotype?

a visual presentation of the chromosome pattern of an individual A karyotype is a photograph of a person's chromosomes aligned in order.

rh negative

absence of antigens

A pregnant client has heard about Down syndrome and wants to know about the risk factors associated with it. What would the nurse include as a risk factor?

advanced maternal age

The third stage of labor ends

after delivery of placenta The first stage of labor ends with complete cervical dilation and effacement. The second stage of labor ends with the birth of the neonate. The fourth stage of labor includes the first 4 hours after birth.

Amnion becomes

amniotic fluid

Prelabor contractions

are usually felt in the abdomen.

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 HR

A client with diabetes mellitus gives birth to a 9-lb, 10-oz (4375 g) neonate at 38 weeks. What is the nurse's priority action after the stabilization of the neonate?

assess neonatal glucose

At 20 weeks' gestation, the fundal height should be

at about the level of the client's umbilicus

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. A large fetus, extended labor, stimulation with oxytocin, and traumatic birth commonly are associated with uterine atony, which may lead to postpartum hemorrhage

Chorion

becomes placenta

the duration of a contraction is the interval between the

beginning and the end of a contraction.

What interval should the nurse use when assessing the frequency of contractions of a multiparous client in active labor admitted to the birthing area?

beginning of one contraction to the beginning of the next contraction

BPP

biophysical profile Normal score 8-10 1. Fetal breathing movement - 1 rhythmic breathing for 30 seconds2.Gross body movement- 3 BIG body movements like a kick or arm flops or rolling3.Fetal tone- > 1 episode of extension of a fetal extremity with return to flexion4.Amniotic fluid volume- 1+ pockets measuring 2cm. Oligohydramnios is not normal5.Non-stress test- >2 accelerations of >15 bpm for >15 seconds in 20-40 minutes.

Which change related to the vital signs is expected in pregnant women?

bp decrease

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