Unit 15 and 16 prep u

The nurse is assessing a client's risk for sexually transmitted infections. Which statement by the client would be cause for concern? "I am not sure if I want to keep the baby. It is a hard decision." "I am unsure who the father of the baby is. I will be raising it alone." "I needed Rho(D) immune globulin after my last pregnancy. Will I need it again?" "I only want my family to see the baby after it is born."

"I am unsure who the father of the baby is. I will be raising it alone."

A client calls the prenatal clinic and tells the nurse, "I think I am in labor." The nurse determines that the client is in true labor based on which client statement? "I feel pressure in my vagina when I have the contraction." "I will have a strong one and then the next one will be weaker." "I feel the tightening primarily in the front of my belly." "The contractions lessen after I drink a large glass of water."

"I feel pressure in my vagina when I have the contraction."

The nurse is teaching the pregnant woman about nutrition for herself and her baby. Which statement by the woman indicates that the teaching was effective? "I can eat any seafood that I like because it contains phosphorus, which is a nutrient that pregnant women need." "I will need to take iron supplementation throughout my pregnancy even if I am not anemic." "Milk production requires higher levels of calcium; therefore, if I am going to breastfeed, I must take a calcium supplement during pregnancy." "Because I am pregnant, I can eat anything I want and not worry about weight gain."

"I will need to take iron supplementation throughout my pregnancy even if I am not anemic."

The nurse is caring for a client at 8 weeks' gestation who states, "I did not plan for this right now and I am not happy or excited about this pregnancy. I am not sure what to do." Which response by the nurse is best? "You will become excited and happy when you feel the baby move." "Many women feel this way during the first trimester." "We can refer you to a clinic for potential termination if you desire." "Do not worry. Once you hold this baby, everything will be fine."

"Many women feel this way during the first trimester."

A client in her third trimester comes to the clinic for an evaluation. Assessment reveals that the cervix is thinning. The client says, "I know my cervix needs to dilate, but why does it get thinner?" Which response by the nurse would be appropriate? "Your cervix thins so that your contractions can increase." "You need the cervix to thin so it can stretch more easily." "It thins to let your baby change positions during labor." "Cervical thinning is a sign that you are in true labor."

"You need the cervix to thin so it can stretch more easily."

A student nurse asks the instructor what percentage of clinically recognized pregnancies end in miscarriages during the first trimester. Which response from the nurse is the most accurate? 5% to 10% 15% to 20% 21% to 30% 31% to 40%

15% to 20%

what is the time frame in which you reassess your pt and interventions

30 seconds

A pregnant woman with diabetes is having a glycosylated hemoglobin (HgbA1C) level drawn. Which result would require the nurse to revise the client's plan of care? 5.5% 6.0% 7% 8.5%

8.5%

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. 90 beats per minute. 95 beats per minute. 100 beats per minute.

85 beats per minute.

When do the organs start to develop?

8th week

Which nursing action has a negative effect on fetal descent? Laying the client on the left side Using a tap water enema Administering opioid pain medication Walking the client in the hall

Administering opioid pain medication

A pregnant client is diagnosed with placenta previa. Which action should the nurse implement immediately for this client? Assess fetal heart sounds with an external monitor. Help the client remain ambulatory to reduce bleeding. Assess uterine contractions by an internal pressure gauge. Prepare for a vaginal examination to assess the extent of bleeding.

Assess fetal heart sounds with an external monitor.

A client's membranes have just ruptured. Her fetus is presenting breech. Which action should the nurse do immediately to rule out prolapse of the umbilical cord in this client? Assess fetal heart sounds. Place the woman in Trendelenburg position. Administer oxygen at 10 L/min by face mask. Administer amnioinfusion.

Assess fetal heart sounds.

A nurse in the maternity triage unit is caring for a client with a suspected ectopic pregnancy. Which nursing intervention should the nurse perform first? Assess the client's vital signs. Administer oxygen to the client. Obtain a surgical consent from the client. Provide emotional support to the client and significant other.

Assess the client's vital signs.

Vitamin C deficiency can lead to what adverse effects for the gestating mother? Low weight gain Hyperglycemia Blood disorders such as easy bruising Placental abruption

Blood disorders such as easy bruising

Which occurs as a result of contraction decrement? Select all that apply. The mother feels the contraction intensifying. Blood flow to the fetus improves. The fetus is pushed down the birth canal. Fetal heart rate should return to baseline. The mother feels a gush of water in the perineal area.

Blood flow to the fetus improves. Fetal heart rate should return to baseline.

Which change related to the vital signs is expected in pregnant women? Pulse decreases. Lung space increases. Blood pressure decreases. Temperature decreases.

Blood pressure decreases.

In the labor and delivery unit, which is the best way to prevent the spread of infection? Use sterile gloves Limit vaginal examinations Complete hand hygiene Provide clean gloves in the room

Complete hand hygiene

Which cardinal movement of delivery is the nurse correct to document by station? Descent Flexion Extension Internal rotation

Descent

The nurse is counseling a young woman who has just entered her second trimester, after an uneventful first trimester. She tells the nurse, "It still doesn't seem real. It's just hard to believe that I will really have a baby." Which future events should the nurse point out that will help the young woman come to believe it is real? Select all that apply. Feeling the baby kick Seeing an ultrasound image of the baby Giving up alcohol Receiving a positive result on a pregnancy test Taking prenatal vitamins

Feeling the baby kick Seeing an ultrasound image of the baby

Which nursing action is a priority when the fetus is at the +4 station? Have a blue bulb suction and an infant warmer ready. Have a tocometer and a client gown ready. Provide lubricating jelly and an internal monitor. Prepare for an immediate cesarean birth..

Have a blue bulb suction and an infant warmer ready.

Which is the most important nursing assessment of the mother during the fourth stage of labor? The mother's psyche Blood pressure Hemorrhage Heart rate

Hemorrhage

The nurse is admitting a client in labor. The nurse determines that the fetus is in a transverse lie by performing Leopold maneuvers. What intervention should the nurse provide for the client? Administer an analgesic to the client. Prepare the client for a cesarean birth. Prepare for a precipitous vaginal birth. Prepare to assist the care provider with an amniotomy.

Prepare the client for a cesarean birth.

The maternal health nurse is caring for a group of high-risk pregnant clients. Which client condition will the nurse identify as being the highest risk for pregnancy? Secondary hypertension Repaired atrial septal defect Pulmonary hypertension Loud systolic murmur

Pulmonary hypertension

A pregnant woman comes to the emergency department stating she thinks she is in labor. Which assessment finding concerning the pain will the nurse interpret as confirmation that this client is in true labor? Radiates from the back to the front Slows when the woman changes position Occurs in an irregular pattern Lasts about 20 to 25 seconds

Radiates from the back to the front

The nurse is reinforcing health care provider education on the technique for an amniocentesis. Which piece of equipment will the nurse have ready? Ultrasound equipment Sterile field with scalpel Foley catheter Sterile urine cup

Ultrasound equipment

Which nursing action would the nurse anticipate doing more often for a cesarean section newborn than a vaginal birth newborn? Monitor the temperature Assess voiding Note number of stools Upper airway suctioning

Upper airway suctioning

Which changes in the female body occur to allow the passage of the fetus down the birth canal? Select all that apply. Vaginal rugae stretch and smooth out Effacement is noted as 0% The cervix dilates to 10 cm Round ligaments contract The cervix softens

Vaginal rugae stretch and smooth out The cervix dilates to 10 cm The cervix softens

There are four essential components of labor. The first is the passageway. It is composed of the bony pelvis and soft tissues. What is one component of the passageway? False pelvis Cervix Perineum Uterus

cervix

A 16-year-old client has been in the active phase of labor for 14 hours. An ultrasound reveals that the likely cause of delay in dilation (dilatation) is cephalopelvic disproportion. Which intervention should the nurse most expect in this case? cesarean birth administration of oxytocin administration of morphine sulfate darkening room lights and decreasing noise and stimulation

cesarean birth

how do you check baby for jaundice

check baby nose or carriage of the ear press on that to see underlying yellow

When assessing cervical effacement of a client in labor, the nurse assesses which characteristic? extent of opening to its widest diameter degree of thinning passage of the mucous plug fetal presenting part

degree of thinning

The student nurse is learning about normal labor. The teacher reviews the cardinal movements of labor and determines the instruction has been effective when the student correctly states the order of the cardinal movements as follows: internal rotation, descent, extension, flexion, external rotation, expulsion descent, flexion, external rotation, extension, internal rotation, expulsion descent, flexion, internal rotation, extension, external rotation, expulsion internal rotation, flexion, descent, extension, external rotation, expulsion

descent, flexion, internal rotation, extension, external rotation, expulsion

When is the most impact to tetragons for the fetus occur?

embryo period 5th-8th week

A woman with an incomplete abortion is to receive misoprostol. The woman asks the nurse, "Why am I getting this drug?" The nurse responds to the client, integrating understanding that this drug achieves which effect? ensures passage of all the products of conception alleviates strong uterine cramping suppresses the immune response to prevent isoimmunization halts the progression of the abortion

ensures passage of all the products of conception

A woman is in the fourth stage of labor. During the first hour of this stage, the nurse would assess the woman's fundus at which frequency? every 5 minutes every 10 minutes every 15 minutes every 20 minutes

every 15 minutes

If a fetus were not receiving enough oxygen during labor because of uteroplacental insufficiency, which pattern would the nurse anticipate seeing on the monitor? a shallow deceleration occurring with the beginning of contractions variable decelerations, too unpredictable to count fetal baseline rate increasing at least 5 mm Hg with contractions fetal heart rate declining late with contractions and remaining depressed

fetal heart rate declining late with contractions and remaining depressed

What is a positive sign of pregnancy? positive pregnancy test fetal movement felt by examiner Hegar sign uterine contractions

fetal movement felt by examiner

Which cardinal movement allows the fetus to travel through the birth canal most efficiently? Extension External rotation Flexion Engagement

flexion

The nurse is reviewing the laboratory test results of a client in labor. Which finding would the nurse consider normal? decreased plasma fibrinogen levels increased blood coagulation time increased blood glucose levels increased white blood cell count

increased white blood cell count

A nurse is meeting with a group of pregnant clients who are in their last trimester to teach them the signs that may indicate they are going into labor. The nurse determines the session is successful after the clients correctly choose which signs as an indication of starting labor? Select all that apply. lightening weight gain constipation bloody show backache

lightening bloody show backache

scheduled c section emergency c section

low transverse incision midline incision

Assessment reveals that the fetus of a client in labor is in the vertex presentation. The nurse determines that which part is presenting? shoulders occiput brow buttocks

occiput

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? feeling distanced from the mother no changes, only the mother has changes during pregnancy physical symptoms similar to the mother desire to be the woman and give birth

physical symptoms similar to the mother

The nurse is collecting a urine specimen from a pregnant client during a prenatal visit. For what will the nurse test this client's urine? Select all that apply. protein glucose bacteria drug levels white blood cells

protein glucose bacteria white blood cells

feel fetal movement

quickening at 18-20 weeks

what blood does rh neg recieves

rh neg

prostaglandin gel

ripens the cervix

At the conclusion of a prenatal assessment, the nurse determines that a client is at risk during the pregnancy. Which data from the client's past illness history does the nurse use to make this decision? Select all that apply. seizure disorder previous cesarean birth hypertension for 10 years history of abnormal Papanicolaou test previous treatment for gonorrhea

seizure disorder hypertension for 10 years previous treatment for gonorrhea

late decels

this can mean fetus in distress not rebound from squeeze decrease oxygen

most difficult stage

transition

abrupto placenta

vaginal bleeding and back pain

The client is being rushed into the labor and delivery unit. At which station would the nurse document the fetus immediately prior to birth? -5 0 +1 +4

+4

When do see on the ultrasound for position?

- First ultrasound 6 weeks; see movement 13 weeks

Babies will have to be induced early?

- Gestational diabetes (fetal may not have adequate lung maturity not enough surfactant; may be given corticosteroid we know they are not maturing or PROM), pregnancy induced hypertension

Why women have change in mobility?

- Progesterone on cartilage, feet don't grow, joint pain and pelvic pain, waddling

when do you receive rhogam

-28 weeks -72 hour after birth -fall -car accident

The nurse assesses the client and tells her the baby is at +1 station. Which is the best response by the nurse when asked by the client what this means concerning the location of the baby? 1 cm below the ischial spine. 1 cm below the symphysis pubis. 1 cm above the ischial spine. 1 cm above the symphysis pubis.

1 cm below the ischial spine.

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? 2/3 lb (0.30 kg) 1 lb (0.45 kg) 1.5 lb (0.68 kg) 2 lb (0.90 kg)

1 lb (0.45 kg)

A client has just given birth to a healthy baby boy, but the placenta has not yet delivered. What stage of labor does this scenario represent? First Second Third Fourth

3rd

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. 3 weeks. 2 weeks. 1 week.

4 weeks.

using an electronic fetal monitor. The reading shows a late deceleration. Which intervention will the nurse implement? Encourage the Valsalva maneuver. Change maternal position to side-lying position. Administer exogenous oxytocin. Place the client in the lithotomy position.

Change maternal position to side-lying position

A client's membranes spontaneously ruptured, as evidenced by a gush of clear fluid with a contraction. What would the nurse do next? Check the fetal heart rate. Perform a vaginal exam. Notify the primary care provider immediately. Change the linen saver pad.

Check the fetal heart rate.

During labor, a woman undergoing induction with oxytocin should be monitored frequently. Which assessment findings should result in the oxytocin being discontinued immediately and the health care provider notified? Select all that apply. Hard contractions every 4-5 minutes lasting 45 to 60 seconds per contraction. Contractions strong at 80 mm Hg pressure with each contraction. Fetal heart rate fluctuation between 140-170 beats/min. Resting uterine pressure at 10-15 mm Hg by monitor. Contractions lasting between 90-120 seconds occurring every 2-3 minutes.

Contractions strong at 80 mm Hg pressure with each contraction. Contractions lasting between 90-120 seconds occurring every 2-3 minutes.

x What term is used to describe the position of the fetal long axis in relation to the long axis of the mother? Fetal presentation Fetal attitude Fetal position Fetal lie

Fetal lie

The nurse is performing an assessment of a woman who has come to a health care facility for a diagnosis of pregnancy. The women is positive for breast changes, nausea, and amenorrhea. On physical exam, it is noted that the client has softening of the cervix. How should the nurse document this in her notes? ballottement Chadwick sign Goodell sign Hegar sign

Goodell sign

A client at 16 weeks' gestation comes to the office for a routine exam. At what location within the abdomen would the nurse anticipate the uterus to be found? At the level of the umbilicus At the xiphoid process Halfway between the symphysis pubis and the umbilicus Below the symphysis pubis

Halfway between the symphysis pubis and the umbilicus

A pregnant woman diagnosed with diabetes should be instructed to perform which action? Discontinue insulin injections until 15 weeks gestation. Ingest a smaller amount of food prior to sleep to prevent nocturnal hyperglycemia. Notify the primary care provider if unable to eat because of nausea and vomiting. Prepare foods with increased carbohydrates to provide needed calories.

Notify the primary care provider if unable to eat because of nausea and vomiting.

A 32-year-old gravida 3 para 2 at 36 weeks' gestation comes to the obstetric department reporting abdominal pain. Her blood pressure is 164/90 mm Hg, her pulse is 100 beats per minute, and her respirations are 24 per minute. She is restless and slightly diaphoretic with a small amount of dark red vaginal bleeding. What assessment should the nurse make next? Check deep tendon reflexes. Measure fundal height. Palpate the fundus and check fetal heart rate. Obtain a voided urine specimen and determine blood type.

Palpate the fundus and check fetal heart rate.

The nurse identifies from a client's prenatal record that she has a documented gynecoid pelvis. Upon the client entering the labor and delivery department, which nursing action is best? Take no extra measures; prepare for a standard labor. Anticipate this client is a one-to-one registered nursing assignment. Notify the client's support person that the labor is typically long. Prepare for vital signs and fetal monitoring hourly.

Take no extra measures; prepare for a standard labor.

During a physical exam, the physician notates that the pregnant client has a positive Chadwick sign. What client findings would be noted for this symptom? The cervix has a bluish, purple discoloration. The cervix is reddened and swollen. There is a rebound of the fetus felt when the physician pushes on the abdomen. There is hyperpigmentation of the abdomen.

The cervix has a bluish, purple discoloration.

The nurse is caring for a client who is late in her pregnancy. What assessment finding should the nurse attribute to the role of prostaglandins? The cervix is softening The uterus is relaxing The cervix is dilating The perineum is relaxing

The cervix is softening

if patient is on pitocin

continuous monitoring

after delivery the fundud descends by 1 finger width every ___ as it returns to normal size

day

During an assessment, a client who is 5 months pregnant tells the nurse that she has to change her diet because she is just becoming too fat. Which nursing diagnosis should the nurse use to guide interventions for the client at this time? powerlessness imbalanced nutrition deficient knowledge disturbed body image

disturbed body image

A client is admitted with a diagnosis of ectopic pregnancy. For what should the nurse anticipate preparing the client? immediate surgery internal uterine monitoring bed rest for the next 4 weeks intravenous administration of a tocolytic

immediate surgery

Which change in the musculoskeletal system would the nurse mention when teaching a group of pregnant women about the physiologic changes of pregnancy? ligament tightening decreased swayback increased lordosis joint contraction

increased lordosis

A woman calls the health care facility stating that she is in labor. The nurse would urge the client to come to the facility if the client reports which symptom? increased energy level with alternating strong and weak contractions moderately strong contractions every 4 minutes, lasting about 1 minute contractions noted in the front of abdomen that stop when she walks pink-tinged vaginal secretions and irregular contractions lasting about 30 seconds

moderately strong contractions every 4 minutes, lasting about 1 minute

Which assessment finding in a client reporting uterine contractions would be most consistent as an indicator of approaching labor? decrease in vaginal secretions development of a membrane further closing the cervix rupture of amniotic membranes decrease in duration of contractions

rupture of amniotic membranes

causes of placenta previa 4 treatment 3

smoking, uterine surgeries, c sections, over 35 pelvic rest, monitor, c section

what does glucocsteriods promote infant

surfactant

fetal monitoring late declaration

tell baby maybe distress we want variability heart rate varies with activities if no activity and no change that is concerning

A pregnant woman at the emergency department informs staff that she is at least 2 weeks past her due date. The physician begins to perform several tests to determine fetal age. The nurse anticipates that the woman's amniotic fluid volume will be decreased. How would the nurse measure the amniotic fluid in this situation? x-ray ultrasound aspiration palpation

ultrasound

what does the heart rate need to be below before you consider chest compression

60 bpm

first sign of hemmmorhage

bleeding and tacycardia

what is CAD

cephalic disportion: the diabetic mom body absorbs sugar; baby can't pass the pelvis

During late pregnancy, the nurse teaches a pregnant woman to lay on her left side to avoid what condition? Supine hypotension syndrome Preeclampsia Frequent urination Heartburn

Supine hypotension syndrome

C section saddle block

- lets mom be awake take part of baby be born; take effect immediately

The nurse is planning to instruct a client who is 6 weeks pregnant about increasing the intake of milk each day. Which statement should the nurse make as the most effective health teaching measure? "The fetus needs milk to build strong bones and teeth." "Your future baby will benefit from a high milk intake." "Milk is a rich source of calcium that is important for fetal growth." "Milk will strengthen your fingernails as well as be good for the baby."

"Milk will strengthen your fingernails as well as be good for the baby."

Plenty folic acid

- green things (collard greens, turnip greens, kale) good spinal and brain development

Gestational diabetes at risk macrosomia babies

- increase insulin resistance blood glucose rise transfer to baby and the baby usually has hypoglycemia

Nausea first trimester

- not getting out of bed immediately; sip on soda and crackers before getting out bed, eat small meals, avoid strong odors

Pregnancy hormone

- progesterone make the lining of uterus thick fluffy shag carpet fertilized egg to implant allows it to grow

Assessing the pt mindful with positions gestation

- progress having mom in supine position cause dizziness and faint position on the left side

Hyper contractibility contraction lasting 2 or minutes

- stop Pitocin can cause uterine rupture

Increase blood volume

- support needs of the fetus to have adequately perfusion to the placenta oxygen and nutrient to get the baby what it needs contribute to headaches and varicose veins

Prenatal vitamins important mom needs to have

- vitamin C for iron supplement do not take with milk can cause nausea or constipation because iron doesn't get absorbed out of vitamin

A fetus is assessed at 2 cm above the ischial spines. How would the nurse document the fetal station? +4 +2 0 -2

-2

Early decels late decals what drops HR

-HR begins to drop start of contraction continues to drop through contraction -HR drops later in the contraction -Cord be squeeze, problem placenta; looking at possible fetal distress

hyperventilation during labor and treat

-anxious and overwhelm -numbness and tingleness -brown paper bag

when should you asses spO2 at birth 4

-baby not breathing -cyanosis -grasping -HR less than 100

second and third trimester warning signs 5

-change fetal movement -uterine cramping before 37 weeks -visual disturbances -severe headaches -epigastric pai

Baby is not crying, poor tone, term gestation what are the interventions 4

-place head in sniffing posistion on warmer -suction airway -dry and stimulate -asses heart rate

Warning signs of pregnancy 1st trimester 5

-severe vomiting -fever -chills -abdominal cramping -vaginal bleeding diarrhea

what three things are vital for the new born to have at birth before placing newborn skin to skin

-term -crying/breathing -good muscle tone

Newborn present with jaundice first 24 hours jaundice present after 24 hours

-that's pathologic hemolytic disease like blood disorder or liver disease -break down of the RBC immature liver

he nurse is reviewing client data following a regular monthly appointment at 6 months' gestation. Which fundal height requires no further intervention? 18 cm 24 cm 30 cm 32 cm

24 cm -between weeks 18 and 32 the fundal height in centimeters should match the gestational age of the pregnancy. For example, if the woman is 18 weeks pregnant, the fundal height should measure 18 cm.

How should the nurse document a pregnant client's gestational status using the GTPAL system after collecting the following data? Currently 18 weeks pregnantClient's fourth pregnancyDelivered one nonviable fetus at 26 weeksExperienced one miscarriageDelivered one viable fetus at 38 weeks' gestation 3, 2, 1, 2, 1 4, 2, 2, 1, 1 3, 2, 1, 1, 1 4, 1, 1, 1, 1

4, 1, 1, 1, 1

Calcium: 4

: milk, yogurt, green vegetables (broccoli), dried beans, legumes, help with bone growth

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? The heart rate increase may indicate that the client is experiencing cardiac overload. The blood pressure should be higher since the cardiac volume is increased. Both findings are normal at this point of the pregnancy. Combined, both of these findings are very concerning and warrant further investigation.

Both findings are normal at this point of the pregnancy.

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 get closer together with activity. Braxton Hicks contractions usually decrease in intensity with walking. Braxton Hicks contractions do not last long enough to be true labor. Braxton Hicks contractions cause "ripening" of the cervix.

Braxton Hicks contractions usually decrease in intensity with walking.

Which consideration is a priority when caring for a mother with strong contractions 1 minute apart? Fetal heart rate in relation to contractions The station in which the fetus is located Maternal heart rate and blood pressure Maternal request for pain medication

Fetal heart rate in relation to contractions

During a vaginal exam, the nurse notes that the lower uterine segment is softened. The nurse documents this finding as: Hegar sign. Goodell sign. Chadwick sign. Ortolani sign.

Hegar sign.

A pregnant mother may experience constipation and the increased pressure in the veins below the uterus can lead to development of what problem? Varicose veins Umbilical hernia Hemorrhoids Gastrointestinal reflux

Hemorrhoids

Which complication occurs as a result of ineffective breathing patterns? Hiccups Nausea Flatus Hyperventilation

Hyperventilation

The nurse has provided care to a client throughout labor and delivery and is comparing assessment findings with expected norms. When tracking the client's cardiac assessments, the nurse should predict that cardiac output will likely be the highest at which time? During active labor Second stage of labor Immediately after birth During transition

Immediately after birth

A 32-year-old woman presents to the labor and birth suite in active labor. She is multigravida, relaxed, and talking with her husband. When examined by the nurse, the fetus is found to be in a cephalic presentation. His occiput is facing toward the front and slightly to the right of the mother's pelvis, and he is exhibiting a flexed attitude. How does the nurse document the position of the fetus? LOA LOP ROA ROP

ROA

A client at 29 weeks' gestation reports she experiences a sharp pain in her lower abdomen when she stands up suddenly. The nurse explains this is most likely a result of tension on which structure? Broad ligament Round ligament Cardinal ligament Sacral-pubic ligament

Round ligament

A client makes an appointment with an obstetrician and assessment reveals positive Hegar and Chadwick signs. What should the nurse teach the client about these results? The client more likely has a gynecologic disorder rather than pregnancy The client is definitively pregnant Pregnancy cannot be confirmed She is probably pregnant, but this must be confirmed by other means

She is probably pregnant, but this must be confirmed by other means

Which physical characteristic of the neonate is typically present in the neonate of a primigravid mother? Thick vernix Single palmar crease Significant head molding Absence of testicular rugae

Significant head molding

The nurse is caring for a woman at 32 weeks' gestation with severe preeclampsia. Which assessment finding should the nurse prioritizeafter the administration of hydralazine to this client? Gastrointestinal bleeding Halos around lights Tachycardia Sweating

Tachycardia

The nurse-midwife is performing a pelvic examination on a client who came to her following a positive home pregnancy test. The nurse checks the woman's cervix for the probable sign of pregnancy known as Goodell sign. Which description illustrates this alteration? The cervix looks blue or purple when examined. The lower uterine segment softens. The fundus enlarges. The cervix softens.

The cervix softens.

The nurse is aware that cord compression is not continuous when variable decelerations occur and that compression happens when which of the following takes place? The uterus relaxes between contractions. The uterus contracts and squeezes the cord against the fetus. prematurity fetal sleep

The uterus contracts and squeezes the cord against the fetus.

The nurse is presenting a nutritional plan to a primigravida client who is questioning the addition of iodized salt to her diet. Which explanation should the nurse prioritize in answering this client? Thyroid activity, which depends on iodine intake, increases during pregnancy. Because of decreased thyroid activity during pregnancy, the thyroid does not produce as much as normal. Progesterone formation is dependent on a high iodine intake. Adrenal gland activity during pregnancy decreases iodine's effectiveness.

Thyroid activity, which depends on iodine intake, increases during pregnancy.

A nurse is conducting a nutrition class for a group of pregnant women. What information accurately addresses this issue? Select all that apply. The baby will require increased protein for development, so the mother needs to ingest 8 to 9 g of additional protein per day above her nonpregnant requirements. Total iron requirements equal 1,000 mg, with the greatest need being in the second trimester. Calcium supplements may decrease the chance of developing pre-eclampsia in women who had a pre-existing deficiency. Since an iodine deficiency can cause intellectual deficits in infants, mothers are recommended to use iodized salt. Folic acid is needed during the third trimester to reduce the chance of birth defects such as neural tube defects and cleft lip/palate.

Total iron requirements equal 1,000 mg, with the greatest need being in the second trimester. Calcium supplements may decrease the chance of developing pre-eclampsia in women who had a pre-existing deficiency. Since an iodine deficiency can cause intellectual deficits in infants, mothers are recommended to use iodized salt.

During which phase of labor would the nurse anticipate providing the most emotional support for the mother? Active phase of labor Final phase of labor Transition phase of labor Latent phase of labor

Transition phase of labor

uterine inversion more common in

after placenta delivery the uterus is prolapse cuts off blood flow medical emergency more common multipara uterine muscles floppy and weak

A nurse is admitting a client who presents in active labor at 41 weeks' gestation. The nurse prepares for the possibility of a cesarean delivery after noting the client has which type of pelvis documented? gynecoid anthropoid android platypelloid

android

Which action is a priority when caring for a woman during the fourth stage of labor? assessing the uterine fundus offering fluids as indicated encouraging the woman to void assisting with perineal care

assessing the uterine fundus

A pregnant woman who is a vegetarian asks the nurse, "What would you suggest to make sure that I get enough protein in my diet while I am pregnant?" Which food(s) would be appropriate for the nurse to suggest? Select all that apply. beans lentils nuts green leafy vegetables orange juice

beans lentils nuts

suture

bonnes come together fetal head connective tissue asses by palpating head

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. breast changes ultrasound pictures fetal heartbeat amenorrhea hydatidiform mole morning sickness

breast changes amenorrhea morning sickness

A client with severe preeclampsia is receiving magnesium sulfate as part of the treatment plan. To ensure the client's safety, which compound would the nurse have readily available? calcium gluconate potassium chloride ferrous sulfate calcium carbonate

calcium gluconate

A nurse is providing care to a pregnant woman in labor. The woman is in the first stage of labor. When describing this stage to the client, which event would the nurse identify as the major change occurring during this stage? regular contractions cervical dilation (dilatation) fetal movement through the birth canal placental separation

cervical dilation (dilatation)

A woman in labor is to receive continuous internal electronic fetal monitoring. The nurse prepares the client for this monitoring based on the understanding that which criterion must be present? intact membranes cervical dilation (dilatation) of 2 cm or more floating presenting fetal part a neonatologist to insert the electrode

cervical dilation (dilatation) of 2 cm or more

Before beginning the initial prenatal examination, a nurse should instruct a client to complete what procedure before undressing? clean-catch urine initial blood tests measurement of fundal height ultrasound for fetal measurements

clean-catch urine

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. feel fetal movements. hear the fetal heartbeat with a stethoscope. palpate the fetal outline.

detect fetal heart sounds with a Doppler.

A client is ready to push. The nurse instructs her to push vigorously and grunt and breathe out during a pushing effort. What would be important to monitor on the client while she is pushing vigorously? level of consciousness temperature fatigue blood pressure

fatigue

what is betamethazone used for

given to mature fetal lungs before 34 weeks

A client is admitted to the labor and birthing suite in early labor. On review of her prenatal history, the nurse determines that the client's pelvic shape as identified in the antepartal progress notes is the most favorable one for a vaginal birth. Which pelvic shape would the nurse have noted? platypelloid gynecoid android anthropoid

gynecoid

what can blood type incombalitity cause

hemolytic disease newborn jaundice

A nurse is taking a history during a client's first prenatal visit. Which assessment finding would alert the nurse to the need for further assessment? history of exercising twice a week history of diabetes for 4 years history of occasional use of OTC pain relievers maternal age of 28 years

history of diabetes for 4 years

what can epidural caus

hypotension

The nurse is identifying nursing diagnoses for a client with gestational hypertension. Which diagnosis would be the most appropriate for this client? risk for injury related to fetal distress imbalanced nutrition related to decreased sodium levels ineffective tissue perfusion related to poor heart contraction ineffective tissue perfusion related to vasoconstriction of blood vessels

ineffective tissue perfusion related to vasoconstriction of blood vessels

A patient who is in her 9th month of pregnancy comes to the emergency department and reports that bright red blood is coming from her vagina. She denies having any pain. What needs to be ruled out before a vaginal examination can be performed? preeclampsia premature labor placenta previa multiple births

placenta previa

A client with a multiple gestation has come to a health care facility for a regular antenatal check-up. When educating the client on pregnancy, about which complication should the nurse inform the client? hypotension fetal macrosomia frequent diarrhea placental dysfunction

placental dysfunction

what is a ripe cervix

progesteron is help ripen the cervix onset of labor

The nursing instructor is teaching students about normal changes of pregnancy. The instructor talks about diastasis recti. What is the instructor presenting? separation of the muscles of the abdominal wall raising of the uterus into the abdomen relaxation of the kidneys movement of the bladder to the rear of the pelvis behind the uterus

separation of the muscles of the abdominal wall

A client who is 8 weeks' pregnant comes to the emergency department reporting abdominal pain and spotting. The client also reports breast tenderness and fatigue. Additional assessment suggests a possible ectopic pregnancy and diagnostic evaluation is scheduled. The nurse would prepare the client for which test(s) to aid in confirming this diagnosis? Select all that apply. transvaginal ultrasound beta-human chorionic gonadotropin (hCG) level urine for protein platelet level complete blood count

transvaginal ultrasound beta-human chorionic gonadotropin (hCG) level

The nurse teaches a primigravida client that lightening occurs about 2 weeks before the onset of labor. The mother will most likely experience which of the following at that time? dysuria dyspnea constipation urinary frequency

urinary frequency

A pregnant client tells the nurse that she is not happy to learn about the pregnancy. At which point in the pregnancy does the nurse realize that the client will change her mind about the pregnancy? around the third month after the seventh month when quickening occurs after lightening happens

when quickening occurs

Do we want to see variability ?

yes; baby contraction baby HR increases then go down shouldn't bottom out; indicator of neurological status