Ch 10, Assessment of High Risk Pregnancy
Which finding in the ultrasonography reports of a pregnant woman would indicate a normal fetus? 1 Amniotic fluid index of 30 cm 2 Amniotic fluid index of 13 cm 3 Amniotic fluid index of 6 cm 4 Amniotic fluid index of 2 cm
Amniotic fluid index of 13 cm An amniotic fluid index of 10 cm or more is considered normal. An amniotic fluid index of 25 cm is considered above the normal range and indicates polyhydramnios. An amniotic fluid index less than 10 cm is considered below the normal range. An amniotic fluid index below 5 cm is considered oligohydramnios.
The nurse is reviewing lab values to determine Rh incompatibility between mother and fetus. Which specific lab result should the nurse assess? 1 Indirect Coombs test 2 Hemoglobin level 3 hCG level 4 Maternal serum alpha-fetoprotein (MSAFP)
Indirect Coombs test The indirect Coombs test is a screening tool for Rh incompatibility. If the maternal titer for Rh antibodies is greater than 1:8, amniocentesis for determination of bilirubin in amniotic fluid is indicated to establish the severity of fetal hemolytic anemia. Hemoglobin reveals the oxygen carrying capacity of the blood. hCG is the hormone of pregnancy. Maternal serum alpha-fetoprotein (MSAFP) levels are used as a screening tool for NTDs in pregnancy.
On reviewing the amniocentesis reports of a pregnant patient, the nurse finds that phosphatidylglycerol (PG) is absent in the amniotic fluid. What can the nurse interpret about development in the fetus from the reports? 1 Impaired cardiac development 2 Impaired brain development 3 Impaired lung development 4 Impaired limb development
Impaired lung development PG is a glycerophospholipid found in the lungs as a pulmonary surfactant. The presence of PG in amniotic fluid is an early indicator of fetal lung maturity. The PG test is used mostly to assess fetal lung maturity in late pregnancy, therefore absence of PG indicates impaired lung development. The PG test is not used to assess the heart, brain, or limb growth of the fetus. Fetal heart activity can be assessed by using transvaginal ultrasound. Magnetic resonance imaging is used to observe the growth and development of the fetal brain. Limb development of the fetus can be observed on ultrasound.
After reviewing the reports of a pregnant patient, the nurse infers that there might be a high risk for intrauterine growth restriction (IUGR). What could be the reason for this? The amniotic fluid index (AFI) is: 1 Less than 5 cm. 2 Equal to or more than 10 cm. 3 Between 5 and 10 cm. 4 More than 25 cm.
1 Less than 5 cm. An AFI less than 5 cm indicates oligohydramnios. Oligohydramnios is associated with intrauterine growth restriction and congenital anomalies. An AFI of 10 cm or greater indicates that the fetus is normal. AFI values between 5 and 10 cm are considered low normal, indicating a comparatively low risk for congenital anomalies. An AFI greater than 25 cm indicates polyhydramnios. This is associated with neural tube defects and obstruction of the fetal gastrointestinal tract.
A 4-week pregnant patient is undergoing an ultrasound. The report shows an absence of fetal heart activity. What does the nurse infer about the fetus from the report? 1 Normal finding 2 Congenital abnormality 3 impaired growth 4 Cardiac disorder
1 Normal finding Fetal heart activity begins around 6 weeks, so 4 weeks is too early to detect fetal heart activity, and this is a normal finding. Absence of fetal heart activity at an advanced gestational age may indicate congenital anomalies, impaired growth, or cardiac disorders. Test-Taking Tip: Study wisely, not hard. Use study strategies to save time and be able to get a good night's sleep the night before your exam. Cramming is not smart, and it is hard work that increases stress while reducing learning. When you cram, your mind is more likely to go blank during a test. When you cram, the information is in your short-term memory, so you will need to relearn it before a comprehensive exam. Relearning takes more time. The stress caused by cramming may interfere with your sleep. Your brain needs sleep to function at its best.
The nurse who is caring for a diabetic pregnant patient finds that the weight gain pattern is poor. Which fetal factor will the nurse check in the ultrasound reports of the patient? 1 Heart activity 2 Growth pattern 3 Anatomic structure 4 Movement frequency
2 Growth pattern Diabetes is known to cause decreased weight gain during pregnancy. This, in turn, causes intrauterine growth restriction. Therefore the nurse should regularly monitor the fetal growth pattern in ultrasound reports. Fetal heart activity and anatomic structure are not influenced by maternal diabetes. Alterations in the amniotic fluid levels are associated with fetal heart activity and anatomic structure. Impaired nutrition of the mother can affect the fetal activity and therefore reduce the frequency of the fetal movements. Decreased fetal movements are not associated with maternal diabetes. Test-Taking Tip: Work with a study group to create and take practice tests. Think of the kinds of questions you would ask if you were composing the test. Consider what would be a good question, what would be the right answer, and what would be other answers that would appear right but would, in fact, be incorrect.
What parameter does the nurse check in the amniocentesis report of a pregnant patient to assess fetal lung growth? 1 Alfa-fetoprotein (AFP) levels 2 Lecithin-to-sphingomyelin (L/S) ratio 3 Creatinine levels in the blood 4 Antibody titer in the blood
2 Lecithin-to-sphingomyelin (L/S) ratio The L/S ratio indicates fetal lung maturity. AFP is assessed to check for the presence of neural defects. Presence of creatinine in the amniotic fluid indicates that the patient's gestational age is more than 36 weeks. The antibody titer is used to determine Rh incompatibility in the fetus.
While reviewing the ultrasonography images of a patient in her seventh month of pregnancy, the nurse observes an enlarged renal pelvis of the fetus. Which screening test does the nurse advise the patient to undergo? 1 Coombs' screening 2 Quad screening 3 Cell-free DNA screening 4 Triple marker screening
2 Quad screening Enlargement of the renal pelvis may indicate Down syndrome in the fetus, and quad screening is done to determine whether the fetus has Down syndrome. In this test, the levels of placental hormone inhibin A are monitored. Low levels of inhibin A indicate Down syndrome. Coombs' test is a screening procedure to determine Rh incompatibilities. Cell-free DNA screening is done to detect certain inherited single-gene disorders. Triple marker screening is less accurate than quad screening in screening for Down syndrome.
Arrange the steps the nurse takes while performing transvaginal ultrasonography for a pregnant patient, in the correct order. 1. Cover the transducer probe with a probe cover. 2. Position the pregnant patient in the lithotomy position. 3. Position the probe for proper view of pelvic structures. 4. Lubricate the transducer probe with water-soluble gel. 5. Insert the transducer probe into the patient's vagina.
2. Position the pregnant patient in the lithotomy position. 1. Cover the transducer probe with a probe cover. 4. Lubricate the transducer probe with water-soluble gel. 5. Insert the transducer probe into the patient's vagina. 3. Position the probe for proper view of pelvic structures. While performing transvaginal ultrasonography, the nurse should first position the patient in the lithotomy position to ensure the optimal view of pelvic structures. The transducer probe is then covered with a suitable probe cover. Then the probe is lubricated with a water-soluble gel to increase penetration of ultrasonic waves. The probe is then inserted into the patient's vagina. Finally, the position of the probe is adjusted for a better view of the inner pelvic structures.
After performing an amniocentesis, the primary health care provider asks the nurse to administer Rho(d) immunoglobulin to a pregnant patient with Rh-negative blood. Why should a patient with Rh-negative blood be administered Rho(d) immunoglobulin? To prevent: 1 Pain from amniocentesis 2 Leakage of amniotic fluid 3 Fetomaternal hemorrhage 4 Infection in the fetus
3 Fetomaternal hemorrhage Fetomaternal hemorrhage may occur after amniocentesis. Administering Rho(d) immunoglobulin to a pregnant patient with Rh-negative blood is advisable to prevent fetomaternal hemorrhage. Administering Rho(d) immunoglobulin after amniocentesis will not provide pain relief. Preventing amniotic fluid leakage during amniocentesis requires expertise in the procedure; administering Rho(d) immunoglobulin does not prevent amniotic fluid leakage. Maintaining aseptic conditions while performing the procedure is helpful in preventing infection during amniocentesis; administering Rho(d) is not.
The contraction stress test (CST) reports of a pregnant patient are positive. What will the primary health care provider recommend? 1 Repeat testing next week. 2 Repeat testing the next day. 3 Hospitalize the patient immediately. 4 Repeat testing within 24 hours.
3 Hospitalize the patient immediately. Fewer than three contractions in 10 minutes or late decelerations in the heart rate that occur with 50% or more of contractions indicate a positive CST result. If CST results are positive, then the primary health care provider is likely to recommend hospitalization for further evaluation or delivery. If CST results are negative, then the patient may be advised to undergo regular weekly testing. If CST results are suspicious, equivocal hyperstimulatory, or unsatisfactory, then the patient may be advised to repeat the test within 24 hours or the next day.
A woman who is at 36 weeks of gestation is having a nonstress test. Which statement by the woman indicates a correct understanding of the test? 1 "I will need to have a full bladder for the test to be done accurately." 2 "I should have my husband drive me home after the test because I may be nauseous." 3 "This test will help to determine if the baby has Down syndrome or a neural tube defect."
4 "This test will observe for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby." The nonstress test is one of the most widely used techniques to determine fetal well-being and is accomplished by monitoring fetal heart rate in conjunction with fetal activity and movements. An ultrasound is the test that requires a full bladder. An amniocentesis is the test that a pregnant woman should be driven home afterward. A maternal alpha-fetoprotein test is used in conjunction with unconjugated estriol levels, and human chorionic gonadotropin helps to determine Down syndrome.
A pregnant patient is about to undergo magnetic resonance imaging (MRI). What information does the nurse give the patient before the procedure? The patient will: 1 Be positioned in a lithotomy position. 2 Need to take fluids to have a full bladder. 3 Be able to move freely during the procedure. 4 Not have pain during the process.
4 Not have pain during the process. MRI is a noninvasive technique that causes little pain. Therefore the patient undergoing MRI should be advised to not worry about pain. The patient undergoing MRI should be positioned in a supine position. The lithotomy position is not suitable for this procedure. The patient need not take fluids before the scan to ensure a full bladder because this procedure enables a full pelvic view without a full bladder. The patient should be instructed not to move during the scanning process because it may blur the images obtained.
A 40-year-old woman with a high body mass index is 10 weeks pregnant. Which diagnostic tool is appropriate to suggest to her at this time? 1 Biophysical profile 2 Amniocentesis 3 Maternal serum alpha-fetoprotein (MSAFP) 4 Transvaginal ultrasound
4 Transvaginal ultrasound Transvaginal ultrasound is useful for obese women whose thick abdominal layers cannot be penetrated adequately with the abdominal approach. A biophysical profile is a method of biophysical assessment of fetal well-being in the third trimester. An amniocentesis is performed after the fourteenth week of pregnancy. A MSAFP test is performed from week 15 to week 22 of the gestation (weeks 16 to 18 are ideal). An ultrasound is the method of biophysical assessment of the infant that is performed at this gestational age.
While reviewing the ultrasonography reports of a pregnant patient, the nurse finds that there is excessive fluid collection at the nape of the neck of the fetus. Which test will the nurse recommend? 1 Fetal acoustic stimulation test 2 Oxytocin challenge test 3 Chorionic villus sampling 4 Percutaneous umbilical blood test
Chorionic villus sampling Excessive fluid in the nape of the neck indicates a genetic abnormality in the fetus. Genetic abnormalities can be tested further by performing chorionic villus sampling. A fetal acoustic stimulation test is done to test the fetal heart rate. Oxytocin challenge is a stress-based test for measuring fetal heart rate. Percutaneous umbilical blood sampling is the procedure done for fetal blood sampling and transfusion.
The biophysical profile (BPP) testing report of a pregnant patient gives the following information: one episode of fetal breathing movement lasting for 30 seconds in a 30-minute observation; three limb movements of the fetus in 30 minutes; an amniotic fluid index greater than 5; a reactive nonstress test; and a BPP score of 1. The test is performed for 120 minutes. What does the nurse expect the primary health care provider to do? 1 Extend the test time to 120 minutes. 2 Repeat the test twice a week. 3 Repeat the test in 4 to 6 hours. 4 Consider delivery of the fetus.
Consider delivery of the fetus If the BPP score is less than 2, regardless of gestational age, delivery can be performed. If the BPP score is 0 to 2 and chronic asphyxia is suspected, then testing time should be extended to 120 minutes. If the BPP score is 8 to 10 and a low risk for chronic asphyxia is suspected, then the test should be repeated at twice-weekly intervals. If the fetal pulmonary test result is negative and the BPP score is 6, then the BPP profile should be repeated in 4 to 6 hours.
The nurse reviews the ultrasound reports of a pregnant patient and finds that the images of fetal anatomic details are not clear. The nurse then prepares the patient for a magnetic resonance imaging (MRI) scan. What does the nurse administer to the patient before performing the MRI scan? 1 A sedative 2 A diuretic 3 An analgesic 4 An antipyretic
1 A sedative The MRI scan may take 20 to 60 minutes. During the scan, the patient must be perfectly still. Moreover, fetal movement during the scan will obscure the anatomic details. To avoid this problem, the patient should be administered a sedative before the MRI scan. Diuretics are administered to increase the rate of urine formation. If a diuretic is given before the MRI, frequent urination may occur. Because the patient does not complain of pain, analgesics need not be administered. Antipyretics would not helpful in decreasing the patient's activity level. They should be administered only if the patient has a fever.
Which condition should the nurse suspect in a fetus with oligohydramnios? 1 Fetal alcohol syndrome 2 Potter syndrome 3 Down syndrome 4 Twin-twin syndrome
2 Potter syndrome Oligohydramnios means that there is a low amniotic fluid volume (AFV). Oligohydramnios is known to cause Potter syndrome. Potter syndrome is the atypical physical appearance of a fetus or a neonate. Excessive alcohol intake during pregnancy may cause fetal alcohol syndrome and is not associated with oligohydramnios. Down syndrome is a genetic abnormality of the fetus and can be identified using prenatal screening tests such as triple marker screen and quad screen. Down syndrome is not associated with oligohydramnios. Twin-twin syndrome is associated mainly with polyhydramnios.
Which condition should the nurse suspect in a fetus with oligohydramnios? 1 Fetal alcohol syndrome 2 Potter syndrome 3 Down syndrome 4 Twin-twin syndrome
Potter syndrome Oligohydramnios means that there is a low amniotic fluid volume (AFV). Oligohydramnios is known to cause Potter syndrome. Potter syndrome is the atypical physical appearance of a fetus or a neonate. Excessive alcohol intake during pregnancy may cause fetal alcohol syndrome and is not associated with oligohydramnios. Down syndrome is a genetic abnormality of the fetus and can be identified using prenatal screening tests such as triple marker screen and quad screen. Down syndrome is not associated with oligohydramnios. Twin-twin syndrome is associated mainly with polyhydramnios.
A patient in the sixth month of pregnancy expresses her wish to see the fetus. What investigation does the nurse suggest for the patient to help her see the fetus? 1 Ultrasonography 2 Magnetic resonance imaging (MRI) 3 Computed tomography (CT) 4 Nuchal translucency (NT)
1 Ultrasonography Three-dimensional (3D) or four-dimensional (4D) ultrasonography is advisable for women who want to see the fetus. MRI cannot be used in this case because it requires the fetus to be still for a long period of time for a clear image. CT uses ionizing radiation for imaging, which can be harmful to the fetus. Therefore CT is contraindicated for fetal imaging. NT is a specific ultrasonography screening procedure used to test for genetic abnormalities in the fetus.
The nurse is preparing a patient for transvaginal ultrasonography. What information does the nurse give the patient before the test? 1 The patient needs to be in the semi-Fowler position for the test. 2 The patient needs to drink lots of fluids to keep the bladder full before the test. 3 There is no pain felt during transvaginal ultrasonography. 4 There is no pressure felt during transvaginal ultrasonography.
3 There is no pain felt during transvaginal ultrasonography. Transvaginal ultrasonography is a painless procedure in which a transducer probe is inserted into the vagina and the pelvic anatomic features are evaluated. The patient is positioned in lithotomy position, not semi-Fowler position, for this procedure. This helps in proper insertion of the probe. Intake of large amounts of fluids is generally recommended for transabdominal ultrasonography but not for transvaginal ultrasonography. Some pressure is felt on the vaginal walls as the transducer probe is moved to get a complete view of the pelvis. STUDY TIP: Establish your study priorities and the goals by which to achieve these priorities. Write them out and review the goals during each of your study periods to ensure focused preparation efforts.
Biochemical examination of the amniotic fluid of a pregnant patient yields the following results: lecithin-to-sphingomyelin (L/S) ratio, 2:1; surfactant-to-albumin (S/A) ratio, 60 mg/g; and phosphatidylglycerol (PG) present. What conclusions will the nurse draw from this report? 1 The fetal lungs are well developed. 2 The gestational age is 36 weeks. 3 The fetus has a neural tube defect. 4 The fetus has an open neural tube defect.
Fetal lungs are well developed Biochemical findings such as an L/S ratio of 2:1, an S/A ratio of 60 mg/g, and the presence of PG in amniotic fluid indicate that the fetal lungs are well developed. The gestational age can be predicted only with the help of creatinine and lipid levels in the amniotic fluid. Creatinine levels greater than 2 mg/dL in amniotic fluid indicate that the gestational age is more than 36 weeks. The presence of alpha-fetoprotein (AFP) in the amniotic fluid indicates a neural tube defect in the fetus. The nurse needs to assess AFP levels in the amniotic fluid to determine whether the fetus has an open neural tube defect. A high AFP level in amniotic fluid after 15 weeks' gestation indicates that the fetus has an open neural tube defect.
The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has smoked throughout the pregnancy, and fundal height measurements now are suggestive of growth restriction in the fetus. In addition to ultrasound to measure fetal size, what tool is useful in confirming the diagnosis? 1 Doppler blood flow analysis 2 Contraction stress test (CST) 3 Amniocentesis 4 Daily fetal movement counts
1 Doppler blood flow analysis Doppler blood flow analysis allows the examiner to study the blood flow noninvasively in the fetus and placenta. It is a helpful tool in the management of high risk pregnancies because of intrauterine growth restriction (IUGR), diabetes mellitus, multiple fetuses, or preterm labor. Because of the potential risk of inducing labor and causing fetal distress, a CST is not performed on a woman whose fetus is preterm. Indications for an amniocentesis include diagnosis of genetic disorders or congenital anomalies, assessment of pulmonary maturity, and the diagnosis of fetal hemolytic disease, not IUGR. Fetal kick count monitoring is performed to monitor the fetus in pregnancies complicated by conditions that may affect fetal oxygenation. Although this may be a useful tool at some point later in this woman's pregnancy, it is not used to diagnose IUGR.
The nurse is assessing a pregnant patient and finds that her blood pressure is 150/90 mm Hg. What procedure does the nurse recommend for this patient? 1 Nuchal translucency (NT) test 2 Chorionic villus sampling (CVS) 3 Doppler blood flow analysis 4 Percutaneous umbilical blood sampling (PUBS)
3 Doppler blood flow analysis Maternal hypertension can cause serious adverse effects on the fetus. A blood pressure reading of 150/90 mm Hg indicates that the mother is hypertensive. To assess the effect of maternal hypertension on the fetus, the nurse should refer the patient for a Doppler blood flow analysis. It is a noninvasive ultrasonic technique used to study fetal blood flow. NT is a technique used to assess genetic abnormalities in the fetus. CVS is a prenatal test used to diagnose structural defects in the fetus. PUBS is used to assess the fetal circulation.
The nurse is documenting the findings of a contraction stress test in a patient. The nurse finds that late decelerations in fetal heart rate occur with 60% of contractions. What does the nurse advise the patient? 1 "Continue with the weekly testing schedule." 2 "You should be hospitalized and monitored continuously." 3 "Take the test again tomorrow at the same time." 4 "You should take the test again today after resting."
2 "You should be hospitalized and monitored continuously." If late decelerations occur with more than 50% of the contractions in the contraction stress testing, this is a positive test result. In this situation, the patient must be hospitalized and evaluated further. If the fetus has no significant variable heart rate decelerations with at least three uterine contractions for a period of 10 minutes, the patient can continue with the weekly testing schedule. If late deceleration in the heart rate occurs with less than 50% of the contractions, the patient should be advised to repeat the test the next day. Repeating the test on the same day can cause fetal distress and should be avoided.
The nurse is reviewing the scanned images of an ultrasonography test of the fetus. The nurse finds that the head and abdominal circumferences of the fetus are large in proportion to other parts of the body. What should the nurse conclude about the fetus? 1 Symmetric growth restriction 2 Asymmetric growth restriction 3 Macrosomia resulting from maternal diabetes 4 Presence of congenital malformations
2 Asymmetric growth restriction The difference in the head and body circumference is a sign of asymmetric growth restriction. Symmetric intrauterine growth restriction is a condition in which all fetal parts are consistently small. Macrosomia is a condition in which the infant weighs more than 4000 g. It may not lead to asymmetric growth. A larger head and abdominal circumference do not indicate congenital malformations, which are associated with more obvious physical signs.
After reviewing the Doppler umbilical flow reports of a pregnant patient, the nurse advises the patient to quit smoking immediately. Which finding in the report could be the reason for this instruction? 1 High amniotic fluid volume (AFV) 2 High systolic-to-diastolic (S/D) ratio 3 Low amniotic fluid volume (AFV) 4 Low systolic-to-diastolic (S/D) ratio
2 High systolic-to-diastolic (S/D) ratio Exposure to nicotine from maternal smoking has been reported to increase the fetal S/D ratio. An elevated S/D ratio indicates a poorly perfused placenta. To improve the blood supply to the placenta, the patient should quit smoking as soon as possible. The AFV cannot be assessed through Doppler umbilical blood flow study. Moreover, smoking does not affect amniotic fluid volume. Smoking increases the S/D ratio; it does not decrease it.
The nurse is reviewing the contraction stress test (CST) reports of a pregnant patient. The nurse expects the fetus to have meconium-stained amniotic fluid. What would be the reason for that conclusion? 1 Negative CST results 2 Positive CST results 3 Suspicious CST results 4 Unsatisfactory CST results
2 Positive CST results Meconium is normally stored in the infant's intestines until after birth, but sometimes (in cases of fetal distress and hypoxia) it is expelled into the amniotic fluid before birth. The amniotic fluid is then said to be meconium stained. Fewer than three contractions in 10 minutes or late decelerations occurring with 50% or more of contractions constitute positive CST results. Positive CST results are associated with meconium-stained amniotic fluid. Negative CST results indicate that the fetus is normal. Suspicious or unsatisfactory CST results are not associated with any other fetal conditions.
While reviewing the ultrasonography reports of a pregnant patient, the nurse finds that there is excessive fluid collection at the nape of the neck of the fetus. Which test will the nurse recommend? 1 Fetal acoustic stimulation test 2 Oxytocin challenge test 3 Chorionic villus sampling 4 Percutaneous umbilical blood test
3 Chorionic villus sampling Excessive fluid in the nape of the neck indicates a genetic abnormality in the fetus. Genetic abnormalities can be tested further by performing chorionic villus sampling. A fetal acoustic stimulation test is done to test the fetal heart rate. Oxytocin challenge is a stress-based test for measuring fetal heart rate. Percutaneous umbilical blood sampling is the procedure done for fetal blood sampling and transfusion. STUDY TIP: A word of warning: do not expect to achieve the maximum benefits of this review tool by cramming a few days before the examination. It doesn't work! Instead, organize planned study sessions in an environment that you find relaxing, free of stress, and supportive of the learning process.
Which technique is used to assess genetic abnormalities in a 12-week-old fetus? 1 Amniocentesis 2 Ultrasonography 3 Chorionic villus sampling (CVS) 4 Magnetic resonance imaging (MRI)
3 Chorionic villus sampling (CVS) CVS is a popular technique used for genetically studying the fetus in the first trimester (11-14 weeks) of pregnancy. The advantage of CVS over other techniques is that it reveals the presence of genetic abnormalities at an early stage of pregnancy very accurately. Amniocentesis can be used for diagnosing genetic abnormalities only after 14 weeks of pregnancy; before 14 weeks, the amount of amniotic fluid available is insufficient for testing. Ultrasonography is not used to detect genetic abnormalities in the fetus. This diagnostic technique is used only for visualizing the fetus. MRI is used mostly to evaluate the fetal structure and overall growth, the placenta, and the quantity of amniotic fluid. This technique is not useful for genetic studies. Test-Taking Tip: Make certain that the answer you select is reasonable and obtainable under ordinary circumstances and that the action can be carried out in the given situation.
During a prenatal checkup, the patient who is 7 months pregnant reports that she is able to feel about two kicks in an hour. The nurse refers the patient for an ultrasound. What is the primary reason for this referral? To check: 1 For fetal anomalies 2 Gestational age 3 Fetal position 4 For fetal well-being
4 For fetal well-being Fetal kick count is a simple method to determine the presence of complications related to fetal oxygenation and activity level. The fetal kick count during the third trimester of pregnancy is approximately 30 kicks an hour; a count lower than that is an indication of poor health of the fetus. Fetal anomalies may not affect the oxygenation levels of the fetus. The nurse already knows the gestational age of the fetus; therefore the nurse need not refer the woman for ultrasonography to find the gestational age. Fetal position does not affect the activity level of the fetus. Test-Taking Tip: Never leave a question unanswered. Even if answering is no more than an educated guess on your part, go ahead and mark an answer. You might be right, but if you leave it blank, you will certainly be wrong and lose precious points.
The nurse is reviewing the ultrasound report of a 20-week pregnant patient to find out whether the patient has placental vascular disease. What assessment parameter does the nurse check in the reports? 1 The fetal heart rate through stethoscope 2 The biophysical profile through ultrasonography 3 The fluid volume in the nape of the fetal neck 4 The systolic-to-diastolic (S/D) ratio of umbilical and uterine arteries
4 The systolic-to-diastolic (S/D) ratio of umbilical and uterine arteries The velocity waveforms of the umbilical and uterine arteries can be used to determine the S/D ratios. An S/D ratio greater than 3 indicates the presence of placental vascular disease. Fetal heart rate is measured to assess fetal well-being. The fetal heart rate does not indicate placental circulation. The biophysical profile includes assessment of amniotic fluid volume, fetal body movements, and fetal tone. Fluid volume in the nape of the fetal neck is measured to assess genetic abnormalities in the fetus.