Chapter 25: Pregnant Women

While caring for a pregnant client at 8 weeks' gestation, the client asks the nurse, "When can you hear the baby's heartbeat?" The nurse should instruct the client that when a Doppler device is used, the earliest time when the fetal heart rate can be heard is the gestational age of

10 weeks

The nurse assesses the uterine fundus and finds it to be halfway between the symphysis pubis and the umbilicus. The nurse would determine that this corresponds to how many gestational weeks?

16

The nurse is measuring the fundal height of a woman who is 28 weeks' gestation. Which measurement would the nurse expect?

28 cm

A client at 32 weeks' gestation, who has had regular prenatal care, is found to have gained 6 pounds in 1 week. What would the nurse to do next?

Assess the legs for edema.

A client at 32 weeks' gestation, who has had regular prenatal care, is found to have gained 6 pounds in 1 week. Which of the following would be most appropriate for the nurse to do next?

Assess the legs for edema.

The nurse is completing a head-to-toe assessment of a pregnant client. What anatomic area should be examined when assessing the Montgomery tubercles?

Breasts

What anatomic area should be examined when assessing Montgomery tubercles?

Breasts

The nurse discovers a soft systolic murmur when auscultating the heart of a client at 32 weeks' gestation. Which action would be most appropriate?

Document and continue to follow at future visits.

A client presents to the health care clinic for her first prenatal checkup. What nutritional supplement should the nurse discuss with the client to prevent neural tube defects in the developing fetus?

Folic acid

The nurse is instructing the pregnant client on the importance of reporting symptoms of urinary tract infection immediately to her care provider. Which of the following symptoms should the client report? (Select all that apply)

Frequent urination Blood in urine Flank pain

A nurse assesses a primigravida client and observes a dark line extending from the umbilicus to the mons pubis. How should the nurse document this pigmentation?

Linea nigra

Before beginning the initial prenatal examination, a nurse should instruct a client to complete what procedure before undressing?

Obtain a clean catch urine

Before beginning the initial prenatal examination, a nurse should instruct a client to complete what procedure before undressing?

Obtain a clean urine patch

A nurse assesses a primigravida client and observes a pinkish color on the palms of the hands. How should the nurse document this pigmentation?

Palmar erythema

In examining a client who is in her third trimester, the nurse notes pinkish-red streaks with slight depressions in the skin over the client's abdomen and breasts. The nurse documents this finding as which of the following?

Striae gravidarum

During the health interview of a client who has just learned that she is pregnant, the nurse is assessing the client's health history. What assessment question most directly addresses a known risk for congenital malformations?

"Do you have diabetes?"

A client in her first trimester of pregnancy has experienced a spontaneous abortion. She states to the nurse, "It was my fault. I should have never gone running!" What is the best response by the nurse

"Miscarriage is common in the first trimester. Nothing you did caused this."

The prenatal client expresses concern about the appearance of raised bumps on her areola. What is the best response by the nurse?

"Small glands on your areola have enlarged in preparation for breastfeeding."

A client who is 32 weeks' gestation tells the nurse that she has been experiencing shortness of breath when walking up the steps at home. She is concerned that something is wrong. What is the nurse's best response?

"The enlarging uterus pushes against your diaphragm, and this makes breathing shallow."

A pregnant client states, "I am only 6 weeks pregnant, but the morning sickness is awful. When is it going to stop?" What is the best response by the nurse?

"Usually after 12 weeks, when the placenta starts managing the production of progesterone, morning sickness ends."

The 22-week prenatal client states, "I feel a pulling type of pain around my belly button." Which is the best initial response by the nurse?

"Your body is stretching as the baby grows."

Mrs. Kelly comes to the clinic for her usual prenatal check-up. The nurse measures the fundal height at 24 cm. What is the estimated length of her gestation?

24 weeks

A client presents to the health care clinic for her first prenatal visit. The client's current nonpregnant weight is normal for her height. What recommendation for proper weight gain should the nurse discuss with the client?

25 to 35 pounds

The blood tests for a primigravida client indicate that the client is Rh-negative and her partner's blood type is unknown. What is an appropriate nursing intervention for this client?

Arrange for Rho immunoglobulin at 28 weeks' gestation

A nurse assesses a 32-year-old primigravida client with twin gestation in her second trimester. The client reports constipation from iron supplements. Which condition should the nurse assess for in this client as a result of the constipation?

Hemorrhoids

A client who is pregnant presents to the health care clinic with reports of left breast pain, redness, and warmth. The nurse recognizes these as signs of which abnormal finding of pregnancy?

Mastitis

In assessing a client who is in her second trimester, a nurse observes that the client is underweight and anemic from lack of dietary iron. The nurse suspects malnutrition and asks the client about her diet and eating habits. The client confesses that she has been craving and eating clay recently. The nurse recognizes this condition as which of the following?

Pica

A client who is in her 34th week of gestation complains of continual vaginal bleeding that started suddenly a few days ago. Which of the following conditions should the nurse most suspect in this situation?

Placenta previa

A woman is only 30 weeks pregnant, but the physician determines that the fetus must be delivered for the safety of the mother. The physician orders a glucocorticosteroid injection to be given. Why does the physician order this injection?

To promote the formation of surfactant in the fetal lungs