Chapter 9

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 to 12 weeks of gestation

First trimester Second trimester Third trimester

12th week 24th week 40th week

Age of viability

24 weeks

A woman has just learned that she is pregnant and would like to know how soon she can find out via ultrasound the sex of her fetus. The nurse should respond with which of the following?

4 months

Biophysical Profile scoring

5 criteria - score of 2 if they meet that criteria At least 8 is good, 6 needs more testing - non stress test

Fetal circulation differs from the circulatory path of the newborn infant. In utero the fetus has a hole connecting the right and left atria of the heart. This allows oxygenated blood to quickly pass to the major organs of the body. What is this hole called?

Foramen ovale

A woman comes in for her annual gynecological examination and informs the nurse that she is going to try and become pregnant. She asks the nurse when the best time in the month is to become pregnant. What is the best response by the nurse?

"3 days before until 2 days after ovulation."

A pregnant client in the first trimester asks the nurse about taking medications while she is pregnant. She tells the nurse that she heard that it can be harmful to the fetus if medications are taken at certain times during pregnancy. What is the best response by the nurse?

"Exposure to certain substances during the embryonic phase may be harmful to the developing fetus."

Fetal movements (kicks)

Around 20 weeks Count 10 movements in 1 hour If less than 10, ambulate and repeat If still less than 10, notify the HCP

A client is scheduled for amniocentesis. Which action by the nurse would be most appropriate when preparing the client for the procedure? Select all that apply:

Ask the client to void. Assess fetal heart rate.

Fetal heart rate

Audible via Doppler at 10 weeks, no later than 12 Assessed at every prenatal visit 120-160 bpm

Naegele's rule

Backwards 3 months and add 7 days

In caring for a fully immunized pregnant woman who is a nurse in a family health practice, the obstetric nurse should remind the patient that she must not come in contact with patients who have symptoms that could indicate which infection?

Chickenpox

A client reports that her last menstrual period was on August 1. Using Naegele's rule, what would the nurse anticipate as the client's due date?

May 8th

McDonald's rule

Every week measure the fundal height 12th week: symphysis 20th week: umbilicus 36 week: Xyphoid process

A client is at 20 weeks' gestation and is scheduled for a fetal survey with ultrasound. The nurse teaches the client about the test The nurse determines that the teaching was successful when the client identifies that the ultrasound will reveal which information about the placenta? Select all that apply.

Placement of the placenta

Assessment for surfactant level via LS ratio in the amniotic fluid is a primary estimation of fetal maturity. The purpose of surfactant is to:

Prevent alveoli from collapsing on expiration.

A mutligravida client is concerned that she may deliver early. When asking the nurse what is the earliest her baby can be delivered and survive, which time frame would the nurse point out?

The end of the second trimester

A Maternal serum alpha-fetoprotein (MSAFP) test reveals an hCG level of 2.5 MoM. The nurse interprets these results as indicating which of the following?

The fetus is at greater risk for Down's syndrome

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.

A client in her third trimester is scheduled for a nonstress test. What is the purpose of the nonstress test for the client?

To determine the well-being of the fetus

A nurse is preparing a patient for rhythm strip testing. She places the woman into a semi-Fowler's position. What is the appropriate rationale for this measure?

To prevent supine hypotension syndrome

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

A 33-year-old pregnant client asks the nurse about testing for birth defects that are safe for both her and her fetus. Which test would the nurse state as being safe and noninvasive?

Ultrasound

The nurse is preparing a 38-year-old pregnant woman for an amniocentesis to determine if there are any congenital disorders or fetal abnormalities present. Which of the following is a nursing consideration before and during the testing?

Use an external fetal heart monitor to ensure fetus is not in distress.

A patient is to have an amniocentesis with ultrasound. What does the nurse explain to the patient that amniocentesis can determine? Select all that apply.

Whether the fetal lungs are mature enough to support respiration outside of the womb. For genetic testing.

Non-stress test

fetal heart rate the most, can it go up 15 beats and stay there for 15 seconds, do this 2 times for 20 minute period

A woman is taking vaginal progesterone suppositories during her first trimester because her body does not produce enough of it naturally. She asks the nurse what function this hormone has in her pregnancy. What should the nurse explain is the primary function of progesterone?

maintains the endometrial lining of the uterus during pregnancy