NU 215 CH29 - assessing child bearing women

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."

This is the appropriate amount of weight gain for a person with a normal BMI (20 to 27).

11.5 to 16 Kg

A nurse auscultates the fetal heart rate with a fetoscope. The nurse expects the heart rate of a normal fetus to be how many beats per minute?

120 to 160

A pregnant client of normal weight is concerned about excessive weight gain during her pregnancy. She states, "I don't want to get fat!" The nurse should inform her that she can expect to gain how much weight during her pregnancy?

25 to 30 pounds

Which prenatal client has the greatest risk of delivering a baby with a defect?

A 6-week pregnant woman who takes lithium (Eskalith) daily for bipolar disease - can lead to heart valve defects

A nurse at the health care facility assesses a client in the 20th week of gestation. The client is healthy and progressing well, without any sign of complications. Where should the nurse expect to measure the fundal height in this client?

At the level of the umbilicus

Which of the following changes in vital signs is expected in pregnant women?

Blood pressure decreases. - pulse and temp also increase; reparations usually dont change

A woman comes to the clinic complaining of irregular contractions lasting less than 30 seconds and occurring no more frequently than 5 times in 1 hour. She is afraid of losing the pregnancy. She is at 26 weeks of gestation with her first child. What is most likely happening to this woman?

Braxton Hicks contractions

A nurse assesses a primigravida client and observes darkening of the skin on the client's face. How should the nurse document this pigmentation?

Chloasma

In performing Leopold's maneuvers to determine the fetal lie, a nurse palpates a soft, irregular mass in the upper quadrant of the maternal abdomen. Which of the following is the nurse most likely palpating?

Fetal buttocks

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

Genetic disorders

A 35-year-old bus driver comes to the office for a prenatal visit. She is approximately 28 weeks pregnant and has had no complications. She mentions having heartburn but no fatigue, headaches, leg swelling, contractions, leakage of fluid, or bleeding. Her blood pressure is 142/92; urine shows no glucose, protein, or leukocytes. Weight gain is appropriate, with no large recent increases. Fetal tones are 140, and her uterus measures 32 centimeters from the pubic bone. Looking back through her chart, the nurse sees that the client's prenatal blood pressure was 120/70 and her blood pressures during the first 20 weeks were usually 120 to 130/70 to 80. What type of blood pressure is this?

Gestational hypertension

A client in her third trimester of pregnancy is undergoing a physical assessment. Her nurse explains that she is about to estimate what position the fetus is presently in by palpating the uterine fundus to see whether the head or buttocks is presenting. What is this procedure called?

Leopold's maneuver

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

Near the bottom of the sternum

Vaginal bleeding may indicate

Placenta previa

A nurse assesses a 23-year-old primigravida client in her first trimester. The client reports problems with excessive salivation. Which of the following conditions should the nurse document in this client?

Ptyalism

A 26-year-old flight attendant comes in for a third-trimester visit. She has had prenatal care since her sixth week of pregnancy. She has no complaints today, and her prenatal course has been unremarkable. Today her blood pressure and weight gain are appropriate and her urine is unremarkable. A first-year student is shadowing the visit, so the nurse asks the student to get Doptones and measure the client's uterus in centimeters. The student promptly reports fetal heart tones of 140 but is having difficulty obtaining the correct measurement. The student knows that one end of the tape goes over the uterine fundus. From what inferior anatomical position should the tape be placed?

Pubic symphysis

What cervical change should a nurse recognize as indicating that a woman has delivered a fetus vaginally?

Slit-like appearance

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

A pregnant client in her first trimester states, "I think I must be having a miscarriage. I have sharp pains in my lower abdomen sometimes!" What does the nurse understand is happening to this client?

The client is experiencing stretching of the round and broad ligaments.

Pica is?

a craving for or ingestion of non-nutritional substances such as dirt or clay, is seen in all socioeconomic classes and cultures

pider nevi

are tiny, red angiomas occurring on the face, neck, chest, arms, and legs, and may occur because of elevated estrogen levels.

Chadwick's sign is

bluish discoloration of the cervix seen in pregnancy.

By 20 weeks' gestation

e uterus is at about the umbilicus;

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

A pregnant client at 12 weeks' gestation visits the clinic and tells the nurse that she has been vomiting severely for the past 5 days. The nurse should refer the client to a physician for possible

hyperemesis gravidarum. - when nutrition is not maintained this is possible

A pregnant client visits the clinic for the first time. She tells the nurse that she has had two spontaneous abortions before this pregnancy. The nurse should refer the client to a physician for possible

incompetent cervix.

Ptyalism,

is increased amounts of salivation in the first trimester

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

pica interferes with

nutrition during pregnancy

While interviewing a pregnant client, the nurse determines that the client has pica. The nurse should assess the client's

nutritional status.

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

The obstetric nurse team leader should intervene when observing a new staff nurse perform which action when assessing a client suspected of being in labor?

position the ultrasounds over the mothers aorta

Nabothian cysts

retention cysts on the surface of the cervix that are normal in women after childbirth.

Linea nigra

s a dark line extending from the umbilicus to the mons pubis.

young woman comes to the ED with lower abdominal pain on the right side and has been spotting blood for 2 days. She is diagnosed with an ectopic pregnancy, which is an obstetric emergency. An ectopic pregnancy is when what occurs?

the egg never leaves the fallopian tube

During the assessment of a pregnant client, the nurse learns that the client is passionate about animals. Her home is a shelter for several stray dogs and cats, which she attends to herself, until she can find suitable homes for them. The nurse should inform the client that she is at risk for which complication of pregnancy due to the cats?

toxoplasmosis