OB TEST #1

The nurse is counseling a couple, one of whom is affected bean autosomal dominant disorder. They express concern about the risk of transmitting that disorder. What is the best response by the nurse regarding the risk that their baby may have the disorder?

"Your risk is 50%, or one in two chances"

Probable Signs (Objective)

- Braxton Hicks contractions (16-28 weeks) - Positive pregnancy test (4-12 weeks) - Abdominal enlargements (14 weeks) - Ballottment (16-28 weeks) - Goodall's sign (5 weeks) - Chadwick' sign (6-8 weeks) - Hegar's sign (6-12 weeks)

Gravida

A pregnant woman

Para

A woman who has produced one or more viable offspring carrying a pregnancy 20 weeks or more

The nurse is preparing her teaching plan for a woman who has just had her pregnancy confirmed. Which information should be included in it?

-Continue your daily walking routine just as you did before this pregnancy -Tetanus, measles, mumps, and rubella vaccines will be given to you now -Avoid tub baths now that you are pregnant to prevent vaginal infections -Sexual activity is permitted as long as your membranes are intact

Danger Signs of Third Trimester

-Gestational hypertension and or preeclampsia - Sudden weight gain; periorbital or facial edema; severe upper abdominal pain, or headache with visual changes. -Possible demise: Decrease in fetal movement for more than 24 hours. -Any of the S/S in the previous trimesters may be present.

Which is the best time for the genetic assessment of an alpha-fetoprotein (AFP) screening test?

16-18 weeks' gestation

A pregnant woman arrives in the L & D unit following premature rupture of membranes along with her spouse, who insists on being present and demands only female nurses assess his wife. When obtaining history and assessment data, the spouse provides all the answers. What is the best approach for the nurse to handle this situation?

Act as an advocate for the woman who has a male-dominant partner.

What is the key nursing role when managing the health care of a child living with a foster family?

Advocating for the child and services needed

Chadwick"s Sign

Bluish-purple coloration of the vaginal mucosa and cervix

During a clinic visit, a pregnant client at 30 weeks' gestation tells the nurse, "I've had some mild cramps that are pretty irregular. What does this mean?" The cramps are probably

Braxton Hicks contractions, which occur through the pregnancy

Which is not true about breastfeeding?

Breastfed infants experience more obesity and allergies

What is the alpha-fetoprotein analysis?

Check for a neurotube disorder

Secondary Prevention

Early detection and treatment of advance health conditions Ex: health screenings

A community-based nurse is involved in secondary prevention activities. What activity might be included?

Fecal occult blood testing, hearing screening, cholesterol testing, and a pregnancy testing. (Test and screen in secondary prevention)

A client comes in to the clinic for pregnancy testing. The nurse explains that the test detects the presence of what hormone?

Human chorionic gonadotropin (hCG)

When obtaining a blood test for pregnancy, which hormone would the nurse expect the test to measure?

Human chorionic gonadotropin (hCG)

Dietary Recommendations for pregnant women

Increase in protein, folate, and calories Fiber if constipated

The nurse teaches the pregnant client how to perform Kegel exercises as a way to accomplish which action?

Increase pelvic muscle tone

A pregnant client's LMP was on August 10. Using Nagele's rule, the nurse calculates that her EDD will be when? Take LMP date, subtract 3 months, add 7 days, and add a year to get the EDD

May 17

A 25-year-old woman presents to the clinic with complaints of nausea, vomiting, and urinary frequency. Based on this information, the nurse knows these are most indicative of what type of signs?

Presumptive signs of pregnancy

Which biophysical profile finding indicates poor oxygenation to the fetus?

Nonreactive fetal heart rate

Which concept characterizes transcultural nursing?

Planning care compatible with the client's health belief system

Primary Prevention

Prevention that comes before the disease/condition occurs through health promotion activities, environmental protection and specific protection against the disease/injury Ex: nutrition, good hygiene, immunizations

Tertiary Prevention

Reduction/limitation of the progress of a permanent, irreversible disease/condition

Prolactin

Regulates insulin production, plays an important role in lactation

Rh Factor

Rogan is given 28 week before pregnancy and 72 hours after birth. It keeps mom from building up Rh- antibodies to attack the next pregnancy

________________ prevention involves the early detection and treatment of adverse health problems.

Secondary

The hospice nurse observes the family of a child with a terminal illness interacting with the child. According to Friedman's structural functional theory, what actions by the family demonstrate affective functioning?

Siblings frequently play games with the child. The parents read to the child at bedtime every night.

Goodell"s Sign

Softening of the cervix: effacement

Hegar's Sign

Softening of the lower uterine segments

Which fish should be limited in a pregnant woman's diet because of its high mercury content?

Swordfish

A woman is to have childbirth at a freestanding birth center. What would the nurse identify as a major disadvantage associated with his community-based setting?

The need to be transferred if an emergency were to occur

The emergency nurse is providing care for a pregnant woman admitted with a broken femur, blackened eye, and multiple contusions. She admits her partner is abusive. What would be considered at the tertiary level of prevention?

The nurse contacts the crisis social worker for assistance.

What factors would change during a pregnancy if the hormone progesterone were reduced or withdrawn?

The uterus would contract more, and peristalsis would increase

Presumptive Signs (subjective)

These signs do not necessarily mean you are pregnant -Fatigue (12 weeks) -Breast tenderness (3-4 weeks) -No period (amenorrhea) 4 weeks -Urinary frequency (6-12 weeks) -Nausea and vomiting (4-14 weeks)

Tertiary prevention is designed to reduce or limit the progression of a disease or disability.

True

Which is a presumptive sign or symptom of pregnancy?

Urinary frequency

A pregnant client close to term comes in the clinic for an exam. The woman complains about experiencing shortness of breath. The nurse knows that this may be caused by the

funds of the uterus is high pushing the diaphragm upward

When teaching a family and client, what do you need to do first?

You need to address the need-to-know information first. Decide when the best time is and dumb it down for them to understand.

A feeling expressed by most women upon learning they are pregnant is

ambivalence

Estrogen

causes enlargement of woman breasts, uterus, and external genitalia

Isotertinoin is a risk factor in pregnancy because..

causes multiple birth defects

Relaxin

causes relaxation of the pelvic ligaments and softens the cervix for birth

Lamaze (psychoprophylactic) method:

focus on breathing and relaxation techniques

Bradley (partner-coached childbirth) method:

focus on exercises and slow, controlled abdominal breathing

Dick-Read (natural childbirth) method:

focus on fear reduction via knowledge and abdominal breathing techniques

Maternal Phenylketonuria is a risk in pregnancy because...

it is a genetic disorder where you can not eat a protein diet

Progesterone

maintain the endometrium, decrease contractility of the uterus,

Atraumatic care employs interventions that minimize physical and ___________ stress to the child and family.

psychological

The nurse is caring for a child from a different culture. What statements by the nurse demonstrates an understanding of how culture impacts a client?

"Culture can impact who a client chooses to see for health care needs." "Culture can impact the diet a client follows." "A client's cultural beliefs can impact spirituality and/or religion." "A client's cultural beliefs should be incorporated into the care a client receives.

Danger signs of first trimester

-Miscarriage - May notice spotting or bleeding. -Infection - May have painful urination. -Hyperemesis gravidarum - Severe persistent vomiting. -Infection - Fever >100F -Ruptured ectopic pregnancy - Abdominal pain with dizziness and accompanied by shoulder pain.

Danger signs of second trimester

-Preterm Labor - Regular uterine contractions -DVT - Pain in calf, often increased with foot flexion. -Premature rupture of membranes - Sudden gush or leakage of fluid from vagina. -Possible fetal distress or demise - Absence of fetal movement for more than 12 hours.

Positive Signs

-Ultrasound verification of embryo/fetus (4-6 weeks) -Fetal movement felt by an experienced clinician (20 weeks) -Auscultation of fetal heart tones via doppler (10-12 weeks)

What anticipatory guidance regarding sexual activity during pregnancy will be included in client teaching?

-Women's sexual desire may change throughout the pregnancy -Couples can try a variety of positions of comfort during pregnancy

Primipara: Multipara: Nullipara:

-one birth after a progeny of at least 20 weeks -two or more pregnancies resulting in viable offspring -no viable offspring; para 0

Cardiovascular System

-Increase blood volume (5-6 Liters) -Increase in cardiac output, venous return, and HR (if mom is uncomfortable turn her on her left side to increase flow to the vena cava)

Which would be considered risk factors for psychological well-being during pregnancy?

-Limited support system and network of friends and family -High levels of stress due to family discord -History of previous high-risk pregnancy with complications -Depression prior to pregnancy and on medication

When planning education for a child and parents, what is the first step the nurse should take?

Determine the child and family's learning needs and styles

After teaching a group of students about fertilization, the instructor determine that the teaching was successful when the group identified what as the usual site of fertilization?

Distal portion of the Fallopian tube

___________ may lead to a decrease in variations in care while at the same time increasing quality and improving health care by achieving the best client outcomes.

Evidence-based practice

G - gravida T - term P - preterm A - abortions L - living

G: the current pregnancy T: number of pregnancies ending over 37 weeks' gestation P: number of preterm pregnancies ending before 20 weeks or viability but before completion of 37 weeks A: the number of pregnancies ending before 20 weeks or viability L: number of children currently living

Ambivalence

Happens in the first trimester. The mother is excited and scared.

Chorionic gonadotropin (CG)

Helps keep the endometrial lining of the uterus maintained

Umbilical cord contains...

One large vein and two small arteries

When will you have urinary frequency during the pregnancy?

Only at the beginning and end of pregnancy

Practicing good oral hygiene is important for all women throughout pregnancy. As a nurse providing anticipatory guidance for pregnant women, what condition can result from periodontal disease if good dental care isn't practiced?

Preterm or low-birth-weight infants

A nurse is developing a plan of care for a client of Muslim faith. What is an understanding of providing culturally competent care?

The client is asked if there are any meal preferences to be included in the care plan.

Fetal development stages: -Zygotic Stage -Blastocyst Stage -Embryonic Stage -Fetal Stage

Zygotic Stage: fertilization of sperm and egg through the second week Blastocyst Stage: the zygote forms a solid ball of cells and attaches to the uterus Embryonic Stage: second-eight week many organ and structures begin to form Fetal Stage: eighth week- birth differentiation and structures specialize

During pregnancy, which foods should the expectant mother reduce or avoid?

raw meat or uncooked shellfish

Reva Rubin identified four major tasks that the pregnant woman undertakes to form a mutually gratifying relationship with her infant. What is "binding in?"

seeking acceptance of self as mother to the infant