Old's Maternity Ch 12

A client at 16 weeks' gestation has a hematocrit of 35%. Her prepregnancy hematocrit was 40%. Which statement by the nurse best explains this change?

"Because your blood volume has increased, your hematocrit count is lower."

A client who is experiencing her first pregnancy has just completed the initial prenatal examination with a certified nurse-midwife. Which statement indicates that the client needs additional information?

"Because I haven't felt the baby move yet, we don't know whether I'm pregnant."

The nurse has completed a community presentation about the changes of pregnancy, and knows that the lesson was successful when a community member states that which of the following is one probable or objective change of pregnancy?

"Enlargement of the uterus"

The client in the prenatal clinic tells the nurse that she is sure she is pregnant because she has not had a menstrual cycle for 3 months, and her breasts are getting bigger. What response by the nurse is best?

"Lack of menses can be caused by many things. We need to do a pregnancy test."

The partner of a client at 16 weeks' gestation accompanies her to the clinic. The partner tells the nurse that the baby just doesn't seem real to him, and he is having a hard time relating to his partner's fatigue and food aversions. Which statement would be best for the nurse to make?

"Many men feel this way. Feeling the baby move in a few weeks will help make it real to you."

The nurse asks a woman how her husband is dealing with the pregnancy. The nurse concludes that counseling is needed when the woman makes which statement?

"My husband is ready for the pregnancy to end so that we can have sex again."

A prenatal educator is asking a partner about normal psychological adjustment of an expectant mother during the second trimester of pregnancy. Which answer by the partner would indicate a typical expectant mother's response to pregnancy?

"She daydreams about what kind of parent she is going to be."

The client at 14 weeks' is in the clinic for a regular prenatal visit. Her mother also is present & states that she is quite uncertain about how she can be a good grandmother because she works full-time. Her own grandmother was always available when needed by a grandchild. What is the nurse's best response?

"What are your thoughts on what your role as grandmother will include?"

A 16-year-old pregnant client is seen at her 10-weeks'-gestation visit. She tells the nurse that she felt the baby move that morning. What response by the nurse is appropriate?

"Would you please describe what you felt for me?"

The adolescent client reports to the clinic nurse that her period is late, but that her home pregnancy test is negative. What should the nurse explain that these findings most likely indicate?

"You might be pregnant, but it might be too early for your home test to be accurate."

The client is at 6 weeks' gestation, and is spotting. The client had an ectopic pregnancy 1 year ago, so the nurse anticipates that the physician will order which intervention?

An antiserumpregnancy test.

The nurse recognizes that subjective pregnancy changes such as amenorrhea can be caused by which conditions? SATA.

Anemia. Pseudocyesis. Thyroid dysfunction.

The nurse has received a phone call from a multigravida who is 21 weeks pregnant and has not felt fetal movement yet. What is the best action for the nurse to take?

Schedule an appointment for her with her physician for that same day.

The introduction of a new baby into the family is often the beginning of which of the following?

Sibling rivalry

The nurse is assessing a client who is at 35 weeks' gestation. What does the nurse expect the client to report at this phase of pregnancy?

Stretch marks on the abdomen

On examination of the prenatal client, the nurse is aware that she will assess for a bluish pigmentation of the vagina. What is this objective (probable) sign of pregnancy also known as?

Chadwick sign

It is 1 week before a pregnant client's due date. The nurse notes on the chart that the client's pulse rate was 74-80 before pregnancy. Today, the client's pulse rate at rest is 90. What action should the nurse should take?

Chart the findings.

Which of the following is common in many non-Western cultures and is on the increase in the United States?

Cosleeping

The nurse is assessing a new client in the clinic. The nurse knows that the subjective (presumptive) signs and symptoms of pregnancy include which of the following?

Increase in urination, amenorrhea, fatigue, breast tenderness, and quickening

The clinic nurse is assessing how the prenatal client is meeting developmental tasks using Rubin's tasks, including which of the following? SATA.

Ensuring safe passage through pregnancy, labor, and birth. Seeking commitment and acceptance of self as mother to the infant. Seeking acceptance of the child by others.

The partner of a pregnant client comes to the clinic with her. He complains to the nurse that he is experiencing different physical changes. The nurse determines he is experiencing couvade when he describes which symptoms? SATA.

Fatigue. Increased appetite. Headache. Backache.

The nurse notes the following findings in a client at 12-weeks' gestation. Which of the findings would enable the nurse to tell the client that she is diagnostically pregnant?

Fetal heart rate by Doppler

What is the increased vascularization causing the softening of the cervix known as?

Goodell sign

The nurse is listening to the fetal heart tones of a client at 37 weeks' gestation while the client is in a supine position. The client states, "I'm getting lightheaded and dizzy." What is the nurse's best action?

Help the client turn onto her left side.

Nurses who are interacting with expectant families from a different culture or ethnic group can provide more effective, culturally sensitive nursing care by doing what?

Obtaining a medical interpreter of the language the client speaks.

The nurse in the prenatal clinic will tell the client at 38-weeks' gestation to lie on her left side when the client complains of which of the following? SATA.

Pallor. Clamminess. Dizziness.

The nurse is examining a pregnant woman in the third trimester. What skin changes should the nurse highlight as an alteration for the woman's healthcare provider?

Petechiae

A client who is in the second trimester of pregnancy tells the nurse that she has developed a darkening of the line in the midline of her abdomen from the symphysis pubis to the umbilicus. What other expected changes during pregnancy might she also notice?

Reddish streaks called striae on her abdomen

The nurse is assessing a client in the third trimester of pregnancy. What physiologic changes in the client are expected? SATA.

The client is using thoracic breathing. The client's chest circumference has increased by 6 cm during the pregnancy. The client may have epistaxis.

A woman calls the clinic and tells a nurse that she thinks she might be pregnant. She wants to use a home pregnancy test before going to the clinic, and asks the nurse how to use it correctly. What information should the nurse give?

The client should follow up with a healthcare provider after taking the home pregnancy test.

The client at 30 weeks' with her first child is upset. She is excited to become a mother, and has been thinking about what kind of parent she will be. But her mother doesn't want to be a grandmother because she doesn't feel old enough, while her husband has said that the pregnancy doesn't feel real to him yet. What is the most likely explanation for what is happening within this family?

The family members are adjusting to the role change at their own paces.

The clinic nurse is culturally sensitive when, while assessing the pregnant client, he asks about which of the following? SATA.

The family's expectations of the healthcare system. Which cultural practices should be incorporated into care. Any alternative healer who should be consulted.

During her first months of pregnancy, a client tells the nurse, "It seems like I have to go to the bathroom every 5 minutes." The nurse explains to the client that this is because of which of the following?

The growing uterus puts pressure on the bladder.

The nurse understands that a client's pregnancy is progressing normally when what physiologic changes are documented on the prenatal record of a woman at 36 weeks' gestation? SATA.

The joints of the pelvis have relaxed, causing a waddling gait. The uterus vasculature contains one sixth of the total maternal blood volume. Gastric emptying time is delayed, and the client complains of constipation and bloating. Supine hypotension occurs when the client lies on her back.

To answer a client's question about home pregnancy tests and their accuracy, the nurse must know that accuracy is affected by which of the following? SATA.

Unclear directions. Completing the test too late.

A client with a normal prepregnancy weight asks why she has been told to gain 25-35 pounds during her pregnancy while her underweight friend was told to gain more weight. What should the nurse tell the client the recommended weight gain is during pregnancy?

Up to 40 pounds for an underweight woman

A client at 32 weeks' gestation comes to the clinic with urinary burning and frequency. The nurse explains that urinary tract infections are common in pregnancy due to which of the following? SATA.

Ureteral atonia. Stasis of urine.