Chapter 11: Maternal Adaptation During Pregnancy (1)

The nurse is caring for a client at 8 weeks' gestation who states, "I did not plan for this right now and I am not happy or excited about this pregnancy. I am not sure what to do." Which response by the nurse is best? pg. 355

"Many women feel this way during the first trimester."

A pregnant client reports an increase in a thick, whitish vaginal discharge. Which response by the nurse would be most appropriate? pg. 337

"This discharge is normal during pregnancy."

A client in her second trimester of pregnancy is anxious about the blotchy, brown pigmentation appearing on her forehead and cheeks. She also reports increased pigmentation on her breasts and genitalia. Which statement by the nurse is most appropriate? pg. 341

"This is called facial melasma (chloasma) and should fade after the birth."

A client is about 16 weeks' pregnant and is concerned because she feels her "abdomen" contracting. She calls the primary care provider's office and speaks to the nurse. What is the nurse's most appropriate response to this client's concern? pg. 336

"What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy."

A pregnant woman who is a vegetarian asks the nurse, "What would you suggest to make sure that I get enough protein in my diet while I am pregnant?" Which food(s) would be appropriate for the nurse to suggest? Select all that apply. pg. 353-354

- beans - lentils - nuts

A mother comes in with her 17-year-old daughter to find out why she has not had a menstrual cycle for a few months. Examination confirms the daughter is pregnant with a fundal height of approximately 24 cm. The nurse interprets this finding as indicating that the daughter is approximately how many weeks pregnant? pg. 335

24

A pregnant client in her third trimester, lying supine on the examination table, suddenly grows very short of breath and dizzy. Concerned, she asks the nurse what is happening. Which response should the nurse prioritize? pg. 336

Blood is trapped in the vena cava in a supine position.

A client in her 39th week of gestation arrives at the maternity clinic stating that earlier in her pregnancy, she experienced shortness of breath. However, for the past few days, she has been able to breathe easily, but she has also begun to experience increased urinary frequency. A nurse is assigned to perform the physical examination of the client. Which observation is most likely? pg. 336

Fundal height has dropped since the last recording.

A pregnant mother may experience constipation and the increased pressure in the veins below the uterus can lead to development of what problem? pg. 338

Hemorrhoids

The nurse is assessing a client who believes she is pregnant. The nurse points out a more definitive assessment is necessary due to which sign being considered a probable sign of pregnancy? pg. 334

Positive home pregnancy test

During late pregnancy, the nurse teaches a pregnant woman to lay on her left side to avoid what condition? pg. 336

Supine hypotension syndrome

During a routine prenatal visit, a pregnant woman reports a white, thick, vaginal discharge. She denies any itching or irritation. Which action would the nurse take next? pg. 337

Tell the woman that this is entirely normal.

A pregnant client at 24 weeks' gestation calls the clinic crying after a prenatal visit, where she had a pelvic exam. She states that she noticed blood on the tissue when she wiped after voiding. What initial statement by the nurse would explain this finding? pg. 337

The cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual.

A nurse is leading a discussion in a prenatal class for a group of primigravida clients. Which factor would the nurse include when explaining the changes that are expected to occur in the uterus during the pregnancy? pg. 335

The uterus changes from a pear-shaped organ to an oval one.

During an examination, a client at 32 weeks' gestation becomes dizzy, lightheaded, and pale while supine. What should the nurse do first? pg. 336

Turn the client on her left side.

What is the major concern for a lactose intolerant woman who is pregnant? pg. 353

calcium deficiency

The nurse is teaching a pregnant woman about breastfeeding. The nurse determines that the teaching was successful when the woman identifies which hormone as being released when the newborn sucks at the breast? pg. 344

oxytocin

The nurse is preparing to teach a community class to a group of first-time parents. Which information should the nurse include concerning what the pregnant woman's partner may experience as a normal response? pg. 356-357

physical symptoms similar to the mother

A new mother voices concerns about breastfeeding her infant. The nurse would explain to the mother the two hormones that control lactation and letdown are: pg. 347

prolactin and oxytocin.

The nurse is assessing a primigravida woman at a routine prenatal visit. Which assessment finding is reinforcing to the client that she is definitely pregnant? pg. 335

ultrasound picture of her fetus