Chapter 15: Pregnancy
Which change related to the vital signs is expected in pregnant women?
Blood pressure decreases. Explanation: Pulse and temperature often increase, while lung space is decreased in pregnant women. It is common for blood pressure to decrease during pregnancy.
A nurse is working with a pregnant client to schedule follow-up visits for the pregnancy. Which statement by the client indicates that she understands the scheduling? "I need to make visits every 2 months until I am 36 weeks' pregnant." "Once I get to 28 weeks' pregnant, I have to come twice a month." "From now until I am 28 weeks' pregnant, I will be coming once a month." "I will make sure to get a day off every 2 weeks to make my visits."
From now until I am 28 weeks' pregnant, I will be coming once a month." Explanation: Continuous prenatal care is important for a successful pregnancy outcome. The recommended follow-up visit schedule for a healthy pregnant woman is as follows: every 4 weeks up to 28 weeks' gestation; every 2 weeks from 29 to 36 weeks' gestation; every week from 37 weeks' gestation to birth.
A nurse is caring for a client in her second trimester of pregnancy. During a regular follow-up visit, the client reports varicosities of the legs. Which instruction should the nurse provide to help the client alleviate varicosities of the legs? Avoid sitting in one position for long periods of time. Refrain from crossing legs when sitting for long periods. Apply heating pads on the extremities. Refrain from wearing any kind of stockings.
Refrain from crossing legs when sitting for long periods. Explanation: To help the client alleviate varicosities of the legs, the nurse should instruct the client to refrain from crossing her legs when sitting for long periods. The nurse should instruct the client to avoid standing, not sitting, in one position for long periods of time. The nurse should instruct the client to wear support stockings to promote better circulation, though the client should stay away from constrictive stockings and socks. Applying heating pads on the extremities is not reported to alleviate varicosities of the legs.
A pregnant woman tends not to eat for long periods of time because of her busy work schedule. What process safeguards her fetus from becoming hypoglycemic during this time? The brain is too undeveloped to use glucose. Women naturally ingest complex carbohydrates to last for long periods during pregnancy. Somatomammotropin helps to regulate glucose levels. Fetal oxygen interferes with the metabolism of glucose and prolongs its action.
Somatomammotropin helps to regulate glucose levels. Explanation: Somatomammotropin makes insulin "less effective" than normal, thus decreasing its ability to produce hypoglycemia.
A 20-year-old woman you see in a prenatal clinic has an accessory nipple. Which teaching point would be most important to make with her? The tendency for accessory nipples is familial. Such growths fade with menopause. Bleeding from such growths is not uncommon. Such growths deepen in color during pregnancy.
Such growths deepen in color during pregnancy. Explanation: Pigment changes can be expected during pregnancy. Alerting women to this can decrease anxiety.
A 33-year-old G1 P0000 patient is on home care for preterm contractions. The client tells her home care nurse that she is afraid to have a bowel movement and has stopped taking her iron supplement. The nurse teaches the client the importance of iron and also suggests: limiting her intake of green leafy vegetables. increasing her intake of oatmeal with milk. limiting her intake of carrots and fish. increasing her intake of fried corn chips.
increasing her intake of oatmeal with milk. Explanation: Increasing intake of fiber and fluids will help prevent constipation. The client should not limit a nutritional source of iron such as green leafy vegetables, or sources of fiber such as vegetables and protein. Fried corn chips are not a nutritious source of fiber.
During the initial prenatal visit, the nurse performs what assessment to guide teaching about nutrition during pregnancy? prepregnancy BMI current weight height and bone structure hemoglobin level
prepregnancy BMI Explanation: Weight gain goal during pregnancy is based on the client's prepregnant BMI. Current weight and height are part of the BMI calculation. Hemoglobin level only provides information about iron stores, not overall nutritional status. Reference:
A potential complication for the mother and fetus is Rh incompatibility; therefore, assessment should include blood typing. If the mother is Rh negative, her antibody titer should be evaluated. If treatment with Rho(D) immune globulin is indicated, the nurse would expect to administer it at which time? at 28 weeks at 32 weeks at 36 weeks only at birth
If indicated, Rho(D) immune globulin should be given at 28 weeks for prophylaxis and again following birth if the infant is Rh+
Which of the following changes, with highest priority, should the nurse teach a pregnant client to report to the health care provider as soon as possible? vomiting 2 to 3 times a day during first trimester abdominal pain coming and going during the third trimester heartburn awakening her at night during the first trimester frequent urination, every 1 to 2 hours, during the first trimester
bdominal pain coming and going during the third trimester Explanation: Any abdominal pain needs to be reported to the health care provider ASAP. This could be a sign of preterm labor and needs to be addressed. Vomiting during the first trimester is normal. Heartburn is caused by the shifting of abdominal organs. Frequent urination is the result of increased pressure on the bladder.
The nurse is concerned that a client is not obtaining enough folic acid. Which test would the nurse anticipate being used to evaluate the fetus for potential neural tube defects? maternal serum alpha-fetoprotein analysis triple-marker screen Doppler flow study amniocentesis
maternal serum alpha-fetoprotein analysis Explanation: Alpha-fetoprotein is a substance produced by the fetus. AFP enters the maternal circulation by crossing the placenta. If there is a developmental defect, more AFP escapes into amniotic fluid from the fetus. The optimal time for AFP screening is 16 to 18 weeks. The triple marker screens for AFP, hCG, and unconjugated estriol. This screens for neural defects and Down syndrome. The Doppler flow study evaluates the blood flow, and amniocentesis evaluates the contents of the amniotic fluid looking for chromosomal defects.
The purpose of a circulatory shunt, such as the ductus arteriosus, is to: allow blood to bypass the fetal heart, which does not function as a pump until birth. allow fetal blood and maternal blood to mix freely. direct blood flow to the lungs to supply nutrients necessary for growth and maturation. permit oxygenated blood to supply the most important fetal organs
permit oxygenated blood to supply the most important fetal organs. Explanation: The ductus arteriosus helps propel oxygenated blood quickly to the coronary arteries, brain, and kidneys.
The nurse is assessing a pregnant woman on a routine prenatal visit. Which breast assessment finding will the nurse document as a normal and expected finding? hypopigmentation of the areola and nipples disappearance of superficial veins expression of colostrum in the first trimester tingling sensations and tenderness
tingling sensations and tenderness Explanation: Normal changes in the breasts associated with pregnancy include tingling sensations and tenderness, enlargement of the breast and nipples, hyperpigmentation of the areola and nipples, enlargement of Montgomery glands (tubercles), prominence of superficial veins, development of striae (stretch marks), and expression of colostrum in the second and third trimesters.