Chapter 7 OB

Human chorionic gonadotropin (hCG) is an important biochemical marker for pregnancy and the basis for many tests. A maternity nurse should be aware that:

A higher than normal level of hCG may indicate an ectopic pregnancy or Down syndrome.Higher levels also could be a sign of multiple gestation. hCG can be detected 7 to 8 days after conception.

A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely will have: Amenorrhea.

Amenorrhea is a presumptive sign of pregnancy. Presumptive signs of pregnancy are felt by the woman.

Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester? Increased pulse rate

Between 14 and 20 weeks of gestation, pulse increases about 10 -15 beats/min, which persists to term.

To reassure and educate pregnant clients about changes in their cardiovascular system, maternity nurses should be aware that:

Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks to term.

To reassure and educate their pregnant clients about changes in their blood pressure, maternity nurses should be aware that:

Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of term pregnancy.

Some pregnant clients may complain of changes in their voice and impaired hearing. The nurse can tell these clients that these are common reactions to:

Congestion and swelling, which occur because the upper respiratory tract has become more vascular

Physiologic anemia often occurs during pregnancy as a result of:

Dilution of hemoglobin concentration.

A woman is in for a routine prenatal checkup. You are assessing her urine for proteinuria. Which findings are considered normal

Dipstick assessment of trace to +1 <300 mg/24 hours

Appendicitis may be difficult to diagnose in pregnancy because the appendix is:

Displaced upward and laterally, high and to the right.

During a client's physical examination the nurse notes that the lower uterine segment is soft on palpation. The nurse would document this finding as

Hegar's sign At approximately 6 weeks of gestation, softening and compressibility of the lower uterine segment occur; this is called Hegar's sign

The diagnosis of pregnancy is based on which positive signs of pregnancy

Identification of fetal heartbeat Visualization of the fetus Verification of fetal movement

To reassure and educate pregnant clients about the functioning of their kidneys in eliminating waste products, maternity nurses should be aware that:

Increased bladder sensitivity and then compression of the bladder by the enlarging uterus results in the urge to urinate even if the bladder is almost empty.

To reassure and educate pregnant clients about changes in the cervix, vagina, and position of the fetus, nurses should be aware that:

Increased vascularity of the vagina increases sensitivity and may lead to a high degree of arousal, especially in the second trimester.

To reassure and educate pregnant clients about changes in their breasts, nurses should be aware that:

Lactation is inhibited until the estrogen level declines after birth.

Which statement about a condition of pregnancy is accurate?

Nausea and vomiting rarely have harmful effects on the fetus and may be beneficial

patient at 24 weeks of gestation contacts the nurse at her obstetric provider's office to complain that she has cravings for dirt and gravel. The nurse is aware that this condition is known as pica and may indicate anemia

Pica (a desire to eat nonfood substances) is an indication of iron deficiency and should be evaluated.

nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse's instructions if she states that a positive sign of pregnancy is:

Positive signs of pregnancy are attributed to the presence of a fetus, such as hearing the fetal heartbeat or palpating fetal movement

A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a:

Primipara.A primipara is a woman who has completed one pregnancy with a viable fetus.

The nurse caring for the pregnant client must understand that the hormone essential for maintaining pregnancy is:Progesterone.

Progesterone is essential for maintaining pregnancy; it does so by relaxing smooth muscles. This reduces uterine activity and prevents miscarriage.

The maternity nurse understands that vascular volume increases 40% to 60% during pregnancy to:

Provide adequate perfusion of the placenta.

During pregnancy, many changes occur as a direct result of the presence of the fetus. Which of these adaptations meet this criteria?

Quickening Ballottement Lightening

31-year-old woman believes that she may be pregnant. She took an OTC pregnancy test 1 week ago after missing her period the test was positive. her assessment interview, nurse inquires about the woman's last menstrual

She takes anticonvulsants.Anticonvulsants may cause false-positive pregnancy test results

The musculoskeletal system adapts to the changes that occur during pregnancy. A woman can expect to experience what change?

She will have increased lordosis.

A woman is at 14 weeks of gestation. The nurse would expect to palpate the fundus at which level

Slightly above the symphysis pubis

Which finding in the urine analysis of a pregnant woman is considered a variation of normal? Glycosuria

Small amounts of glucose may indicate "physiologic spilling." The presence of protein could indicate kidney disease or preeclampsia.

Numerous changes in the integumentary system occur during pregnancy. Which change persists after birth?

Striae gravidarum, or stretch marks, reflect separation within the underlying connective tissue of the skin

Which time-based description of a stage of development in pregnancy is accurate?

Term—pregnancy from the beginning of week 38 of gestation to the end of week 42

first-time mother at 18 weeks of gestation comes for her regularly scheduled prenatal visit. client tells the nurse that she is afraid that she is going into premature labor because she is beginning to have regular contractions.

The nurse explains that this is the Braxton Hicks sign and teaches the client that this type of contraction

The mucous plug that forms in the endocervical canal is called the:Operculum

The operculum protects against bacterial invasion.

To reassure and educate pregnant clients about changes in the uterus, nurses should be aware that:

The woman's increased urinary frequency in the first trimester is the result of exaggerated uterine antireflexion caused by softening

A woman is in her seventh month of pregnancy. She has been complaining of nasal congestion and occasional epistaxis. The nurse suspects that:

This is a normal respiratory change in pregnancy caused by elevated levels of estrogen.Elevated levels of estrogen cause capillaries to become engorged in the respiratory tract.

A patient in her first trimester complains of nausea and vomiting. She asks, "Why does this happen?" The nurse's best response is

"It may be due to changes in hormones."

gravida is a pregnant woman; para comes from parity, meaning a viable fetus; primi means first; multi means many; and null means none

. A multipara is a woman who has completed two or more pregnancies with a viable fetus. A nulligravida is a woman who has never been pregnant.

woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. GTPAL system?

3-1-0-1-0

1. A woman's obstetric history indicates that she is pregnant for the fourth time and all of her children from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system

4-1-2-0-4