Edapt: Nursing Care: During Pregnancy

A nurse is reinforcing teaching a pregnant woman about the danger signs during pregnancy. For which occurrences should the nurse advise the client to contact her health care provider? SATA

-Decreased fetal movement​ -Severe epigastric pain -Blurred vision -Muscular convulsions

7. Which two healthcare provider orders should the nurse address first?​

-Fetal heart tones auscultation -Side lying position

4. Which of the following nursing diagnoses should the nurse select for Amy? SATA

-Knowledge deficit -Imbalanced nutrition: less than body requirements​

Case Study: The nurse is caring for Amy, a 28-year-old, whose pregnancy has just been positively confirmed by visualization of the fetus on ultrasound. She is at the clinic for her first antepartum visit. Review the electronic health record (EHR) before answering each question. 1. Based on Amy's obstetric and gynecological history, Amy is a G2 T1 P0 A0 L1. Which statements explain what this notation means? SATA

-She has not had any spontaneous or elective abortions.​ -This is her second pregnancy, and she has delivered one other child.​ -She has one living child who was born at term.​

A sexually active woman of childbearing age states that she began her menses 3 days ago, but the bleeding is lighter than usual. What would lead her provider to order a pregnancy test even though she states she began her menses? ​SATA

-She may be pregnant and experiencing implantation bleeding rather than her menses​. -She may be having a miscarriage even though she didn't realize she was pregnant​.

8. After Amy is stabilized and it is determined that the baby is safe and she is not in labor, the nurse reinforces with Amy the danger signs of pregnancy that need to be reported immediately. The nurse confirms that Amy understands the danger signs of pregnancy when Amy repeats which indicators? SATA

-Sudden and/or continuous headache -Diarrhea -Severe abdominal or epigastric pain -Absence or decrease in fetal movement -Blurred vision -Vaginal bleeding, no matter the amount​

All major organs and systems develop simultaneously, approximately 8 weeks after fertilization. Why is this a very critical stage of pregnancy? SATA

-This is the time when birth defects develop. -All major body organs develop. -The developing embryo is vulnerable to teratogenic agents.

A woman who is pregnant for the 3rd time, has had a miscarriage, and has one living child who was born prematurely. Select the correct number for each component of GTPAL below. 1. Gravida 2. Term 3. Preterm 4. Abortions 5. Living

1. 3 2. 0 3. 1 4. 1 5. 1

A normal pregnancy lasts ___(1)___ weeks from the ___(2)___ day of the last menstrual period (LMP).​

1. 40 2. first

Select the correct structure for each description. Each item will fit only one structure. 1. Blocks transfer of certain substances to fetus​ 2. Carries de-oxygenated blood away from fetus and oxygenated blood to fetus​ 3. Connects placenta to fetus​ 4. Cushioned to protect from compression​ 5. Cushions fetus from compression​ 6. Exchanges nutrients, oxygen, and waste products between fetus and maternal circulation​ 7. Provides for fetal lung development ​ 8. Regulates fetal temperature​ 9. Secretes hormones that maintain pregnancy​ 10. Amniotic sac that contains the fetus​

1. placenta 2. umbilical cord 3. umbilical cord 4. umbilical cord 5. amniotic fluid 6. placenta 7. amniotic fluid 8. amniotic fluid 9. placenta 10. fetal membranes

Identify whether each of the following is a presumptive, probable, or positive sign of pregnancy. ​ 1. Ballottement: ​ 2. Chadwick's sign: 3. Darkening areolae: 4. Fetal heartbeat present: ​ 5. Goodell's sign: ​ 6. Nausea and vomiting: 7. Palpation of fetal outline: ​ 8. Positive pregnancy test: ​ 9.Ultrasound visualization of pregnancy: ​

1. probable 2. probable 3. presumptive 4. positive 5. probable 6. presumptive 7. positive 8. probable 9. positive

6. The nurse reinforces with Amy that she must consume enough nutrients in order to maintain a healthy pregnancy. How many calories should Amy consume per day?

2450-2500 kcals/day​ To meet the increased nutrient needs for both mother and child during pregnancy and lactation, caloric intake of nutrient-dense foods should be increased by 450 to 500 kcal/day. Adequate daily caloric intake for non-pregnant women is 2000 kcals/day. Therefore, during pregnancy and lactation, Amy should consume 2450-2500 kcals/day.​

3. Click to indicate which findings are consistent with normal pregnancy and which are abnormal or indicative of danger signs in pregnancy. 1. 5 pound weight gain 2. Negative glucose 3. Diarrhea 2 times a day 4. Elevated platelets​ 5. Swollen face and fingers 6. Hirsutism 7. Pain with urination 8. Swollen, tingly feet at night​ 9. Vital signs 10. Trace proteinuria

Abnormal or Dangerous 5 pound weight gain, Diarrhea 2 times a day, Swollen face and fingers, Pain with urination, Vital Signs. Normal Negative glucose, Elevated platelets, Hirsutism, Swollen, tingly feet at night, trace proteinuria.

Which finding is a presumptive sign of pregnancy?​

Amenorrhea

5. The nurse is speaking with Amy's healthcare team about her condition and treatment plan. For each potential action (healthcare provider order or nursing intervention), click to specify whether it is anticipated, unrelated, or contraindicated for Amy's care.​ Antiplatelet medication to lower platelet count​ Consult with endocrinologist due to hirsutism ​ Educational reinforcement ​ Fluid restriction due to swollen face and fingers ​ Food and water intake diary ​ Frequent weight measurements ​ Low protein diet due to proteinuria ​ Medication to lower heart rate ​

Anticipated Educational reinforcement Food and water intake diary Frequent weight measurements Unrelated Antiplatelet medication to lower platelet count Consult with endocrinologist due to hirsutism Contraindicated Fluid restriction due to swollen face and fingers Low protein diet due to proteinuria Medication to lower heart rate

2. Click to indicate if each finding requires follow-up by the nurse or does not require follow-up.​ 1. Anxiety 2. Dark yellow urine with odor 3. Decreased oral fluid intake 4. Fatigue ​5. Frequent vomiting for over a week 6. Human chorionic gonadotropin (HCG) in urine 7. Light-headed 8. Mucousy vaginal discharge​ 9. Reddened, softened cervix ​ 10, Tender breasts​

Requires Follow Up Anxiety, Dark yellow urine with odor, Decreased oral fluid intake, Frequent vomiting for over a week, Light-headed. No Follow Up Required Fatigue, Human chorionic gonadotropin (HCG) in urine, Mucousy vaginal discharge, Reddened, softened cervix, tender breasts