Maternal Child Chapters 1-3
Genetic testing is being discussed with a couple at a fertility clinic. What is the best response to their concerns?
Environmental factors can have an impact on genetic factors
A nurse in a prenatal clinic examines a client and determines that her uterus has risen out of the pelvis and is now an abdominal organ. At what week gestation does this occur?
12th week
Which research based knowledge guides a nurse regarding emotional factors of pregnancy? -A rejected pregnancy will result in a rejected infant -An effective mother does not experience ambivalence and anxiety about mothering -A mother's love usually develops within the first week after birth -Ambivalence and anxiety about mothering are common
Ambivalence and anxiety about mothering are common
A client tells the nurse that the first day of her last menstrual period was July 22, 2015. What is the EDD? April 29, 2016 May 7, 2016 March 6, 2016 April 22, 2016
April 29, 2016
What is the best advice you can give to a pregnant woman in the first trimester?
Avoid drugs, and refrain from smoking and ingesting alcohol.
The nurse reads the history of a neonate admitted to the nursery and discovers that the infant's mother was listed as gravida 1, para 1 before the baby was born. How should the nurse use the data to gather more information?
Consider that someone recorded the gravida and para incorrectly.
You are teaching a childbirth class to a group of pregnant women. One of the women asks at what point during the pregnancy the embryo becomes a fetus. How should you respond?
During the 8th week of pregnancy
A pregnant client is making her first antepartum visit. She has a 2-year-old son born at 40 weeks, a 5-year-old daughter born at 38 weeks, and 7-year-old twin daughters born at 35 weeks. She had a spontaneous aborthion 3 years ago at 10 weeks. Using the GTPAL format, what does the nurse document about the client's obstetric history?
G5 T2 P1 A1 L4
A 36-year-old multigravida who is at 14 weeks' gestation is scheduled for an alpha-fetoprotein test. She asks the nurse, "What does the alpha-fetoprotein test indicate?" The nurse bases a response on the knowledge that this test can indicate an increased risk for what?
Neural tube defects
At her first prenatal visit, a client says to the nurse, " I guess I'll be having an internal examination today." What is the nurse's BEST response?
Have you ever had an internal examination done before?
A pregnant client is being prepared for a pelvic examination. She states that she is always tired and feels sick to her stomach, especially in the morning. What is the nurse's BEST response?
Let's discuss ways to resolve these common problems.
A pregnant client uses a computer continuously during her working hours. THis has impications for her plan of care during pregnancy. What should a nurse recommend? -Try to walk around every few hours during the workday -tell your boss that you cannot work beyond the 2nd trimester -ask for time in the morning and afternoon to get something to eat -ask for time in the morning and afternoon to elevate your legs
Try to walk around every few hours during the workday
When is it most important for a female client to know that a fetus may be structurally damaged by the ingestion of drugs?
When planning to become pregnant
Why might a history of HSV-1 or HSV-2 in a pregnant female and/or her partner result in a c-section delivery? Explain your reasoning.
a history of HSV-1 or HSV-2 in a pregnant female and/or her partner result in a c-section delivery by a c-section because it is a risk of virus transmission by mother to child. HSV-1 is transmitted during childhood by non-sexual contacts.
What change does a nurse expect in a client's hematologic system during the second trimester of pregnancy? a decrease in WBCs (white blood cells) a decrease in sedimentation rate (sed rate) an increase in blood volume an increase in hematocrit
an increase in blood volume
A nurse is teaching a prenatal class about the changes that occur during the 2nd trimester of pregnancy. What cardiovascular changes should the nurse include? SELECT ALL THAT APPLY.
cardiac output increases, blood pressure decreases, heart is displaced upward
A pregnant woman reports nausea and vomiting during the first trimester of pregnancy due to an increase in which hormone?
chorionic gonadotropin
What recommendation should a nurse give to clients who have fluid retention during pregnancy? -ask the health care provider for a diuretic -maintain a low-sodium diet -elevate the lower extremities -decrease fluid intake
elevate the lower extremities
A nurse is planning a prenatal class about the changes that occur during pregnancy and the necessity of routine health care supervision throughout pregnancy. Which cardiovascular compensatory mechanism should he/she explain will occur? SELECT ALL THAT APPLY.
increased blood volume, increased cardiac output, enlargement of the heart
When involved in prenatal teaching, a nurse should inform clients that there is an increase in vaginal secretions during pregnancy called leukorrhea. What causes the increase?
production of estrogen
A nurse is assessing a pregnant client in the 3rd trimester. What clinical finding is an expected response to pregnancy?
shortness of breath on exertion
A client who is visiting the prenatal clinic for the first time has a serology test for toxoplasmosis. What information in the client's history indicates to the nurse that there is a need for this test? taking care of a cat using chemical cleaners consuming raw vegetables working as a dog trainer
taking care of a cat
A pregnant client asks the clinic nurse how smoking will affect her baby. What information about cigarette smoking will influence the nurse's response?
the resulting vascoconstriction affects both fetal and maternal blood vessels
A client at 35 weeks' gestation asks a nurse why her breathing has become more difficult. How should the nurse respond?
your diaphragm has been displaced upward
A woman visits the prenatal clinic because an OTC (over the counter) pregnancy test was positive. After the initial examination verifies the pregnancy, the nurse explains some of the metabolic changes that occur during the first trimester of pregnancy. SELECT ALL THAT APPLY.
-Fluid retention increases -Calcium requirements increase -Need for sleep increases
While caring for a pregnant client and her partner, a nurse suspects domestic violence. Which assessments support this suspicion? -Woman has visited the clinic several times in the last month. -Partner refuses to come into the examination room. -Woman has injuries to the breasts and abdomen. -Partner answers questions that are asked of the woman. -Partner is excessively attentive while the health history is being taken.
-Woman has visited the clinic several times in the last month. -Woman has injuries to the breasts and abdomen. -Partner answers questions that are asked of the woman.
A client has several tests during the pregnancy. Place the tests in the order they should be performed during pregnancy. 1. routine ultrasound 2. Sickle cell screening 3. Group B streptococcus culture 4. Serum glucose 5. Alpha-fetoprotein testing
2, 5, 1, 4, 3
At what time during prenatal development should the nurse expect the greatest fetal weight gain? -3rd trimester -First 8 weeks -Second trimester -Implantation period
3rd trimester
During a physical in the prenatal clinic the client's vaginal mucosa is observed to have a purplish discoloration. What sign should be documented in the client's clinical record?
Chadwick
Explain Naegel's Rule including the formula.
The Naegel's Rule is a calculation used for estimating the due date of a baby, and it is based of the woman's last menstrual period. The number is just an estimation because it is based on a 28-day cycle (which most women do not have so it vary) with a typical gestation period of 40 weeks. Calculations: = Have the last Menstrual period of the women and subtract 3 months, add 7 days to the LMP and 1 year= EDD. (This equation is best used LMP April- December) =Add 7 days LMP and add 9 months= EDD (This equation is best used LMP January - March)
Why might the due date for a baby be considered inaccurate? Utilize CER method for your response.
The due for a baby be considered inaccurate because of Naegele's Rule is just an educated guess or estimating the due date of a baby. I say this because each woman has their own different thing in their body and their bodies are not going to do the same thing that every other woman does during birth. One where someone may get the wrong due date is because they may forget their LMP and just say s random number. Another one would be getting the wrong formal that is not appropriate formal. The number is just an estimation because it is based on a 28-day cycle (which most women do not have so it vary) with a typical gestation period of 40 weeks.
A primigravida tells the nurse that she has morning sickness. What suggestions should the nurse make to help relieve the nausea? eat three meals a day increase dietary calcium drink 2 quarts or more of fluid a day avoid long periods without food
avoid long periods without food
A nurse is teaching a class of expectant parents about changes that are to be expected during pregnancy. What changes does the nurse explain result from the melanocyte-stimulating hormone? chloasma urinary frequency morning sickness cervical softening effacement linea nigra
chloasma, linea nigra
A client at 8 weeks' gestation reports having to urinate more often. The nurse explains that urinary frequency often occurs because the bladder capacity during pregnancy is diminished by what?
compression by the enlarging uterus
A nurse teaches a pregnant woman to avoid lying on her back during labor. What information about the result of lying in the supine position is the basis for the nurse's teaching?
placental perfusion is decreased
What does the nurse explain to a pregnant client about the cause of her physiologic anemia? -utilization of iron decreases -erythopoiesis decreases -detoxification by the liver increases -plasma volume increases
plasma volume increases
At her first visit to the prenatal clinic, a client tells the nurse she is ambivalent about continuing the pregnancy. Why does the nurse conclude that the client is experiencing a crisis?
pregnancy is a period of change and adjustment to change