New Family Exam 2 Prep U

Signs and symptoms of pre-eclampsia

BP of 140/90, edema of the face, head ache (from prepU select all that apply)

What should a pregnant women with sickle cell anemia do to prevent crisis?

Drink 8 glasses of water every day

A woman is lightly stroking her abdomen in rhythm with her breathing during contractions. The nurse identifies this technique as

Effleurage

Cure for pre-eclampsia

Have the baby

A 34-year-old gravida 3 para 2 is experiencing severe back pain with each contraction. She is extremely uncomfortable and upset because she never had this type of pain with her other labors. What intervention is most likely to help in this situation?

Intradermal water injections

What is priority in a client with pregestational diabetes?

Maintain glycemic control

When caring for a client in the third stage of labor, the nurse notes that expulsion of the placenta has not occurred within 5 minutes after birth of the infant. What should the nurse do?

Nothing. Normal time for stage three is 5-30 minutes.

What is RhoGAM given for?

To prevent maternal D antibody formation

If a 1 hour glucose tolerance test is elevated, what is neccessary?

a 3 hour follow up test

What do pregnant woman with gestational diabetes need to eat before they exercise?

A sustaining carbohydrate snack

A nurse is providing care to a pregnant woman in labor. The woman is in the first stage of labor. When describing this stage to the client, which event would the nurse identify as a major change occurring during this stage?

Cervical Dilation

A client makes an appointment with an obstetrician and assessment reveals positive Hegar and Chadwick signs. What should the nurse teach the client about these results?

She is probably pregnant, but this must be confirmed by other means. (probable signs)

During a nonstress test, when monitoring the fetal heart rate, the nurse notes that when the expectant mother reports fetal movement, the heart rate increases 15 beats or more above the baseline. This occurs about 4 or 5 times during the testing period. The nurse interprets this as:

reactive pattern.

The coach of a client in labor is holding the client's hand and appears to be intentionally applying pressure to the space between the first finger and thumb on the back of the hand. The nurse recognizes this as which form of therapy?

Acupressure

Magnesium Sulfate is used for?

seizures in eclampsia. Can become toxic in system, but reversed by calcium gluconate.

A primagravida, who is 1 cm dilated, is in early latent labor. She has expressed a desire to avoid epidural anesthesia and asks about nonpharmacologic options for pain relief as her labor progresses. How could the nurse appropriately respond? Select all that apply

"I can show you some simple breathing exercises that can help you relax" "You may want to go for a walk now" "When you come back, i'll show you how to use the birthing ball"

The nurse is caring for a pregnant woman determined to be at high risk for gestational diabetes. The nurse prepares to rescreen this client at which time frame?

24 - 28 weeks

Changes insulin pumps every

24 to 48 hours

When should RhoGAM be given?

28 weeks gestation and again within 72 hours after birth

Utilize the GTPAL system to classify a woman who is currently 18 weeks pregnant. This is her 4th pregnancy. She gave birth to one baby vaginally at 26 weeks who died, experienced a miscarriage, and has one living child who was delivered at 38 weeks gestation.

4, 1, 1, 1, 1

Characteristics of Varicella

AKA chickenpox - spread by respiratory droplets, highly contagious - highest risk occurs if the woman contracts varicella in the 2nd trimester between 13 and 20 weeks

Braxton Hicks Contractions are termed "practice contractions" and occur throughout pregnancy. When the woman's body is getting ready to go into labor, it begins to show signs of impending labor. Among these signs are Braxton Hicks contractions that are more frequent and stronger in intensity. What differentiates braxton hicks contractions from true labor?

Braxton Hicks contractions usually decrease in intensity with walking

The nurse is assisting a client in labor and delivery and notes the placenta is now delivered. What will the nurse document?

Completion of third stage of labor

With placenta previa you should never

Do cervical checks

What is a normal blood sugar during pregnacy?

Fasting - 70-95 1 hr after meal - 70-140 2 hrs after meal - 70 - 120 120-140 at bedtime

A client's maternal serum-alpha fetoprotein level was unusually elevated at 17 weeks. The nurse suspects which condition?

Open spinal defects

The nurse explains to a pregnant client that she will need to take iron during her pregnancy after being diagnosed with iron-deficiency anemia. The nurse suggests that absorption of the supplemental iron can be increased by taking it with which substance?

Orange Juice (contains absorbic acid)

Psychological changes during 3rd trimester

Prepare for parentgood

The client is 32 weeks pregnant and has been referred for BPP after a nonreassuring nonstress test. Which statement made by the client indicates that the nurse's explanation of the procedure was effective?

The BPP is an ultrasound that measures breathing, body movement, tone, and amniotic fluid volume.

A client is in the third stage of labor. Which finding would alert the nurse that the placenta is separating?

Uterus becomes globular

The client's pregnancy screening test shows that the maternal serum alpha-fetoprotein (MS-AFP) level is high. Which information should the nurse provide the client upon this finding?

a high level of MS-AFP is associated with neural tube defects. We will schedule you for another type of test to determine if your baby has neural tube defects.

A client asks why she should learn breathing patterns for labor. After instruction is given, the nurse determines teaching has been effective when the client states

breathing patterns are distraction techniques taught to decrease pain in labor

Hemoglobin during pregnancy?

less than 11g/dL require nutritional counseling

What is abruptio placentae?

premature separation of a normally implanted placentae

Psychological changes during 2nd trimester

Accept baby

A pregnant client tells the nurse that she has a 2-year-old child at home who was born at 38 weeks; she had a miscarriage at 9 weeks; and she gave birth to a set of twins at 34 weeks. Which documentation would be appropriate for the nurse?

gravida 4, para 2

A woman in her 40th week of pregnancy calls the nurse at the clinic and says she is not sure whether she is in true or false labor. Which statement by the client would lead the nurse to suspect that the woman is experiencing false labor?

"The contractions slow down when I walk around"

A pregnant woman comes to the clinic for a visit. This is her third pregnancy. She had a miscarriage at 12 weeks and gave birth to a son, now 3 years old, at 32 weeks. Using the GTPAL system, the nurse would document this woman's obstetric history as:

30111

A patient makes an appointment at the prenatal clinic because she thinks she might be pregnant. Which assessment is a probable sign of pregnancy?

a positive pregnancy test probable sign of pregnancy is something that is objective (usually felt by trained examiner) , but can be caused by another condition.

Psychological changes during 1st trimester

Accept pregnancy

Which feature would alert the nurse that the client is in the transition phase of labor?

Beginning to bear down

Assessment of a woman in labor reveals cervical dilation of 3 cm, cervical effacement of 30%, and contractions occurring every 7 to 8 minutes, lasting about 40 seconds. The nurse determines that this client is in?

Latent phase of the first stage

A nurse suspects that client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding?

Elevated liver enzymes. (symptoms are hemolysis, elevated liver enzymes, and low platelets.

A woman comes to the prenatal clinic and undergoes a pelvic exam. The doctor notes a softening of the uterine isthmus. The nurse recognizes that this finding is known as what sign?

Hegar sign

What is a normal hematocrit during pregnancy?

Hematocrit: Normal pre-pregnancy: 36-46%. Worry during pregnancy if it's <33.

A nurse is educating a pregnant client about obtaining a blood sample for an alpha-fetoprotein level. Which response by the client indicates that the health teaching was successful?

If my AFP level is high, it could mean there is a problem with my baby's spinal cord

A client who requested "no drugs" in labor asks the nurse what other options are available for pain relief. The nurse reviews several options for non pharmacologic pain relief, and the client thinks effleurage may help her manage the pain. This indicates the nurse will

Instruct the client or her partner to perform light fingertip repetitive abdominal massage.

What is the most prevalent form of anemia in pregnancy?

Iron deficiency anemia

A nurse recommends to a client in labor to try concentrating intently on a photo of her family as a means of managing pain. The woman looks skeptical and asks, "how would that stop my pain?", which explanation should the nurse give?

It distracts your brain from the sensations of pain

A client last menstrual period was April 11th. Using Nagele's rule, her estimated date of birth would be?

January 18th plus 7 days, minus 3 months

What would the nurse recommend to a client who is at 35 weeks gestation who reports irregular contractions and lower backache?

Lie down and rest and see if the contractions stop and pain subsides.

The nurse performs a nonstress test (NST) on a client at 36 weeks' gestation. What criteria does the nurse look for on the racing to determine if the NST is reactive?

Presence of 2 accelerations in 20 minutes

a client's menstrual period is two weeks late. She has been feeling tired and has had bouts of nausea in the morning. What classification of pregnancy symptoms is this client experiencing?

Presumptive Any subjective data reported by the women is presumptive

A pregnant woman comes to the emergency department because she thinks she is in labor. The nurse determines that the client is in true labor when assessment of contractions reveals which finding?

Radiating to the front of the abdomen from the back

A nurse is providing education to a woman 28 weeks gestation who has tested positive for gestational diabetes mellitus. What would be important for the nurse to include in client teaching?

She is at increased risk for type 2 diabetes mellitus after her baby is born

A woman who has had sickle cell anemia asks the nurse if her infant will develop sickle cell disease. The nurse would base the answer on which information?

Sickle cell anemia is recessively inherited

The nurse is caring for a client at 39 weeks gestation who is noted to be at 0 station. The nurse is correct to document which?

The fetus is in the true pelvis and engaged

A woman in labor has chosen to use hydrotherapy as a method of pain relief. Which statement by the woman would lead the nurse to suspect that the woman needs additional teaching?

The temperature of the water should be at least 105

During a physical exam, the physician notates that the pregnant client has a positive Chadwick sign. What client findings would be noted for this symptom?

The vagina has a bluish, purple discoloration

Elevated blood glucose levels in the first trimester of pregnancy are linked to?

congenital anomalies

A woman in early labor is using a variety of techniques to cope with her pain. When the nurse enters the room she notes that the woman is making light, circling movements with her fingertips across her abdomen. What technique is she using?

effleurage

The nurse should encourage a pregnant client who is taking short-acting insulin for her diabetes to avoid eating after self-administering insulin

false

A nurse is caring for a pregnant client with rhythmic uterine contractions. Which feature should the nurse identify as associated with true labor?

increase in frequency of contractions