OB chapter 25

April 27th

a 25 year old woman comes to the clinic and says she thinks she is pregnant. Her last period was July 20th. Based on this fact, what is the expected date of delivery

progesterone

a leading hormone of pregnancy that is secreted by the corpus luteum and later the placenta. This hormone has properties that enable it to relax the organs. It is frequently referred to as the maintenance hormone of pregnancy because it is responsible for the normal contractility of the uterus being halted, which enables implantation to take place without interruption

quantity of amniotic fluid, femur length

a patient is scheduled for an ultrasound scan. She is at 22 weeks gestation. The patient asked how they will be able to tell the gestational age of her fetus. When planning the response, the nurse correctly recognizes that which measurements will be used in this determination

16 and 20 weeks

a pregnant client asks the nurse in the clinic when she will be able to start feeling the fetus move. The nurse responds by telling the mother that fetal movement will be noted between which weeks of gestation

tell the client that these are common and they may occur throughout the pregnancy

a pregnant client is seen in the health care clinic for a regular prenatal visit. The client tells the nurse that she is experiencing irregular contractions. The nurse determines that the client is experiencing Braxton Hicks contractions. Based on this finding, which nursing action is appropriate

That is linea nigra, a darkened line from the pubis to the umbilicus, as a result of increased hormones

a pregnant patient asks the nurse about a darkened line that is seen on her abdomen. What would be the best response

extends her leg and dorsiflexes her foot during the cramp

a pregnant patient at her third office visit asked the nurse, what can I do when my leg goes into a cramp? The patient demonstrates understanding of the nurses instruction regarding relief of leg cramps if she

I can stop taking my vitamins if I have hemorrhoids

a pregnant patient comes into the clinic complaining of constipation. Which statement by the patient indicates the need for further teaching

10wks

a pregnant patient comes to the clinic for a prenatal visit. At how many weeks gestation would a patient need to be to hear fetal heart tones using a Doppler scan

you may find that you need to modify your exercising to walking later in your pregnancy, around the seventh month

a pregnant woman at 10 weeks of gestation drugs 3 or 4 times per week. She is concerned about the effect of exercise on the fetus. What information can be provided by the nurse

turn the woman on her side

a pregnant woman at 32 weeks of gestation and reports feeling dizzy and lightheaded while her fundal height is being measured. Her skin is pale and moist. What should the nurses initial action be

estrogen

a primary hormone of pregnancy that is secreted by the corpus luteum and later the placenta. It is responsible for the increased vascularity needed in the developing pregnancy

fetal heart rate of 180 beats per minute

a primipara is being evaluated and they Clinic during her second trimester of pregnancy. Which indicates and abnormal physical finding that necessitates further testing

fetal movement causes an increase in maternal heart rate

a test that may be done in late pregnancy to determine fetal well-being is the non-stress test. This test is based on which phenomenon

come to the office right away

a woman at 23 weeks of gestation cost to tell the nurse she thinks she is leaking fluid from her vagina. What information should be included in the nurses response to the patient

1-2-1-3

a woman is admitted in labor has an obstetric history that indicates that she has had three children, all of whom are living. One was born at 39 weeks gestation, another at 34 weeks of gestation, and another at 35 weeks of gestation. She had a miscarriage at 16 weeks gestation. What are her gravida and para de for the TPAL system

the movement is flutter like and is called quickening

a woman who is in her first trimester is talking with the nurse. The patient has inquired about the feelings she will have when she first feels her baby move. What information can be provided by the nurse

planning

after admitting a new patient to the maternity unit, the nurse writes a care plan. This process of determining outcomes and interventions is which stage of the nursing process

intactness of the placenta

after delivery, the nurse is examining the placenta. What is the most important observation that the nurse should note and document

used to detect biochemical or chromosomal abnormalities. Later in pregnancy, amniocentesis is primarily used to determine fetal lung maturity. It may also be performed to detect intrauterine infection and Fetal distress and to assist fetal laboratory values

an amniocentesis is performed to identify what conditions

this is called emotional liability and is related to hormone changes and anxiety during pregnancy. The mood swings will subside as she adjust to being pregnant

an expectant father confides in the nurse that his pregnant wife is driving him crazy. 1 minute she seems happy, and the next minute she seems unhappy, and the next she is crying over nothing at all. Is there something wrong with her? What is the most appropriate response by the nurse

number of fetuses, gestational age of fetuses, congenital anomalies, placement of the placenta

at one of her prenatal visits, the patient is scheduled for a sonogram. Sonographic can be used to assess

gravida 3 para 2

based on the definitions of gravida and para, what documentation best describes a woman in the clinic who is currently pregnant and has had to prior children

have you been vomiting? If yes, how frequently?

big pregnant woman reports frequently feeling ill in the morning with bouts of nausea throughout the day. What question is most important to differentiate between morning sickness and the more serious condition of hyperemesis gravidarum

slight decrease in the second trimester

blood pressure changes during pregnancy

increase by 15 mL or 40% to 50% above pregnancy level

blood volume changes during pregnancy

increase is 30 to 50%

cardiac output changes during pregnancy

Zygote

cell formed by the union of two reproductive cells

drink six to eight glasses of water daily

constipation is a frequent symptom as a pregnancy progresses. Which measure is best to recommend for relief of constipation

great abdominal distention that gives the pelvis a forward tilt, decreased abdominal muscle tone, and increased weight-bearing creates a realignment of the spinal curvature, the woman center of gravity shifts Ford, lordosis develops, and increased curvature in the cervicodorsal region is also seen, the expectant mother may also be noted with an exaggerated anterior flexion of the head, enlarging breast and a stoop shoulder since further accentuates the lumbar and dorsal curves

describe the musculoskeletal changes that women may experience during pregnancy

Morula

developmental stage of the fertilized ovum in which there is a solid mass of cells resembling a mulberry

implantation

embedding of the fertilized ovum in the uterine mucosa

implantation bleeding

enzymes allow the blastocyst to enter the endometrium and implant, may cause slight bleeding in some individuals

the placenta function as an endocrine gland that secretes HCG and the steroidal hormones estrogen and progesterone, which maintain the pregnancy. In addition, the placenta is the site of the exchange of nutrients, oxygen, and waste products between the fetus and the maternal circulation. The puss in it allows transfer of oxygen and nutrients through such processes as diffusion and active transport, and it also blocks the transfer of certain substances

explain the function of the placenta

Dick-Read Method

focuses on Progressive relaxation techniques and avoidance of analgesics

increases 10 to 15 beats per minute

heart rate during pregnancy

decreases

hemoglobin and hematocrit changes during pregnancy

human chorionic gonadotropin, human placental lactogen, estrogen, progesterone, relaxin

hormone secreted during pregnancy

how to calculate, start with the first day of the woman's last normal menstrual period and count back 3 months then at 7 days

how do you estimate the date of birth using the Nagele's rule

to hear the fetal heart tones, place the instrument in the midline, just above the symphysis pubis, and apply firm pressure. Some difficulty may be seen in locating heart tones in obese women during the early stages. Fetal heart tones are to be assessed for a full minute

how would you assess the fetal heart tones

human placental lactogen

impax maternal metabolism, resulting in the maintenance of energy sources for the fetus

ectopic pregnancy

implantation of the fertilized egg outside of the uterine cavity

HCG

initially secreted by the trophoblast in the developing pregnancy. It is responsible for simulation of the corpus luteum to promote production of estrogen and progesterone until the placenta is functioning. This is the hormone assist with a pregnancy test

relaxin

it is secreted by the corpus luteum in later the decidua of the uterine lining and the placenta. This hormone is linked to the softening of the cervix and pubic symphysis and preparation for labor and delivery

common methods of prepared childbirth include Dick-Read, Bradley, Leboyer, Lamaze

list common methods of prepared childbirth

abortion

medical term used to refer to the loss of a pregnancy prior to 20 weeks gestation

increase 18%

red blood cell mass changes during pregnancy

villi

short vascular processes or protrusions growing on certain membranous surfaces

Bradley method

stresses control of environmental factors, such as lighting, temperature, and noise to provide a calm, supportive environment for childbirth

conception

takes place when the sperm joins or fuses with the ovum

mechanical injury, temperature, musculoskeletal

the amniotic fluid acts as a cushion against___________ _________ , helps regulate fetal_________ , allows the developing embryo or fetus room for growth promoting______________ development, and provides for fetal lung development

July 27th 2017

the client arrives at the prenatal clinic for her first prenatal assessment. The client tells the nurse that the first day of her last period was October 20th 2016. Using the naegele's rule, the nurse determines the estimated date of birth is which

Blastocyst

the embryonic form, a spherical mass of cells having a central fluid-filled cavity surrounded by two layers of cells

8wks, fetus

the embryonic stage last for________. after this initial stage, the embryo is called the_______

reassure the mother that crying with relief and joy is an understandable response

the mother has diabetes and is at risk for placental insufficiency. The results of the non-stress test shows three fetal movements accompanied by 2 increases of 15 beats per minute in a 20 minute period. the mother is so relieved that she starts crying. What should the nurse be prepared to do for the patient

if excessive leakage is a problem, breast pads can be useful

the mother is in her second trimester and reports free milk is leaking from her breast. What should the nurse tell the mother

severe headaches

the nurse explains to the patient that she should contact her healthcare provider if she experiences any of the danger signs of pregnancy. Which symptom is a danger sign during pregnancy

place the Doppler just above the symphysis pubis and apply firm pressure

the nurse is assessing fetal heart tones on a woman who is 12 weeks pregnant. What is the correct method for this procedure

gravida 2 para 1

the nurse is collecting data from a client who is pregnant with triplets. The the client also has a three-year-old child who was born at 39 weeks gestation. The nurse should document which gravida and para status on this client

G2, T1,P0,A0, L1

the nurse is collecting data from a client who is pregnant with twins. The client has a healthy five year old child who was delivered at 38 weeks comment tells the nurse that she does not have his history of any type of abortion or fetal demise. The nurse should document the GTPAL for this client as witch

Ballottement, Chadwick's sign, Uterine enlargement, Braxton Hicks contractions

the nurse is collecting data from a client who suspect she is pregnant. The nurse is checking the clot for probable signs of pregnancy. Which are the probable signs of pregnancy that the nurse should note

28 cm

the nurse is collecting data from a pregnant mother who is 28 weeks gestation. The nurse measures the fundal height in centimeters and should expect which finding

possible intrauterine growth restriction

the nurse is comparing today's fundal height measurement with the previous recording taken 5 weeks ago. What is the significance of a stable or decrease measurement

the cord has two vessels, two artery and one vein

the nurse is examining the umbilical cord immediately after delivery. Which finding should be reported to the healthcare provider for further investigation of fetal anomalies

you and your partner can watch the images on the screen if you would like to

the nurse is helping a woman prepare for an abdominal ultrasound. Which information is correct

family will have additional stress related to finances if there is no insurance coverage

the nurse is interviewing a woman who has just found out that she is pregnant. From a nursing standpoint, what is the best rationale for asking about insurance coverage for maternity and newborn care

a softening of the cervix

the nurse is reviewing the record of a client who has just been told that her pregnancy test is positive. The nurse knows that the healthcare provider has documented the presence of Goodell sign. the nurse determines that this is a sign indicatives of which

have you ever had rubella or have you had the vaccination

the nurse is taking a health history and the information is likely to be used later during genetic counseling. Which question is the most appropriate in the initial data collection

suck on hard candy

the nurse notes in the healthcare providers documentation that the patient is experiencing ptyalism. what should the nurse instruct the patient to do

facial swelling is something that has to be reported to your health care provider for follow-up care and evaluation

the nurse notices the patient has facial swelling. What is the nurses best response

fetal movement palpated by the primary caregiver, presence of fetal heart tones

the nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. Which are positive signs of pregnancy

it is the fetal movement that is felt by the mother

the nursing instructor as a nursing student to describe the process of quickening. Which statement indicates an understanding of this term

instructs a patient to lie supine on the examination table

the nursing student is preparing to measure fundal height. At which Step would the nurse intervene

prolonged or repeated Beetle temperature evaluation may result in birth defects

the patient in the first trimester is advised to avoid exercising for more than 35 minutes in hot, humid weather. What is the best rationale for this advice

declining levels of quantitative human Chorionic gonadotropin

the patient is at risk for miscarriage. Which diagnostic test result is consistent with a miscarriage

presumptive

the patient reports experiencing nausea, vomiting, and breast tenderness along with missing her period. these symptoms are considered to be what type of signs of pregnancy

my baby should move at least 10 times in a one to two hour period

the pregnant patient has been instructed to count fetal movements. Which statement demonstrates that the patient understands the procedure

pain in burning sensation with urination

the pregnant patient phones the clinic and reports having some symptoms that are causing discomfort and worry. Which symptom is the most serious and warrants immediate evaluation by the healthcare provider

preterm delivery with low birth weight

the pregnant woman is a heavy smoker and she feels that it is unlikely that she will be able to quit. Because of the oxygen deprivation in the utero, which outcome should the healthcare team be prepared to deal with

check the patient's blood pressure

the pregnant woman reports bleeding or diplopia. Which assessment should the nurse immediately perform

10 weeks

the very first fetal movements, characterized as bubbling through a straw in the stomach, maybe experienced at

Chadwicks sign

the vulva have a violet or purple discoloration

formed all organs and structures

the woman has entered her 16th week of pregnancy and ask the nurse how is the baby growing the nurse provides accurate information by informing the mother that the baby will have

will you have to travel to areas where the water is untreated, have you checked the policies of the airline that you usually fly, are you planning to travel to a foreign country, when you drive, do you use the lap belt or shoulder harness

the woman with a low risk pregnancy tells the nurse that she frequently has to travel for her job. Which questions are most relevant

Leboyer method

uses a warm water bath to reduce the trauma of birth

Lamaze method

uses breathing, distraction, and focusing techniques to mentally control pain and requires discipline training throughout the pregnancy

visual disturbances, headaches, edema, rapid weight gain, pain, signs of infection, vaginal bleeding, vaginal drainage, persistent vomiting, muscular irregularity or convulsions, absence or decrease in fetal movement once felt

what are the danger signs during the pregnancy that may indicate the need for immediate medical attention

amenorrhea, nausea and vomiting, frequent urination, breast changes, changing in the shape of the abdomen, quickening, skin changes, Chadwicks sign

what are the presumptive signs that can indicate that a woman is pregnant

breast changes begin early in pregnancy. Many women report tingling and a feeling of fullness. Increased sensitivity is also common. Generally, the breast grows in preparation for lactation. Nipples and areola darken. Colostrum may be secreted by the nipple in second half of pregnancy

when do the changes in breasts occur during pregnancy

use only acceptable medical terminology when referring to body parts and functions

when obtaining a reproductive health history from a female patient. What should the nurse do

review the woman's dietary intake

when planning a diet with a pregnant woman. What should the nurses initial action be

increase in the platelet count

which laboratory results should be reported to the healthcare provider because pregnancy increases the risk for blood clots

amenorrhea, breast changes, Chadwick sign

which of the following maternal changes are presumptive signs of pregnancy

the exercises are most beneficial if they are done 10 times in a row at least 3 times a day

which patient response indicates that she understands how to perform kegel exercises

vaginal bleeding

which symptom is considered a first trimester warning sign and should be reported immediately to the healthcare provider

no alcohol

while giving a health history to the nurse, the patient reports that she usually has a glass of wine with dinner. What is the safe level of alcohol intake for her during her pregnancy

14 to 16 weeks gestation

while in the clinic, a first-time pregnant patient asks the nurse when she should be able to feel the fetus move. What is the nurses best response

flagellation

whip like movements of sperm traveling through the mucus of the cervical canal

increases in second and third trimester

white blood cell count changes during pregnancy