OB EAQ 1

The nurse teaches a high school sex education class that herpes genitalis infection cannot be cured, but the disease is marked by remissions and exacerbations. What else should the students be taught about this infection?

Although exacerbations occur, they are not as severe as the initial episode. The initial infection is both local and systemic; exacerbations are milder and localized. Although optimum health habits may limit exacerbations, they will not prevent them. There is no treatment that will limit the number of exacerbations. Exacerbations are precipitated by physical and emotional stress, not by sexual activity.

The nurse is caring for a client who has had a spontaneous abortion. Which complication should the nurse assess this client for?

Hemorrhage Hemorrhage may result if placental tissue is retained or uterine atony occurs. There is no indication that the client has been deprived of fluids. Hypotension, not hypertension, may occur with postabortion hemorrhage. Subinvolution is more likely to occur after a full-term birth.

A nurse is caring for a client with tertiary syphilis. Which body system should the nurse monitor most closely?

Cardiovascular Syphilis is primarily a vascular disease; aortitis, valvular insufficiency, and aortic aneurysms are the most prevalent problems in tertiary syphilis. Although lesions may occur around the mouth (chancre in primary syphilis, mucous patches in secondary syphilis), the structures of the respiratory tract are not the major structures involved in tertiary syphilis. Although lesions occur on the genitalia in primary and secondary syphilis, the reproductive system is not the major body system affected by tertiary syphilis. A gumma skin lesion is the least commonly occurring lesion associated with tertiary syphilis; skin lesions, such as macular and papular eruptions, most commonly occur in secondary syphilis.

Which are barrier methods of contraception? Select all that apply.

Condom Lea's Shield Diaphragm A condom is considered a barrier method of contraception because it prevents the entrance of sperm into the vagina. Lea's shield is a reusable vaginal contraceptive made of silicone. A diaphragm is a cervical covering used to prevent sperm from reaching the egg. Spermicidal foams are a chemical methods of contraception. Coitus interruptus is a withdrawal contraceptive method.

A 28-year-old woman comes into the clinic and tells the nurse that she fears that she is infertile, because she has been trying to become pregnant unsuccessfully for 2 years. While collecting the health history the nurse learns that the client experiences irregular and infrequent menstrual periods. The client is overweight and has severe acne and alopecia. The primary healthcare provider diagnoses the condition polycystic ovarian syndrome (PCOS). Which of the following interventions is the most important?

Discussing weight loss, exercise, and a balanced low fat diet. Weight loss, exercise, and a balanced low-fat diet can reduce insulin and androgen levels related to PCOS. Meeting with a dietitian may be helpful. Surgery is not necessary at this time. The primary healthcare provider would most likely prescribe hormones, other medications, or both. If pregnancy does not occur, surgery is an option. Pregnancy may be possible with hormones, other medications, or both. Early detection of PCOS is important, because the condition can lead to type 2 diabetes; hypertension; cardiovascular disease; and ovarian, breast, and endometrial cancers. The nurse should encourage treatment compliance and positive lifestyle changes.

A pregnant client at 37 weeks' gestation is taught the signs and symptoms that should be reported immediately to the primary care provider. The nurse determines that the client understands the information presented when she states that she will immediately report what?

Leakage of fluid from the vagina Leakage may indicate rupture of the amniotic membranes; the client is at risk for an ascending infection from the vagina if birth does not occur within 24 hours or if early treatment is not instituted. Lower back pain is a common discomfort of pregnancy because the enlarged uterus causes a shift in the client's center of gravity. Leukorrhea is common during pregnancy because of increased vascularity of the cervix and increased production of mucus. Preparatory (Braxton Hicks) contractions occur at irregular intervals throughout pregnancy; they become stronger after the 28th week of gestation.

A client who is at 13 weeks' gestation arrives at the emergency department. She states that she began to have spotting and a small amount of vaginal bleeding several hours ago. This is her second pregnancy. Which gravidity should the nurse record?

Multigravida A multigravida is a woman who had more than one pregnancy. A multipara is a woman who has had two or more viable infants. A primipara is a woman who has had one viable infant. A primigravida is a woman who is pregnant for the first time.

At 32 weeks' gestation a client undergoes an ultrasound examination, which reveals a low-lying placenta. What complication should the nurse anticipate as the client's pregnancy approaches term?

Painless vaginal bleeding Because the process of effacement occurs in the latter part of pregnancy, placental separation from the uterus may occur, causing painless bleeding. There is pain with premature separation of a normally implanted placenta (abruptio placentae). Lower back pain is not associated with placenta previa. Rupture of membranes usually does not occur before the placenta starts to separate.

Which information concerning the childbearing process should the nurse teach a client during the first trimester of pregnancy?

Physical and emotional changes resulting from pregnancy Increasing the client's knowledge of physical and psychologic changes resulting from pregnancy prepares the client for expected changes as pregnancy continues; it is most effective when taught during the first trimester. It is too early to teach about labor and birth; this should be done in the last trimester. The client should be alerted to danger signs and symptoms; however, primary teaching is directed toward increasing her knowledge of expected physiological changes. Concerns about role transition to parenthood should be addressed in the third trimester.

A pregnant client is asking the nurse when she will gain the greatest amount of weight during the pregnancy. At which time during prenatal development should the nurse tell the client to expect the greatest fetal and maternal weight gain?

Third trimester The third trimester is the period in which the fetus stores deposits of fat. There is growth, but fat deposition does not occur in the second trimester. The first 8 weeks is the period of organogenesis, when cells differentiate into major organ systems. The implantation period is the period of the blastocyst, when initial cell division takes place.