Pregnancy EAQ
Which statements would the nurse include in a teaching session for pregnant couples regarding fetal growth and development?
"Development occurs in a head to toe and central to peripheral pattern" "Pregnancy includes the preembryonic, embryonic, and fetal stages of development" "During pregnancy the embryo grows from a single cell to a complex physiologic being"
Which client statement indicates understanding of teaching about a nonstress test?
"If the heart reacts well, my baby should be OK when I give birth." The nonstress test is used to evaluate the response of the fetus to movement and activity. A reactive test indicates that the fetus is healthy.
After a speculum examination in the first trimester of pregnancy, the nurse states that the client's cervix is bluish purple, which is know as the Chadwick sign. Which explanation of this sign would the nurse provide?
"It is caused by increased blood blow to the uterus during pregnancy" Stating that the Chadwick sign is caused by increased blood flow to the uterus during pregnancy underscores the normalcy of Chadwick sign and provides a simple explanation of the cause; women often need reassurance that the physical changes associated with pregnancy are expected.
At 12 weeks gestation a client with a history of several spontaneous abortions says to the nurse, "Every day I wonder whether I'll be able to have this baby." How would the nurse respond?
"It's understandable for you to be worried that you won't be able to carry this pregnancy to term. You've had a difficult time." Affirming the validity of the client's concerns acknowledges her fearful feelings. It also permits further communication.
Which instruction would the nurse give to the pregnant client with a positive group B streptococcus (GBS) result at 36 weeks gestation?
"This information will be in your prenatal record; however, please remind your labor and delivery nurse of this finding" A client who has a positive result on a GBS screening will need to be treated with an intravenous antibiotic, often penicillin or ampicillin, throughout the labor process to help prevent transmission of the infection to the neonate.
The pregnant client is 5 ft 3 in (160 cm) tall and weighs 130 lb (57 kg) at the beginning of her pregnancy. Which weight would be recommended for her to reach at the end of the pregnancy?
155 lb (68 kg) A weight of 155 lb (70 kg) would put the client within the recommended weight gain of 25-35 lb (11-15.9 kg) for a woman with a normal body mass index (BMI) before pregnancy.
Which is a consideration when planning prenatal counseling for a client who has had two uneventful pregnancies ending in term vaginal births of healthy children?
Each pregnancy is a unique experience that is stressful despite muluitparity Each pregnancy is unique and creates a stressful situation because it is a developmental crisis.
A client at 7 week's gestation tells the nurse in the prenatal clinic that she has been bothered by episodes of nausea throughout the day. Which interventions would the nurse recommend?
Focus on and repeat a rhythmic chant Eat small, frequent meals and eat dry crackers in between Focusing helps mitigate odors, tastes, and thoughts that may cause nausea. Avoiding an empty stomach decreases the occurrence of nausea associated with pregnancy.
While a client is being interviewed on her first prenatal visit she states that she has a 4 year old son who was born at 41 week's gestation and a 3 year old daughter who was born at 35 week's gestation. The client lost one pregnancy at 9 weeks and another at 18 weeks. using GTPAL system, how would you record this information
G5 T1 P1 A2 L2
At term a client's hemoglobin level is 10.6 g/dL (106 mmol/L) and her hematocrit is 31%. Which physiological factor accounts for these values?
Hemodilution The increase in circulating blood volume during pregnancy is reflected in lower hemoglobin and hematocrit readings (physiological anemia of pregnancy); this represents hemodilution.
Which pregnancy hormone is thought to cause the nausea and vomiting the client is experiencing in the first trimester of pregnancy?
Human chorionic gonadotropin (hCG) hCG, secreted by the chorionic villi during early pregnancy, frequently causes nausea; as the level of hCG decreases, the nausea usually subsides. Estrogen is not associated with nausea; it makes the reproductive tract receptive to the embryo.
Which estimated date of birth (EDB) would the nurse calculate if the client states that her last menstrual period began on April 11 and that she also had some spotting on May 8?
January 18 To use Naegele's rule, subtract 3 months and add 7 days to the first day of the last normal menstrual period, April 11. The spotting is discounted because it was not a normal menstrual period.
Which sign of symptom would the nurse instruct a client at 29 week's gestation to report immediately to the primary care provider?
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.
Which is a consequence on the neonate of maternal smoking during pregnancy?
Low birth weight Smoking during pregnancy causes a decrease in placental perfusion, resulting in a newborn who is small for gestational age (SGA).
Which changes would the nurse include in the childbirth class focusing on the maternal psychologic and physiologic alterations that occur near the end of pregnancy?
Nesting needs increase Anxiety about childbirth increases Gastrointestinal motility decreases Nesting needs increase as pregnancy reaches term; it is a psychologic preparation for motherhood. As pregnancy nears term, maternal thoughts turn to the problems that may occur during labor and birth. Because the enlarged uterus is pressing on the organs of the gastrointestinal tract, digestive and elimination problems increase.
Which activities would be taught by the nurse as methods of relieving back pain in pregnancy?
Pelvic rocking Forward tilting Sacral pressure Pelvic rocking eases tension in the muscles of the lumbar region. Lumbar pain during pregnancy results from the changes in posture as the uterus grows. Forward tilting eases tension in the muscles of the lumbar region. Applying the heel of the hand to the laboring client's sacral area (counterpressure) helps relieve the back discomfort that may result when a fetus is in the occiput posterior position.
A client at 42 week's gestation is admitted for a nonstress test. The nurse concludes that this test is being done because of which possible complication related to a prolonged pregnancy?
Placental insufficiency Placental function peaks at 37 weeks and declines slowly thereafter; therefore, continuation of the pregnancy past term (42 weeks) places the fetus at risk because of placental insufficiency.
Which foods would the nurse counsel the client at 14 week's gestation to avoid during pregnancy?
Raw shellfish Herbal supplements Soft-scrambled eggs The March of Dimes has included raw shellfish, which may be contaminated with hepatitis or typhoid, on its list of foods to avoid during pregnancy. Herbal supplements and teas often contain ingredients that are medicinal and should not be taken during pregnancy unless a primary health care provider has been consulted regarding their safety. The March of Dimes has included soft-scrambled eggs on its list of foods to avoid during pregnancy because they may be contaminated with Salmonella.
A woman arrives for an appointment at an obstetrics clinic. During the visit the nurse records the following information. Which finding indicates a need for future intervention?
Rubella titer less than 1:8 (nonimmune) The rubella titer is very low, indicating that the client does not have adequate antibodies against rubella and is susceptible. The client will need a rubella vaccine after the pregnancy ends.
Which information would the nurse include when explaining common body changes in the first trimester of pregnancy?
Sleep needs increase Urinary frequency increases Calcium requirements remain the same Fatigue is a common feature of the first trimester of pregnancy thought to be due to increased levels of progesterone and increased metabolism rate. Urinary frequency occurs from the growing uterus exerting pressure on the urinary bladder. During the first trimester approximately 1000 mg of calcium is needed each day. There is no longer a recommendation for an increase in daily calcium intake during pregnancy and lactation.