Test 1 Review - Ch 11-12
The nurse is conducting a prenatal class for a group of primigravida clients. Which instruction will the nurse prioritize when teaching about breast care? Use hot water and a mild soap to keep the nipples clean. Wash the nipples with a deodorant soap to keep them clean and help toughen them. Use an antibacterial soap and cool water to keep the nipples clean. Wash the nipples with clean water only
Correct response: Wash the nipples with clean water only. Explanation: She should use only clean water to wash the nipples. The use of any soap will dry the nipples and can lead to cracking
What conditions must be met for a minor to be emancipated?
Conditions that state law may require before approving a declaration of emancipation may include: The minor is at least 14 years of age, willingly lives separate and apart from parents or guardians with their consent or acquiescence, demonstrates ability to manage financial affairs, and has a source of income other than criminal activity. A valid marriage or service in the armed forces usually qualifies as acceptable conditions for a declaration of emancipation, but is not a requirement.
An older female pregnant with her first child develops some pain in her legs associated with warmth to touch. Suspecting a blood clot, an ultrasound is presribed and a peripheral venous thrombosis is diagnosed. Which intervention was likely prescribed for this woman? "Take your blood thinner the same time each day." "Buy and wear medical support hose every day." "Take a baby aspirin every morning and evening to prevent further clot formation." "If you sit at a desk, set a timer and get up and walk every 2 to 3 hours."
Correct response: "Buy and wear medical support hose every day." Explanation: The woman should wear elastic support stockings and put them on before she arises in the morning because once she is on her feet, blood pooling begins, and the stockings will be less effective. The nurse should be certain a woman understands the stockings she buys should be labeled "medical support hose." Otherwise, as many pantyhose manufacturers advertise their stockings as giving "firm support," she may assume erroneously this is sufficient for her. Blood thinners and aspirin are contraindicated in pregnancy. Because it stimulates venous return, exercise is as effective as rest periods for alleviating varicosities. Sitting at a desk for prolonged periods of time with legs bent at the knee also encourages venous stasis
A client who is 28 weeks' pregnant asks the nurse if it is safe to use mineral oil to relieve constipation. What is the best response by the nurse? "No, mineral oil may interfere with the absorption of fat-soluble vitamins from your diet." "No, mineral oil may initiate premature labor and birth." "Yes, mineral oil will enhance the absorption of water soluble vitamins from the diet." "Yes, mineral oil may increase the bulk of the feces and prevent constipation."
Correct response: "No, mineral oil may interfere with the absorption of fat-soluble vitamins from your diet." Explanation: Mineral oil should be avoided because it interferes with the absorption of fat soluble vitamins that are needed by the fetus. It does not alter the absorption of water soluble vitamins, change the bulk of the stool, or cause preterm labor
A client at 10 weeks gestation comes to the clinic for a prenatal follow up. The client reports experiencing morning sickness. She states, "It happens at any time of the day. Is there anything I can do?" Which suggestions by the nurse would be most helpful? Select all that apply. "Limit the number of meals to 2 meals per day." "Try eating some dry crackers before you getting out of bed in the morning." "Avoid any strong food odors as much as possible." "Limit your intake of fluids when you eat your meals." "Eat a high-fat snack before going to bed at night."
Correct response: "Try eating some dry crackers before you getting out of bed in the morning." "Avoid any strong food odors as much as possible." "Limit your intake of fluids when you eat your meals." Explanation: Measures to help alleviate nausea and vomiting of pregnancy include eating small, frequent meals that are bland and low in fat, eating dry crackers, Cheerios, or cheese before getting out of bed, avoiding any strong food odors, limiting the intake of fluids and soups during meals, and eating a high-protein snack before going to bed.
A client who is in her first trimester is anxious to have an ultrasound at each visit. The nurse explains that it is not necessary and schedules a second ultrasound to be performed when she is about: 18 to 20 weeks pregnant. 15 to 17 weeks pregnant. 21 to 23 weeks pregnant. 24 to 26 weeks pregnant.
Correct response: 18 to 20 weeks pregnant. Explanation: There are no hard-and-fast rules as to how many ultrasounds a woman should have during her pregnancy; however, the first ultrasound is usually performed during the first trimester to confirm the pregnancy. A second scan may be performed at about 18 to 20 weeks to look for congenital malformations. A third one may be done at around 34 weeks to evaluate fetal size and verify placental position
A urinalysis is done on a client in her third trimester. Which result would be considered abnormal? Trace of glucose 2+ Protein in urine Specific gravity of 1.010 Straw-like color
Correct response: 2+ Protein in urine Explanation: During pregnancy, there may be a slight amount of glucose found in the urine due to the fact that the kidney tubules are not able to absorb as much glucose as there were before pregnancy. However, there should be minimal protein in the urine. A specific gravity of 1.010 and a straw- like color are both normal findings.
At her 16-week checkup, a client's blood pressure is slightly decreased from her prepregnancy level. The nurse evaluates this change based on which statements concerning blood pressure during pregnancy? Normally, blood pressure increases steadily throughout pregnancy. Blood pressure remains stable until decreasing the day of the birth. A decrease in the second trimester may occur because of placental growth. Blood pressure progressively decreases throughout the entire pregnancy.
Correct response: A decrease in the second trimester may occur because of placental growth. Explanation: Because the placenta "traps" a great deal of blood for fetal circulation as it expands at about 3 months, maternal blood pressure may temporarily be slightly decreased. Otherwise, blood pressure stays fairly constant throughout pregnancy.
A hospitalized client with hyperemesis gravidarium has been tolerating small amounts of clear fluids for the past 6 hours. What is the next step in the plan of care? Add small quantities of dry toast every 2 to 3 hours. Progress the client to a soft diet with extra liquids. Add juices and milk to increase vitamin and protein intake. Continue the client on clear fluids for at least 24 hours.
Correct response: Add small quantities of dry toast every 2 to 3 hours. Explanation: After clear liquids, the client is given small quantities of dry toast. Juices and milk are avoided because they may irritate the GI tract. Only after tolerating the dry toast if the diet progressed furthe
During the physical exam at the first prenatal visit a speculum exam is performed. What sign of pregnancy does the practitioner look for during the speculum exam? Hagar's sign Chadwick's sign Nagel's sign Goodell's sign
Correct response: Chadwick's sign Explanation: During the speculum examination, the practitioner obtains a Papanicolaou test or Pap smear and notes signs of pregnancy, such as Chadwick's sign
A client wants to know if she can engage in intercourse during pregnancy. Which information should the nurse confirm to ensure that sexual intercourse or orgasm is not contraindicated in the client? Select all that apply. Client does not have breast tenderness. Client is not at risk for preterm labor. Client does not face a risk of threatened abortion. Client has experienced quickening. Client does not have dependent edema.
Correct response: Client is not at risk for preterm labor. Client does not face a risk of threatened abortion. Explanation: To confirm that intercourse or orgasm is not contraindicated in the pregnant client, the nurse should ensure that the client does not have placenta previa, and the client is not at risk for preterm labor or a threatened abortion. Breast tenderness and dependent edema are not contraindications for sexual intercourse in a pregnant client. Breast tenderness generally occurs in the first trimester of pregnancy. Dependent edema is a common vascular problem occurring during pregnancy.
A pregnant client is concerned she may develop preeclampsia, so she has stopped adding any salt to her food and is now questioning the nurse about avoiding prepared foods. The nurse should point out some salt is very beneficial and can help prevent which negative outcome for her baby? Congenital hypothyroidism Low birth weight Neural tube defects Night blindness
Correct response: Congenital hypothyroidism Explanation: Iodized sodium is needed by the body for normal thyroid function. Women with severe iodine deficiencies deliver infants with congenital hypothyroidism. Low birth weight is related to smoking and alcohol. Neural tube defects are caused by low folic acid levels. When vitamin A levels are too low, night blindness may occur.
When discussing infection prevention with a group of prenatal women, which interventions should the nurse emphasize to prevent toxoplasmosis in this population? Select all that apply. Apply bug spray to exposed skin every time one goes outside. Use condoms regularly when having sex with different partners. Cook meat thoroughly before eating. Avoid crowds of young children at daycare facilities. Have a significant other change the litter box throughout the pregnancy
Correct response: Cook meat thoroughly before eating. Have a significant other change the litter box throughout the pregnancy. Explanation: Toxoplasmosis, a protozoan infection, is spread most commonly through contact with uncooked meat, although it may also be contracted through handling cat stool in soil or cat litter. Malaria is caused by mosquitos primarily in Africa and South America. Insect repellant helps to prevent malaria. Sexually transmitted diseases can be prevented with condom use. Avoiding crowds of young children at daycare facilities can prevent exposure to CMV.
The nurse is assessing a pregnant client at her 20-week visit. Which breast assessment should the nurse anticipate documenting? Slack, soft breast tissue Deeply fissured nipples Enlarged lymph nodes Darkened breast areolae
Correct response: Darkened breast areolae Explanation: As part of the pigment changes that occur with pregnancy, breast areolae become darker. The breast tissue should not be softer or slacker than before. There should not yet be any lymph enlargement, and the nipples should not have fissures.
The nurse is preparing a care plan for a primigravida client and her partner who are excited about her pregnancy and ask lots of questions on various subjects. Which nursing diagnosis should the nurse prioritize for this client and her partner in this care plan? Health-seeking behaviors Fear related to lack of knowledge Risk of injury Deficient knowledge
Correct response: Deficient knowledge Explanation: The most appropriate nursing diagnosis in this case would be "deficient knowledge." This can entail various topics to include nutrition, exercise, testing, and even the sex of the baby. The other choices are also potential nursing diagnoses but would involve other types of activities. The couple is not displaying fear but are seeking information that will help them be successful with their pregnancy.
The nurse is in the process of administering medications to clients on the unit and notices one new mother is in the process of attempting to breast-feed her newborn infant. The nurse makes several suggestions to assist this mother. Which action should the nurse prioritize related to this interaction? Assess maternal-infant interactions Document the care given Evaluate the mother's ability to feed her infant Identify outcomes from care given
Correct response: Document the care given Explanation: Document nursing actions such as medication administration as soon as possible after the intervention to ensure the action is communicated, especially in the care of childbearing women and children. The other actions are important but not the priority. It's important to remember that "if it isn't recorded, it didn't happen.
A 25-year-old client at 27 weeks' gestation reports waking up with leg cramps. Which suggestion should the nurse point out to the client to help relieve this discomfort? Use plantar flexion exercises three times every day. Dorsiflex the foot while extending her leg during the cramp. Encourage her to drink more fluids, 10 glasses a day. Avoid any supplementation of vitamins or minerals.
Correct response: Dorsiflex the foot while extending her leg during the cramp. Explanation: Plantar flexion can make cramps worse, so dorsiflexion while extending the leg can relieve the cramp; excess fluid and lack of supplementation with vitamins or minerals may worsen cramps. Performing plantar flexion exercise does not prevent the cramp. Increasing fluids may help, but has never proven to eliminate cramping.
Which would be a normal finding by the nurse during a physical exam of a woman in her third trimester? Dyspnea Kyphosis Ptyalism Increased hematocrit
Correct response: Dyspnea Explanation: In the third trimester, women experiences dyspnea from the uterus pushing up into the diaphragm. A pregnant woman will experience lordosis, not kyphosis. Ptyalism is excessive saliva production and is often seen in the first trimester of pregnancy. The hematocrit of a pregnant woman will decrease in the third trimester, not increase
When providing family-centered care for a new mother and infant, which is the appropriate action by the nurse? Have the infant stay in the nursery. Oversee care provided by the mother. Encourage rooming-in to develop bonding. Limit interactions by other family members
Correct response: Encourage rooming-in to develop bonding. Explanation: The nurse should encourage rooming-in of the infant with the mother to develop bonding and provide physical and emotional care. This increases comfort level while nursing staff is available to monitor and provide guidance and assistance; it also promotes a healthy family unit
The nurse is caring for a 16-year-old boy with injuries from a car accident. Which activity describes the nurse's manager role? Facilitating return to school by working with the school nurse Teaching the mother cast care Discussing driving safety with the teen Changing dressings covering the skin abrasions
Correct response: Facilitating return to school by working with the school nurse Explanation: Much of an adolescent's life revolves around school and peers. In helping the teen return to school and friends, the nurse and the school nurse are achieving continuity of care and a supportive environment for healing. Teaching the mother cast care addresses the mother's learning needs and the teaching role of the nurse. Discussing driving safety with the teen is important and a factor in many adolescent injuries and deaths but is not a management activity. Changing dressings is a direct care activity of the nurse
Which nursing intervention would best demonstrate evidence-based practice in maternal-child health care? Family-centered pediatric care Minimizing parental interaction with preterm infants Placing adults and children with similar diseases on the same unit Decentralizing care to allow clients to be closer to home
Correct response: Family-centered pediatric care Explanation: Evidence-based practice has become the standard that nurses are to strive for in caring for their clients. By involving the family in caring for ill children, the child and the family are better served and have improved outcomes. Parental interaction is encouraged for preterm infants to foster bonding. Children and adults need to be separated on inpatient units to ensure that the caregivers have a clear understanding of each client's needs, since children are not small adults. Centralized care has proved to be most beneficial to client's outcomes by providing resources and specialists in one location.
The 5-year-old in the emergency room is having glass removed from a wound. Which action constitutes ethical behavior by the nurse? Holding the child's hand in order to facilitate removal of the glass Telling the child, "Stop screaming! You are scaring the other kids here!" Discussing with the physician the merits of sutures versus staples for wound closure Asking the parent to leave the emergency room cubicle due to crowding
Correct response: Holding the child's hand in order to facilitate removal of the glass Explanation: Restraining the child only as much as is needed in order to provide needed care is practicing ethically while being sensitive to the sanctity and quality of human life. It is practicing nonmaleficence means avoiding causing harm, intentionally or unintentionally. Removing the parent is not just. The child needs the support. Discussing sutures and staples while the child listens harms through fear. Developmentally, the child will misinterpret and not understand. Telling the child not to scream and promoting guilt ("scare others") does not benefit the child. At 5 years of age, he does not have emotional control when hurt. Promoting guilt is inappropriate for the developmental stage (initiative vs. guilt)
The nurse is conducting an assessment of a pregnant client at a routine second trimester prenatal visit. Which lower extremity assessment should the nurse prioritize? Lateral movement of the kneecap Presence of varicosities Diameter of the calf muscle Blanching and refilling of toenails
Correct response: Presence of varicosities Explanation: During pregnancy, women are prone to develop varicosities because of uterine pressure on lower-extremity veins. Evaluating the diameter of the calf would be important if a deep vein thrombosis was suspected. Capillary refill of the toenails would be a routine evaluation. Lateral movement of the kneecap would not be a priority.
A primigravida client has come to the clinic for a prenatal checkup. What teaching topics would help to promote a healthy pregnancy for this client? Douching is recommended to decrease the risk of vaginal infections. More frequent tooth brushing is recommended to prevent caries related to ptyalism. Applying lanolin ointment to the breasts is recommended to prevent cracked nipples. Swimming in a pool is a recommended exercise during pregnancy.
Correct response: Swimming in a pool is a recommended exercise during pregnancy. Explanation: Swimming in a pool is good exercise for a pregnant woman. However, swimming in a lake can be harmful because of the danger of infection, especially in the latter months. Douching can increase the risk of vaginal infections. Increased salivation or ptyalism, seen in some women during pregnancy, does not cause tooth decay and necessitate more frequent brushing. Lanolin ointments may damage the areola and nipple and have not been shown to be effective in preventing sore and cracked nipples.
The nurse dealing with global populations knows that the health of individuals in North America continues to improve, but much room for improvement remains. Which statement accurately reflects the state of health in North America? The prevalence of chronic diseases is increasing. The prevalence of childhood infectious diseases is increasing. The incidence of overweight and obesity in children is decreasing. The birthrate for teen mothers is increasing.
Correct response: The prevalence of chronic diseases is increasing. Explanation: Many childhood infectious diseases, such as mumps and measles, have almost disappeared because of the emphasis placed on immunization, however, the prevalence of chronic diseases is increasing. The incidence of overweight and obesity in young children and teens is increasing rapidly. The birthrate for teen mothers (ages 15 to 19 years) has seen a significant downward trend, a reduction of 36% since its peak in 1990
The nurse is presenting a nutritional plan to a primigravida client who is questioning the addition of iodized salt to her diet. Which explanation should the nurse prioritize in answering this client? Thyroid activity, which depends on iodine intake, increases during pregnancy. Because of decreased thyroid activity during pregnancy, the thyroid does not produce as much as normal. Progesterone formation is dependent on a high iodine intake. Adrenal gland activity during pregnancy decreases iodine's effectiveness.
Correct response: Thyroid activity, which depends on iodine intake, increases during pregnancy. Explanation: Hyperplasia of glandular tissue and increased vascularity can cause the thyroid gland to increase in size. Iodine is a necessary mineral for optimal thyroid function. So as the thyroid increases, the need for additional iodine increases. Progesterone formation is not dependent on iodine. The activity of the adrenal gland does not effect iodine's effectiveness
A nurse is teaching a parenting class about key issues that threaten children's health today. Which statements by the participants would indicate comprehension of those key issues? (Select all that apply.) Unintentional injuries are a leading cause of injury after 1 year of age. Childhood obesity is a continuing threat to children's health. The environmental toxin threat to children's health is improving. Mental health issues for children are not a concern until young adulthood. Allergies are a serious threat to childhood health.
Correct response: Unintentional injuries are a leading cause of injury after 1 year of age. Childhood obesity is a continuing threat to children's health. Allergies are a serious threat to childhood health. Explanation: Unintentional injuries continue to be the leading cause of death in children greater than 1 year. Obesity, environmental toxins, allergies, and mental health problems are some of the key issues that endanger children's health today
Which woman requires the most weight gain during pregnancy? a woman carrying twins and a prepregnant BMI of 23 a woman with a prepregnant BMI of 27 with a single fetus a woman with a prepregnant BMI of less than 19 a woman who is pregnant for the third time in 5 years
Correct response: a woman carrying twins and a prepregnant BMI of 23 Explanation: Women carrying a twin gestation have additional requirements for weight gain during pregnancy. Women with a low BMI or frequent pregnancies need to be assessed for signs of nutrient deficits; dietary intake should be modified as needed.
A young couple are concerned that their fetus may be born with sickle cell anemia. The nurse explains that the recessive traits of sickle-cell anemia can be determined by using which test? chorionic villus sampling amniocentesis blood typing percutaneous umbilical blood sampling
Correct response: chorionic villus sampling Explanation: Chorionic villus sampling (CVS) is a procedure for obtaining a sample of the chorionic villi for prenatal evaluation of chromosomal disorders, enzyme deficiencies, fetal gender determination, and to identify sex-linked disorders such as hemophilia, sickle cell anemia, and Tay-Sachs disease. Amniocentesis is used to evaluate for neural tube defects, chromosomal disorders, and inborn errors of metabolism. Blood typing is performed via a blood sample. Percutaneous umbilical blood sampling allows for rapid chromosomal analysis
Which effect would the nurse identify as a normal physiologic change in the renal system due to pregnancy? decrease in glomerular filtration rate dilation of the renal pelvis reduction in kidney size shortening of the ureters
Correct response: dilation of the renal pelvis Explanation: The renal pelvis becomes dilated during pregnancy, possibly due to the effect of progesterone on smooth muscle. The glomerular filtration rate increases during pregnancy. The kidneys enlarge during pregnancy. The ureters elongate, widen, and become more curved above the pelvic rim.
A 28-year-old primigravida client with diabetes mellitus, in her first trimester, comes to the health care clinic for a routine visit. The client reports frequent episodes of sweating, giddiness, and confusion. What should the nurse tell the client about these experiences? tissue sensitivity to insulin increases as pregnancy advances use of insulin needs to be reduced as pregnancy advances increased secretion of insulin occurs in the first trimester insulin resistance becomes minimal in the latter half of the pregnancy
Correct response: increased secretion of insulin occurs in the first trimester Explanation: Increased secretion of insulin in the maternal body in the first trimester is due to the rise in serum levels of estrogen, progesterone, and other hormones. During the second half of pregnancy, tissue sensitivity to insulin progressively decreases, producing hyperglycemia and hyperinsulinemia. Use of insulin needs to be increased not reduced as pregnancy advances. Insulin resistance becomes maximal not minimal in the latter half of the pregnancy
During a routine antepartal visit, a pregnant woman says, "I've noticed my gums bleeding a bit since I've become pregnant. Is this normal?" The nurse bases the response on the understanding of which effect of pregnancy? elevated progesterone levels increased venous pressure influence of estrogen and blood vessel proliferation effects of regurgitation from relaxation of the cardiac sphincter
Correct response: influence of estrogen and blood vessel proliferation Explanation: During pregnancy, the gums become hyperemic, swollen, and friable and tend to bleed easily. This change is influenced by estrogen and increased proliferation of blood vessels and circulation to the mouth. Elevated progesterone levels cause smooth muscle relaxation, which results in delayed gastric emptying and decreased peristalsis. Increased venous pressure contributes to the formation of hemorrhoids. Relaxation of the cardiac sphincter, in conjunction with slowed gastric emptying, leads to reflux due to regurgitation of the stomach contents into the upper esophagus
A client who is in her sixth week of gestation is being seen for a routine prenatal care visit. The client asks the nurse about changes in her eating habits that she should make during her pregnancy. The client informs the nurse that she is a vegetarian. The nurse knows that she has to monitor the client for which risks arising from her vegetarian diet? Select all that apply. epistaxis iron-deficiency anemia decreased mineral absorption constipation low gestational weight gain
Correct response: iron-deficiency anemia decreased mineral absorption low gestational weight gain Explanation: When caring for a pregnant client who follows a vegetarian diet, the nurse should monitor her for iron-deficiency anemia, decreased mineral absorption, and low gestational weight gain. Risk of epistaxis and increased risk of constipation are not reported to be associated with a vegetarian diet.
Which vaccines are contraindicated during pregnancy since they may transmit a viral infection to the fetus? Select all that apply. measles mumps influenza rubella Tdap vaccine (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis
Correct response: measles mumps rubella Explanation: Live virus vaccines, such as measles, HPV, mumps, rubella, and poliomyelitis (Sabin type), are contraindicated during pregnancy because they may transmit a viral infection to a fetus. Women are advised to be vaccinated against influenza before/during pregnancy. Tetanus is also treated the same in pregnant women as in others by Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) injection.
A woman who is pregnant for the first time has arrived to the labor department thinking she was in labor only to be diagnosed with Braxton Hicks contractions and sent home. Prior to leaving ther unit, the woman asks, "How will I know when it is 'true' labor?" Which signs/symptoms should the woman assoicate with true labor? Select all that apply. pain in back that wraps across the abdomen that increases in frequency and intensity leakage of white to yellow discharge from the nipples pink-tinged blood and mucus mixture on underwear sudden gush of clear fluid coming from the vagina urine leakage after coughing or sneezing
Correct response: pain in back that wraps across the abdomen that increases in frequency and intensity pink-tinged blood and mucus mixture on underwear sudden gush of clear fluid coming from the vagina Explanation: True labor contractions usually begin in the back and sweep forward across the abdomen similar to the tightening of a rubber band. They gradually increase in frequency and intensity over a period of hours. As the cervix softens and ripens, the mucus plug that filled the cervical canal during pregnancy is expelled. The exposed cervical capillaries seep blood as a result of pressure exerted by the fetus. This blood, mixed with mucus, takes on a pink tinge and is referred to as "show" or "bloody show." Labor may begin with rupture of the membranes, experienced either as a sudden gush or as a scanty, slow seeping of clear fluid from the vagina. Leaking colostrum from the nipples can occur throughout the pregnancy. Occasionally, a woman notices urinary incontinence (involuntary loss of urine on coughing or sneezing) during pregnancy
During the initial prenatal visit, the nurse performs what assessment to guide teaching about nutrition during pregnancy? prepregnancy BMI current weight height and bone structure hemoglobin level
Correct response: prepregnancy BMI Explanation: Weight gain goal during pregnancy is based on the client's prepregnant BMI. Current weight and height are part of the BMI calculation. Hemoglobin level only provides information about iron stores, not overall nutritional status.
A woman in the third trimester of her first pregnancy expresses fear about the birth canal being wide enough for her to push the baby through it during labor. She is a petite person, and the baby seems so large. She asks the nurse how this will be possible. To help alleviate the client's fears, the nurse should mention the role of the hormone that softens the cervix and collagen in the joints, which allows dilation and enlargement of the birth canal. What is this hormone? relaxin progesterone estrogen human placental lactogen
Correct response: relaxin Explanation: Relaxin, secreted by the corpus luteum of the ovary as well as the placenta, is responsible for helping to inhibit uterine activity and to soften the cervix and the collagen in joints. Softening of the cervix allows for dilatation at birth; softening of collagen allows for laxness in the lower spine and so helps enlarge the birth canal. The effect of estrogen is to cause breast and uterine enlargement. Progesterone has a major role in maintaining the endometrium, inhibiting uterine contractility, and aiding in the development of the breasts for lactation. Human placental lactogen (hPL), also known as human chorionic somatomammotropin, serves as an antagonist to insulin, making insulin less effective, thereby allowing more glucose to become available for fetal growth.
A nurse is instructing a pregnant woman about monitoring fetal movements and informs her that normally the fetus will move the same amount every day. The nurse also adds that the client may notice an unusual increase or decrease in movement, explaining that this is due to which situation? fetal shifting of activity-sleep balance response to a need for oxygen fetal heartburn cramping in the uterus and trying to get comfortable
Correct response: response to a need for oxygen Explanation: A fetus normally moves more or less the same amount every day. If there is an unusual increase or decrease in movement, the client should be examined because such a change suggests that the fetus is responding to a need for oxygen.
As part of a 31-year-old client's prenatal care, the nurse is assessing immunization history. Which immunization is most relevant to ensuring a healthy fetus? rubella hepatitis A and B measles diphtheria, tetanus, and pertussis
Correct response: rubella Explanation: Maternal exposure to rubella during pregnancy poses a particular fetal risk that supersedes the significance of hepatitis, measles, diphtheria, tetanus, or pertussis.
To control an elevated cholesterol level, the nurse would teach the client to include which type of fish in the diet? Select all that apply. salmon trout tuna swordfish mackerel
Correct response: salmon trout Explanation: Salmon and trout are high in omega-3 oil. Tuna is also high in omega-3 oil but potentially has high mercury content and needs to be limited during pregnancy. Swordfish and mackerel also have potentially high mercury content and are not high in omega-3 oil.
The United States lags behind other industrialized countries regarding infant mortality. The main factor that contributes to this is: lack of available facilities for caring for the infants. older mothers having babies. the large number of preterm births in the U.S. more congenital anomalies in children born in the U.S.
Correct response: the large number of preterm births in the U.S. Explanation: Two factors that contribute to the fact that the United States lags behind other industrialized countries are the large number of preterm births and the differences in reporting live births in various countries.
What sort of changes does the pressure of the growing fetus generate in the pregnant woman?
The nurse should consider the pressure caused by the growing fetus on the diaphragm as the most likely cause of the client's problem. Displacement of the stomach by the growing fetus causes heartburn in the pregnant client. Pressure on the pelvic area by the growing fetus causes dependent edema. Pressure on the rectal vein by the growing fetus causes hemorrhoids.
How much weight should women gain during pregnancy based on their BMI?
Women with a body mass index of 18.5 to 24.9 (considered healthy weight) should gain 25 to 35 pounds (11 to 18 kilograms). This client's BMI is 21 and is thus considered normal. A woman with a body mass index of 25 to 29.9 is considered overweight and should gain no more than 15 to 25 pounds (7 to 11 kilograms) during pregnancy. A woman with a body mass index less than 18.5 should gain 28 to 40 pounds (13 to 18 kilograms).
The nurse is assessing a pregnant woman on a routine prenatal visit. Which breast assessment finding will the nurse document as a normal and expected finding? hypopigmentation of the areola and nipples disappearance of superficial veins expression of colostrum in the first trimester tingling sensations and tenderness
Correct response: tingling sensations and tenderness Explanation: Normal changes in the breasts associated with pregnancy include tingling sensations and tenderness, enlargement of the breast and nipples, hyperpigmentation of the areola and nipples, enlargement of Montgomery tubercles, prominence of superficial veins, development of striae, and expression of colostrum in the second and third trimesters
A pregnant client has come to a health care provider for her first prenatal visit. The nurse needs to document useful information about the past health history. What are goals of the nurse in the history-taking process? Select all that apply. to prepare a plan of care that suits the client's lifestyle to develop a trusting relationship with the client to prepare a plan of care for the pregnancy to assess the client's partner's sexual health to urge the client to achieve an optimal body weight
Correct response: to prepare a plan of care that suits the client's lifestyle to develop a trusting relationship with the client to prepare a plan of care for the pregnancy Explanation: When documenting a comprehensive health history while caring for a client, it is important for the nurse to prepare a care plan that suits the client's lifestyle, to develop a trusting relationship with the client, and to prepare a plan of care for the pregnancy. The nurse does not need to assess the client's partner's sexual health during the history-taking process or urge the client to achieve an optimal body weight. Achieving optimal body weight before conception helps the client to achieve a positive impact on the pregnancy
What is couplet care?
Couplet care is allowing the newborn and mother to stay in the same room after delivery.
