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Review Units 3&4

A woman has had her molar pregnancy evacuated and is prepared for discharge. The nurse should make certain that the client understands that it is essential that she: Not become pregnant for at least a year
A woman is 30 weeks pregnant. She has come to the hospital because her membranes have ruptured. Based solely on this information, which of the following nursing diagnoses could be made for her (not her fetus) Risk for infection
In order to determine if a client has ectopic pregnancy which of the following procedures would be performed Pelvic exam and ultrasound
a woman with PIH: BP158/100, uninary output 50ml/hour lungs clear to auscultation, urine dip stick 1 plus protein, edema of the feed and ankles. On the next hourly assessment which of the following would be a sign that her PIH is becoming more severe? Urine dipstick 3 plus protein & Urinary output 20ml/hour
What is the cause of epigastric pain that sometimes occurs with severe PIH? Liver distension
A 26 year old multipara is 24 weeks pregnant. Her previous births include two LGA and one unexplained still birth. With this history, which of the following assessments should be made to identify her probable pre-gestational problem Blood glucose
What is the most effective factor in reducing the risk of congenital anomalies in the fetus of a diabetic mother Strict control of blood glucose before conception and in the early weeks of pregnancy
The screening test done to determine if a pregnant woman has been sensitized to the Rh factor is: Indirect coombs' test
A pregnant woman is married to an IV Drug user, She has a negative HIV screening test just after missing her menstrual period. Which of the following data would indicate that she needs to be retested for HIV unusual fatigue and recurring Candida Vaginitis
Which of the following is true regarding Cytomegalovirus Cytomegalovirus is the least prevalent of the TORCH
Ultrasound is especially useful in pregnancy because it: Causes minimal pain to the mother, Has been found to have no fetal risk, is considered a noninvasive procedure
The Naegle's rule for determining EDC is: From the clients first day of her last menstrual period subtract 3 months and add 7 days.
A woman is 32 weeks pregnant. Her fundal height is measuring 26 cm. The client is scheduled for a series of utrasounds every two weeks. The main purpose of this is: Evaluate fetal growth, Grade the placenta
What is the purpose of Doppler velocimentry? Access placental function by studying blood flow changes.
A client is having an amniocentesis. Just prior to having the procedure she has an ultrasound done. The purpose of the ultrasound at that time is to: Locate the placenta and fetus
Which of the following test results on the amniotic fluid would indicate that the fetus is at least 36 weeks gestation? The presence of phosphatidylgycerol(PG) and L/S in the fluid.
A client informs the nurse that she had a male child on her due date, one spontaneous miscarriage at 8 weeks, one female child at 33 weeks. She has 2 children at home this client is currently pregnant, according to TPAL what is her Gravida and Parity G 4 P1112
The client has a fundal height of 28 cm. The nurse looks at her pre-natal record and determines that the client is 27 5/7 weeks. What should the informed nurse do with this information Tell the client her fetus is growing appropriately for gestational age
A client is a gravid Parity 0352. As a professional nurse you identify that the client is at high risk for what possible complication with her current pregnancy High risk for miscarriage and preterm delivery
All pregnant woman have glucose tolerance test. What value is considered normal less than 140
A client is 20 weeks pregnant and her weight is 153 pounds. At her 24 week appointment what should her weight be? 157 pounds
What tests are used to determine SROM? (Spontaneous rupture of the membranes) Nitrazine test & Ferning
What symptoms are expected side effects of Magnesium Sulfate? Pulmonary edema & Lethargic and flushed hot feeling.
What client should receive Rhogam Rh negative mother and Rh positive baby
Trisomy21 Low level of alpha fetoprotein
Neuraltube High level of alpha fetoprotein
progesterone causes the blood pressure to fall slightly in the second trimester
Naegle's The rule from the first day of the LMP minus 3months plus 7days
sonograms reason done is to evaluate fetal growth
Fundal height Done from the symphysis to the top of the urerus
preterm after 20 weeks but before 37 weeks
quickening occurs around 16-20 weeks
Risk What factors age, being a smoker, low income and weight under 100 pounds put the pregnant woman at.
Pound The woman should gain 1-5 pounds in the first trimester and this amount per week in the second and third trimester
ferning the most accurate test that checks amniotic fluid
Pica eating non-nutritional substances.
incomplete The type of abortion that expells part of the products of conception. Has Cervical Dialation
Gravida The number of times pregnant.
Parity The number of viable infants delivered.
Nitrazine A test done first to check for ROM (litmus test) and may be followed by looking under the microscope (ferning).
decidua Endometrium called after implantation.
Protein pregnancy causes 20% increase, up to 60 grams/day.
Vegan Eats no animal products so requires special diet consults.
Carbohydrates The primary source of energy
HELLP Multiple Organ Failure Syndrome, Hemolysis (breakdown of RBCs), Elevated Liver enzymes, Low Platelets (below 100,000)
HIV Take antiretroviral drug therapy, and Western Blot and ElISA diagnosis
Prenatal Visits every 4 weeks-till 28 weeks, every 2 weeks-28-36 weeks, every week-36-Birth
16-20 Weeks Labs Maternal Serum Fetal Protien/alpha fetoprotein (up is tubal, down is Downs), Ultrasound
28 weeks Labs H&H (hemoglobin & Hemocrite), 1 hour GTT (sugars 130-140), Rohgam (direct coombs-Baby & indirect coombs-mom)
36 week Labs H&H (hemoglobin and Hemocrite), GBS (Group B Strep)
1st Sign of Pregnancy Tender Breasts
3rd Trimester need the most calcium, phosphorus, and iron
Vitamin A can be toxic in excess
Hyperflexia and Clonus are signs of PIH
Positive Oxytocin Test Late decelerations with more than 50% of the contractions (bad)
Nonstress Test Assess fetal wellbeing (how well baby is tolerating 15 beats for 15 seconds within 20 mins=Reactive)
Periodic Happen with contractions
Contraction Stress Test Can fetus tolerate labor, (negative-no decelerations, positive-late decelerations 50%)
L/S Lungs maturity level, achieved at 35 weeks
PG Fetal Lung Maturity has been achieved
Liver distention causes Epigastric Pain
Herpes Simplex Virus Primary transmission very teratogenic to fetus
No increase in Carbohydrates in which trimester 1st Trimester
Side Effects of Magnesium Sulfate (MAGSO4) Lethargy, sweating, warmth, flushing, nasal congestion, N/V, constipation, visual blurring, HA, slurred speech (fetus is lethargy and hypotonia(low muscle tone))
Signs of toxic levels of Magnesium Sulfate Magnesium levels (reduced by Calcium gluconate), RR of less than 10, Reflexes, urine output
Hyperemesis Gravidarum increases in hCG causes excessive vomiting
Placenta previa implanted low on the uterine wall, may cover the cervical OS(decreased blood to the placenta) Bright Red bleeding
Abruptio placentae Detachment of all or part of placenta, hemorrhage can be apparent or concealled. (fetal hypoxia)Dark Red Bleeding
Threatened Abortion No cervial dialation, bleeding and cramping
Missed Abortion Pregnancy retained in uterus for 8 weeks or longer, brown discharge and negative pregnancy test
Preeclampsia 160/110, Proteinuria 1+ or greater (increase protien in diet), decreased renal perfusion, (watch drop in urinary output), Edema (dependent & hands & face), decreased placenta perfusion (fetus SGA)
what is the rationale for measuring deep tendon relexes and clonus on a woman with preeclampsia it indicates central nervous system irritability
maternal measurements should the nurse obtain on a client who is receiving magnesium sulfate? Respirations, Blood Pressure, Urinary Output, patellar tendon reflex
Created by: wfawcett