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Nursing Antepartum
Test 1 Part 1
| Question | Answer |
|---|---|
| lots of things are going on in the 1st trimester - Growth of uterus is under the influence of what hormones | estrogen and progesterone |
| 1st trimester there is an increase in what | vascularity |
| blood vessels in the 1st trimester | dilate |
| what happens to fibers in the 1st trimester | hyperplasia (production of new fibers) and hypertrophy (growth of new fibers) |
| what is developed in the uterus the 1st trimester | decidua (lining of the uterus) |
| the uterus becomes abdominal organ | 12 weeks |
| when does the height of fundus reach the highest point | week 38 |
| what is the sign called when the dr uses 2 fingers to see if the lower uterine segmant has become soft | Hegar's sign |
| where is the uterus at 20 weeks | at umbilicus |
| what happens to the position of the uterus during the 2nd and 3rd trimester | anteflexed becoming dextrorated (goes more towards the right) |
| why does the uterus move this way | to maintain a longitudinal position |
| where does the uterus reach at term | xyphoid process |
| how much does the uterus weigh at birth | 1000-1200 grams |
| what is it called when the baby drops | lightning |
| when does this usually occur | 38-40 weeks |
| what is one thing we can teach the pt to do that helps with back pain | pelvic rocking |
| what occurs throughout pregnancy to help with contractility | Braxton Hicks |
| when can braxton hicks usually be felt | 28th week of gestation |
| braxton hicks usually stop with what | walking or exercise |
| what does placental perfusion depend on | maternal blood flow |
| how of maternal blood volume in uterine vascular system | 1/6 |
| how many ml/hr of blood flow through the uterus | 500ml/hr |
| how many ml/min of 02 is consummed | 25ml/min |
| what hormone is responsible for the increase in uterine blood flow | estrogen |
| blood flow to the uterus can also decrease - this is due to 4 things - what are they | DM-low or high maternal BP-contractions of the uterus and supine position |
| what position should you NEVER place a pregnant women in | supine |
| the cervix goes thru many changes also - what happens to the feel of the cervix | it becomes softer |
| what is the sign used that uses 1 finger to touch the cervix | Goodell's sign |
| what color does the cervix become when someone is pregnant | bluish |
| what does the cervix easily do from increased vascularity | bleeds easily |
| what test can be done around 16-18 weeks to test for pregnancy that the cervix is tapped and it taps back | ballotment test |
| The vagina and vulva go under many changes during pregnancy - what happens to the vaginal mucosa | it thickens |
| what happens to connective tissue | it loosens |
| what happens to the smooth muscle | hypertrophy |
| what happens to the vaginal vault | it lenghthens |
| what is the operculum | mucus plug |
| what happens to the acidity of vaginal secretions and what does this cause | it becomes more acidic and causes more yeast infections |
| what is the sign called that checks to see if the vulva is bluish | chadwicks |
| breasts also change during pregnancy-what happens to the weight of them | they become heavy |
| what happens to the nipples and areola | they have increased pigmentation and nipples become erect |
| what happens to sebaceous glands | they become hypertrophy - women sweat more |
| what is venous congestion | bluish lines on the breasts |
| when does colostrum begin to appear | third month of pregnancy |
| where does it appear | in acini cells of the breast |
| the colostrum occurs because the body is under the influence of what hormones | luteal and placental hormones |
| the heart also goes under many changes when someone is pregnant-what happens to the positioning of the heart and what causes this | growing uterus leads to heart displacement to left and upward-PMI shift |
| what happens to the womens pulse | it usually increases 10-15 bpm |
| what may be disturbed during pregnancy in regards to cardiac | cardiac rhythms |
| bp is also changed during pregnancy - it is affected by what 3 things | anxiety, position and bp apparatus |
| what happens to BP in 2nd trimester and why | it decreases d/t vasodilation |
| what causes vessels to dilate | progesterone |
| what are the 2 pregnancy tests that can be done | blood and urine (blood can detect HCG 6 days after conception) |
| blood volume is also affected during pregnancy-beginning 10th-12th week of pregnancy how much does blood volume increase | 40-45% or 1500ml |
| when does this actually become evident | 20-24 weeks |
| when does blood volume reach it's peak | 32-34th week |
| there is also a change in the composition of the blood during pregnancy-there is an increase in production of RBC's-why is this | the baby needs more 02 |
| If a women takes an iron supplement what percentage are RBC's increased | 30-33% |
| if the women does not take an iron supplement what percentage do the RBC's increase to? | 18% - it is very important to take iron supplements but watch out for constipation |
| what happends to the womens hgb because there is an increase in RBC's | there is a decrease to 11 (norm - 12-16) |
| what happens to womens Hct | decrease to 35 (norm - 37-47) because of these changes the mother gets hemodilution and it looks as though she is anemic but it is actually a normal anemia |
| If it were infact a true anemia what would the Hgb be like/Hct | 10 or less and the Hct would be 33 or less |
| what part of blood increases in the 2nd trimester and peaks in the 3rd | granulocytes (WBC's) |
| what happens to serum cholesterol during pregnancy | it can increase to >200 |
| the number of weeks since the first day of the LMP | gestation |
| delivery that occurs prior to the end of 20 weeks gestation | abortion |
| normal duration of pregnancy-beginning of the 38th week to the end of 41st week | term |
| delivery that occurs after 20 weeks but before the completion of the 37th week of gestation | preterm |
| time between conception and the onset of labor or birth; usually used to describe the period during which a woman is pregnant; used interchangeably with prenatal | antepartum |
| time from the onset of labor until the delivery of the products of conception-infant and placenta | intrapartum |
| time from birth until the woman's body returns to an essentially prepregnancy state; | the first 6 weeks following delivery postpartum |
| any pregnancy, regardless of duration, including present pregnancy | gravida |
| a woman who has never been pregnant | nulligravida |
| a woman who has been pregnant more that once | multigravida |
| a woman who is pregnant for the first time | primigravida |
| a fetus born dead after 20 weeks of gestation | stillborn |
| the period of time from the point of viability through the neonatal period | perinatal |
| the capacity to live outside the uterus | viability |
| at what week (per NCLEX) is a baby viable | 24 weeks |
| the 1st 28 days of life | neonate |
| what are the 5 parts to the 5 digit code | G-Gravida T-Term P-Preterm A-abortions L-Living |
| symptoms that the woman experiences and reports | subjective/presumptive |
| signs perceived by the practitioner | objective/probable |
| signs perceived by the examiner and can be caused only by pregnancy | diagnostic/positive |
| which one are the following? amenorrhea | subjective |
| goodell's sign | objective |
| quickening | subjective |
| fetal heartbeat | positive |
| enlargement of abdomen | objective/probable |
| n/v | subjective/presumptive |
| visulization of fetus by ultrasound or X-ray | positive |
| braxton hicks contractions | objective/probable |
| urinary frequency | subjective/presumptive |
| breast tenderness | subjective/presumptive |
| fetal movement | objective/probable |
| chadwick's/hegar's/ballottment | objective/probable |
| uterine enlargemnet | objective/probable |
| positive pregnancy test | objective/probable |
| what happens to bp in week 1-13 (1st trimester) | stays the same |
| what happens to bp in 2nd trimester - week 14-26 | decreases-due to vasodilation from progesterone |
| what happens to bp in 3rd trimester- week 27-40 | goes back to being the same as it was in the 1st trimester |
| NOTE - if the bp is increased in the 2nd trimester what could this mean | could be an indicator for pre-eclampsia |
| what happens to coagulation during pregnancy | it increases |
| what happens to fibrinolytic activity (splitting up or dissolving of a clot) during pregnancy | it decreases |
| during pregnancy in regards to blood there is an decrease change of what but then an increase chance of what | decrease chance of bleeding but an increase chance of thrombosis |
| see chart on P 310 for iron rich foods | |
| what happens to BMR during pregnancy | it increases |
| what kind of breathing does a pregnant women do | thoracic |
| what happens to your tidal volume when pregnant | it increases (this is how much air you can breath in) |
| BMR increases by 2nd trimester and is increased by 15-20% at term | |
| progesterone increases the sensitivity of the respiratory center and this leads to what regarding tidal volume/what happens to PCO2 and bicarbonate and what happens to PH | increased tidal volume/PCO2 falls/HCO3 or bicarbonate falls/PH becomes slightly alkalotic |
| these changes in acid-base balance facilitate transport of CO2 from the fetus and facilitates O2 release from the mother to the baby | |
| with the renal system we have anatomic and functional changes - pressure is placed on renal system from enlarging uterus-what happens to the renal pelvis and ureters | they dilate |
| what happens to ureters and urethra | they lengthen |
| what happens to the womens urine flow rate | it slows down |
| what happens to the tone of the bladder and what does this mean | it decreases - this means the women can hold more urine |
| how many cc's can a pregnant womens bladder hold | around 1500 |
| renal function is best when mom is in what position and least effective when mom is in what position | lateral recumbent and least effective when she lies supine |
| what 2 things are found in a womens urine that are okay only if trace or +1 | glucose and protein |
| changes that occur with the skin are hyperpigmentation-women gets the face mask-what is another name for this | chlosoma |
| what happens to hair, nail, sweat and sebaceous glands | they all increase |
| what is the fancy word for stretch marks | striae gravidarum |
| what happens to the rectus abdominis muscles when pregnant | they separate |
| what are 2 other things a women has in regards to musculoskeletal system when pregnant | lordosis and waddling gate |
| in regards to appetite-what is it like sometimes in 1st trimester | decreased |
| what is appetite usually like in 2nd trimester | increased |
| know what PICA is | |
| what are 2 things that can happen with the pregnant womens mouth during pregnancy | pregnancy gingivitis (she may bleed a lot from gums) and ptyalism (excessive salivation) |
| as a result of increase progesterone what happens to the tone of smooth muscles in the intestines | there is a decrease in the tone |
| the increase in progesterone also results in an increase in what absorbtion | water |
| in regards to the gall bladder during pregnancy what happens | Increased emptying time and thickening of bile favors development of gallstones during pregnancy |
| what do elevated levels of estrogen and progesterone suppress the secretion of | elevated levels of estrogen and progesterone suppress secretion of follicle-stimulating hormone and luteinizing hormone by the anterior pituitary |
| after inplantation what produces Hcg until the placenta takes over | the the ovum and chorionic villi |
| what happens to Serum prolactin – produced by anterior pituitary in the 1st trimester | it starts to rise |
| what is it responsible for | for initial lactation |
| what does oxytocin do? | Oxytocin also stimulates the let-down after birth in response to the infant sucking. |
| what happens to the thyroid gland and what is this due to | Increases in size- increased levels due to increased level of estrogen |
| what does the parathyroid gland control | Controls CA++ and Magnesium metabolism- |
| what does pregnancy induce in regards to the parathyroid hormone and why | pregnancy induces a slight hyperparathyroidism due to increased fetal needs and for CA++ and Vitamin D. |
| if your LMP was July 10th what is your due date? explain how you figure it out | you take last day of LMP minus 3 months and add 7 days - due date is April 17th |
| how often do you go to the drs. up until your 26th week | every month |
| how often do you go to the drs 27-36 weeks | every 2 weeks |
| how often do you go to the drs. 37 weeks up to delivery | every week |
| what is the 1 expense in OB | preterm delivery |
| can you test a mother for drugs without her consent? what about her baby | no-yes you can test the baby |
| what does caffine and smoking do to a pregnant womens blood vessels | vasoconstricts |
| what is given to the mother if her baby is RH - and she is RH + | rhogam is given at 28 weeks |
| what dx lab tests are done 8-18 weeks | rheubella, group and type, sickle cell, vanerial disease |
| what ratio should rheubella be | > 1:8 (non-immune) |
| what is the ratio like when rheubella is immune | 1:4 |
| what dx lab tests are done 24-28 weeks | DM and RH factor |
| how do they do the 1hr glucose test | pt drinks 50g glucola then 1hr later blood is drawn - if it is <140 then that is good |
| what happens if the blood sugar is 140 or greater | have to do the 3hr glucose test |
| how is the 3hr glucose test done | same as the 1hr but instead of waiting 1hr you wait 3hrs to draw blood |
| what happens if you fail the 3hr glucose test | have to do a FBS (fasting blood sugar) |
| how is the FBS test done | pt has to drink 100g of glucola then blood is drawn after 1hr, 2hr and 3hr - you have to get 2 elevations in order for the pt to be considered gestational diabetes |
| what is EDC | estimated date of confinement |
| NOTE: The amnt of weight gain by the mother during pregnancy has a direct impact on the outcome of the pregnancy | inadequate weight gain has an increased risk of delivering a baby with what intrauterine growth restriction (IUGR) |
| greater weight gain during pregnancy increases the likelihood of what (5) | Macrosomia (big baby) - C-section-trauma-infant death and congenital defects |
| when is a BMI usually checked for the mother | at the 1st pre-natal visit |
| BMI is classified into 4 different catorgories - what is the BMI for someone underweight | less than 19.8 |
| what is the BMI for someone considered normal | 19.8 - 26 |
| what is the BMI for someone who is considered obese | 26-29 |
| what is the BMI for someone who is considered obese | above 29 |
| weight gain during pregnancy - if someone has a low BMI how much weight is recommended for gain | 28-40lbs |
| if someone has a normal BMI what is considered a good weight gain | 25-35lbs |
| if someone has a high BMI what is the recommended weight gain | 15-25lbs |
| What is the rule of thumb for a womens weight gain during pregnancy | she should gain 2-4lbs in the 1st trimester and then 1lb a week thereafter |
| during the 1st and 2nd trimester growth takes place primarily in what tissue | maternal tissue |
| during the 3rd trimester growth takes place primarily in what tissue | fetal tissues |
| components of weight gain during pregnancy-amniotic fluid is how much | 2-2lbs |
| breast tissue is how much | 1.1-2.2lbs |
| extra blood is how much | 4.4 - 5.5lbs |
| extra "stores of largely fat" is how much | 4.4 - 6.6lbs |
| extra tissue is how much | 3.3 - 5.5lbs |
| fetus is how much of the weight gain | 6.6 - 8.3 lbs |
| placenta is how much of the weight gain | 2.2 - 2.42 lbs |
| for labor to be considered pre-term cervical changes and uterine contraction occur between what weeks of pregnancy | 20-36 (anything before 20 weeks is considered abortion) |
| for birth to be considered pre-term the birth occurs before the completion of what week | 37th |
| when is a birth weight considered low birth weight | when the weight falls within the 10th percentile |
| what are some demographic risks for pre-term labor | non-white - <17 yrs age - >35 yrs of age - unmarried |
| what are some biophysical risks for preterm labor | previous hx of preterm delivery or preterm labor - increased gravida |
| **NOTE that previous hx of preterm delivery or preterm labor is the 1 reason for preterm labor | |
| what are some behavioral-psychosocial risks for preterm labor | smoking-poor nutrition-drug use-long car commute to work (weight is on the cervix) |
| what are some s/s of preterm labor? (3) | uterine activity (may be painless) - discomfort - vaginal discharge (may be bloody show) |
| what are some things we can teach mom about what she should watch out for as s/s of preterm labor | contractions menstrual-like cramps that come and go or don’t go away pelvic-pressure-feels like the baby is pushing down that comes and goes low, dull backache-comes and goes or doesn’t go away abdominal cramping-with or without diarrhea |
| what are 2 warning signs that a mother should be aware of | Increase or change in vaginal discharge; PROM (premature rupture of membranes) |
| what is a mother susceptible to when her membranes rupture | infection |
| what are 2 things we can tell mom to do if she is having preterm contractions | Drink two or three glasses of water or juice Lie down on her left side for an hour |
| -when should mom call the doctor or clinic immediately | If signs do not go away or if fluid begins to leak from vagina |
| what is key for preterm labor | early recognition and dx |
| what are 5 lifestyle modifications a women must do if she wants to stop preterm labor | she must stop the following; Sexual activity Long trips Heavy lifting or carrying Climbing stairs Hard physical work |
| how do you know if baby is infected when in utero | the smell and also fetal HR is increased |
| bed rest is another way we can stop preterm labor but there are 3 adverse effects of this - what are they | Maternal physical effects Maternal psychosocial effects Effects on support system |
| what is something we can do for mom while she stays at home in regards to monitering | home uterine activity monitoring |
| what are the 5 meds associated with preterm labor/tocolytics | Bethamethasone, Terbutaline, Magnesium Sulfate, Naproxen, Nifedipine |
| what does Tocolytics mean | breaks up contractions |
| which med do we give to increase production of surfactant in fetal lungs | Bethamethasone |
| which med is a beta 2 adrenergic agonist and relaxes smooth muscle and inhibits uterine contractility in preterm labor | Terbutaline |
| with Terbutaline what is a s/e for both mother and baby | tachycardia |
| which med is a CNS depressent | Magnesium sulfate |
| which med is used for preterm labor and pre-eclampsia | Magnesium sulfate |
| what is something BIG we need to watch for when someone is on magnesium sulfate | abscence of deep tendon reflexes |
| what is another thing we need to watch for as a s/e when someone is on magnesium sulfate | urine output |
| what is the antidote for magnesium sulfate | calcium gluconate |
| what med is used as maintenance following administratin of other tocolytics to prevent the return of uterine contractions | Nifedipine (calcium chanel blocker) |
| which med is NEVER used as a long term med | Naproxen (Prostaglandin synthetase inhibitor) |
| when is a kick test usually done | 24-28 weeks |
| how many fetal movements do we look for in 1 hr | 3 or more in 1 hr |
| if the mother does not feel 3 or more movements in 1 hr what test is usually done right then | a NST (non stress test) |
| what are we looking for with a NST | looking for an increasein fetal h/r in relation to fetal movement - the infants h/r should increase w/movement |
| what is it called if you have an increase in h/r with fetal movement | a reactive strip-this is good |
| what is it called if you have no increase in h/r when the baby moves | a non-reactive strip - this is bad |
| what is ordered if a pts NST is read Non-reactive | CST (contraction stress test) |
| what is given to mother if she has a CST | a tiny bit of pitocin |
| what is another thing that can be done to irritate the uterus | nipple stimilation |
| we want the CST to show how many contractions in 10 mins and without what | 3 contractions in 10 minutes without late decelerations |
| what do you want the CST to be read as | negative |
| what do you want baby's h/r to be like throughout the contractions | steady |
| what is another test that can be done in leiu of CST | biophysical profile |
| what test is done to measure fetal age | ultrasound |
| what test is done to determine fetal lung maturity and to determine if the fetus can be deliver | L/S ratio (Lecithin/Sphingomyelin) |
| when is a L/S ratio test usually done | around the 35th week and beyond |
| what do they like to see the ratio at for baby to be delivered | 2:1 (greater than 2) |
| what test is used as a screening tool for neural tube defects | AFT (Alpha-fetoprotein) |
| when is an AFP test usually done | between 15-22 weeks |
| what test is done to detect fetal chromosomal abnormalities where a small amnt of tissue is removed from the feal portion of the placenta | CVS - chorionic Villi Sampling |
| chills and fever are indicitive of what during pregnancy | infection |
| what can headaches during pregnancy indicate | severe preeclampsia |
| abdominal pain in the epigastric area may be due to what and may indicate what is impending | edema of the liver and may indicate convulsion is impending |
| what does a rigid, board-like abdomen during the last trimester usually indicate | abruptio placenta |
| what does blurred vision and visual disturbances indicate | elevated blood pressure or a complication with severe preeclampsia |
| what could early bleeding indicate (4) | miscarriage, abortion, ectopic pregnancy or hydatiform mole |
| bleeding in the last trimester may be indicative of what (2) | placenta previa or abruptio placenta |
| what is swelling especially in the periorbital and digital areas indicative of | mild preeclampsia |
| A nurse is describing the process of fetal circulation to a client during a prenatal visit. The nurse accurately tells the client that fetal circulation consists of: | Two umbilical arteries and one umbilical vein |
| A nursing instructor is conducting lecture and is reviewing the functions of the female reproductive system. She asks Mark to describe the follicle-stimulating hormone (FSH) and the luteinizing hormone (LH). Mark accurately responds by stating that: | FSH and LH are released from the anterior pituitary gland. |
| During a prenatal visit at 38 weeks, a nurse assesses the fetal heart rate. The nurse determines that the fetal heart rate is normal if it is? | 110-160 BPM |
| A client who is pregnant with twins. The client has a healthy 5-year old child that was delivered at 37 weeks and tells the nurse that she doesn’t have any history of abortion or fetal demise. The nurse would document the GTPAL for this client as: | G2 T0 P1 A0 L1 |
| A nurse is reviewing the record of a client who has just been told that a pregnancy test is positive. The physician has documented the presence of a Goodell’s sign. The nurse determines this sign indicates: | A softening of the cervix |
| A nursing instructor asks a nursing student who is preparing to assist with the assessment of a pregnant client to describe the process of quickening. Which of the following statements if made by the student indicates an understanding of this term? | “It is the fetal movement that is felt by the mother.” |
| A nurse midwife is performing an assessment of a pregnant client and is assessing the client for the presence of ballottement. Which of the following would the nurse implement to test for the presence of ballottement? | Initiating a gentle upward tap on the cervix |
| A nurse is assisting in performing an assessment on a client who suspects that she is pregnant and is checking the client for probable signs of pregnancy. | Uterine enlargement, Hegar’s sign (softening/thinning of uterine segment), Goodell’s sign (softening of the cervix), Chadwick’s sign (bluish coloration), ballottement (rebounding of the fetus), Braxton Hicks and positive pregnancy test measuring hCG |
| A pregnant client calls the clinic and tells a nurse that she is experiencing leg cramps and is awakened by the cramps at night. To provide relief from the leg cramps, the nurse tells the client to: | Dorsiflexion of the foot while extending the knee stretches the affected muscle, prevents the muscle from contracting, and stops the cramping. |
| A nurse is providing instructions to a client in the first trimester of pregnancy regarding measures to assist in reducing breast tenderness. The nurse tells the client to: | Wash the breasts with warm water and keep them dry |
| A pregnant client in the last trimester has been admitted to the hospital with a diagnosis of severe preeclampsia. A nurse monitors for complications associated with the diagnosis and assesses the client for: | Any bleeding, such as in the gums, petechiae, and purpura |
| A nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes. Which statement if made by the client indicates a need for further education? | “I need to avoid exercise because of the negative effects of insulin production.” |
| A primagravida is receiving magnesium sulfate for the treatment of pregnancy induced hypertension (PIH). The nurse who is caring for the client is performing assessments every 30 minutes. What assessment finding would be of most concern to the nurse? | Respiratory rate of 10 BPM |
| A nurse is caring for a pregnant client with Preeclampsia. The nurse prepares a plan of care for the client and documents in the plan that if the client progresses from Preeclampsia to eclampsia, the nurse’s first action is to: | Clean and maintain an open airway |
| A nurse is monitoring a pregnant client with pregnancy induced hypertension who is at risk for Preeclampsia. The nurse checks the client for which specific signs of Preeclampsia... | The three classic signs of preeclampsia are hypertension, generalized edema, and protenuria. Increased respirations are not a sign of preeclampsia. |
| A pregnant client is receiving magnesium sulfate for the management of preeclampsia. A nurse determines the client is experiencing toxicity from the medication if which of the following is noted on assessment? | Respirations of 10 per minute |
| A woman with preeclampsia is receiving magnesium sulfate. The nurse assigned to care for the client determines that the magnesium therapy is effective if: | Seizures do not occur |
| In the 12th week of gestation, a client completely expels the products of conception. Because the client is Rh negative, the nurse must administer Rhogam when? | Admister RhoGAM within 72 hours if not sensitized |
| In a lecture on sexual functioning, the nurse plans to include the fact that ovulation occurs when the: | Blood level of LH is too high |
| he chief function of progesterone is the: | Progesterone stimulates differentiation of the endometrium into a secretory type of tissue. |
| The developing cells are called a fetus from the: | In the first 7-14 days the ovum is known as a blastocyst; it is called an embryo until the eighth week; the developing cells are then called a fetus until birth. |
| After the first four months of pregnancy, the chief source of estrogen and progesterone is the: | When placental formation is complete, around the 16th week of pregnancy; it produces estrogen and progesterone. |
| The nurse recognizes that an expected change in the hematologic system that occurs during the 2nd trimester of pregnancy is: | The blood volume increases by approximately 40-50% during pregnancy. The peak blood volume occurs between 30 and 34 weeks of gestation. The hematocrit decreases as a result of the increased blood volume. |
| The nurse is aware than an adaptation of pregnancy is an increased blood supply to the pelvic region that results in a purplish discoloration of the vaginal mucosa, which is known as: | Chadwick’s sign |
| Pt has a two year old son born at 40 weeks, a 5 year old daughter born at 38 weeks, and 7 year old twin daughters born at 35 weeks. She had a spontaneous abortion 3 years ago at 10 weeks. Using the GTPAL format: | 5 pregnancies; 2 term births; twins count as 1; 1 abortion; 4 living children |
| An expected cardiopulmonary adaptation experienced by most pregnant women is: | Shortness of breath on exertion |
| During a prenatal examination, the nurse draws blood from a young Rh negative client and explain that an indirect Coombs test will be performed to predict whether the fetus is at risk for: | Acute hemolytic disease |
| When involved in prenatal teaching, the nurse should advise the clients that an increase in vaginal secretions during pregnancy is called leukorrhea and is caused by increased: | The increase of estrogen during pregnancy causes hyperplasia of the vaginal mucosa, which leads to increased production of mucus by the endocervical glands. |
| A 26-year old multigravida is 14 weeks’ pregnant and is scheduled for an alpha-fetoprotein test. She asks the nurse, “What does the alpha-fetoprotein test indicate?” The nurse bases a response on the knowledge that this test can detect: | The alpha-fetoprotein test detects neural tube defects and Down syndrome. |
| The pituitary hormone that stimulates the secretion of milk from the mammary glands is: | Prolactin is the hormone from the anterior pituitary gland that stimulates mammary gland secretion. Oxytocin, a posterior pituitary hormone, stimulates the uterine musculature to contract and causes the “let down” reflex. |
| A 21-year old client, 6 weeks’ pregnant is diagnosed with hyperemesis gravidarum. This excessive vomiting during pregnancy will often result in? | Excessive vomiting in clients with hyperemesis gravidarum often causes weight loss and fluid, electrolyte, and acid-base imbalances. |
| Clients with gestational diabetes are usually managed by which of the following therapies? | Clients with gestational diabetes are usually managed by diet alone to control their glucose intolerance. |
| The antagonist for magnesium sulfate should be readily available to any client receiving IV magnesium. Which of the following drugs is the antidote for magnesium toxicity? | Calcium gluconate is the antidote for magnesium toxicity. Ten ml of 10% calcium gluconate is given IV push over 3-5 minutes. |
| Which of the following answers best describes the stage of pregnancy in which maternal and fetal blood are exchanged? | Blood exchange only occurs in complications and some medical procedures accidentally. |
| Gravida refers to which of the following descriptions? | Gravida refers to the number of times a female has been pregnant, regardless of pregnancy outcome or the number of neonates delivered. |
| A pregnant woman at 32 weeks’ gestation complains of feeling dizzy and lightheaded while her fundal height is being measured. Her skin is pale and moist. The nurse’s initial response would be to: | Turn the woman on her side. |
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