Ch. 20 Reproductive System Flashcards
The nurse is preparing to teach a prenatal class about fetal circulation. Which statements should be included in the teaching plan? Select all that apply
- The ductus arteriosus allows blood to bypass the fetal lungs.
- One vein carries oxygenated blood form the placenta to the fetus.
- The normal fetal heart tone range is 140 to 160 beats per minute in early pregnancy.
- Two arteries carry deoxygenated blood and waste products away from the fetus to the placenta.
- Two veins carry blood that is high in carbon dioxide and other waste products away from the fetus to the placenta
1, 2, 4
Rationale
The ductus arteriosus is a unique fetal circulation structure that allows the nonfunctioning lungs to receive only a minimal amount of oxygenated blood for tissue maintenance.
Oxygenated blood is transported to the fetus by one umbilical vein.
The normal fetal heart tone range is considered to be 110 to 160 beats per minute.
Arteries carry deoxygenated blood and waste products from the fetus, and the umbilical vein carries oxygenated blood and provides oxygen and nutrients to the fetus.
Blood pumped by the embryo’s heart leaves the embryo through the two umbilical arteries.
The nursing instructor asks the student to describe fetal circulation, specifically the ductus venosus. Which statement by the student indicates an understanding of the ductus venosus?
- It connects the pulmonary artery to the aorta.
- It is an opening between the right and left atria.
- It connects the umbilical vein to the inferior vena cava.
- It connects the umbilical artery to the inferior vena cava
3.
Rationale
The ductus venosus connects the umbilical vein to the inferior vena cava.
The foramen ovale is a temporary opening between the right and left atria.
The ductus arteriosus joins the aorta and the pulmonary artery.
The nurse is performing an assessment on a client who is at 38 weeks’ gestation and notes that the fetal heart rate (FHR) is 174 beats/minute. On the basis of this finding, what is the priority nursing action?
- Document the finding.
- Check the mother’s heart rate.
- Notify the HCP.
- Tell the client that the fetal heart rate is normal.
3.
Rationale:
The FHR depends on gestational age and ranges from 160-170 beats/minute in the 1st trimester, but slows with fetal growth to 110-160 bpm near or at term.
At or near term, if the FHR is less than 110 bpm or more than 160 bpm with the uterus at rest, the fetus may be in distress.
Because the FHR is increased from the reference range, the nurse should notify the HCP. Options 2 and 4 are inappropriate actions based on the information in question. Although the nurse documents the findings, based on the information in question, the HCP needs to be notified.
The nurse is conducting a prenatal class on the female reproductive system. When a client in the class asks why the fertilized ovum stays in the fallopian tube for 3 days, what is the nurse’s best response?
- “It promotes the fertilized ovum’s chances of survival.”
- “It promotes the fertilized ovum’s exposure to estrogen and progesterone.”
- “It promotes the fertilized ovum’s normal implantation in the top portion of the uterus.”
- “It promotes the fertilized ovum’s exposure to luteinizing hormone and follicle-stimulating hormone.”
1
Rationale:
The tubal isthmus remains contracted until 3 days after conception to allow the fertilized ovum to develop within the tube. This initial growth of the fertilized ovum promotes its normal implantation in the fundal portion of the uterine corpus.
Estrogen is a hormone produced by the ovarian follicles, corpus luteum, adrenal cortex, and placenta during pregnancy.
Progesterone is a hormone secreted by the corpus luteum of the ovary, adrenal glands, and placenta during pregnancy.
Luteinizing hormone and follicle-stimulating hormone are excreted by the anterior pituitary gland.
The survival of the fertilized ovum does not depend on it staying in the fallopian tube for 3 days.
A couple comes to the family planning clinic and asks about sterilization procedures. Which question by the nurse should determine whether this method of family planning would be most appropriate?
- “Did you ever had surgery?”
- “Do you plan to have any other children?”
- “Do either of you have diabetes mellitus?”
- “Do either of you have problems with high blood pressure?”
2.
Rationale:
Sterilization is a method of contraception for couples who have completed their families. It should be considered a permanent end to fertility because reversal surgery is not always successful. The nurse would ask the couple about their plans for having children in the future.
Options 1,3, and 4 are unrelated to this procedure.
The nurse should make which statement to a pregnant client found to have a gynecoid pelvis?
- “Your type of pelvis has a narrow pubic arch.”
- “Your type of pelvis is the most favorable for labor and birth.”
- “Your type of pelvis is a wide pelvis, but it has a short diameter.”
- “You will need a cesarean section because this type of pelvis is not favorable for a vaginal delivery.”
2.
Rationale:
A gynecoid pelvis is a normal female pelvis and is the most favorable for successful labor and birth.
An android pelvis (resembling a male pelvis) would be unfavorable for labor because of the narrow pelvic planes.
An anthropoid has an outlet that is adequate, with a normal or moderately narrow pubic arch.
A platypelloid pelvis (flat pelvis) has a wide transverse diameter, but the anteroposterior diameter is short, making the outlet inadequate.
Which purposes of placental functioning should the nurse include in a prenatal class? Select all that apply.
- It cushions and protects the baby.
- It maintains the temperature of the baby.
- It is the way the baby gets food and oxygen.
- It prevents all antibodies and viruses from passing to the baby.
- It provides an exchange of nutrients and waste products between the mother and developing fetus.
3, 4
Rationale:
The placenta provides an exchange of oxygen, nutrients, and waste products between the mother and fetus.
The amnioitc fluid surrounds, cushions, and protects the fetus and maintains the body temperature of the fetus.
Nutrients, medications, antibodies, and viruses can pass through the placenta.
