chapter 13-maternal and fetus risk factors Flashcards
A woman arrives at the clinic seeking confirmation that she is pregnant. The following information is obtained: She is 24 years old with a body mass index (BMI) of 17.5. She indicates that she has used cocaine “several times” during the past year and drinks alcohol occasionally. Her blood pressure (BP) is 108/70 mm Hg, her pulse rate is 72 beats/min, and her respiratory rate is 16 breaths/min. The family history is positive for diabetes mellitus and cancer. Her sister recently gave birth to an infant with a neural tube defect (NTD). Which characteristics place the woman in a high risk category?
a. Blood pressure, age, BMI
b. Drug and alcohol use, age, family history
c. Family history, blood pressure, respiratory rate
d. Family history, BMI, drug and alcohol use
D
A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although she has had irregular menstrual periods all her life. She has a history of smoking approximately one pack of cigarettes a day, but she tells you that she is trying to cut down. Her laboratory data are within normal limits. What diagnostic technique could be used with this pregnant woman at this time?
a. Ultrasound examination
b. Maternal serum alpha-fetoprotein screening (MSAFP)
c. Amniocentesis
d. Nonstress test (NST)
A
The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has smoked throughout the pregnancy, and her fundal height measurements now are suggestive of growth restriction in the fetus. In addition to ultrasound to measure fetal size, what would be another tool that is useful in confirming the diagnosis?
a. Doppler blood flow analysis
b. Contraction stress test (CST)
c. Amniocentesis
d. Daily fetal movement counts
A
A 41-week pregnant multigravida presents in the labour and delivery unit after a nonstress test indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool would yield more detailed information about the fetus?
a. Ultrasound for fetal anomalies
b. Biophysical profile (BPP)
c. Maternal serum alpha-fetoprotein screening (MSAFP)
d. Percutaneous umbilical blood sampling (PUBS)
B
At 35 weeks of pregnancy, a woman experiences preterm labour. Although tocolytics are administered and she is placed on bedrest, she continues to experience regular uterine contractions, and her cervix is beginning to dilate and efface. What would be an important test for fetal well-being at this time?
a. Percutaneous umbilical blood sampling (PUBS)
b. Ultrasound for fetal size
c. Amniocentesis for fetal lung maturity
d. Nonstress test
C
A 40-year-old woman is 10 weeks pregnant. Which diagnostic tool would be appropriate to suggest to her at this time?
a. Biophysical profile
b. Amniocentesis
c. Maternal serum alpha-fetoprotein (MSAFP)
d. Transvaginal ultrasound
D
A maternal serum alpha-fetoprotein (AFP) test indicates an elevated level. It is repeated and again is reported as higher than normal. What would be the next step in the assessment sequence to determine the well-being of the fetus?
a. Percutaneous umbilical blood sampling (PUBS)
b. Ultrasound for fetal anomalies
c. Biophysical profile (BPP) for fetal well-being
d. Amniocentesis for genetic anomalies
B
A patient asks her nurse, “My doctor told me that he is concerned about the grade of my placenta because I am overdue. What does that mean?” What is the basis for the nurse’s response?
a. The placenta is given a score that indicates the amount of calcium deposits it has. The more calcium deposits, the higher the grade.
b. Grading is only done when the placenta isn’t working properly.
c. An amniocentesis will need to be done now to detect if the woman has any placental damage.
d. There is no need to worry as most pregnant women have their placenta graded.
A
A woman is undergoing a nipple-stimulated contraction stress test (CST). She is having contractions that occur every 3 minutes. The fetal heart rate (FHR) has a baseline of approximately 120 beats/min, without any decelerations. How would the nurse document the interpretation of this test?
a. Negative
b. Positive
c. Satisfactory
d. Unsatisfactory
A
Which is true?
a. More than 20% of pregnancies meet the definition of high risk to either the mother or the infant.
b. The chief factor in high-risk pregnancies is the number of women who have no access to prenatal care.
c. High-risk pregnancy status extends from first confirmation of pregnancy to birth.
d. High-risk pregnancy is less critical a medical concern because of the reduction in family size and the decrease in unwanted pregnancies.
B
What should the nurse be aware of when assisting expectant mothers to assess their daily fetal movement counts?
a. Alcohol or cigarette smoke can irritate the fetus into greater activity.
b. “Kick counts” should be taken every half hour and averaged every 6 hours, with every other 6-hour stretch off.
c. The fetal alarm signal should go off when fetal movements continue non-stop for 24 hours.
d. If six movements are not felt in 2 hours, further evaluation is required.
D
In comparing the abdominal and transvaginal methods of ultrasound examination, what should the nurse explain to the patient?
a. Both require the woman to have a full bladder.
b. The abdominal examination is more useful in the first trimester.
c. Initially, the transvaginal examination can be painful.
d. The transvaginal examination allows pelvic anatomy to be evaluated in greater detail.
D
In the first trimester, what information can be gained via ultrasonography?
a. Amniotic fluid volume
b. Nuchal translucency
c. Placental location and maturity
d. Cervical length
B
What should the nurse be aware of in relation to the biophysical profile (BPP)?
a. It’s an accurate indicator of fetal well-being.
b. It’s a compilation of health risk factors of the mother during the later stages of pregnancy.
c. It consists of a Doppler blood flow analysis and an amniotic fluid index.
d. It involves an invasive form of ultrasonic examination.
A
What should the nurse be aware of with regard to amniocentesis?
a. Because of new imaging techniques, it is now possible in the first trimester.
b. Despite the use of ultrasonography, complications still occur in the mother or infant in 5 to 10% of cases.
c. It allows accurate assessment of fetal lung maturity late in pregnancy.
d. It is only reliable in the third trimester.
C
