Lecture 4B Assessment of risk factors Flashcards
A 39-year-old primigravida woman believes that she is approximately 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; however, she tells the nurse that she is trying to cut down. Her laboratory data are within normal limits. What diagnostic technique would be useful at this time?
Ultrasound examination. [An ultrasound examination could be performed to confirm the pregnancy and to determine the gestational age of the fetus. An NST is performed to assess fetal well-being in the third trimester.]
The results of a normal or reassuring nonstress test (NST) are described as _
Reactive. (Two accelerations observed within 20 minutes. Non-reactive therefore warrants further evaluation.)
The nurse sees a woman for the first time when she is 30 weeks pregnant. The client has smoked throughout the pregnancy, and fundal height measurements now are suggestive of intrauterine growth restriction (IUGR) in the fetus. In addition to ultrasound to measure fetal size, what is another tool useful in confirming the diagnosis?
Doppler blood flow analysis. [Doppler blood flow analysis allows the examiner to study the blood flow noninvasively in the fetus and the placenta. It is a helpful tool in the management of high-risk pregnancies because of IUGR, diabetes mellitus, multiple fetuses, or preterm labor. IUGR is not an indication for performing amniocentesis.]
A 30-year-old gravida 3, para 2-0-0-2 is at 18 weeks of gestation. Which screening test should the nurse recommend be ordered for this client?
MSAFP (maternal serum alpha-fetoprotein). [This test is performed at weeks 15 to 20 of gestation; weeks 16 to 18 are ideal.]
An abnormal MSAFP suggests _ and the follow-up test is a _
Neural tube defects; targeted ultrasound for fetal anomalies.
The results of a normal or reassuring contraction stress test (CST) are described as _
Negative. (At least three contractions in a 10-minute period, with no late or significant variable decelerations. Positive therefore warrants further evaluation.)
Which clinical finding is a major use of ultrasonography in the first trimester?
Presence of maternal abnormalities. [Ultrasonography can detect certain uterine abnormalities such as bicornuate uterus, fibroids, and ovarian cysts. Amniotic fluid volume, placental location and maturity, and cervical length are not available via ultrasonography until the second or third trimester.]
