MATERNAL & NEONATAL Flashcards
An antenatal G2, T1, P0, L1 client is discussing her postpartum plans for birth control with her HCP. In analyzing the available choices, which has the greatest impact on her birth control options? A/ Satisfaction with prior methods B/ Preference of sexual partner C/ Breast or Bottle feeding plan D/ Desire for another child in 2 years
C/ Breast or bottle feeding is the greatest factor influencing postpartum birth control methods.
Most contraceptives should not be started until breast milk production is well established which can take up to 4-6 weeks.
Low-dose contraceptives may be the alternative choice
Which of the following information would be important to include in the teaching plans for a client who wants more information on ovulation and fertility management?
A/ The ovum survives for 96 hours after ovulation, making conception possible during this time
B/ The basal body temperature falls at least 0.2 F after ovulation has occurred.
C/ Ovulation usually occurs on day 14, plus or minus 2 days, before the start of the next menstrual cycle.
D/ Most women can tell they have ovulated because of severe pain and thick-scant cervical mucous
C/ When ovulation occurs. Typically on the 14th day before the start of the next menstrual cycle, plus or minus 2 days.
The ovum typically only survives 12-24 hours after ovulation, during which time conception is possible.
The Basal Body temp rises at least 0.5 F and up to 1 F, NOT 0.2 F
Although some women may feel pelvic discomfort during ovulation, severe or unusual pain is rare.
Which instructions about activities during menstruation would the nurse include when counseling and adolescent who has begun menstruating?
A/ Take a mild analgesic if needed for pain
B/ Avoid cold foods if pain persists
C/ Stop exercising while menstruating
D/ Avoid tampons until you’ve been menstruating for 1 year
A/ Take mild analgesics like Tylenol or Advil.
Foods rich in iron should be eaten, and exercise should not stop as it can strengthen abdominal tone.
Avoiding cold foods does not help with dysmenorrhea
Pads and Tampons are a person choice, and no evidence exists on waiting to use tampons.
After teaching a reproductive class to adolescent females, the nurse concludes the teaching has been effective when a student states…
A/ “ Under ideal conditions, sperm can reach the ovum in 15 - 30 minutes resulting in pregnancy”
B/ I will not become pregnant if I abstain from sex during the last 14 days of my menstrual cycle”
C/ “Sperms from a healthy man usually remain viable in the female reproductive tract for 96 hours”
D/ “After the egg is fertilized by the sperm, the ovum contains 21 pairs of chromosomes”
A/ 15 - 30 minutes is all it takes to ruin your pre-adult life.
Sperm remains viable for only 24-72 hours in a female
After fertilization, there are 46 chromosomes
A 20-year-old nulligravida expresses a desire to learn more about symptothermal method of family planning. Which information should be included in her teaching plan?
A/ This method has a 50% failure rate in the first year of its initiation
B/ Couples must abstain from sex for 5 days after menses
C/ Cervical mucous is carefully monitored for changes
D/ The male partner uses condoms for significant effectiveness
C/ Requires monitoring of cervical mucous changes and body temperature changes. This is because regular menstrual cycles often are 1-2 days late or early, this helps to determine the time which ovulation may occur.
Abstinence during ovulation is required, not 5 days post menses because this is an unlikely time for ovulation to occur.
The failure rate is more like 10-20%
Before advising a 24-year-old client desiring oral contraceptives for family planning, the nurses assess the client for which of the following? A/ Anemia B/ Hypertension C/ Dysmenorrhea D/ Acne Vulgaris
B/ Hypertension
Clients with HTN, thrombophlebitis, obesity or a hx of cerebral or cardiovascular incidents are poor candidates for oral contraceptives.
In addition, women who smoke, or are over 40 or have a hx of pulmonary disease should be advised not to take this form of contraceptive.
The other answers have no relation.
After teaching a 20-year-old nulligravida about the adverse effects of oral contraceptives, the nurse realizes further education is needed when the client states which of the following as an adverse effect? A/ Weight Gain B/ Nausea C/ Headache D/ Ovarian Cancer
D/ There isn’t enough evidence to suggest any link between ovarian cancer and oral contraceptives.
The others are common side effects depending on the medication.
Which information should be included for a 32-year-old female requesting information about using a diaphragm for family planning?
A/ Douching which an acidic solution after intercourse is recommended. LOL
B/ Diaphragms should not be used if the client develops acute cervicitis
C/ The diaphragm should be washed with a weak solution of bleach and water
D/ The diaphragm should be left in place for 2 hours after sex
B/ Acute cervicitis
This could be due to the rubber used in the diaphragm. Evidence also suggests diaphragms increase the risk of UTIs
Wash with mild soap and water
Leave in place for 6-24 hours after sex
YUCK.
After being examined and fitted for a diaphragm, a 24-year-old client receives instructions on its use. Which statement indicates a need for more teaching?
A/ “I can continue to use the diaphragm for 2-3 years if I keep it in the case”
B/ “If I get pregnant, I will have to be refitted for another diaphragm after birth”
C/ “Before inserting the diaphragm, I should coat the rim with contraceptive jelly”
D/ “If I gain or lose 20 lb, I can still use the same diaphragm”
D/ Gaining or losing 20 lbs.
If the client gains or loses more than 15 lbs, their pelvic and vaginal contours to such a degree that the diaphragm will no longer protect against pregnancy.
It can be used for 2-3 years if protected well
A 22-year-old patient states that she and her husband are trying to have a baby. When teaching the client about reducing the incidence of neural tube defects, the nurse should emphasize the need for increase the intake of which foods? SELECT ALL THAT APPLY.
A/ Leafy Green Veggies B/ Strawberries C/ Beans D/ Milk E/ Sunflower Seeds F/ Lentils
A/ Leafy Green Veggies B/ Strawberries C/ Beans E/ Sunflower Seeds F/ Lentils
Basically everything but Milk.
These all have folic acid, which women require 400-800mcg/day when prego.
A couple is inquiring about vasectomy as a method of contraception. What should be included in their teaching plan?
A/ Another method of contraception should be used until sperm count is 0
B/ Vasectomy is easily reversed if children are desired in the future
C/ Vasectomy is contraindicated in males with a history of cardiac disease
D/ Vasectomy only requires a yearly follow up once the procedure is completed.
A/ Slap on some rubber until your soldiers die off.
The number of ejaculations differs from male to male, but it usually takes multiple episodes until sperm count is Zero, which can be determined by the lab.
All others are not true.
A 39-year-old multigravida client asks the nurse for information about female sterilization with tubal ligation. Which client statement reflects effective teaching?
A/ “My fallopian tubes will be tied off through a small abdominal incision”
B/ “Reversal of a tubal ligation is easily done”
C/ “After the procedure, I must abstain from sex for at least 3 weeks”
D/ “Both of my ovaries will be removed during the procedure”
A/ A small incision will be made in which the tubes will be tied off.
Reversal is not easily done and the pregnancy success rate afterwards is roughly 30%
You can bump uglies 2-3 days afterwards.
If a client is using the Basal temperature method for ovulation detection, what is the most important thing for them to know in order to ensure accuracy and success?
Take their temperature every morning at the same time when they get out of bed. Just before the day of ovulation, their temp will fall by around 0.5 F, and then rises during ovulation by 0.4-0.8 F
A client is scheduled for IVF therapy for infertility. Which client statement suggests they understand the procedure?
A/ IVF requires supplemental estrogen to enhance the implantation process
B/ The pregnancy rate with IVF is higher than that of gamete intrafallopian transfer
C/ IVF involves bypassing the blocked or absent fallopian tubes
D/ Both ova and sperm are implanted in the open end of the fallopian tube
C/ Involves bypassing the blocked or absent fallopian tubes
Progesterone is given to enhance the implantation process, NOT estrogen
Gamete intrafallopian transfer has a higher success rate than IVF, however it cannot be used in women with blocked or absent fallopian tubes as it requires implantation in the fallopian tube.
A 20-year-old primigravida client tells the nurse that is afraid of dying during childbirth as her mother had a friend who hemorrhaged 10 years ago. Which response would be MOST helpful to the client?
A/ Today’s modern medicine has resulted in a low maternal mortality rate
B/ Do no concern yourself with things that happened in the past
C/ The Canada, mothers rarely die from childbirth
D/ What is it that concerns you about pregnancy, labor, and birth?
D/ Gather additional data, asking her about what her concerns are will provide you an opportunity to educate her and help her through her concerns.
What is an Ectopic pregnancy and why is it potentially life-threatening?
When implantation of fertilized ovum occurs in the fallopian tube or elsewhere in your abdomen. This can cause the rupture of the fallopian tube with hemorrhaging.
Which of the following instructions should the nurse include for the health teaching of a 30-year-old multigravida who will be using an IUD for family planning?
A/ Amenorrhea is common with IUDs
B/ The client should use additional protection for contraception
C/ IUDs are more costly than other forms of contraceptives
D/ Severe cramping may occur when IUD is inserted.
D/ Severe cramping may occur
Common side effects include menstrual bleeding and subsequent anemia… NOT amenorrhea.
IUDs have an effective rate of 98%, so other protection is not required.
In the long run they are less expensive, as it is a one-time purchase rather than monthly contraceptives.
When developing a teaching plan for an 18-year-old who asks about treatments for STIs, the nurse should explain that….
A/ Acyclovir is used to cure herpes genitalis
B/ Chlamydia is treated with penicillin
C/ Ceftriaxone is commonly used to treat Gonorrhoeae infections
D/ Metronidazole is used to treat condylomata acuminata (Genital warts)
C/ Ceftriaxone treats Gonorrhoeae
It is commonly combined with Doxycycline.
Acyclovir is used in herpes treatment but does not cure it.
Chlamydia is treated with doxycycline or azithromycin.
Metronidazole is used to treat vaginitis, NOT genital warts.
A primigravid at 15 weeks gestation has had an amniocentesis and has received teaching concerns signs and symptoms to report. Which statement indicates further teaching is needed?
A/ “I need to call if I start to leak Amniotic fluid from my vagina”
B/ “If I start bleeding, I need to call back”
C/ “If my baby does not move, I need to call my HCP”
D/ “If I start running a fever, I should let the office know”
C/ A first-time prego will not feel her baby move at 15 weeks gestation. Typically does not occur until 18-20 weeks, and 16-18 weeks for a multipara.
All other symptoms need to be followed up.
A 32-week gestation primigravida complains of heartburn. She needs further instruction when she states she must do what to avoid the heartburn? A/ Avoid highly seasoned foods B/ Avoid Lying down after a meal C/ Eat small frequent meals D/ Consume liquids only between meals
D/ Consuming liquids only between meals does not prevent heartburn; however, it is a great way to reduce nausea and vomiting during pregnancy
The other methods should be used to prevent heartburn.
An Antenatal primigravida client is expecting twins. The nurse realizes she needs more prenatal education when the client states that carrying twins puts her at risk for which of the following complications? A/ Preterm Labor B/ Twin-to-twin Transfusion C/ Anemia D/ Group B Streptococcus
D/ Group B Streptococcus risk is associated with all pregnancies, so just because you’re having twins doesn’t make you special.
All others are associated with twins.
After instructing a client about the radioimmunoassay preg test, the nurses determines the client understands the test when she states the test measures which of the following levels? A/ Prolactin B/ Follicle-Stimulating hormone C/ Luteinizing hormone D/ human chorionic gonadotropin (hCG)
D/ hCG - can be found in a little as 24-48 hours after implantation.
Prolactin is secreted by the pituitary gland to prepare breasts for lactation
Follicle-stimulating hormone is involved in follicle maturation during menstruation cycles.
Luteinizing hormone is responsible for stimulating ovulation
Using Nägele's Rule for a client whose last period was May 10, the nurse determines that her due date is: A/ Jan 13 B/ Jan 17 C/ Feb 13 D/ Feb 17
D/ Feb 17
The nurse implements Nägele’s Rule by counting back three months from her last period and adding 7 days, making it February 17.
The nurse determines that her primigravid client needs more teaching about the purpose of a placenta when the client states that which hormone is produced by the placenta? A/ Estrogen B/ Progesterone C/ human chorionic gonadotropin (hCG) D/ Testosterone
D/ Testosterone
hCG - stimulates the synthesis of estrogen and progesterone until the placenta can maintain this function later in pregnancy
Progesterone - Maintains the endometrium, inhibiting uterine contraction, development of breasts for lactation
Estrogen - Uterine and breast enlargement
The nurse is assessing a 24-week gestation primigravida and is unable to find the fetal heartbeat. The fetal heartbeat was heard during her previous visit 4 weeks prior. According to priority, the nurse should do the following tasks in which order?
- Call the HCP
- Explain that the fetal heartbeat cannot be found
- Obtain different equipment and recheck
- Ask the client if the baby is or has been moving
- Is/has Baby moving?
- New equipment
- Explain heartbeat cannot be found
- Call HCP
A primiparous client at 10 weeks gestation asks why she needs to have ultrasounds because she states she feels fine. Which of the following nursing responses is appropriate/accurate for the client? SELECT ALL THAT APPLY
A/ Ultrasound helps us to view the gross anatomy of your fetus
B/ We need to determine gestational age
C/ The test will determine if the fetus is viable
D/ We must determine fetal position
E/ We must determine if there is sufficient supply for the fetus.
A/ Gross anatomy
B/ Gestational age
At this time, ultrasound cannot determine if the fetus is viable, nor is it important to see their fetal position in the first trimester.
Ultrasounds provide no information on nutrient supply.
When measuring the fundal height of a primigravid client at 20 weeks gestation, the nurse will locate the fundal height at which point?
A/ Halfway between the symphysis pubis and the umbilicus
B/ At or near the umbilicus
C/ Between their umbilicus and xiphoid process
D/ In their throat.
B/ 20 weeks, the fundal height should be around the umbilicus
12 weeks = symphysis pubis
36 weeks = xiphoid
Never should it be in her throat. Never.
A primigravida at 8 weeks gestation states that she wants an amniocentesis because Haemophilia A runs in her family. The nurse informs the client they cannot do the test until 15 weeks because…
A/ Fetal development must be complete before testing
B/ The volume of amniotic fluid needed for testing is not available until 15 weeks
C/ Cells indicating Haemophilia A are not present until week 15
D/ Amniocentesis prior to 15 weeks greatly increases the risk of infection
B/ Volume needed
At 15 weeks there are roughly 15mL available
Fetal development is ongoing…
Cells needed for Haemophilia A testing are present throughout pregnancy but aren’t typically discoverable until 12 weeks…
Amniocentesis always carries the risk of infection.
When developing a teaching plan for a client who is 8 weeks prego, what foods should the nurse suggest to meet the client’s need for increased folic acid? SELECT ALL THAT APPLY
A/ Spinach B/ Bananas C/ Seafood D/ Yogurt F/ Beans
A/ Spinach
F/ Beans
Both are rich in folic acid.
Which of the following choices are appropriate for teenagers but also for their fetus? Select all that apply
A/ Milkshake or yogurt with fresh fruit
B/ Chicken Nuggets and tater tots
C/ Cheese pizza with spinach and mushroom toppings
D/ Peanut Butter With crackers and juice
E/ Buttery light popcorn with diet soda
F/ Cheeseburger with a pickle and ketchup
A/ Milkshake/fruit
C/ Cheese Pizza
D/ Peanut Butter
The nurse is reviewing the file of a 24-week prego. Which of the following results should be reported? A/ A+ Blood type B/ 5mmol/L Blood Sugar C/ VDRL Positive D/ Rubella Titer Immune
C/ VDRL is a screening test for syphilis
The pregnant mother must be treated for syphilis before birth or she may transmit the disease to her baby.
The nurse is reviewing the immunization report for a pregnant client and remember which of the following immunizations are contraindicated during pregnancy? SELECT ALL THAT APPLY
A/ Tetanus B/ Rubella C/ Mumps D/ Herpes Varicella-zoster E/ Live Attenuated Flu Vaccine F/ Hepatitis B
B/ Rubella
C/ Mumps
D/ Herpes Varicella-zoster
E/ Live Attenuated Flu Vaccine
All of these are living vaccines and cannot be given to a fetus.
A 17-year-old gravida presents for her regularly scheduled 26-week prenatal visit. She appears disheveled, is wearing ill-fitted clothing and avoids eye contact. Which of the following items should the nurse discuss this visit? SELECT ALL THAT APPLY.
A/ Intimate partner violence B/ Substance abuse C. Depression D/ Blood Glucose Testing E/ hCG levels
A/ Intimate partner violence
B/ Substance abuse
C. Depression
D/ Blood Glucose Testing
All except E/ apply.
Health care workers should always assess for partner violence, especially during pregnancy.
Pregnant teens have increased rates of not finishing school, smoking, and substance abuse.
Based on appearance and lack of eye contact, it is possible the client is depressed.
It is routine the discuss blood glucose testing around 24-28 weeks gestation
A primigravid at 28 weeks gestation tells the nurse that she and her husband wish to travel to relatives 7 hours away. Which of the following responses is most appropriate for the nurse?
A/ “Try to avoid traveling anywhere in your 3rd trimester”
B/ “Limit the time you spend in the care to 4-5 hours per day”
C/ “Taking the trip is fine if you can stop every hour or two for a 10-minute walk”
D/ “Avoid wearing your seatbelt and drink alcohol to help yourself sleep for most of the trip”
C/ 10-minute breaks
After long periods of rest, the circulatory system becomes sluggish, so exercise will maintain proper blood flow.
Which of the following statements best identifies the rationale for why an adolescent primigravid should continue prenatal care throughout pregnancy?
A/ Pregnant adolescents are at a higher risk for pregnancy-induced hypertension
B/ Gestational diabetes can commonly develop in adolescent pregos
C/ Adolescents need additional instructions related to common discomforts
D/ The father is rarely involved in this age group.
A/ Pregnancy-induced hypertension
This is a common factor in adolescent mothers, and close prenatal screening may prevent this.
Other risks for young mothers include:
- Low birth weight
- Preterm Labour
- Iron deficiency anemia
- Cephalopelvic disproportion
In preparation for a prenatal class for newly pregnant women, the nurse should include which of thew following learning points?
A/ Your temperature decreases slightly in the first trimester
B/ Cardiac output increases by 25% to 50% during pregnancy
C/ The circulating fibrinogen level decreases as much as 50% during pregnancy
D/ The anterior pituitary gland secretes oxytocin late in pregnancy
B/ Cardiac output increases
So does their total blood volume
Temp increases in early pregnancy, not decreases.
Fibrinogen levels increase… not decrease
The Posterior pituitary gland releases oxytocin.. not the anterior
Which of the following factors affect fetal movement in utero? SELECT ALL THAT APPLY A/ Fetal Sleep B/ Barometric pressure changes C/ Blood Glucose D/ Time of day E/ Smoking
A/ Fetal Sleep
C/ Blood Glucose
D/ Time of day
E/ Smoking
Barometric pressure has no effect on fetal movement.
A primigravid client at 36 weeks gestation tells the nurse that she has been experiencing insomnia for 2 weeks. Which suggestion would be most helpful?
A/ Practice relaxation techniques before bed
B/ Drink a cup of hot chocolate before bed
C/ Drink a small glass of wine before bed
D/ Exercise 30 minutes before bed
A/ Frankie Says Relax
Relaxation will help soothe discomfort and relax thought processes.
Caffeine will stimulate the client, so hot chocolate and coffee should be avoided.
Never is alcohol okay during pregnancy
Exercise will cause the client to become stimulated prior to sleep and make falling asleep more challenging.
What does the following mean?
G5 T4 P0 A1 L4
What does it mean about this woman specifically?
G = Gravity (number of total pregnancies)
T = Term Deliveries (38 weeks or more)
P = Preterm Births (Viability up to 37 weeks)
A = Abortions (Surgical and miscarriages)
L = Living children
So this woman has been pregnant 5 times (G5), Had 4 Term babies (T4), Had 0 preterm babies (P0), has had 1 abortion (A1), and has 4 living Children (L4).
What does the following mean about this woman?
G4 T1 P1 A2 L2
Pregnant 4 times (G4) Went to term once (T1) Went preterm once (P1) Had 2 abortions (A2) Has 2 living Children (L2)
What fetal feature develops around 3 months (roughly 9-12 weeks) in utero? A/ External genitalia B/ Myelination of nerves C/ Brown fat stores D/ Air ducts and alveoli
A/ External Sex organs. Although it is not easily discernable at this time
A primigravid client tells the nurse that twins run in her family. What should the nurse tell the client?
A/ Monozygotic twins results from fertilization of one ovum
B/ Monozygotic twins occur by chance regardless of race or heredity
C/ Dizygotic twins are usually the same gender
D/ Dizygotic twins occur more often in primigravidas than multigravidas.
B/ Don’t get yer hopes up… it is totally random and genetics play no role in identical twins.
C/ is not always true.
D/ Primigravidas are less likely to have twins than multigravidas.
A primigravid client asks how much blood is lost during a normal vaginal birth. The nurse should tell the woman:
A/ Maximum blood loss is considered around 500mL
B/ Minimum blood loss is considered within normal limits around 1000mL
C/ Blood loss during childbirth is rarely estimated unless there is a hemorrhage
D/ It would be unusual to lose more than 100mL of blood
A/ In a normal uncomplicated birth, up to 500mL is expected.
Blood loss is almost always calculated because it is a good way to rule out a hemorrhage
A client is experiencing pain during the first stage of labour. What should the nurse instruct the client to do in order to manage her pain? SELECT ALL THAT APPLY
A/ Walk in the hospital room B/ Use slow chest breathing C/ Request pain medication on a regular basis D/ Lightly massage the abdomen E/ Sip Ice Water
A/ Walking
B/ Use slow breathing
D/ Massage abdomen
Pain medication could delay delivery
Sipping ice water will not help with pain, only hydration.
During a prenatal class, a primigravid states “How will I know I am in true labour?” The nurses best response to educate her on true contractions are…
A/ True labour contractions will decrease with ambulation
B/ True labour contractions may disappear with with ambulation, rest or sleep.
C/ The duration and frequency of true labour contractions remain the same
D/ True labour contractions are felt first in the back and then the abdomen.
D/ True labour is felt first in the back then the abdomen. The duration and frequency WILL increase, and ambulation and rest will not stop or decrease contractions.
False labour contractions stop with ambulation
A primigravid client tells the nurse that she has been experiencing some yellowish-gray frothy vaginal discharge and local itching. What is the best advice for the nurse to provide this client?
A/ Use and over-the-counter cream for yeast infections
B/ Schedule an appointment in the clinic for an examination
C/ Administer a vinegar douche under low pressure
D/ Prepare for preterm labour
B/ You got an infection.
Over-the-counter meds will not address this issue as it is unlikely a yeast infection due to it’s presentation.
Douching is contraindicated during pregnancy
This is not a sign of preterm labour
A multigravid client who has experienced hemolytic disease of the newborn in a previous pregnancy should be prepared for frequent antibody titer evaluations obtained from which source? A/ Placental Blood B/ Amniotic Fluid C/ Fetal Blood D/ Maternal Blood
D/ Maternal Blood
For the Rh negative mother who may be pregnant with an Rh positive fetus, and indirect Coombs test measures antibodies in the maternal blood.
Titers should be performed monthly in the 1st and 2nd trimesters. and bi-weekly in the 3rd.
Which diagnostic test would be the most appropriate for a 40-year-old primigravid in her second trimester? A/ Beta Strep Screening B/ Chorionic Villus Sampling C/ Ultrasound Testing D/ Quad Screen
D/ Quad Screen
Quad testing tests AFP, hCG, STriol, and Inhibin-A.
High levels of AFP indicated neural tube defects such as anencephaly or spina bifida. Abnormally low levels may indicate Trisomy 21
Beta strep is done in the 3rd trimester
Chorionic Villus sampling is done at 10 weeks to detect anomalies.
Ultrasounds are done in first and third trimesters.
A primigravid has completed her first prenatal visit and blood work. Her blood tests reveal that her Hep B surface antigen is positive. The nurse can advise the patient that the plan of care for her newborn will include the following: SELECT ALL THAT APPLY
A/ Hep B immune globulin at birth
B/ Series of 3 Hep B vaccinations per recommended schedule
C/ Hep B Screening when born
D/ Isolation of infant during hospitalization
E/ Universal precautions of mother and infant
F/ Contraindication for breastfeeding
A/ Hep B immune globulin at birth
B/ Series of 3 Hep B vaccinations per recommended schedule
E/ Universal precautions of mother and infant
Hep B immune globulin at birth provides the infant with passive immunity to Hep be and serves as prophylactic treatment.
The infant will be started on vaccinations
Routine precautions will still be provided. This is standard practice for all babies and mothers.
Hep B Mothers can breastfeed
A primigravid with asthma controlled through medication receives instruction on being pregnant. Which of the following statements reveals the new mother needs further teaching?
A/ I need to continue taking my medication as prescribed for asthma
B/ It is my goal to limit or prevent asthma attacks
C/ During an asthma attack, oxygen levels need to be high for both myself and my fetus
D/ Bronchodilators should be used only when necessary because the risk they present to my fetus
D/ Bronchodilator use
Bronchodilators can prevent asthma attacks and should be used throughout pregnancy and prophylactic treatment. They do not harm mother or fetus.
All other responses are true.
A woman at 22-weeks-gestation has right upper quadrant pain radiating to her back. She states the pain is a 9 out of 10 and says that it has occurred twice in the last week for around 4 hours each time. She does not associate the pain with food. Which nursing measure is the highest priority for this client?
A/ Educate the client on the changes occurring in the gallbladder as a result of pregnancy
B/ Refer the client to her HCP for evaluation and treatment of the pain
C/ Discuss nutritional strategies to decrease the possibility of heartburn
D/ Support the client’s use of acetaminophen to relieve pain
B/ Refer to HCP
Referral makes the most sense due to the severity of the pain.
Due to the severity and increasing incidence of pain, it is most appropriate for the nurse to refer out. Along with the fact the nurse cannot diagnose the cause of the pain.
A client in the triage area states that she has not felt her baby move in the past week. She is 19 weeks pregnant. The fetal heart monitor shows no signs of heart tones. While evaluating this client, the nurse identifies her at being highest risk for developing which problem?
A/ Abruptio Placentae
B/ HELLP Syndrome
C/ Disseminated intravascular coagulation
D/ Threatened abortion
C/ DIC
The fetus has died and being retained in the uterus places mother at-risk for D.I.C.
This is because the clotting factors of the mother have been consumed when the non-viable fetus is retained. The longer the fetus is retained in utero, the greater the risk of D.I.C. and clotting
Disseminated intravascular coagulation (DIC), is a pathological process characterized by the widespread activation of the clotting cascade that results in the formation of blood clots in the small blood vessels throughout the body. This leads to compromised tissue blood flow and can ultimately lead to multiple organ damages.
She has no signs of Abruptio Placentae (Sharp pain, firm abdomen)
HELLP syndrome is a complication of preeclampsia that only happens after 20 weeks.
She shows no signs of an abortion (Vaginal bleeding, cramping, etc).
A 41-year-old client is expecting has a 3-year-old trisomy 21 child at home. The nurse is discussing amniocentesis and chorionic villus sampling as genetic screening methods for the expected baby. The nurse is confident that the teaching has been understood when the client makes which statement?
A/ Each test identifies a different part of the fetus’ genetic makeup
B/ Chorionic Villus sampling can be performed earlier in pregnancy
C/ The test results take the same length of time to be completed.
D/ Amniocentesis is more dangerous procedure for the fetus
B/ CVS can be completed around 8-12 weeks, whereas Amniocentesis cannot be done before week 11.
Both test the genetic makeup as a whole rather than specific parts
CVS takes less time to complete
Both procedures at a risk to the fetus.
A 10-week gestational client undergoes a dilatation and curettage (DC) after experiencing cramping and bright red vaginal spotting and the passage of material. The nurse should expect which expression from the client? A/ Ambivalence B/ Anxiety C/ Fear D/ Guilt
D/ Guilt
Associated with the loss of a fetus can be the feeling of guilt as to whether the couple or mother could have done something to prevent the miscarriage.
Anger, sadness, and disappointment are also common emotions after a loss.
