Maternity Nursing Chap 7

Question 1

Pregnancy can be diagnosed by assessing a woman for the presence of specific signs and symptoms associated with pregnancy. _______ indicators of pregnancy can be caused by conditions other than gestation and are not reliable for diagnosis. _________ indicators of pregnancy are those observed by the health care provider. ______ indicators of pregnancy verify that a woman is pregnant.

Answer 1

• presumptive
• probable
• positive

Question 2

_____ rule is used to determine the estimated date of birth by subtracting 3 months from and adding 7 days to the first day of the last menstrual period. Pregnancy is divided into three 3 month periods called trimesters.

Answer 2

-Nagele’s

Question 3

_____ can occur when a woman is placed in the lithotomy position because of the compression of the vena cava and aorta by the weight of the abdominal contents, including the uterus. Signs and symptoms indicating that this has occurred include pallor, dizziness, faintness, breathlessness, tachycardia, nausea, and clammy skin (sweating).

Answer 3

-supine hypotension

Question 4

A variety of assessment methods are used to evaluate the progress of pregnancy. ______ is measured beginning in the second trimester as one indicator of the progress of fetal growth. The pinch test determines whether nipples are everted or inverted by placing the thumb and forefinger on the areola and pressing inward gently.

Answer 4

-fundal height

Question 5

The health status of the fetus is assessed by evaluating ______, the _______, and abnormal ________. The fetal gestational age is estimated after determining the duration of pregnancy and the estimated date of birth (EDB).

Answer 5

• fetal movement
• fetal heart rate and rhythm
• maternal or fetal symptoms

Question 6

Maternal adaptation during pregnancy includes mastery of certain _____ tasks that include accepting the pregnancy, identifying with the role of mother, reordering relationships with her mother and her partner, establishing a relationship with the unborn child, and preparing for the birth experience.

Answer 6

-developmental

Question 7

As a pregnant woman establishes a relationship with her fetus, she progresses through three phases. In phase 1 she accepts the ________ and needs to be able to state I am pregnant. In phase 2 the woman accepts the growing fetus as distinct from herselfand as a(n) person to nurture. She can now say I am going to have a baby. Finally, in phase 3 the woman prepares realistically for the birth and parenting. She expresses the thought I am going to be a mother.

Answer 7

-biologic fact of pregnancy

Question 8

______ refers to rapid an unpredictable changes in mood. Having conflicting feelings simultaneously regarding the pregnancy is termed ambivalence.

Answer 8

-emotional lability

Question 9

The _________ phase is the early period of paternal adaptation during which the father accepts the biologic fact of pregnancy. During the moratorium phase, the father adjusts to the reality of the pregnancy. The father becomes actively involved in the pregnancy and the relationship with his child during the focusing phase. The couvade syndrome refers to the phenomenon of men experiencing pregnancy like symptoms.

Answer 9

-announcement

Question 10

The __________ is a tool used by parents to communicate the childbirth options that they have chosen to their health care provider.

Answer 10

-birth plan

Question 11

Certain cultural practices are expected by women of all cultures to ensure a good outcome to their pregnancy. Cultural ___________ are directives that tell a woman what to do during pregnancy. Cultural proscriptions are directives that tell a woman what not to do during pregnancy; they establish taboo.

Answer 11

-prescriptions

Question 12

Quadruple screening is used to detect _______, Down syndrome, and other chromosomal abnormalities. It is done ideally between 16 and 18 weeks of gestation and measures levels of maternal serum alpha-fetoprotein, human chorionic gonadatropin, unconjugated estriol, and inhibin-Aman chorionic gonadatropin.

Answer 12

-neural tube defects

Question 13

Target body parts for battering during pregnancy include the _____, _____, ______, and _______. _____ is common.

Answer 13

• head
• breasts
• abdomen
• genitalia
• sexual assault

Question 14

how to calculate the estimated date of birth (EDB):

Answer 14

last menses began on May 5, 2010:

LMP month day year:
5 5 2010
- 3 +7
EDB 2 12 2011

Question 15

Describe how cultural beliefs affect participation in prenatal care:

Answer 15

• beliefs that conflict with typical prenatal practices
• lack of money and transportation
• communication difficulties
• concern regarding modesty and gender of health care provider
• fear of invasive procedures
• view of pregnancy as healthy whereas health care providers imply illness
• view of pregnancy problems as a normal part of prenancy

Question 16

Components of fetal assessment:

Answer 16

• measurement of fundal height
• gestational age determination
• health status of fetus: including FHR and pattern, fetal movements, and unusual or abnormal maternal or fetal signs and symptoms

Question 17

Signs and symptoms of first trimester:

Answer 17

• severe vomiting; hyperemesis gravidarum
• chills, fever; infection
• burning on urination; infection
• diarrhea; infection
• abdominal cramping; vaginal bleeding; miscarriage, ectopic pregnancy

Question 18

Signs and symptoms of 2nd and 3rd trimester:

Answer 18

• persistent, severe vomiting; hyperemesis gravidarum, hypertension, preeclampsia
• sudden discharge of fluid from vagina before 37 weeks; premature rupture of membranes (PROM)
• vaginal bleeding, severe abdominal pain; miscarriage, placenta previa, abruptio placentae
• chills, fever, burning on urination, diarrhea; infection
• severe backache or flank pain; kidney infection or stones, preterm labor
• change in fetal movements: absence of fetal movements after quickening, any unusual change in pattern or amount; fetal jeopardy or intrauterine fetal death
• uterine contractions, pressure, cramping before 37 weeks; preterm labor
• visual disturbances: blurring, double vision, or spots; hypertensive conditions, preeclampsia
• swelling of face or fingers and over sacrum; hypertensive conditions, preeclampsia
• headaches: severe, frequent, or continuous; hypertensive conditions, preeclampsia
• muscular irritability or convulsions; hypertensive conditions, eclampsia
• epigastric or abdominal pain (perceived as severe stomachache, heartburn); hypertensive conditions, preeclampsia, abruptio placentae
• glycosuria, positive glucose tolerance test reaction; gestational diabetes mellitus

Question 19

Nursing approach when discussing signs of complications with pregnant woman and her family:

Answer 19

• inform as to what the signs are, possible cause, when and to whom to report
• present the signs verbally and in written form
• provide time to answer questions and discuss concerns; make follow up phone calls
• gather full information of signs that are reported; use this information as the basis for action
• document all assessments, actions, and responses

Question 20

True or False: Women should consider avoiding weight bearing exercises such as jogging and running during pregnancy.

Answer 20

True

Question 21

True or False: The use of a condom is necessary during pregnancy if the woman is at risk for a sexually transmitted infection.

Answer 21

True

Question 22

True or False: Intercourse is safe during a normal pregnancy as long as it is not uncomfortable.

Answer 22

True

Question 23

True or False: Exposure to secondhand smoke is associated with growth restriction and an increase in perinatal and infant morbidity and mortality.

Answer 23

True

Question 24

True or False: It is not necessary to screen pregnant women for HIV because there is no effective measure to reduce transmission tot he fetus.

Answer 24

False –

Question 25

True or False: A woman should be scheduled for prenatal visits once a month until the 36th week of pregnancy.

Answer 25

False – once a month up to 28 weeks. From week 28-36 every two weeks. Then every week until birth.

Question 26

True or False: A 1 hour glucose tolerance test is performed on all pregnant women at 28 weeks of gestation to screen for the presence of gestational diabetes.

Answer 26

False – screens for gestational diabetes and it’s weeks 24-28 for those who are not already known to be diabetic.

Question 27

True or False: During the second and third trimesters (weeks 18 to 30), the height of the fundus in inches is approximately the same as the weeks of gestation if the woman’s bladder is full.

Answer 27

False – in cm and the bladder is empty.

Question 28

True or False: Quickening usually occurs between weeks 16 and 20 of gestation.

Answer 28

True

Question 29

True or False: A woman should avoid tub bathing and should shower instead once she reaches the midpoint of her pregnancy.

Answer 29

False – Tub bathing is only contraindicated after rupture of membrane. Bathing and showering can be very therapeutic.

Question 30

True or False: The side lying position promotes uterine perfusion and fetoplacental oxygenation.

Answer 30

True

Question 31

True or False: Once the uterus enlarges, the pregnant woman should use only the lap belt and avoid using a shoulder harness while she is in a motor vehicle.

Answer 31

False

Question 32

True or False: A woman with inverted nipples should perform nipple rolling and tugging exercises during the third trimester to break adhesions.

Answer 32

False – Exercises to break the adhesions that cause the nipples to invert do no work and may cause uterine contractions. The use of breast shells. The woman should wear this 1 to 2 hours daily during the last trimester of pregnancy.

Question 33

True or False: Hepatitis B vaccination is contraindicated during pregnancy.

Answer 33

False – This can be given during pregnancy. The contraindicated vaccinations would be your live viruses measles, mumps, chickenpox.

Question 34

True or False: All pregnant women should be taught to recognize signs and symptoms of preterm labor.

Answer 34

True

Question 35

True or False: Breast shells can be used by women with inverted or flat nipples to help the nipples evert or become erect, thereby facilitating latch-on of the newborn once breastfeeding begins after birth.

Answer 35

True

Question 36

True or False: Women who are positive for hepatitis B should not breastfeed.

Answer 36

False – HIV

Question 37

True or False: Women often react to the confirmation of pregnancy with mixed feelings or ambivalence.

Answer 37

True

Question 38

True or False: Emotional lability (mood swings) might be related to profound hormonal changes that are part of the maternal response to pregnancy.

Answer 38

True

Question 39

True or False: Children typically respond to their mother’s pregnancy in terms of their age and dependency needs.

Answer 39

True

Question 40

True or False: The reaction of a mother to her daughter’s pregnancy can influence her daughter’s self confidence about her pregnancy.

Answer 40

True

Question 41

Protocol for fundal measurement:

Answer 41

• consider woman’s position
• type of measuring tape used (paper, nonstretchable)
• measurement method
• conditions of the examination such as empty bladder and condition of uterus (relaxed or contracted)

Question 42

Factors used to estimate gestational age:

Answer 42

• include menstrual history
• contraceptive history
• pregnancy test result
• specific findings related tot he maternal fetal unit (time of appearance of the specific signs of pregnancy

Question 43

Contradindications for breastfeeding:

Answer 43

• include deepseated aversion to breastfeeding by the mother or her partner
• need to take certain medications or use illicit drugs
• medical complications such as positive HIV infection

Question 44

A nurse is assessing a pregnant woman during a prenatal visit. Several presumptive indicators of pregnancy are documented. Which one of the following is a presumptive indicator?

a. uterine enlargement
b. quickening
c. ballottement
d. palpation of fetal movement by the nurse

Answer 44

b. quickening

a and c are probable
d is positive sign

Question 45

A woman’s last menstrual period began on September 10, 2010, and ended on September 15, 2012. Using Nagele’s rule, the EDB would be:

a. June 17, 2011
b. June 22, 2011
c. August 17, 2011
d. December 3, 2011

Answer 45

a. June 17, 2011

Question 46

A woman at 30 weeks of gestation assumes a supine position for a fundal measurement and Leopold maneuvers. She begins to complain about feeling dizzy and nauseous. Her skin feels damp and cool. The nurse’s first action would be to:

a. assess the woman’s respiratory rate and effort
b. provide the woman with an emesis basin
c. elevate the woman’s legs 20 degrees from her hips
d. turn the woman on her side

Answer 46

d. turn the woman on her side
- supine hypotension related to compression of aorta and vena cava is being experienced. The first action is to remove the cause of the problem by turning the woman on her side. This should alleviate the symptoms being experienced, including nausea. Assessment of vital signs can occur after the woman’s position is changed.

Question 47

The nurse evaluates a pregnant woman’s knowledge about prevention of urinary tract infections at the prenatal visit following a class on infection prevention that the woman attended. The nurse recognizes that the woman needs further instruction when she tells the nurse about which one of the following measures she now uses to prevent urinary tract infections:

a. I drink about 1 quart of fluid a day
b. I have stopped using bubble baths and bath oils
c. I have started wearing panty hose and underpants with a cotton crotch
d. I drink cranberry juice instead of orange juice and have yogurt for lunch

Answer 47

a. I drink about 1 quart of fluid a day

intake should be 2 to 3 liters of fluid a day.