Third Trimester of Pregnancy

Question 1

A pregnancy is considered term, when ?

Answer 1

If it advances to 37 to 40 weeks

Question 2

What is the expected weight gain per week in the Third trimester ?

Answer 2

No more than 1 lb per week

if more assume the worst

Question 3

What should be monitored in the Third trimester ?

Answer 3

BP

Question 4

Why should you monitor BP in the 3rd trimester and report any increases from baseline ?

Answer 4

Because Pre-eclampsia develops after 20 weeks gestation and client will have…

• Increased BP
• Proteinuria
• Edema

(All indicate trouble)

Question 5

In the 3rd trimester you should watch closely and worry about pre-eclampsia if what occurs ?

Answer 5

Two or more pounds of weight gain in a week

Question 6

The client with Pre-eclampsia can have what ?

Answer 6

A seizure

Question 7

What is the Drug of choice for severe pre-eclampsia ?

Answer 7

Magnesium Sulfate

Question 8

How is Magnesium Sulfate given ?

Answer 8

Given…

• IV
• In Hospital setting
• Under close supervision

Question 9

What is Pre-eclampsia defined as ?

Answer 9

BP of 160/110 or greater that is documented 6 hours apart

Question 10

What does Magnesium Sulfate act like ?

Answer 10

An Anticonvulsant

Question 11

Magnesium Sulfate also does ___________ & ____________ ?

Answer 11

Sedates & Vasodilates

Question 12

What is the difference between Pre-eclampsia and eclampsia ?

Answer 12

The seizure

Question 13

Its called Eclampsia when ?

Answer 13

They have a seizure

Question 14

What should the fetal HR be in the Third Trimester ?

Answer 14

110 to 160

Question 15

How is the fetal position/presentation determined in the 3rd trimester ?

Answer 15

Leopold maneuvers

–> palpating the abdomen to find the head, back (listen to fetal HR) and butt

Question 16

Before performing Leopold maneuvers, what should you have the client do first ?

Answer 16

Void

Question 17

If a client I shaving contractions, when should Leopold’s be done ?

Answer 17

Between contractions

Question 18

What are signs of labor in the Third Trimester ?

Answer 18

• Lightening
• Engagement
• Fetal stations
• Other signs

Question 19

When does Lightening usually occur ?

Answer 19

2 weeks before term

Question 20

What is Lightening defined as ?

Answer 20

When the presenting part of the fetus (usually the head) descends into the pelvis

Question 21

What sign in the Third trimester will tell the mother that Lightening has occurred ?

Answer 21

Client will be able to breathe more easily

-B/c the pressure on the diaphragm decreases

Question 22

When does Urinary frequency become a problem again ?

Answer 22

In the 3rd trimester

Question 23

Why does Urinary frequency become a problem again in the 3rd trimester ?

Answer 23

Because of lightening occurring and the baby descending into the pelvis
(takes pressure off the diaphragm, BUT puts it back on the bladder)

Question 24

What is Engagement defined as in the 3rd trimester ?

Answer 24

The largest presenting part is in the pelvic inlet

hopefully the fetal head is presenting first

Question 25

what is Fetal station measured in ?

Answer 25

cm

Question 26

What does fetal station measure ? (won’t ask on NCLEX)

Answer 26

Measures the relationship of the presenting part of the fetus to the ischial spines of the mother

Question 27

What other signs of Labor in the 3rd trimester ?

Answer 27

• Braxton Hicks contractions (more frequent and stronger than before)
• Softening of the cervix (ripening before it will dilate)?
• Bloody show (Dont want to see heavy bleeding)
  (blue post-it ash book on pg 221)
• Sudden burst of energy called Nesting
• Diarrhea
• Rupture of the membranes

Question 28

When should a pregnant client go the Hospital ?

Answer 28

When the contractions are 5 minutes apart OR when the Membranes Rupture

Question 29

What are we worried about when the membranes rupture ?

Answer 29

Prolapsed cord (could kill baby fast)

infection also, but always pick the worst possible answer