UNIT 1 HEALTH ASSESSMENT CHAPTER 7, 8, Flashcards

Question 1

Q

What is Gestation

Answer

A

age in weeks of pregnancy

Question 2

Q

What is Trimester

Answer

A

segments (13 1/3 weeks)

Question 3

Q

What his Antepartum

Answer

A

time before birth

Question 4

Q

What is Intrapartum?

Answer

A

time during labor and birth

Question 5

Q

What is Post Partum

Answer

A

return to pre-pregnant
state (about 6 weeks)

Question 6

Q

Which of the following weeks of Gestation is in accordance with a full-term pregnancy?

A. 37 weeks
B. 19 weeks
C. 49 weeks
D. 12 weeks

Answer

A

A. 37 weeks

Question 7

Q

What is the range of a Full Term Pregnancy

Answer

A

37-42 weeks

Question 8

Q

What is the range of a Preterm pregnancy

Answer

A

20-36 weeks

Question 9

Q

What amount of weeks would the fetus NOT be viable to live outside of the mothers womb?

A. 15 weeks
B. 21 weeks
C. 37 weeks
D. 25 weeks

Answer

A

A. 15 weeks

Viability-20 or more weeks gestation

Question 10

Q

FILL IN THE BLANK

The total number of pregnancies is….

A.Gravidity
B.Nullgravida
C.Primigravida
D.Multigravida

Answer

A

A.Gravidity

number of pregnancies

Question 11

Q

What is Paravididty

Answer

A

number of viable pregnancies (> 20
weeks)

Parity: The number of pregnancies in which the fetus or fetuses have reached
20 weeks of gestation or more, not the number of fetuses (e.g., twins) born. Parity is not affected by whether the fetus is born alive or is stillborn (i.e., showing no signs of life at birth).
Nullipara: A woman who has not completed a pregnancy with a fetus or fetuses who have reached at least 20 weeks of gestation
Primipara: A woman who has completed one pregnancy with a fetus or fetuses who have reached 20 weeks of gestation or more
Multipara: A woman who has completed two or more pregnancies to 20 weeks of gestation or more

Question 12

Q

What is Gravida

Answer

A

pregnant (been pregnant)

Question 13

Q

What is Nullgravida

Answer

A

never pregnant

Question 14

Q

What is Primigravida

Answer

A

Primigravida-pregnant or one child

Question 15

Q

What is Multigravida

Answer

A

pregnant second or
more times

Question 16

Q

Drugs used during Pregnancy -process

Answer

A

Terbutaline (Brethine)- pt goes into preterm labor and drug is used to slow down labor, stop them from having contraction
Nifedipine (Procardia)- to treat hypertension
Magnesium Sulfate- used for pts with preeclampsia, magnesium relaxes the body systems
Betamethasone (Celestone)/Dexamethasone- steriod decreases inflammation(used to mature babies lungs due to preterm labor
Oxytocin (Pitocin)- Causes contactions , induce uterine contractions
Dinoprostone (Cervidil)- soften cervix
Misoprostol (Cytotec)- used for uterine contraction, can cause an abortion when not used on pt in labor
Methylergonovine maleate (Methergine)- helps with decreasing excessive bleeding after labor
Carboprost tromethamine (Hemabate)- helps with decreasing excessive bleeding after labor
Fentanyl- opiod analgesic - PAIN
Morphine Sulfate- opiod analgesic - PAIN
Butorphanol Tartrate (Stadol)

Question 17

Q

What is Naegeles rule?

Answer

A

it is the expected date of birth

Question 18

Q

How do you calculate the Expected Date of Birth?

Answer

A

+7 days +9 months from the first day of her last menstrual cycle

Question 19

Q

The pregnant patient reports that THE START or first day of her period was on February 3. What would be her expected due date due to Naegeles Rule?

A. November 10
B. April 10
C. December 21
D. October 3

Answer

A

A. November 10

Most women give birth from 7 days before to 7 days after EDB

Question 20

Q

What consists of the Gravida Calculation?
SELECT ALL THAT APPLY

A.GRAVIDA
B.SEX
C.TERM
D.GENETIC CODE
E.PRETERM
F.ABORTION
G.LIVING

Answer

A

GTPAL

GRAVIDA - NUMBER OF PREGNANCY
TERM- 37-42 WEEKS OF PREGANCY
PRETERM- 20-36 WEEKS OF PREGNANCY
ABORTION- delivery before 20 weeks
LIVING- BABIES AT HOME living

Question 21

Q

Hormones of Pregnancy

Answer

A

Human Chorionic Gonadotropin (hCG)
* Maintain corpus luteum
* In urine & serum 10-14 days after conception

Human Placental Lactogen (hPL)
Insulin antagonist by placenta increase blood glucose
Estrogen
Increase blood flow to uterus (vasodilation).
Change sensitivity of respiratory system to carbon dioxide.
Soften cervix, initiate uterine activity, maintain labor.
Develop breasts for lactation, secretion of prolactin

Question 22

Q

What would be a subjective sign of pregnancy

Answer

A

SHE SAID

*My breasts are bigger, sore, tingling…”
* “My bowels don’t work as well.”
(constipation)
* “I have urinary frequency”
* “I am soooo tired all of the time.”
(fatigue)
* “I missed my period!” (amenorrhea)
* “I have to throw up EVERY
morning.”(N/V)
* “I think I am feeling the baby kick.”
(quickening

Question 23

Q

What would be a probable sign of pregnancy.

Answer

A

Goodell’s sign- softening of the cervical tip. This probable sign of pregnancy, the Goodell sign, is due to increased vascularity, slight hypertrophy, and hyperplasia (increase in the number of cells).
Chadwick’s sign- Increased vascularity results in the violet-blue color of the vaginal mucosa and cervix, known as the Chadwick sign. This is evident at 6 to 8 weeks of pregnancy.
Hegar’s sign- At approximately 6 weeks of gestation, softening and compressibility of the lower uterine segment (uterine isthmus) occurs (Hegar sign)
Enlarging Uterus
Positive pregnancy test
Stria Gravidarum- stetch mark
Braxton Hick’s contractions- Soon after the 4th month of pregnancy, intermittent uterine contractions may be felt through the abdominal wall. These are referred to as Braxton Hicks contractions and are thought to enhance blood flow through the intervillous spaces. Braxton Hicks contractions are irregular and painless, although some women complain that they are annoying- ing.
Ballottement- Passive movement of the unengaged fetus is called ballottement and can be identified by the examiner generally between the 16th and 18th weeks. Ballottement is a technique of palpating a floating structure by bouncing it gently and feeling it rebound. To palpate the fetus, the examiner places a finger within the vagina and taps gently upward on the cervix, causing the fetus to rise. The fetus then sinks, and a gentle tap is felt on the finger

Question 24

Q

What Is Leukorrhea

Answer

A

Vaginal discharge increases during pregnancy. Leukorrhea is a white or slightly gray mucoid vaginal discharge with a faint musty odor. This copious mucoid fluid occurs in response to cervical stimula- tion by estrogen and progesterone.

Question 25

Q

What drug can cause a false positive pregnancy test?

Answer

A

Blood hCG 2 days after implantation- MOST PRECISE IN PREGNANCY TESTING

Fertility drugs-Methadone: false
positive

Question 26

Q

What drug can cause a false negative pregnancy test?

Answer

A

Urine 42 days after first day of last
menstrual period

Promethazine: false negative

Question 27

Q

A 30 year old female is 25 weeks pregnant with twins. She has 5 living children. Four of the 5 children were born at 39 weeks gestation and one child was born at 27 weeks gestation. Two years ago she had a miscarriage at 10 weeks gestation. What is her GTPAL?*
A. G=7, T=4, P=0, A=1, L=5
B. G=7, T=4, P=1, A=1, L=5
C. G=6, T=4, P=0, A=1, L=5
D. G=6, T=2, P=2, A=1, L=5

Answer

A

B. G=7, T=4, P=1, A=1, L=5

Question 28

Q

A 27 year old female is currently 16 weeks pregnant. She has 2 year-old twins that were born at 39 weeks gestation and a 5 year-old who was born at 40 weeks gestation. She had no history of miscarriage or abortion. What is her GTPAL?*
A. G=3, T=1, P=0, A=1, L=3
B. G=3, T=1, P=1, A=0, L=3
C. G=3, T=2, P=0, A=1, L=1
D. G=3, T=2, P=0, A=0, L=3

Answer

A

D. G=3, T=2, P=0, A=0, L=3

Question 29

Q

A 20 year old female is currently 8 weeks pregnant. She had a miscarriage at 12 weeks gestation two years ago. She has no living children. What is her GTPAL?*
A. G=2, T=0, P=0, A=1, L=0
B. G=3, T=1, P=1, A=0, L=3
C. G=2, T=2, P=0, A=1, L=2
D. G=1, T=1, P=1, A=0, L=1

Answer

A

A. G=2, T=0, P=0, A=1, L=0

Question 30

Q

A 26 year old female is currently 26 weeks pregnant. She had a miscarriage at 10 weeks gestation five years ago. She has a three year old who was born at 39 weeks. What is her GTPAL?*
A. G=3, T=1, P=0, A=1, L=1
B. G=3, T=1, P=1, A=0, L=3
C. G=3, T=2, P=0, A=2, L=2
D. G=2, T=1, P=0, A=1, L=1

Answer

A

A. G=3, T=1, P=0, A=1, L=1

Question 31

Q

A 35 year old female is currently pregnant with twins. She has 10 year old triplets who were born at 32 weeks gestation, and a 16 year old who was born at 41 week gestation. Twelve years ago she had a miscarriage at 19 weeks gestation. What is her GTPAL?*
A. G=4, T=1, P=2, A=1, L=4
B. G=3, T=1, P=1, A=0, L=4
C. G=4, T=1, P=1, A=1, L=4
D. G=4, T=1, P=1, A=1, L=1

Answer

A

C. G=4, T=1, P=1, A=1, L=4

Question 32

Q

A patient presents to the clinic for her first prenatal appointment. She states that she has 2 living children, both born at 39 weeks, and she has had one miscarriage. Which of the following would be her correct GTPAL?

A, 3-2-0-1-2
B. 4-2-0-0-2
C. 4-2-0-1-2
D. 3-2-0-1-2

Answer

A

C. 4-2-0-1-2

Question 33

Q

Function of Progesterone?

Answer

A

Progesterone
* Prepare uterus for implantation.
* Prevent immunologic response to fetus.
* Relaxes smooth muscle
* GI decrease motility & improve
absorption of nutrients.
* Enlarges ureters & bladder to increase
capacity.
* Develop alveoli (milk secretion) & ductal
system for lactation

Question 34

Q

Function of Relaxin

Answer

A

Relaxin: Relaxes pelvic muscles & joints

Question 35

Q

Breast Function

Answer

A

Lactation
* Progesterone (glands)/Estrogen
(ducts)/Prolactin (milk secretion)
* Lactogenesis-breast development
to secrete milk in pregnancy

Physiologic changes with
menstruation; self-examination
best 5-7 days after end of period(do mot palpate or self exam during period due to hormonal changes)
Organs for sexual arousal

Question 36

Q

What would be a possible breast change during pregnancy?

Answer

A

Increase size, fullness, heaviness, tingling
Darkening of areola
Hypertrophy: alveolus hyperplasia epithelial
cell lining
Breast can secrete milk 18 weeks gestation

Question 37

Q

What sign is the softening of the cervix?

Question 38

Q

What signs is the softening of the lower segment of the uterus?

Question 39

Q

What sign is the change of the cervix (bluish color)

Answer

A

Chadwick sign

Question 40

Q

What sign causes intermittent contractions that start after the 4th month of pregnancy?

Answer

A

Braxton hicks

Question 41

Q

What could be a positive sign of pregnancy?

Answer

A

Fetal heart rate detected by electronic device
(Doppler transducer) at 10 to 12 weeks and by nonelectronic device (fetoscope) at 20 weeks of gestation
Active fetal movements palpable by examiner
Outline of fetus via radiography or ultrasonogra-
phy

Question 42

Q

What sign is the tapping of the cervix to so the fetus can rise?

Answer

A

Ballotment

Question 43

Q

Is this a positive sign of pregnancy?

“my stomach has gotten bigger in the last month and I missed my period”

Answer

A

NO

this is a presumptive sign, “she said”

Question 44

Q

What changes to the uterus during pregnancy?

Answer

A

Almost solid organ to thin-
walled, hollow organ; can hold
15-20 liters. or 15000ml to 20000 ml
Position moves up in pelvis
Braxton Hicks contractions- intermittent contarations HARMLESS
Mucous plug-Cervix moves behind uterus.
Impending labor: cervix moves forward, softens,
opens.

Question 45

Q

What is the function of the Placenta?

Answer

A

Nutrition oxygenation for the baby , the baby’s life line

Transport oxygen & nutrients
Removes metabolic wastes
Barrier separating maternal & fetal structures
Secretes Human Chorionic Gonadotropin (hCG),
progesterone, estrogen, human placental lactogen (hPL)

The placenta provides for exchange of nutrients
and waste products between the fetus and birth-
ing parent.
2. The placenta begins to form at implantation; the
structure is complete by week 12.
3. It produces hormones to maintain pregnancy
and assumes full responsibility for the produc- tion of these hormones by the 12th week of ges- tation.
4. In the third trimester, transfer of maternal im- munoglobulin provides the fetus with passive immunity to certain diseases for the rst few months after birth.
5. By week 10 to 12, genetic testing can be done via chorionic villus sampling (CVS).

Question 46

Q

What is quickening?

Answer

A

Quickening is the first recognition of fetal movements, or “feeling life.” It can be detected by the multiparous woman as early as 14 to 16 weeks of gestation.

Question 47

Q

What occurs during Placenta Previa

Answer

A

low lying placenta;
covers os

PAINLESS BRIGHT RED BLOOD

MANADATORY C SECTION

Question 48

Q

What occurs during Placenta Accreta

Answer

A

Placenta accreta: chorionic villi extend
into myometrium; separate @ delivery
difficult
PLACENTA ATTACHES TO THE UTERINE WALL

Question 49

Q

What occurs during Abruptio Placenta

Answer

A

Abruptio placenta: premature
separation placenta prior to delivery, form
retroplacental blood clot; oxygen &
nutrients to fetus compromised

PREMATURELY DETACHES TO UTERINE WALL MEDICAL EMERGENCY

baby is missing its nutrients when its nutrients and oxygen

Question 50

Q

How do you measure fundus height

Answer

A

START AT PUBIC BONES

by the gestation age of the baby, there is a range -2/+2 from gestation age is a proper fungus height

Question 51

Q

Where would the fundus be in the gestation age if the fetus is 12 weeks?

Answer

A

at publical synthesis
10centimeters - 14 centimeters

Question 52

Q

Where would the fundus be in the gestation age if the fetus is 20 weeks?

Answer

A

at the umbilicus
18 centimeters - 22 centimeters

Question 53

Q

Where would the fundus be in the gestation age if the fetus is 36 weeks?

Answer

A

Xiphoid process
34centimeters- 38 centimeters

Question 54

Q

What is the function of “Lightening” ?

Answer

A

Between weeks 38 and 40, the fundal height decreases as the fetus begins to descend into the pelvis (lightening) in preparation for birth (see Fig. 7.1, dashed line). In general, lightening occurs in the nullipara ap- proximately 2 weeks before the onset of labor and in the multipara at the start of labor.

THE FUNDUS HEIGHT DECREASES TO PREPARE FOR BIRTH

Question 55

Q

Is having increased vaginal discharge normal in pregnancy?

Question 56

Q

A client calls the physician’s office to schedule an appointment because a home pregnancy test was performed and the results were positive. The nurse determines that the home pregnancy test identified the presence of which of the following in the urine?
A. Human chorionic gonadotropin (hCG)
B. Progesterone
C. Estrogen
D. Follicle-stimulating hormone (FSH)

Answer

A

A. Human chorionic gonadotropin (hCG)

Question 57

Q

The rubella titer comes back on a pregnant client as non-immune. What is the best plan for this client?
A. Counsel the client to avoid people with signs of rubella.
B. Vaccinate the client at her next prenatal visit.
C. Have the client return to the clinic immediately for vaccination.
D. Plan to have the patient vaccinated after delivery.

Answer

A

D. Plan to have the patient vaccinated after delivery.

Question 58

Q

The nurse is reviewing the record of a client who has just been told that her pregnancy test is positive. The physician has documented the presence of Goodell’s sign. The nurse determines that this sign is indicative of:
A. The presence of human chorionic gonadotropin (hCG) in the urine
B softening of the cervix
C. A soft blowing sound that corresponds to the maternal pulse while auscultating the uterus
D. The presence of fetal movement

Answer

A

B softening of the cervix

Question 59

Q

Which of the following hormones are found in urine or blood to report pregnancy?

A. Human Chorionic Gonadotropin (hCG)
B.Estrogen
C. Oxytocin
D. Prostaglandins

Answer

A

A. Human Chorionic Gonadotropin (hCG)

Maintain corpus luteum
* In urine & serum 10-14 days after conception

Question 60

Q

Which of the following statements would mean that the female patient is positive for being pregnant?

A. positive Goodells sign
B. Amenorhea’
C. fetus is shown in ultrasound
D. Positive Hegars sign

Answer

A

C. fetus is shown in ultrasound

Question 61

Q

. Your patient is 48 hours post-delivery. While assessing fundal height, you would expect the fundal height to be?

A. 1 cm above the umbilicus

B. 2 cm above the umbilicus

C. 1 cm below the umbilicus

D. 2 cm below the umbilicus

Answer

A

The answer is D. The fundal height will decrease by 1 cm per day below the umbilicus. Therefore, if the woman is 48 hours postpartum (2 days) the fundal height will be 2 cm BELOW the umbilicus.

Question 62

Q

You’re providing discharge teaching to a new mother who is going home after a vaginal delivery. The woman asks when the uterus will return to its pre-pregnancy size. Your response is?

A. At about 14 days

B. At about 6 months

C. At about 6 weeks

D. At about 7 days

Answer

A

The answer is C. The uterus will return to its pre-pregnancy state at about 6 weeks.

Question 63

Q

During a prenatal visit, you are assessing the fundal height. You find the fundus of the uterus to be right above the symphysis pubis. Based on this finding the patient is about how far along in her pregnancy?

A. 20 weeks

B. 12 weeks

C. 16 weeks

D. 24 weeks

Answer

A

The answer is B. At about 12 weeks of pregnancy, the fundal height can be found right above the symphysis pubis.

Question 64

Q

You’re assessing a patient’s chart and find that the patient is 36 weeks pregnant. Where should you find the fundus of the uterus during your assessment of fundal height?
A. midway between the umbilicus and xiphoid process

B. about 4 cm below the xiphoid process

C. at the xiphoid process

D. 5 cm above the umbilicus

Answer

A

The answer is C. At 36 weeks of pregnancy, the fundal height should be at the xiphoid process.

Answer 62

A

The answer is C. The patient should be + or – 2 cm of their week of pregnancy. Remember that after 20 weeks of pregnancy the number of weeks the patient is pregnant will match the fundal height measurement plus or minus 2 cm. Therefore, if the patient is 24 weeks, a normal measurement would be either 22 cm to 26 cm.

Answer 63

A

Increased production
of estrogen &
progesterone initiates
uterine growth.

Answer 64

A

The answer is C.

Answer 65

A

C. February 28, 2017

Answer 66

A

D. September 1, 2017

Answer 67

A

A. October 27, 2016

Answer 68

A

D. the number of completed pregnancies at 20 weeks or greater.

Answer 69

A

C. the number of times a woman has been pregnant regardless of the outcome.

Answer 70

A

B. Nullipara

The answer is B. Nullipara means that the woman has never given birth or completed a pregnancy at greater than 20 weeks or greater.

Answer 71

A

The answer is C. Nulligravida means that a woman has never been pregnant before.

Answer 72

A

A. 3 cm

each day the fundus drops 1 cm under the umbilicus after giving birth

Answer 73

A

The maternal immune system functions during pregnancy to protect the mother against infection while also preventing rejection of the ge- netically foreign fetus. Pregnancy is not a state of immunosuppression; instead, there is both activation and dampening of aspects of the mater- nal immune system. There is evidence that the placenta has an active role in regulating the differentiation and function of the immune cells of the mother to support the pregnancy while also protecting the fetus.

Answer 74

A

d. lordosis

Answer 75

A

B. Oligohydramnios

Functions
* Characteristics
* 98% water 2% salts
* Average at 34 weeks peaks @ 800
mL, @ term about 600 mL
* Polyhydramnios
* Oligohydramnios

Answer 76

A

Mucosa thicken, rugae pronounced

Increase discharge(Luekhorea), acidic environment
(prevent infections).

Superficial muscles-vaginal opening back
past rectum; deeper muscle across
perineum (sling)

Cervix, vaginal, abdominal tissue never
return to pre-pregnant statu

Answer 77

A

C. so the uterus is midline during the diagnostic test

Answer 78

A

Decreased gastrointestinal motility
* Nausea/vomiting
* Constipation/hemorrhoids
* Delayed gallbladder emptying
* Increased vascularity of gums, saliva
* Heartburn
* Hiatal hernia

The gums can become hyperemic, spongy, and swollen during pregnancy. They tend to bleed easily because the increasing levels of estrogen cause selectively increased vascularity and connective tissue proliferation (a nonspecific gingivitis).

Some pregnant women complain of ptyalism (excessive saliva- tion), often due to the unconscious decrease in swallowing by the woman when nauseated.

Answer 79

A

eat a small snack or cracker before getting out of bed

Answer 80

A

glomerular filtration is increased

Answer 81

A

A. No

The glomerular filtration rate (GFR) in- creases by 50% during the first trimester and remains elevated through- out pregnancy. These changes are caused by pregnancy hormones; an increase in blood volume; and the woman’s posture, physical activity, and nutritional intake. The woman’s kidneys must manage the increased metabolic and circulatory demands of the maternal body, as well as the excretion of fetal waste products. The increase in GFR results in in- creased creatinine clearance and a reduction or decrease in serum creatinine, blood urea nitrogen (BUN), and uric acid levels

Answer 82

A

A. No

the glomerular filters are not filtering properly

During normal pregnancy, there is an increase in the urinary excre- tion of protein and albumin, most notable after 20 weeks of gestation. This is due to increased GFR and impaired proximal tubular function. It is considered abnormal when proteinuria exceeds 300 mg/24 hours or when albuminuria is greater than 30 mg/24 hours. The amount of protein excreted is not an indication of the severity of renal disease, nor does an increase in protein excretion in a pregnant woman with known renal disease necessarily indicate a progression in her disease. However, a pregnant woman with hypertension and proteinuria must be evaluated carefully because she may be at greater risk for adverse pregnancy outcomes (Cunningham et al., 2018).

Answer 83

A

B. Yes

Yes due to the increase in blood volume the kidneys have more blood to filter which results in more production of urine

Answer 84

A

B. left side lying

Renal function is most efficient when the woman lies in the lateral recumbent position and least efficient when the woman assumes a supine position. A side-lying position increases renal perfusion, which increases urine output and decreases edema. When the pregnant woman is lying supine, the heavy uterus compresses the vena cava and the aorta and CO decreases. As a result, blood flow to the brain and heart is continued at the expense of other organs, including the kid- neys and uterus.

Answer 85

A

Slight hypertrophy; placement up & forward
Pulse increase-palpitations
Increased blood volume: Physiologic anemia
Increased cardiac output
Pulse rate
Stroke volume
Hypercoagulable state
Thrombosis risk

Answer 86

A

Changes compensate to maternal need
Increased oxygen consumption;
efficiency of oxygen utilization
Estrogen relaxes intracoastal ligaments
Increase vascularity; nasal & sinus
congestion; epistaxis
Diaphragm elevated (4 cm into thorax
at 36 weeks); 3rd trimester Shortness of Breathe
common

Answer 87

A

In pregnant women laying supine fetus presses on vena cava disrupts circulation, can cause light-headedness to pregnant women, repositioning can prevent vena cava syndrome

Answer 88

A

*Center gravity shifts
forward; Lordosis
* Relaxation of joints;
pelvic joint mobility:
Gait more unsteady
* Abdominal muscles
stretch & lose tone/may
separate

The muscles of the abdominal wall stretch and ultimately lose some tone. During the third trimester, the rectus abdominis muscles can separate (diastasis recti abdominis), allowing abdominal contents to protrude at the midline. The umbilicus flattens or protrudes. After birth, the muscles gradually regain tone. However, separation of the muscles can persist.

Answer 89

A

Edema involving the peripheral nerves can result in carpal tunnel syndrome during the last trimester.

Answer 90

A

Sensory changes in legs
Sciatica
Restless leg
syndrome
Carpal tunnel;
Acroesthesia
Tension headaches
Syncope
Muscle cramps

The olfactory sense is altered during pregnancy. Many women report an enhanced sense of smell and sensitivity to certain odors that previ- ously were benign.

Answer 91

A

A. No\

Headache during pregnancy can be a symptom of a complication such as pre- eclampsia. Therefore, all pregnant women complaining of headaches should be carefully evaluated to rule out complications.

Answer 92

A

Melasma (also called chloasma or mask of preg- nancy) is a blotchy, brownish hyperpigmentation of the skin over the cheeks, nose, and forehead, especially in pregnant women with dark

Striae gravidarum, or stretch marks (see Fig. 7.9), appear in 50% to 80% of pregnant women during the second half of pregnancy.

The linea nigra (Fig. 7.9) is a pigmented line extending from the symphysis pubis to the top of the fundus in the midline.

Angiomatas, commonly known as vascular spiders, are tiny star- shaped or branched, slightly raised, and pulsating end-arterioles usu- ally found on the neck, thorax, face, and arms.

Pinkish red, diffusely mottled, or well-defined blotches are seen over the palmar surfaces of the hands in the majority of women during pregnancy. These color changes, called palmar erythema, are related to increased estrogen levels.

Nail and hair growth may be accelerated. Some women notice thin- ning and softening of the nails. Hirsutism, the excessive growth of hair or growth of hair in unusual places, is commonly reported.

Answer 93

A

*Higher risk for anemia,
preeclampsia, preterm birth
* Possible impulsive behaviors &
lack life experience to make
informed, complex decisions
* Additional nutrition to provide for
own growth
* Possibly lack resources to support
education or provide care for self
or newborn
* Self-esteem issues

Answer 94

A

Possible preexisting conditions
(diabetes & hypertension)
Increased risk vaginal bleeding,
preeclampsia, multiple gestation,
gestational diabetes, preterm labor,
dysfunctional labor, cesarean birth
Fetus at greater risk for low birth
weight, macrosomia, chromosomal
abnormalities & congenital
malformations
Long identification as adult with
mature relationships/communicatio

Answer 95

A

Promote health, well-being;
preventative care
Provide resources: poverty, lack
health insurance
Culturally sensitive care,
communication
Prenatal care of marginalized
women
Inadequate prenatal care = increased
infant mortality, maternal/fetal
complications

Answer 96

A

Childbearing, reproductive
history/current pregnancy
Health history; Review of systems
Mental health history
Nutrition history
History drug, herbal preparations
use
Family history
Social, experiential, occupational
history
History physical abuse
Physical examination; laboratory
tests
Biographic data
Reason for seeking care
Present health or history of
present illness
Past health
Family history
Screen for abuse
Review of systems
Functional assessment

Answer 97

A

Signs and Symptoms
* Pallor
* Dizziness,faintness,breathlessness
* Tachycardia
* Nausea
* Clammy(damp,cool)skin;sweating

Interventions
* Position woman on her side until he r signs and symptoms subside and vital signs stabilize to within normal limits.

Answer 98

A

Intimate partner
violence (IPV)
Physical, emotional
or sexual abuse
Isolation
Controlling all aspects of the woman’s life
Money
Shelter
Time
Food

Answer 99

A

Rates range 4% to 8%; (20% in some
populations)

Incidence intimate partner violence
may escalate

Often first incident during pregnancy

Risk to fetus: increased miscarriage,
preterm birth, and stillbirth

Answer 100

A

Women with the Rh-negative (D-negative) blood type who are carrying an Rh-positive (D-positive) fetus can develop antibodies against the D antigen on the fetal red blood cell, causing lysis of the fetal red blood cells. This can lead to life-threatening hemolytic disease of the fetus and newborn (see Chapter 25).

A dose of 300 mg of Rh immune globulin is routinely administered at 26 to 30 weeks to all Rh-negative women without evidence of anti-D alloimmunization. If she gives birth to an Rh-positive infant, the dose of Rh immune globulin is repeated within 72 hours after birth (see the Medication Guide in Chapter 19).

Answer 101

A

Although UTIs can be asymptomatic, typical symptoms include frequency, urgency, dysuria, dribbling, and hesitancy; gross hematuria can occur.

Answer 102

A

Helpful in maintaining wellness, coping
with illness

Refers to efforts of our being, humanity

Holistic approach to women’s wellness

Spiritual assessment

Spirituality more basic to humanity than
religion

Answer 103

A

General appearance/objective
data/describe findings
Vital signs
Cultural considerations,
communication variations
Literacy
Woman expert on her life,
culture, experiences
Respect, genuine desire to learn
encourage self disclosure
Appropriate to disrobe
completely for physical exam?

Answer 104

A

CBC- anemia, infection, or clotting disorders
Blood type-blood group A, B, AB, or O
Rh status-mom Rh (-); if fetus Rh (+) risk
isoimmunization
Coombs-screen antibodies to Rh (+) proteins
Rubella/Varicella- not immune? postpartum
vaccination offered
STIs-mainly syphilis, gonorrhea, chlamydia
HIV-screen for HIV, positive? further testing

Answer 105

A

More perspiration, body odor & acne may
shower more
Leukorrhea thin, white, scant vaginal
discharge, no douching
Cotton underwear, wipe front to back
Sexual activity-sex until due date for most
healthy women, try different positions as
fetus grows
Travel-safe to 36 weeks, ambulate every 1-2
hours fluids
Work:-avoid heavy lifting, chemicals, fumes
exposure, radiation, diseases, rest & brief
walks to promote circulation

Answer 106

A

Any fluid from vagina-not leukorrhea
Abdominal or pelvic pain
Epigastric pain; severe heartburn
Sudden or severe edema in face, hands
Severe or unusual continuous headache
Dizziness, blurred vision, seeing spots
Persistent vomiting
Temperature 100.4 F or higher
Dysuria, oliguria
No fetal movement for 12 hours
Leg edema with pain or redness

Answer 107

A

a condition in pregnancy characterized by high blood pressure, sometimes with fluid retention and proteinuria.

Answer 108

A

Gastrointestinal
* Nausea and vomiting
* Ptyalism
* Dyspepsia
* Flatulence
* Constipation; hemorrhoids

Respiratory
* Nasal Congestion
* Shortness of breath/hyperventilation

Musculoskeletal
* Backache; leg cramps
* Dependent edema
* Varicosities

Answer 109

A

Monthly first 28 weeks
* Every 2 weeks from 28-35 weeks
* Weekly 36 weeks-delivery

Visits added with unusual symptoms.
Schedule adjusted as needed if high-
risk complications

Answer 110

A

15-18 weeks-
Maternal multiple Marker

Quad screening
1. Assesses for the presence of four specic sub- stances
2. Screens for other chromosomal defects, includ- ing Down’s syndrome and neural tube and ab- dominal wall defects
3. Interventions
a. a-Fetoprotein level is determined by a blood
sample drawn between 16 and 18 weeks of
gestation. NTD
b. If the level is abnormal and the gestation is
less than 18 weeks, a second sample is drawn
and screened.
c. An ultrasound is performed for elevated lev-
els to rule out fetal abnormalities or multiple
gestation.
d. Amniocentesis is performed to diagnose and
conirm chromosomal defect and/or neural
tube conditions.

This diagnostic test is used to test for any chromosomal abnormalities and neural tube defects in the fetus through a blood test

Answer 111

A

15-26weeks
Ultrasound screening to measure the head and anatomical parts of the fetus and to see if the fetus is growing correctly

d. Amniocentesis is performed to diagnose and
conirm chromosomal defect and/or neural
tube conditions.

Answer 112

A

24-28 weeks

Answer 113

A

ANSWER 3
Rationale: Because amniocentesis is an invasive procedure, informed consent needs to be obtained before the procedure. After the procedure, the client is instructed to rest, but may resume light activity after the cramping subsides. The client is instructed to keep the puncture site clean and to report any complications, such as chills, fever, bleeding, leakage of fluid at the needle insertion site, decreased fetal movement, uter- ine contractions, or cramping. Amniocentesis is an outpatient procedure and may be done in the obstetrician’s office or in a special prenatal testing unit. Hospitalization is not necessary after the procedure.

Answer 114

A

“The vaginal discharge may be bothersome, but
is a normal occurrence.”

Rationale: Leukorrhea begins during the first trimester. Many clients notice a thin, colorless, or yellow vaginal discharge throughout pregnancy. Some clients become distressed about this condition, but it does not require that the client report to the health care clinic or emergency department immediately. If vaginal discharge is profuse, the client may use panty liners, but should not wear tampons because of the risk of infection. If the client uses panty liners, the client needs to change them frequently.

Answer 115

A

1, 2, 3, 4

Answer 116

A

24-28 weeks

give the first dose and then the next dose within 72 hours of post delivery protect pregnancy

Answer 117

A

at 35-37 gestation

swab around mothers vagina and rectum to test for the bacteria

The test will either be positive or negative

if the test is positive you are required to give antibiotics 4 hours before delivery ton protect the baby from infection

This bacteria is teratogenic to the fetus and a=can kill the baby if not managed properly

Answer 118

A

No
always culture herpes lesion

Answer 119

A

*Family history
* Multiple fetal pregnancy
* African-American race
* Obesity
* Before 19 & after 40 years old
* Pre-existing medical or genetic
conditions

Answer 120

A

You can find 2arteries and 1 vein in the placenta
A-Artery
V-Vein
A-Artery

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UNIT 1 HEALTH ASSESSMENT CHAPTER 7, 8, Flashcards

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