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Review Units 3&4
| Question | Answer |
|---|---|
| A woman has had her molar pregnancy evacuated and is prepared for discharge. The nurse should make certain that the client understands that it is essential that she: | Not become pregnant for at least a year |
| A woman is 30 weeks pregnant. She has come to the hospital because her membranes have ruptured. Based solely on this information, which of the following nursing diagnoses could be made for her (not her fetus) | Risk for infection |
| In order to determine if a client has ectopic pregnancy which of the following procedures would be performed | Pelvic exam and ultrasound |
| a woman with PIH: BP158/100, uninary output 50ml/hour lungs clear to auscultation, urine dip stick 1 plus protein, edema of the feed and ankles. On the next hourly assessment which of the following would be a sign that her PIH is becoming more severe? | Urine dipstick 3 plus protein & Urinary output 20ml/hour |
| What is the cause of epigastric pain that sometimes occurs with severe PIH? | Liver distension |
| A 26 year old multipara is 24 weeks pregnant. Her previous births include two LGA and one unexplained still birth. With this history, which of the following assessments should be made to identify her probable pre-gestational problem | Blood glucose |
| What is the most effective factor in reducing the risk of congenital anomalies in the fetus of a diabetic mother | Strict control of blood glucose before conception and in the early weeks of pregnancy |
| The screening test done to determine if a pregnant woman has been sensitized to the Rh factor is: | Indirect coombs' test |
| A pregnant woman is married to an IV Drug user, She has a negative HIV screening test just after missing her menstrual period. Which of the following data would indicate that she needs to be retested for HIV | unusual fatigue and recurring Candida Vaginitis |
| Which of the following is true regarding Cytomegalovirus | Cytomegalovirus is the least prevalent of the TORCH |
| Ultrasound is especially useful in pregnancy because it: | Causes minimal pain to the mother, Has been found to have no fetal risk, is considered a noninvasive procedure |
| The Naegle's rule for determining EDC is: | From the clients first day of her last menstrual period subtract 3 months and add 7 days. |
| A woman is 32 weeks pregnant. Her fundal height is measuring 26 cm. The client is scheduled for a series of utrasounds every two weeks. The main purpose of this is: | Evaluate fetal growth, Grade the placenta |
| What is the purpose of Doppler velocimentry? | Access placental function by studying blood flow changes. |
| A client is having an amniocentesis. Just prior to having the procedure she has an ultrasound done. The purpose of the ultrasound at that time is to: | Locate the placenta and fetus |
| Which of the following test results on the amniotic fluid would indicate that the fetus is at least 36 weeks gestation? | The presence of phosphatidylgycerol(PG) and L/S in the fluid. |
| A client informs the nurse that she had a male child on her due date, one spontaneous miscarriage at 8 weeks, one female child at 33 weeks. She has 2 children at home this client is currently pregnant, according to TPAL what is her Gravida and Parity | G 4 P1112 |
| The client has a fundal height of 28 cm. The nurse looks at her pre-natal record and determines that the client is 27 5/7 weeks. What should the informed nurse do with this information | Tell the client her fetus is growing appropriately for gestational age |
| A client is a gravid Parity 0352. As a professional nurse you identify that the client is at high risk for what possible complication with her current pregnancy | High risk for miscarriage and preterm delivery |
| All pregnant woman have glucose tolerance test. What value is considered normal | less than 140 |
| A client is 20 weeks pregnant and her weight is 153 pounds. At her 24 week appointment what should her weight be? | 157 pounds |
| What tests are used to determine SROM? (Spontaneous rupture of the membranes) | Nitrazine test & Ferning |
| What symptoms are expected side effects of Magnesium Sulfate? | Pulmonary edema & Lethargic and flushed hot feeling. |
| What client should receive Rhogam | Rh negative mother and Rh positive baby |
| Trisomy21 | Low level of alpha fetoprotein |
| Neuraltube | High level of alpha fetoprotein |
| progesterone | causes the blood pressure to fall slightly in the second trimester |
| Naegle's | The rule from the first day of the LMP minus 3months plus 7days |
| sonograms | reason done is to evaluate fetal growth |
| Fundal height | Done from the symphysis to the top of the urerus |
| preterm | after 20 weeks but before 37 weeks |
| quickening | occurs around 16-20 weeks |
| Risk | What factors age, being a smoker, low income and weight under 100 pounds put the pregnant woman at. |
| Pound | The woman should gain 1-5 pounds in the first trimester and this amount per week in the second and third trimester |
| ferning | the most accurate test that checks amniotic fluid |
| Pica | eating non-nutritional substances. |
| incomplete | The type of abortion that expells part of the products of conception. Has Cervical Dialation |
| Gravida | The number of times pregnant. |
| Parity | The number of viable infants delivered. |
| Nitrazine | A test done first to check for ROM (litmus test) and may be followed by looking under the microscope (ferning). |
| decidua | Endometrium called after implantation. |
| Protein | pregnancy causes 20% increase, up to 60 grams/day. |
| Vegan | Eats no animal products so requires special diet consults. |
| Carbohydrates | The primary source of energy |
| HELLP | Multiple Organ Failure Syndrome, Hemolysis (breakdown of RBCs), Elevated Liver enzymes, Low Platelets (below 100,000) |
| HIV | Take antiretroviral drug therapy, and Western Blot and ElISA diagnosis |
| Prenatal Visits | every 4 weeks-till 28 weeks, every 2 weeks-28-36 weeks, every week-36-Birth |
| 16-20 Weeks Labs | Maternal Serum Fetal Protien/alpha fetoprotein (up is tubal, down is Downs), Ultrasound |
| 28 weeks Labs | H&H (hemoglobin & Hemocrite), 1 hour GTT (sugars 130-140), Rohgam (direct coombs-Baby & indirect coombs-mom) |
| 36 week Labs | H&H (hemoglobin and Hemocrite), GBS (Group B Strep) |
| 1st Sign of Pregnancy | Tender Breasts |
| 3rd Trimester | need the most calcium, phosphorus, and iron |
| Vitamin A | can be toxic in excess |
| Hyperflexia and Clonus are signs of | PIH |
| Positive Oxytocin Test | Late decelerations with more than 50% of the contractions (bad) |
| Nonstress Test | Assess fetal wellbeing (how well baby is tolerating 15 beats for 15 seconds within 20 mins=Reactive) |
| Periodic | Happen with contractions |
| Contraction Stress Test | Can fetus tolerate labor, (negative-no decelerations, positive-late decelerations 50%) |
| L/S | Lungs maturity level, achieved at 35 weeks |
| PG | Fetal Lung Maturity has been achieved |
| Liver distention causes | Epigastric Pain |
| Herpes Simplex Virus | Primary transmission very teratogenic to fetus |
| No increase in Carbohydrates in which trimester | 1st Trimester |
| Side Effects of Magnesium Sulfate (MAGSO4) | Lethargy, sweating, warmth, flushing, nasal congestion, N/V, constipation, visual blurring, HA, slurred speech (fetus is lethargy and hypotonia(low muscle tone)) |
| Signs of toxic levels of Magnesium Sulfate | Magnesium levels (reduced by Calcium gluconate), RR of less than 10, Reflexes, urine output |
| Hyperemesis Gravidarum | increases in hCG causes excessive vomiting |
| Placenta previa | implanted low on the uterine wall, may cover the cervical OS(decreased blood to the placenta) Bright Red bleeding |
| Abruptio placentae | Detachment of all or part of placenta, hemorrhage can be apparent or concealled. (fetal hypoxia)Dark Red Bleeding |
| Threatened Abortion | No cervial dialation, bleeding and cramping |
| Missed Abortion | Pregnancy retained in uterus for 8 weeks or longer, brown discharge and negative pregnancy test |
| Preeclampsia | 160/110, Proteinuria 1+ or greater (increase protien in diet), decreased renal perfusion, (watch drop in urinary output), Edema (dependent & hands & face), decreased placenta perfusion (fetus SGA) |
| what is the rationale for measuring deep tendon relexes and clonus on a woman with preeclampsia | it indicates central nervous system irritability |
| maternal measurements should the nurse obtain on a client who is receiving magnesium sulfate? | Respirations, Blood Pressure, Urinary Output, patellar tendon reflex |
Created by:
wfawcett
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