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60 Cards in this Set

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A pregnant woman has a blood glucose screening at 26 weeks' gestation. The result is 128mg/dl. The nurse should expect that
a. no additional glucose testing will be neded
b. insulin injections will be needed by 30 weeks' gestation
c. oral drugs may be prescribed to lower her glucose level
d. more testing is needed to determine additional therapy
a
What two factors contribute to a woman's sense of dyspnea?
The growing uterus eventually lifts the diaphragm and reduces lung expansion. Because the respiratory center becomes more sensitive to carbon dioxide, the minute volume increases and the partial pressure of carbon dioxide falls.
What prenancy-induced changes in pigmentation may occur in the face? What hormone is responsible?
Chloasma, or mask of pregnancy, a highly pigmented aref of the forehead, cheeks, and bridge of the nose
What is "supine hypotensive syndrome"?
Lying in the supine position places the heavy uterus over the aorta and inverior vena cave, which temporarily occludes these vessels.
What pregnancy-induced changes in pigmentation may occur in the abdomen? What hormone is responsible?
Linea nigra extends from the umbilicus to the symphysis. Estrogen is responsible for increased pigmentation, which is more prominent in dark skinned women.
When during pregnancy is the Fundus at the xiphoid process?
36 weeks
Why is pregnancy risk assessment not a one-time evaluation?
Later in the pregnancy risk factors may appear that were not apparent at previous assessments.
What should the nurse do to prevent or relieve supine hypotensive syndrome?
Prevention/treatment is to position woman on her side or with a pillow under one hip.
Use Nagele's rule to calculate estimated dates of delivery (EDD) for each of these dates representing last menstual period dates.
a. February 4
b. August 2
a. November 11
b. May 9
What is the cause of Goodell's sign during pregnancy?
Cervical, uterine, and vaginal softening with increased vascularity and softening of the connective tissue.
Describe the edema that is expected during pregnancy and why it occurs. When should it be reported?
Edema of the legs and feet is not uncommon. Edema above the waist (face and fingers) may be an indication of pregnancy-induced hypertension and should be reported.
Why does the pregnant woman's bone mass stay stable even though the fetus requires calcium for skeleton development?
Although parathyroid hormone usually acts to increase absorption of calcium from the intestine, reduce renal losses, and mobilize bone, estrogen and calcitonin interfere with its effects on bone mobilization during pregnancy.
When during pregnancy is the Fundus at the level of umbilicus?
20 weeks
Define uterine souffle and specify the heart rate to which it corresponds.
Placental blood flow sounds, corresponding to maternal heart rate and rhythm.
lightening
descent of fetus into pelvis, reducing pressure on diaphragm
physiologic anemia of pregnancy
fall in hematocrit that occurs because plasma volume expands more than red blood cell volume
What breast changes occur during pregnancy?
Darkening of the areolae, increased nipple and areolae size, areolae become more erect, Montgomery's tubercles become prominent.
What is the difference among the three classifications (presumptive, probable, and positive indications of pregnancy)
Presumptive indicators are the least reliable because they are often caused by other conditions; probable indicators are stronger evidence but still may have other causes; positive indicators are those caused only by pregnancy.
What routine urine testing is done during prenatal visits?
Protein, glucose, ketones
How does Uterine size differ when a woman has a multifetal pregnancy?
Uterine size is larger than expected for the length of gestation.
Describe maternal cardiac workload changes that occur in a multifetal pregnancy.
Cardiac workload is higher due to increased blood volume.
What is the cause of Chadwick's sign during pregnancy?
Bluish color that often extends to the vagina and labia; cause is hyperemia
A pregnant woman expects to give birth to her fisrt baby in about a week. She asks the nurse if she has a bladder infection since she urinates so much, even though urination causes no discomfort. The nurse should explain to her that:
a. urinary tract infections are most common just before birth, so she should have a urine specimen tested
b. her fetus is probably lower in her pelvis, putting more pressure on her bladder
c. limiting her fluid can reduce the number of times she must interrupt her activity to urinate
d. the fetal growth has probably stopped and she should expect to start labor in a few days
b
Describe maternal bowel changes that occur in multifetal pregnancy.
Pressure on bowels increases constipation.
How do fetal movements differ when a woman has a multifetal pregnancy?
Fetal movements are more numerous, which the woman who has had a previous pregnancy is more likely to notice.
A woman having physiologic anemia of pregnany has a hemoglobin and hematocrit level of at least
a. 10 gm and 30%
b. 10.5 gm and 33%
c. 11 gm and 35%
d. 12 gm and 38%
b
hyperplasia
growth that occurs because of an increase in the number of normal cells
A pregnant woman complains that both of her thumbs hurt at times. Nither thumb is inflamed or discolored. The nurse should explain to the woman that
a. she probably injured her hand and does not recall doing so
b. an undiagnosed fracture may have healed improperly
c. osteoarthritis often has its onset during pregnancy
d. increased tissue fluid is causing compression of a nerve
d
A pregnant woman is prone to urinary tract infection primarily because
a. a large volume of fetal wastes must be excreted by her kidneys
b. nutrients that enhance bacterial growth are excreted by her kidneys
c. the volume of urine excreted is reduced and its specific gravity is high
d. reduced blood flow to the urinary tract allows wastes to accumulate
b
Slight respiratory alkalosis during pregnancy enhances
a. growth of fetal arteries within the placenta
b. the fall in systolic and diastolic blood pressures
c. maternal metabolism of food and nutrients
d. transfer of fetal carbon dioxide to maternal blood
d
What is the cause of a Bloody Show during pregnancy?
Mixture of cervical mucus and a small amount of blood; disruption of mucous plug and small capillaries of cervix.
ballottement
fetal rebound in the amniotic fluid when the cervix is touched
hypertrophy
growth that occurs because of increased size of existing cells
Describe the maternal blood volume changes that occur in a multifetal pregnancy.
There is a 500-ml increase in blood volume over the singleton pregnancy.
What signs and symptoms might a woman with supine hypostensive syndrome display?
faintness, lightheadedness, dizziness, agitation, and sometimes brief unconsciousness. This position can reduce placental blood flow.
List the presumptive, probable, and positive indications of pregnancy.
table 13-1, p 273
At what point in gestation is it possible to hear fetal heart sounds with the Doppler?
10 to 12 weeks
What is the cause of McDonald's sign during pregnancy?
Easy flexion of the uterine body against the cervix; cause same as Goodell's sign
What changes in carbohydrate metabolism and the production, utilization, and breakdown of insulin occur during pregnancy? Why do the changes occur? How does the woman's body normally respond to these changes?
The fetus draws on maternal glucose and amino acids, which reduces the mother's glucose levels and her ability to synthesize glucose. During the first trimester, the lower maternal blood glucose causes the pancrease to secret less insulin. During the second trimester, hormones (human placental lactgen, prolactin, progesterone, and cortisol) reduce the maternal tissue sensitivity to insulin. Thus the mother's blood glucose levels rise to make more available for the fetus. The woman normally responds by increasing insulin.
Describe maternal respiratory workload changes that occur in multifetal pregnancy.
Greater diaphragm elevation increases dyspnea
striae gravidarum
irregular reddish streaks caused by tears in connective tissue; "stretch marks"
Define Funic souffle and specify the heart rate to which it corresponds.
Umbilical cord blood flow sounds, corresponding to fetal heart rate and rhythm.
When during pregnancy can the uterus first be palpated above the symphysis pubis?
a. 12 weeks
When during pregnancy can the fundus be palpated about halfway between symphysis pubis and umbilicus?
16 weeks
What is the possible result of an increase in vascularity in the vagina during pregnancy?
Bluish color (as in Chadwick's sign), thickening of vaginal mucosa, prominence of rugae, heightened sexual interest
What is the cause of Hegar's sign during pregnancy?
Softening of the isthmus of the cervix; cause is same as Goodell's sign
What is the possible result of Growth of connective tissue in the vagina during pregnancy?
Greater pliability and distensibility of the vagina
Describe maternal blood vessel compression changes that occur in a multifetal pregnancy.
Greater compression of aorta and inferior vena cava causes earlier and more pronounced supine hypotension.
Why are pregnant women morelikely to develop gallstones?
Hypotonia prolongs emptying time and allows bile to become thicker.
At what point in gestation is it possible to hear fetal heart sounds with the Fetoscope?
18 to 20 weeks
Why does the pregnancy-induced change in fibrinogen levels have a protective effect, yet also increase risk?
Increased fibrinogen levels offer protection from excess blood loss but also predispose the woman to thrombus formation.
What is the cause of Mucous Plug during pregnancy?
Plug caused by increased secretion of mucus from cervical glands that blocks ascent of bacteria from the vagina
What is the possible result of Secretion of increased amounts of glycogan in the vagina during pregnancy?
Increased acidic vaginal discharge that retards growth of bacteria, but favors growth of Candida albicans (yeast)
What nasal changes are common during pregnancy? What causes them?
Vasocongestion from estrogen's effects causes increased vascularity and edema, leading to nasal stuffiness, nosebleeds, and voice changes. It may also result in ear fullness or earaches.
Progesterone is produced first by the _______ and then by the ______.
corpus luteum, placenta
Describe maternal ureter compression changes that occur in multifetal pregnancy.
Greater ureter compression increases edema and proteinuria.
What pregnancy-induced changes in pigmentation may occur in the breasts? What hormone is responsible?
Areolae darken
How does weight gain differ in a multifetal pregnency?
Greater weight gain occurs because of greater uterine growth, increased blood volume and amniotic fluid, and presence of two or more fetuses
Describe the changes in maternal heart sounds that may occur during pregnancy. When do the heart sound changes occur? Describe common changes in heart sounds.
Changes in heart sounds begin between 12 and 20 weeks and end 2 to 4 weeks after birth. They may include splitting of the first heart sound, a systolic murmur, and in about 20% of women, a diastolic murmur also.
Why is progesterone essential during pregnancy?
Pregnancy cannot be maintained without progesterone