In the beginning
A pregnant woman diagnosed with a life-threatening condition refuses a necessary medical intervention that could save both her life and the fetus. Which ethical principle should guide the nurse's actions?
a. Beneficence
b. Justice
c. Autonomy
d. Non-maleficence
What is C? Autonomy
A pregnant woman at 8 weeks gestation presents to the clinic with complaints of breast tenderness and darkening of the areolas. The nurse explains that these changes are primarily due to:
a. Increased estrogen and progesterone levels
b. Decreased blood flow to the breasts
c. Elevated prolactin levels
d. Changes in breast tissue elasticity
What is A? Increased estrogen and progesterone levels
A score of 8-10 correlates with normal fetal oxygenation.
What is Biophysical Profile (BPP)?
A pregnant woman at 28 weeks gestation is diagnosed with gestational diabetes mellitus (GDM). The nurse educates the woman about managing this condition primarily through:
a. Reducing protein intake to stabilize blood glucose levels
b. Monitoring blood glucose levels regularly and adjusting diet and exercise
c. Avoiding all carbohydrates to prevent hyperglycemia
d. Increasing fluid intake to prevent dehydration
What is b? Monitoring blood glucose levels regularly and adjusting diet and exercise
In this condition, pregnant clients may experience painless vaginal bleeding and should not deliver vaginally.
What is placenta previa?
Appropriate duties the nurse delegates to the UAP include:
What is vital signs, linen changes, bathing or turning patients, feeding patients, transporting patients, ambulating patients, assisting with ADLs, blood sugars
A nurse is describing the process of fetal circulation to a client during a prenatal visit. The nurse accurately tells the client that fetal circulation consists of:
What is 2 arteries carrying deoxygenated blood and 1 vein carrying oxygenated blood
Elevated levels of this are associated with neural tube defects?
What is Alpha-Fetoprotein (AFP)?
A pregnant woman at 36 weeks gestation is diagnosed with preeclampsia. The nurse should monitor the woman closely for which potential complication?
a. Gestational hypertension
b. Hyperemesis gravidarum
c. Placenta previa
d. HELLP syndrome
What is D? HELLP syndrome
A pregnant woman at 34 weeks gestation reports sudden onset of severe abdominal pain and dark red vaginal bleeding. On assessment, the nurse notes uterine tenderness and signs of shock. The fetal heart rate is irregular. The nurse suspects which condition and should initiate which action?
a. Placenta previa; prepare for cesarean delivery.
b. Abruptio placentae; prepare for immediate delivery.
c. Cervical polyp; reassure the woman and monitor bleeding.
d. Ectopic pregnancy; prepare for surgical intervention.
What is b? Abruptio placentae; prepare for immediate delivery.
Age, socioeconomic status, abnormal prepregnancy weight, and substance abuse are all examples of this
What are nutritional risk factors?
Pregnancy resulting from two ova that are fertilized by different sperm
Dizogotic (Fraternal) twins
This invasive test performed between 10-13 weeks gestation can be done to diagnose fetal chromosomal, metabolic, or DNA abnormalities.
What is Chorionic Villus Sampling (CVS)?
A pregnant client at 28 weeks of gestation presents to the emergency department with complaints of vaginal bleeding. On assessment, the bleeding is moderate and bright red. The client denies abdominal pain or contractions. Which of the following actions should the nurse prioritize initially?
a) Administering IV fluids
b) Preparing for an emergency cesarean section
c) Performing a pelvic exam
d) Monitoring fetal heart rate
A prenatal nurse is providing instructions to a group of pregnant clients regarding measures to prevent toxoplasmosis. Which statement if made by one of the clients indicates a need for further instructions?
A. "I need to cook meat thoroughly."
B. "I need to avoid touching my mouth or eyes while handling raw meat."
C. "I need to drink unpasteurized milk only."
D. "I need to avoid contact with materials that are possibly contaminated with cat feces."
What is C? "I need to drink unpasteurized milk only."
Pregnant women should be cautioned against eating these things during pregnancy
What is fish with high mercury levels, raw fish, soft cheese, unpasteurized milk, raw sprouts, unwashed fruits/vegetables, lunch meat/hot dogs unless reheated?
A pregnant woman in her first trimester complains of heartburn after meals. Which nursing intervention is most appropriate to help alleviate this symptom?
a. Encouraging the woman to lie down immediately after meals.
b. Recommending the woman avoid spicy and acidic foods.
c. Suggesting the woman increase her intake of carbonated beverages.
d. Advising the woman to skip meals to reduce gastric acid production.
What is B? Recommend avoid spicy and acidic foods
A reactive result of this test indicates two or more accelerations within a 20 minute period
What is Nonstress Test?
A pregnant client is receiving magnesium sulfate for the management of preeclampsia. A nurse determines the client is experiencing toxicity from the medication if which of the following is noted on assessment?
A. Presence of deep tendon reflexes (DTRs)
B. Serum magnesium level of 6 mEq/L
C. Proteinuria of +3
D. Respirations of 10 per minute
What is D? Respiratory rate 10 bpm
A nurse is caring for a pregnant client with severe preeclampsia who is receiving IV magnesium sulfate. Name the nursing interventions you would anticipate for this client:
What is: Monitor uop, keep calcium gluconate on hand, monitor DTR hourly, notify provider if uop <30 ml/hr, monitor vs hourly?
Amniotic fluid is made of fetal urine and has these functions:
What is cushions against the impacts to the maternal abdomen, allows symmetric development, prevents the membranes from adhering to developing fetal parts, and allows room for buoyancy and movement?
positive indicators of pregnancy include
Confirms pregnancy, verifies location of pregnancy, gestational age, and location of uterus, cervix, and placenta
What is the first trimester ultrasound?
The nurse is preparing to administer Rho (D) immune globulin (RhoGAM) to a woman following the delivery of a newborn infant. Which statement made by the woman indicates she understands the teaching provided by the nurse?
A. "My baby is protected from developing physiological jaundice."
B. "My baby is protected from having Rh+ blood."
C. "My baby is protected from being affected by Rh incompatibility."
D. "My baby is protected from developing Rubella."
What is C? "My baby is protected from being affected by Rh incompatibility."
Which of the following assessments would be most indicative of a possible rupture of an ectopic pregnancy?
a) Mild, crampy abdominal pain and nausea
b) Sudden, severe abdominal pain with shoulder pain
c) Spotting and lower back pain
d) General fatigue and dizziness
What is b) Sudden, severe abdominal pain with shoulder pain ?