Genetics in Maternity
Offspring of two carriers of an autosomal recessive disorder have what percentage chance of inheriting two abnormal genes and thus the disorder?
25%
Birth control comes in different forms, with each the role of the nurse is to assess the client for pertinent information. What type of information would the nurse need for oral birth control given monthly?
Having a good understanding of the clients menstrual cycle will help the physician to determine the method of contraception and advise on the best course of action.
During a sexual abuse examination, what is the nurse's role regarding the client's clothing?
To allow the woman to take off her own clothes and not try to help her remove them or bag them
What physical sign of pregnancy, evident at 6 to 8 weeks, is characterized by the violet-blue color of the vaginal mucosa and cervix due to increased vascularity?
Chadwick sign
What is the most abused substance during pregnancy?
Alcohol
Nurses play an essential role in providing what type of support to families facing genetic concerns?
Emotional support
For women who have difficulty remembering to take daily birth control pills, what is a good contraceptive choice?
Depo-Provera
What important point should nurses make to clients who have a hard time admitting they have a problem with abuse?
That the cycle of violence continues and escalates over time
What is the pigmented line extending from the symphysis pubis to the top of the fundus in the midline, which appears during pregnancy?
Linea nigra
Universal screening for which bacterial organism is recommended for all pregnant women between 35-37 weeks of gestation?
Group B streptococcus (GBS)
What is the recommended treatment for a pregnant woman who tests positive for GBS, and when is it typically administered?
Antibiotic prophylaxis, typically administered during labor and continued until delivery
What is the primary purpose of the nurse gathering client and family information during genetic evaluations?
To provide clues as to whether the client has a genetic trait, inherited condition, or inherited predisposition
What is a tubal ligation?
A tubal ligation is a sterilization procedure for women performed in the postpartum period to prevent getting pregnant.
How does the cycle of violence typically change over time if the abuser is not removed?
It typically increases in frequency and severity
Softening of the cervical tip around the beginning of the 6th week of pregnancy is known as what sign?
Goodell sign
Immunization with what type of viruses is contraindicated during pregnancy due to potential teratogenicity, according to the sources?
Live or attenuated live viruses
What is Phenylketonuria, or PKU, an example of?
An Autosomal Recessive Inheritance disorder
What is the nurse’s role when a client asks to seek an abortion for the present pregnancy?
Counseling about abortion includes helping the woman identify how she perceives the pregnancy, providing information about the choices available (i.e., having an abortion or carrying the pregnancy to term and then either keeping the infant or placing the baby for adoption), and informing about the types of abortion procedures and risks Provide information only it is not your role to tell her not to or guilt her into not having an abortion. If a client is experiencing an abortion during the first trimester, the only role of the nurse is to provide them with information.
Several symptoms women experiencing violence and abuse can have, including physical and psychological ones.
Chronic pelvic pain, substance use disorder, headaches, backaches, withdrawal, anxiety, sexually transmitted infections, pregnancy, depression, guilt, nervousness, and sexual dysfunction
Between weeks 38 and 40 of pregnancy, what happens to the fundal height as the fetus descends into the pelvis in preparation for birth, and what is this process called?
The fundal height decreases, and this process is called lightening
What is Naegele's Rule used to determine pregnancy?
The Estimated Due Date (EDD) or Estimated Date of Confinement (EDC)
Naegele’s Rule ▪ Use the first day of the last normal menstrual period.
▪ Subtract 3 from the number of months
▪ Add 7 to the number of days
▪ Adjust the year by adding 1 year.
▪ Estimated due date (+ or − 2 weeks) =
While nurses should be able to take a family medical history for genetic risk, they are unable to provide families with what?
Diagnoses to conditions they have
This procedure is not 100% certain that a client will not become pregnant, but it is highly unlikely you will become pregnant. The procedure does not prevent STIs or increase the menstrual cycle.
(non violence related question)
What are some pregnancy-related complications?
Hypertension can cause fetal issues, necessitating accurate vital signs.
Proteinuria (protein in the urine, parameters greater than 2+) can indicate preeclampsia.
Deep tendon reflexes are assessed, and parameters are important in evaluating for preeclampsia .
Weight gain recommendations during pregnancy vary based on pre-pregnancy weight. Women with normal pre-pregnancy weight should gain 25-35 pounds, underweight 28-40 pounds, overweight 15-25 pounds, and obese 11-20 pounds. The appropriateness of pre-pregnancy weight for height is the primary factor.
Optimal weight gain rate varies by trimester. First trimester: 2-4 lbs for normal weight women. Second and third trimesters: ~1 lb/week for underweight and normal weight, 0.6 lb/week for overweight, and 0.5 lb/week for obese women.
Weight loss is not advised during pregnancy, even for overweight or obese women, as they need to gain enough weight for the products of conception. Restricting energy intake can limit essential nutrients and lead to ketonemia, which may be associated with preterm labor. Emphasis should be on nutrient-dense foods.
Hyperemesis gravidarum (severe nausea and vomiting) treatment prioritizes rehydration with an IV line. This allows for hydration and antiemetic administration if needed. Routine prenatal labs and a 24-hour urine collection may be done to assess renal function. Urinalysis and culture check for UTI, common in diabetic pregnancies. Thyroid function tests may be done due to the risk of coexisting thyroid disease. Glycosylated hemoglobin A1c level assesses recent glycemic control.
Soon after the 4th month of pregnancy, intermittent and usually painless uterine contractions may be felt through the abdominal wall. What are these called?
Braxton Hicks Contractions
What is the softening and compressibility of the lower uterine segment (uterine isthmus) occurring around 6 weeks, leading to exaggerated uterine anteflexion in the first 3 months
Hegar sign