What are the factors that enable the baby to initiate respiration immediately postpartum quizlet?
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After reviewing the laboratory reports of a female patient, the nurse informs that the patient is pregnant. Which laboratory finding indicates that the female is pregnant? Show Decreased levels of insulin hormone in the patient Increased levels of thyroxine hormone in the patient Increased levels of follicle-stimulating hormone (FSH) Increased levels of human chorionic gonadotropin (hCG) Increased levels of human chorionic gonadotropin (hCG) The GTPAL (gravidity, term, preterm, abortions, and living children) of a patient is 3-1-2-1-3. What does the nurse infer from this? The patient has: Three pregnancies with one miscarriage, one preterm birth, and three living children. Three pregnancies with two miscarriages, one preterm birth, and three living children. Three pregnancies with one miscarriage, two preterm births, and three living children. Three pregnancies with no miscarriages, two preterm births, and three living children Three pregnancies with one miscarriage, two preterm births, and three living children. The nurse is assessing a patient who is 7 months pregnant. The nurse observes that there are increased chest movements and decreased abdominal movements while breathing. What does the nurse interpret from this finding? Normal finding during pregnancy Impaired diaphragm function Decreased abdominal muscle tone Presence of obstructive lung disorder Normal finding during pregnancy A patient who has confirmed her pregnancy at the clinic gets a false-negative result at her home. What should the nurse identify as the reason for the error in the pregnancy test? The patient: Takes tranquillizers for insomnia. Takes anticonvulsants for seizures. Used first-voided morning urine sample. Performed the test too early in pregnancy Performed the test too early in pregnancy Human chorionic gonadotropin (hCG) is the earliest biologic marker of pregnancy. Low levels of hCG can show a false-negative result in the pregnancy test. The patient got a false-negative pregnancy test result because the test was done too early in pregnancy. The levels of hCG rise to the optimal level only by the sixth week of pregnancy. Tranquillizers and anticonvulsants cause false-positive results in the pregnancy test. First-voided morning urine specimen should be taken to obtain accurate results of the pregnancy test. The nurse reviews the medical records of a patient and suggests the patient avoid becoming pregnant. Why does the nurse suggest so? The patient: Is using isotretinoin (Accutane). Has increased blood sugar levels. Is taking promethazine (Phenergan). Is using isotretinoin (Accutane). The nurse suggests the patient avoid pregnancy because the patient is using isotretinoin (Accutane) for the treatment of acne. This medication is teratogenic and is associated with fetal malformations. Proteinuria and increased blood glucose levels are the common conditions during pregnancy, although they disappear after childbirth. Promethazine (Phenergan) therapy can cause only false-negative results for pregnancy tests. This drug is not a contraindication for pregnancy. The nurse is assessing a pregnant female who is a primigravida. What question does the nurse ask the patient to determine the duration of the pregnancy? "What are the medications you have been using?" "What is the result of your previous pregnancy?" "What is the date of your last menstrual period?" "When was the urine pregnancy test performed?" "What is the date of your last menstrual period?" Primigravida is the female who is pregnant for the first time. The duration of the pregnancy is measured by adding 9 months and 7 days to the date of the last menstrual cycle. Medications used may affect the pregnancy and interfere with the pregnancy test, but they do not coincide with the length of the pregnancy. The patient is a primigravida, which means that the female did not have a previous pregnancy. Moreover, previous pregnancy is not an indicator for the period of gestation in the present pregnancy. The length of pregnancy cannot be calculated based on the time when the pregnancy confirmation by urine test was done. In some females, pregnancy can be detected early and in some late because of variations in the human chorionic gonadotropin (hCG) level. The laboratory reports of a pregnant female reveal severe hyponatremia. Which hormone supplementation helps in normalizing sodium levels in the patient? Insulin Oxytocin Aldosterone Serum prolactin Aldosterone stimulates excess sodium reabsorption from the renal tubules of the kidneys. The nurse reviews the laboratory reports of a female patient and infers that the patient has an ectopic pregnancy. What finding would prompt the nurse to consider this clinical diagnosis? Very low levels of: Insulin Anemia Thrombocytopenia Human chorionic gonadotropin (hCG) Human chorionic gonadotropin (hCG) Human chorionic gonadotropin (hCG) is produced by the fertilized ovum. Abnormally low levels of hCG indicate impending miscarriage or ectopic (tubal) pregnancy. Decreased levels of insulin hormone are indicative of diabetes. Lower levels of RBC indicate anemia. Low levels of platelets indicate that the patient may have impaired clotting ability. Diabetes, anemia, and thrombocytopenia are not the conditions predisposing ectopic pregnancy. Over-the-counter (OTC) pregnancy tests usually rely on which technology to test for human chorionic gonadotropin (hCG)? Radioimmunoassay Radioreceptor assay Latex agglutination test Enzyme-linked immunosorbent assay (ELISA Enzyme-linked immunosorbent assay (ELISA OTC pregnancy tests use ELISA for its one-step, accurate results. The radioimmunoassay tests for the summit of hCG in serum or urine samples. This test must be performed in the laboratory. The radioreceptor assay is a serum test that measures the ability of a blood sample to inhibit the binding of hCG to receptors. The latex agglutination test in no way determines pregnancy. Rather, it is done to detect specific antigens and antibodies. The nurse is assessing a pregnant woman who reports to have noticed the appearance of bluish channels on the surface of the breast. What is the possible reason for such observation in the patient? Pigmentation on the breasts Dilation of the blood vessels Hypertrophy of the breast glands Proliferation of the lactiferous duct Dilation of the blood vessels Increased blood supply to the breast during pregnancy causes dilation of the blood vessels beneath the skin. This enhances their visibility and gives a blue network-like appearance. Pigmentation, hypertrophy of the breast glands, or proliferation of the lactiferous duct does not lead to blue network appearance. Pigmentation on the breasts in pregnancy is seen on the nipples and areolae, which gives a pinkish appearance. Hypertrophy of the breast (sebaceous) glands in primary areolae is seen around the nipples that secrete antiinfective substances to protect the nipple. Proliferation of the lactiferous ducts causes growth and enlargement of breasts. The nurse observes that the patient does not have any labor pain at the expected date of delivery. Which intervention would be helpful in inducing labor pain in the patient? Administration of: Intravenous fluids Intravenous insulin Intravenous oxytocin Intravenous diuretics Intravenous oxytocin Oxytocin hormone stimulates uterine contractions and milk ejection from the breasts. These contractions cause labor pain in the pregnant woman. Therefore the administration of oxytocin would induce labor pain in the patient. Intravenous fluids, insulin, and diuretics do not affect the uterine muscles. Intravenous fluids are administered to maintain fluid and electrolyte balance in the body. Insulin hormone regulates the blood glucose levels in the body. Diuretics are used to promote urine and are restricted in pregnant women. After reviewing the obstetric reports of a pregnant patient, the nurse finds that the patient's fundal height has not changed in the last 4 weeks. What condition does the nurse potentially interpret from this finding? Multifetal gestation Maternal malnourishment Intrauterine growth restriction (IUGR) Intrauterine growth restriction (IUGR) Stable or decreasing fundal height indicates that fetal growth does not correspond to the mother's gestational age. This indicates intrauterine growth restriction of the fetus. Polyhydramnios is a condition in which the amniotic fluid volume is greater than normal. In this condition, fundal height is greater than normal. Multifetal gestation is the presence of more than one child. Maternal malnourishment may affect the growth of the fetus but is not directly associated with fundal height. A patient who is 6-months pregnant asks about proper placement of her seatbelt. Teaching by the nurse has been successful if the patient makes which statement? "I need to place the lap belt portion snugly over the upper part of my uterus." "I need to place the lap belt portion low across my hip bones as snugly as is comfortable." "I need to position the lap belt loosely directly over my bellybutton." "I need to place the lap belt portion low across my hip bones as snugly as is comfortable." A pregnant woman reports a sudden discharge of fluid from the vagina before 37 weeks' gestation. What does the nurse infer from this observation? This is a sign
of: Intrauterine fetal death. Gestational diabetes mellitus. Premature rupture of membrane Premature rupture of membrane Sudden discharge of fluid from the vagina before 37 weeks indicates premature rupture of membranes. Severe backache or flank pain is sign of renal calculus (renal stone). Absence of fetal movements during the third trimester indicates intrauterine fetal death. A positive glucose tolerance test indicates gestational diabetes mellitus. A pregnant patient asks the nurse, "How can I prevent blockage of the nipples while breastfeeding when my baby is born?" What cleaning instructions should the nurse provide to the patient regarding nipple care? "Apply tincture." "Use alcohol." Use warm water Use warm water Warm water increases blood circulation and prevents blockage of the ducts with dried colostrum. Therefore the nurse should advise the patient to clean her nipples with warm water. The nurse should advise the patient to avoid using soap, tincture, or alcohol to clean her nipples because these substances remove the protective oils that keep the nipples supple. Use of these substances may cause cracks on the nipple during lactation. The nurse is teaching a pregnant patient who complains of vomiting about the use of dry carbohydrate in the morning. The patient asks the nurse, "My husband has similar problems. Will it be useful for my husband as well?" What can the nurse interpret from this? The husband has: Vena cava syndrome. Couvade syndrome. Carpal tunnel syndrome. Brachial plexus traction syndrome Couvade syndrome. Intake of dry carbohydrate is recommended in pregnant patient's diet to suppress the vomiting observed during early pregnancy. Sometimes pregnancy symptoms are also experienced by the male partner. This is called couvade syndrome. Vena cava syndrome (supine hypotension) and carpal tunnel syndrome are not affected by intake of dry carbohydrate. Brachial plexus traction syndrome is manifested as drooping of the shoulder, which eventually disappears after childbirth. A dry carbohydrate diet has no effect on brachial plexus traction syndrome. The nurse is documenting the findings of a contraction stress test in a patient. The nurse finds that late decelerations in fetal heart rate occur with 60% of contractions. What does the nurse advise the patient? "Continue with the weekly testing schedule." "You should be hospitalized and monitored continuously." "Take the test again tomorrow at the same time." "You should take the test again today after resting." "You should be hospitalized and monitored continuously." IF late decelerations occur with more than 50% of the contractions in the contraction stress testing, this is a positive test result. In this situation, the patient must be hospitalized and evaluated further. If the fetus has no significant variable heart rate decelerations with at least three uterine contractions for a period of 10 minutes, the patient can continue with the weekly testing schedule. If late deceleration in the heart rate occurs with less than 50% of the contractions, the patient should be advised to repeat the test the next day. Repeating the test on the same day can cause fetal distress and should be avoided. The nurse is assessing a pregnant patient and finds that her blood pressure is 150/90 mm Hg. What procedure does the nurse recommend for this patient? Nuchal translucency (NT) test Chorionic villus sampling (CVS) Doppler blood flow analysis Percutaneous umbilical blood sampling (PUBS) Doppler blood flow analysis Maternal hypertension can cause serious adverse effects on the fetus. A blood pressure reading of 150/90 mm Hg indicates that the mother is hypertensive. To assess the effect of maternal hypertension on the fetus, the nurse should refer the patient for a Doppler blood flow analysis. It is a noninvasive ultrasonic technique used to study fetal blood flow. NT is a technique used to assess genetic abnormalities in the fetus. CVS is a prenatal test used to diagnose structural defects in the fetus. PUBS is used to assess the fetal circulation. What parameter does the nurse check in the amniocentesis report of a pregnant patient to assess fetal lung growth? Lecithin-to-sphingomyelin (L/S) ratio Creatinine levels in the blood Antibody titer in the blood Lecithin-to-sphingomyelin (L/S) ratio The L/S ratio indicates fetal lung maturity. AFP is assessed to check for the presence of neural defects. Presence of creatinine in the amniotic fluid indicates that the patient's gestational age is more than 36 weeks. The antibody titer is used to determine Rh incompatibility in the fetus. During a prenatal checkup, the patient who is 7 months pregnant reports that she is able to feel about two kicks in an hour. The nurse refers the patient for an ultrasound. What is the primary reason for this referral? To check: For fetal anomalies Gestational age Fetal position For fetal well-being For fetal well-being Fetal kick count is a simple method to determine the presence of complications related to fetal oxygenation and activity level. The fetal kick count during the third trimester of pregnancy is approximately 30 kicks an hour; a count lower than that is an indication of poor health of the fetus. Fetal anomalies may not affect the oxygenation levels of the fetus. The nurse already knows the gestational age of the fetus; therefore the nurse need not refer the woman for ultrasonography to find the gestational age. Fetal position does not affect the activity level of the fetus. The nurse is reviewing the contraction stress test (CST) reports of a pregnant patient. The nurse expects the fetus to have meconium-stained amniotic fluid. What would be the reason for that conclusion? Negative CST results Positive CST results Suspicious CST results Unsatisfactory CST results Positive CST results Meconium is normally stored in the infant's intestines until after birth, but sometimes (in cases of fetal distress and hypoxia) it is expelled into the amniotic fluid before birth. The amniotic fluid is then said to be meconium stained. Fewer than three contractions in 10 minutes or late decelerations occurring with 50% or more of contractions constitute positive CST results. Positive CST results are associated with meconium-stained amniotic fluid. Negative CST results indicate that the fetus is normal. Suspicious or unsatisfactory CST results are not associated with any other fetal conditions. The nurse reviews the ultrasound reports of a pregnant patient and finds that the images of fetal anatomic details are not clear. The nurse then prepares the patient for a magnetic resonance imaging (MRI) scan. What does the nurse administer to the patient before performing the MRI scan? A sedative A diuretic An analgesic An antipyretic A sedative The MRI scan may take 20 to 60 minutes. During the scan, the patient must be perfectly still. Moreover, fetal movement during the scan will obscure the anatomic details. To avoid this problem, the patient should be administered a sedative before the MRI scan. Diuretics are administered to increase the rate of urine formation. If a diuretic is given before the MRI, frequent urination may occur. Because the patient does not complain of pain, analgesics need not be administered. Antipyretics would not helpful in decreasing the patient's activity level. They should be administered only if the patient has a fever. Which finding in the ultrasonography reports of a pregnant woman would indicate a normal fetus? Amniotic fluid index of 30 cm Amniotic fluid index of 13 cm Amniotic fluid index of 6 cm Amniotic fluid index of 2 cm Amniotic fluid index of 13 cm An amniotic fluid index of 10 cm or more is considered normal. An amniotic fluid index of 25 cm is considered above the normal range and indicates polyhydramnios. An amniotic fluid index less than 10 cm is considered below the normal range. An amniotic fluid index below 5 cm is considered oligohydramnios. After performing an amniocentesis, the primary health care provider asks the nurse to administer Rho(d) immunoglobulin to a pregnant patient with Rh-negative blood. Why should a patient with Rh-negative blood be administered Rho(d) immunoglobulin? To prevent: Pain from amniocentesis Leakage of amniotic fluid Fetomaternal hemorrhage Infection in the fetus Fetomaternal hemorrhage Fetomaternal hemorrhage may occur after amniocentesis. Administering Rho(d) immunoglobulin to a pregnant patient with Rh-negative blood is advisable to prevent fetomaternal hemorrhage. Administering Rho(d) immunoglobulin after amniocentesis will not provide pain relief. Preventing amniotic fluid leakage during amniocentesis requires expertise in the procedure; administering Rho(d) immunoglobulin does not prevent amniotic fluid leakage. Maintaining aseptic conditions while performing the procedure is helpful in preventing infection during amniocentesis; administering Rho(d) is not. While performing the fetal acoustic stimulation test (FAST) in a patient, the nurse observes that there is no fetal response even after 3 minutes of testing. Which test does the nurse suggest? Biophysical profile (BPP) Cordocentesis Coombs' test Biophysical profile (BPP) Lack of response after 3 minutes of FAST indicates that the fetus has low activity levels. In this situation, to accurately assess fetal activity, the nurse should recommend a BPP of the fetus. Amniocentesis helps detect genetic abnormalities in the fetus. Fetal activity cannot be determined using this technique. In cordocentesis, the umbilical blood is tested for Rh incompatibility and hemolytic anemia in the fetus. Coombs' test is used to determine the presence of antibody incompatibilities in the fetus and the mother. After a woman undergoes amniocentesis, the most appropriate nursing intervention is to: administer RhoD immunoglobulin. administer anticoagulant. send the patient for a computed tomography (CT) scan before the procedure. assure the mother that short-term radiation exposure is not harmful to the fetus. administer RhoD immunoglobulin Because of the possibility of fetomaternal hemorrhage , administering RhoD immunoglobulin to the woman who is Rh negative is standard practice after an amniocentesis. Anticoagulants are not administered because this can increase the risk of bleeding when the needle is inserted transabdominally. A CT is not required because the procedure is ultrasound guided. The mother is not exposed to radiation during amniocentesis. After reviewing the reports of a pregnant patient, the nurse infers that there might be a high risk for intrauterine growth restriction (IUGR). What could be the reason for this? The amniotic fluid index (AFI) is: Less than 5 cm. Equal to or more than 10 cm. Between 5 and 10 cm. More than 25 cm Less than 5 cm An AFI less than 5 cm indicates oligohydramnios. Oligohydramnios is associated with intrauterine growth restriction and congenital anomalies. An AFI of 10 cm or greater indicates that the fetus is normal. AFI values between 5 and 10 cm are considered low normal, indicating a comparatively low risk for congenital anomalies. An AFI greater than 25 cm indicates polyhydramnios. This is associated with neural tube defects and obstruction of the fetal gastrointestinal tract. The nurse who is caring for a diabetic pregnant patient finds that the weight gain pattern is poor. Which fetal factor will the nurse check in the ultrasound reports of the patient? Heart activity Growth pattern Anatomic structure Movement frequency Growth pattern Diabetes is known to cause decreased weight gain during pregnancy. This, in turn, causes intrauterine growth restriction. Therefore the nurse should regularly monitor the fetal growth pattern in ultrasound reports. Fetal heart activity and anatomic structure are not influenced by maternal diabetes. Alterations in the amniotic fluid levels are associated with fetal heart activity and anatomic structure. Impaired nutrition of the mother can affect the fetal activity and therefore reduce the frequency of the fetal movements. Decreased fetal movements are not associated with maternal diabetes. The nurse is caring for a pregnant client who is in the second stage of labor. The nurse instructs the client not to hold her breath or tighten the abdominal muscles while having intense labor pain. What is the rationale for this instruction? To prevent: The onset of fetal hypoxia. Maternal hypotension. increased fetal heart rate. Hemorrhoids in the client. The onset of fetal hypoxia. While caring for a client who is in the second stage of the labor, the nurse should instruct the client to refrain from performing the Valsalva maneuver. During the Valsalva maneuver, the client holds her breath and tightens the abdominal muscles, which may reduce the oxygen content in the blood and cause fetal hypoxia. Tightening of the abdominal muscles increases the intrathoracic pressure and may cause hypertension in the client, but not hypotension. Due to reduced oxygen supply, the pulse rate may decrease and cause fetal bradycardia, but not tachycardia. The pressure exerted by the fetus on the vaginal wall during the delivery causes hemorrhoids, but these are not associated with the Valsalva maneuver. The nurse palpates the fontanels and sutures to determine the fetal presentation. What is the feature of the anterior fontanel? It measures about 1 cm by 2 cm. It closes after 6 to 8 weeks of birth. It lies near the occipital bone. It is diamond shaped in appearance. The anterior fontanel is diamond shaped and measures about 3 cm by 2 cm. It closes by 18 months after birth. It lies at the junction of the sagittal, coronal, and frontal sutures. The posterior fontanel is triangular in shape and measures about 1 cm by 2 cm. It closes 6 to 8 weeks after birth. It lies at the junction of the sutures of the two parietal bones and the occipital bone. During the vaginal examination of a laboring
patient, the nurse analyzes that the fetus is in the right occiput anterior (ROA) position at -1 station. What is the position of the lowermost portion of the fetal presenting part? 1 cm above the ischial spine. at the level of the ischial spine. 1 cm below the ischial spine. 1 cm above the ischial spine. When the lowermost portion of the presenting part is 1 cm above the ischial spine, it is noted as being minus (-)1. When positioned 2 cm above the ischial spine, it is -2 station. At the level of the spines the station is referred to as 0 (zero). When the presenting part is 1 cm below the spines, the station is said to be plus (+)1. What are the factors that enable the baby to initiate respiration immediately after birth? Fetal respiratory movements increase during labor. Fetal lung fluid is cleared from the air passage. Arterial carbon dioxide pressure is decreased. Arterial pH and bicarbonate level is increased. Fetal lung fluid is cleared from the air passage. Fetal lung fluid is cleared from the air passage as the infant passes through the birth canal during labor and vaginal birth. There is a decrease in fetal respiratory movements during labor. Arterial carbon dioxide pressure (Pco2) increases. There is a decrease in arterial pH and bicarbonate levels. Which pelvic shape is most conducive to vaginal labor and birth? Gynecoid Platypelloid Anthropoid Gynecoid The gynecoid pelvis is round and cylinder shaped, with a wide pubic arch. Prognosis for vaginal birth is good. Only 23% of women have an android-shaped pelvis, which has a poor prognosis for vaginal birth. The platypelloid pelvis is flat, wide, short, and oval. The anthropoid pelvis is a long, narrow oval with a narrow pubic arch. It is more favorable than the android or platypelloid pelvic shape. During a prenatal evaluation, the nurse notes that the patient has a flat pelvis. What term does the nurse use to refer to this type of pelvis? Gynecoid Android Anthropoid Platypelloid Platypelloid About 3% of women may have a flat pelvis, which is referred to as a platypelloid pelvis. It is flattened anteroposteriorly and wide transversely. About 50% of women have gynecoid pelvis or the classic female type of pelvis. It is slightly ovoid or transversely rounded. An android pelvis resembles the male pelvis and may be found in 23% of women. It is heart shaped or angulated. The anthropoid pelvis resembles the pelvis of anthropoid apes and may be found in 24% of women. It is oval and wider anteroposteriorly. On
completion of a vaginal examination on a laboring woman, the nurse records: 50%, 6 cm, -1. What is a correct interpretation of the data? Effacement is 4 cm from completion. Dilation is 50% completed. The fetus has achieved passage through the ischial spines. The fetal presenting part is 1 cm above the ischial spines. During the vaginal examination of a patient in labor, the nurse identifies the presenting part as the scapula. Which fetal presentation does the nurse recognize? Cephalic Frank breech Complete breech Shoulder Shoulder The presenting part can be defined as that part of the fetus that lies closest to the internal os of the cervix. In the shoulder presentation, the presenting part is the scapula. In a cephalic presentation, the presenting part is usually the occiput. In a breech presentation, the presenting part is the sacrum. The sacrum is the presenting part in a frank breech presentation. The sacrum and feet are the presenting parts in a complete breech presentation. After a vaginal examination, the nurse documents "RSA" on the patient's chart. What does this indicate? The presenting part is the: Sacrum in the left anterior quadrant of the maternal pelvis. Scapula in the right anterior quadrant of the maternal pelvis. Sacrum in the right anterior quadrant of the maternal pelvis. Scapula in the left transverse quadrant of the maternal pelvis Sacrum in the right anterior quadrant of the maternal pelvis. Fetal position is denoted by a three-letter abbreviation. The first letter denotes the location of the presenting part in the right (R) or left (L) side of the mother's pelvis. The middle letter stands for the specific presenting part of the fetus: O for occiput, S for sacrum, M for mentum, and Sc for scapula. The third letter stands for the location of the presenting part in relation to the anterior (A), posterior (P), or transverse (T) portion of the maternal pelvis. RSA indicates that the presenting part is the sacrum in the right anterior quadrant of the maternal pelvis. LSA indicates that the presenting part is the sacrum in the left anterior quadrant of the maternal pelvis. RScA shows that the presenting part is the scapula in the right anterior quadrant of the maternal pelvis. LScT indicates that the presenting part is the scapula in the left transverse quadrant of the maternal pelvis. The nurse is assessing a client who is 6 months pregnant. The nurse determines that the fetus is lying in a longitudinal position with the sacrum as the presenting part and with general flexion. What fetal position should the nurse document? Cephalic presentation Shoulder presentation Complete breech position Single footling breech position Complete breech position While assessing a pregnant client, the nurse should check the fetal lie, fetal attitude, and the presenting part in order to determine the fetal position. If the fetus lies in the longitudinal or vertical position with sacrum and feet as the presenting part and with general flexion it indicates that the fetus is in complete breech position. If the presenting part is the head instead of sacrum, then the fetus is in the cephalic position. If the fetus lies in the longitudinal or vertical position with the sacrum as the presenting part but with only one leg extended at the hip and knee, the fetus is in single footling breech. The nurse is assessing a 3-month pregnant patient who is given folic acid supplement. The patient is worried because of the appearance of reddish spider-like rashes on the face and neck. What does the nurse tell the patient about these rashes? "This is a side effect of folic acid." "This disappears after pregnancy." "This is caused by a food allergy." "This is caused by decreased estrogen." "This disappears after pregnancy." Vascular spider-like rashes are tiny, star-shaped or branched, slightly raised, and pulsating end-arterioles usually found on the neck, thorax, face, and arms during pregnancy. These spider-like rashes usually disappear after pregnancy. The appearance of vascular spider-like rashes is common during the 2 to 5 months of pregnancy and is not a result of a food allergy. Folic acid supplementation is given in pregnancy to reduce birth defects. Folic acid does not cause vascular or skin changes. Vascular spider-like rashes are not caused by elevated estrogen levels. A patient with a dark complexion has brownish pigmentation over the cheeks, the nose, and the forehead. The patient reports that this pigmentation was present during pregnancy, which faded and has recurred now. What relevant drug history does the nurse assess in the patient? Antibiotics Antipsoriatics Antihistamines Contraceptives Contraceptives Facial pigmentation that occurs during pregnancy and fades away with childbirth is referred to as melasma. This occurs because of increased production of melanotropin during pregnancy. Oral contraceptive use can also cause stimulation of melanotropin production. This may cause melasma to recur. Antibiotics are the drugs used for treating bacterial infection. They do not trigger the recurrence of melasma. Antipsoriatics are used to treat the itchy and scaly patches in psoriasis. Antihistamines, antipsoriatics, and antibiotics do not affect the anterior pituitary gland. Antihistamines are used to relieve itching in mild pruritus and they do not cause pigmentation. Following an assessment, the nurse informs that the patient has high blood pressure. What could have been the mean arterial pressure (MAP) of the patient? 86 mm Hg 90 mm Hg 100 mm Hg 100 mm Hg Mean arterial pressure (MAP) depends on the blood pressure. The normal MAP readings in the nonpregnant woman are 86 ± 7.5 mm Hg (78.5-93.5 mm Hg). The MAP reading of 100 mm Hg (greater than normal) implies high blood pressure. The MAP of 80 mm Hg, 86 mm Hg, or 90 mm Hg is considered normal. A patient who is pregnant used a home pregnancy test that showed a negative result. What will the nurse check for in the medication history of the patient? Diuretics Analgesics Tranquilizers Anticonvulsants Diuretics Diuretics are the medications that are usually prescribed to a patient with hypertension. These drugs may interfere with the levels of human chorionic gonadotropin (hCG) hormone. This may give a false-negative home pregnancy test result. Analgesics are the group of drugs used for pain relief. These drugs do not affect the hCG levels and therefore do not show a false report in the home pregnancy test. Tranquilizers are the drugs used for reducing anxiety, fear, and tension. The use of a tranquilizer results in a false-positive pregnancy test result because it increases hCG levels. Anticonvulsants are a group of drugs used in treating epileptic seizures; they affect the hCG levels and create a false-positive test result. The nurse is assessing a pregnant patient who has a positive Hegar sign. The fetal heartbeat is evident by Doppler ultrasound stethoscope, and there is about 5 mm Hg decrease of carbon dioxide partial pressure. The nurse suspects the patient is in which week of gestation? Week 10 Week 20 Week 30 Week 35 Week 10 Hegar sign is the softening and compressibility of the lower uterine segment that is seen during weeks 6 to 12 of the gestation period. The fetal heartbeat is detected using ultrasound stethoscope between 8 and 17 weeks. A decrease in the partial pressure of carbon dioxide by 5 mm Hg is seen at week 10 of gestation. Therefore it is most likely that the fetus is in the tenth week of gestation. Fetal heartbeat can be detected by fetal stethoscope after week 17 of pregnancy. Therefore, at weeks 20, 30, and 35 of gestation, Doppler ultrasound stethoscope is not required. Hegar sign is not seen in weeks 20, 30, or 35. Following an assessment, the nurse finds that a pregnant female is
alcoholic and a smoker. What advice does the nurse give the patient? "Avoid these behaviors because they can: Lead to hemolytic anemia in pregnancy." Elevate blood pressure in pregnancy." Increase the risk for bleeding during delivery." Elevate blood pressure in pregnancy." Smoking and alcohol stimulates the sympathetic nervous system. Thus the heart rate and blood pressure gets increased, which may also affect the fetus. Alcohol and smoking are usually consumed to relieve stress and are not known to induce stress in pregnancy. Hemolytic anemia is a form of anemia that occurs because of hemolysis of red blood cell (RBC). Smoking and alcohol does not cause hemolysis. Bleeding may be caused as a side effect of anticoagulants; it may not be a harmful effect of smoking and alcohol. A patient reports to the nurse that she had missed her period this month and suspects that she is a pregnant. What would be the most suitable nursing action for this patient? Assess for Hegar sign. Assess for Chadwick sign. Obtain an order for a urine pregnancy test. Obtain an order for a serum pregnancy test. Obtain an order for a serum pregnancy test. Because the woman has missed her period, it is likely that the woman is 4 to 6 weeks pregnant. A serum pregnancy test helps in the earliest detection of pregnancy. This test can be used to detect pregnancy in women who are 4 weeks pregnant. Therefore the nurse should ask the patient to take the serum pregnancy test. It is performed during weeks 4 to 12 of pregnancy. Hegar sign and Chadwick signs will be observed during weeks 6 to 12 of pregnancy, and pelvic congestion may be the other cause for such signs. Urine pregnancy test gives positive results during weeks 6 to 12 of pregnancy.
Cardiovascular system changes occur during pregnancy. Which finding is considered normal for a woman in her second trimester? Less audible heart sounds (S1, S2) Increased pulse rate Increased blood pressure Decreased red blood cell (RBC) production Increased pulse rate Between 14 and 20 weeks of gestation, the pulse increases about 10 to 15 beats/min, which persists to term. Splitting of S1 and S2 is more audible. In the first trimester, blood pressure usually remains the same as the prepregnancy level, but it gradually decreases up to about 20 weeks of gestation. During the second trimester, both the systolic and diastolic pressures decrease by about 5 to 10 mm Hg. Production of RBCs accelerates during pregnancy. While reviewing the laboratory reports of a pregnant female, the nurse finds that the patient's urine glucose levels fluctuate. What does the nurse infer from the assessment? The patient has: A normal pregnancy. Decreased fat absorption. Decreased glucose metabolism. Sensitive pancreatic β-cells. A normal pregnancy. In pregnant woman, the tubular reabsorption of glucose is impaired causing glucosuria to occur. This urine glucose level can vary from 0 to 20 mg/dL in a pregnant female. Although glucosuria is a normal finding in pregnancy, the possibility of diabetes should be considered. Decrease in fat absorption does not affect the glucose reabsorption in the kidneys but may lead to malnutrition. A decreased rate of metabolism does not affect glomerular filtration process. β-cells of the islets of Langerhans help in the production of insulin; they are not involved in the glucose absorption by the kidneys. During a woman's physical examination, the nurse notes that the lower uterine segment is soft on palpation. The nurse documents this finding as the: Hegar sign. McDonald sign. Chadwick sign. Goodell sign. Hegar sign At approximately six weeks of gestation, softening and compressibility of the lower uterine segment occur; this is called the Hegar sign. The McDonald sign is flexibility of the uterus at the junction of the cervix and uterus and usually can be detected at seven to eight weeks of gestation. The Chadwick sign is a blue-violet cervix caused by increased vascularity; this occurs around the fourth week of gestation. Softening of the cervical tip is called the Goodell sign, which may be observed around the sixth week of pregnancy. The nurse is assessing a patient who is pregnant and has diabetes. The Doppler ultrasound examination shows that there is a decrease in the uterine blood flow velocity. Which is the reason for reduced uterine blood flow in the patient? Reduced estrogen levels Lying in the lateral position Low arterial blood pressure Relaxation of the uterine muscles Low arterial blood pressure An increase in the arterial pressure increases the velocity of blood flow to the uterus. Therefore low arterial pressure decreases the uterine blood flow velocity and thereby decreases the blood supply to the fetus. Supine position of the mother decreases the intervillous blood flow. Therefore lateral position is preferred for sleeping. The blood flow would be the highest in this position, compared with the supine and prone positions. Estrogen has a vasodilator effect. Therefore reduced estrogen levels would decrease the velocity of the uterine blood flow. Contraction of the uterine muscles reduces the blood flow, whereas relaxation of the uterine muscles increases the blood flow. A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a: primipara. primigravida. multipara. nulligravida. primipara. A primipara is a woman who has completed one pregnancy with a viable fetus. Gravida is a pregnant woman; para comes from parity, meaning a viable fetus; primi means first; multi means many; and null means none. A primigravida is a woman pregnant for the first time. A multipara is a woman who has completed two or more pregnancies with a viable fetus. A nulligravida is a woman who has never been pregnant. The nurse is caring for a pregnant patient who is in the third trimester. The patient reports a burning sensation starting from the hands to the elbow. On further evaluation, the nurse finds compression in the carpal ligament of the wrist. What finding does the nurse infer from examining the patient? Neuralgia Acroesthesia Paresthesia Paresthesia Paresthesia is an abnormal sensation that is perceived as a burning and tingling in the skin. This is caused by edema that compresses the nerves. Edema in carpal ligament of the wrist causes carpal tunnel syndrome, which is characterized by paresthesia. Sciatica is a burning pain that is felt in the back, buttocks, and leg when the sciatic nerve is irritated. Neuralgia is a stabbing, burning pain that occurs along a damaged nerve. Acroesthesia is the numbness and tingling of the hands caused by stoop-shouldered stance. According to the blood reports of a 6-month primigravida, the hemoglobin level is 11 g/dL, red blood cell count level is 5.5 million/mm3, hematocrit is 33%, and white blood cell count is 12,000/mm3. What can the nurse infer from this report? The patient: Has iron deficiency. Is at risk for bleeding. Has physiologic anemia. Has myelosuppression. Has physiologic anemia. Hemoglobin levels and hematocrit tend to decrease during pregnancy. A hemoglobin level of 11 g/dL and hematocrit of 33% are indicative of physiologic anemia. Hemoglobin levels of less than 11 g/dL would indicate that the patient has iron deficiency. Based on the information, the nurse cannot predict that the patient is at a risk for bleeding. The nurse should check the prothrombin time to determine the risk for bleeding. Because the white blood cell count is elevated (normal: 5000-10,000/mm3), the nurse cannot conclude that the patient has myelosuppression. The nurse is explaining to a pregnant patient about prevention of motor vehicle accidents. What risk is most associated with motor vehicle accidents in pregnant patients? Preterm birth Thrombophlebitis Ectopic pregnancy Abruptio placentae Abruptio placentae Every pregnant patient should be taught about safety measures to prevent motor vehicle accidents. Automobile accidents may lead to placental separation, causing fetal death. This condition is called abruptio placentae. Preterm birth and ectopic pregnancy are not associated with automobile accidents. Thrombophlebitis is commonly observed in pregnant patients because the heavy abdominal contents compress the blood vessels. Pregnant patients are usually taught certain exercises to prevent thrombophlebitis. After reviewing the standard ultrasound scan reports of a pregnant patient, the nurse advises the patient to undergo a specialized ultrasound scan. What is the nurse's rationale for this suggestion? To estimate the amniotic fluid volume To identify the detailed fetal anatomy To assess for physiologic abnormalities To assess for fetal genetic abnormalities To assess for physiologic abnormalities Specialized or targeted ultrasound scans are performed only if a patient is suspected of carrying an anatomically or physiologically abnormal fetus. Limited ultrasound examination is used to estimate the amniotic fluid volume. Standard ultrasound scan is used to see the detailed anatomy of the fetus. Ultrasound scan is not used to find genetic abnormalities in the fetus. The biophysical profile (BPP) testing report of a pregnant patient gives the following information: one episode of fetal breathing movement lasting for 30 seconds in a 30-minute observation; three limb movements of the fetus in 30 minutes; an amniotic fluid index greater than 5; a reactive nonstress test; and a BPP score of 1. The test is performed for 120 minutes. What does the nurse expect the primary health care provider to do? Extend the test time to 120 minutes. Repeat the test twice a week. Repeat the test in 4 to 6 hours. Consider delivery of the fetus. Consider delivery of the fetus. If the BPP score is less than 2, regardless of gestational age, delivery can be performed. If the BPP score is 0 to 2 and chronic asphyxia is suspected, then testing time should be extended to 120 minutes. If the BPP score is 8 to 10 and a low risk for chronic asphyxia is suspected, then the test should be repeated at twice-weekly intervals. If the fetal pulmonary test result is negative and the BPP score is 6, then the BPP profile should be repeated in 4 to 6 hours. The nurse is reviewing the scanned images of an ultrasonography test of the fetus. The nurse finds that the head and abdominal circumferences of the fetus are large in proportion to other parts of the body. What should the nurse conclude about the fetus? Symmetric growth restriction Asymmetric growth restriction Macrosomia resulting from maternal diabetes Presence of congenital malformations Asymmetric growth restriction The difference in the head and body circumference is a sign of asymmetric growth restriction. Symmetric intrauterine growth restriction is a condition in which all fetal parts are consistently small. Macrosomia is a condition in which the infant weighs more than 4000 g. It may not lead to asymmetric growth. A larger head and abdominal circumference do not indicate congenital malformations, which are associated with more obvious physical signs. The nurse is reviewing the amniocentesis reports of a patient who has completed 20 weeks of pregnancy. The reports reveal the presence of high alpha-fetoprotein (AFP) levels. What can the nurse infer from this information related to the clinical condition of the fetus? Cardiac disorder Neurologic disorder Circulatory disorder Pulmonary disorder Neurologic disorder High AFP levels after 15 weeks' gestation indicate an open neural tube or other disorder relating to the central nervous system. AFP levels in amniotic fluid cannot test cardiac disorders. Doppler blood flow analysis can be used to assess circulatory disorders in the fetus. The lecithin-to-sphingomyelin (L/S) ratio of the amniotic fluid is a useful predictor of pulmonary disorders in the fetus. While reviewing the ultrasonography images of a patient in her seventh month of pregnancy, the nurse observes an enlarged renal pelvis of the fetus. Which screening test does the nurse advise the patient to undergo? Coombs' screening Quad screening Cell-free DNA screening Triple marker screening Quad screening Enlargement of the renal pelvis may indicate Down syndrome in the fetus, and quad screening is done to determine whether the fetus has Down syndrome. In this test, the levels of placental hormone inhibin A are monitored. Low levels of inhibin A indicate Down syndrome. Coombs' test is a screening procedure to determine Rh incompatibilities. Cell-free DNA screening is done to detect certain inherited single-gene disorders. Triple marker screening is less accurate than quad screening in screening for Down syndrome. The nurse is studying the chart of a patient in labor. If the patient's chart indicates "RMA," what is the presenting part? Chin Sacrum Scapula Occiput Chin The chin or mentum is the presenting part of the fetus if the chart indicates "RMA." If the sacrum is the presenting part, the middle letter is S. If the scapula is the presenting part, the middle letter is Sc. If the occiput is the presenting part, the middle letter is O.
The charge nurse on the maternity unit is orienting a new nurse to the unit and explains that the 5 Ps of labor and birth are: Select all that apply. placenta. passageway. psychological response. powers. position passageway. psychological response. powers. position At least five factors affect the process of labor and birth. These are easily remembered as the five Ps: passenger (fetus and placenta), passageway (birth canal), powers (contractions), position of the mother, and psychological response. After a pelvic examination of a pregnant woman, the nurse concludes that the client may require a forceps-assisted delivery. What pelvic finding would support this conclusion? Slightly ovoid-shaped. Moderate depth. Blunt ischial spines. Subpubic arch is narrow. Subpubic arch is narrow. The presence of a narrow subpubic arch indicates that the client has either an android pelvis or an anthropoid pelvis. In such situations, the fetus may not easily pass through the birth canal and the client may require a forceps-assisted delivery. The presence of a slightly ovoid pelvis with moderate depth and blunt ischial spines indicates a gynecoid pelvis. Women with gynecoid pelvises have wider subpubic arches, which allow the fetus to more easily pass through the birth canal. These clients may not require forceps-assisted deliveries. The lab reports of a patient in labor reveal 1+ proteinuria. Which physiologic mechanism is responsible for this lab finding? Breakdown of muscle tissue Increased white blood cell count Stagnation in the area of the vaginal introitus Breakdown of muscle tissue During normal labor, the patient's muscle tissues break down due to increased physical activity. Urine examination shows proteinuria of 1+, which is a normal finding in a patient who is in labor. Nausea and belching occur as a reflex response to full cervical dilation. An increase in white blood cell count does occur during labor; however, it is not related to normal proteinuria in labor. Great distensibility occurs in the area of the vaginal introitus during labor.
What will the nurse mention about the effect of secondary powers during labor to the patient? Contractions are expulsive in nature. The intraabdominal pressure is decreased. Contractions move downward in waves. Contractions begin at pacemaker points Contractions are expulsive in nature. As soon as the presenting part of the fetus touches the pelvic floor, the patient uses secondary powers or bearing-down efforts. This results in contractions that are expulsive in nature. The voluntary bearing-down efforts of the patient also result in increased intraabdominal pressure. Primary powers signal the beginning of labor with involuntary contractions that move downward over the uterus in waves. These contractions begin at pacemaker points in the thickened muscle layers of the upper uterine segment. The student nurse asks the clinical coordinator about the
physiologic process of conception. Which statements should the clinical coordinator include in the teaching? Select all that apply. It involves the removal of the protective coat from the sperm head. It is the fusion of the sperm cell and the egg cell to form a zygote. It defines the process of differentiation in the primary germ layer. It includes the process of the embryo adhering to the uterine wall. It is the process of developing organ systems and external features It is the first phase in the process of a woman becoming pregnant. It is the fusion of the sperm cell and the egg cell to form a zygote. Conception is the very first step that involves the fusion of the sperm and the egg cell to form a zygote. This is considered the beginning of pregnancy. The process of removing a protective coat on the sperm head is called capacitation. It occurs before conception and is the result of physiologic changes. The primary germ layer is differentiated into three layers, 3 weeks after conception. The process where the embryo adheres to the wall of the uterus is called implantation. This occurs after conception. Organ systems and external features are developed after differentiation of the primary germ layer. It takes place after conception. A genetic test in a patient
with hemophilia shows that the patient's partner is not a carrier for hemophilia. The patient is worried and wants to know about the chances of hemophilia in their children. What information should the nurse convey to the patient? The chance of hemophilia in the: "Male offspring is 100%." "Female offspring is 50%." "Female offspring is 100%." "Male offspring is 100%." Hemophilia is an X-linked recessive inheritance disorder carried on the X chromosome. In the scenario, the patient is homozygous to hemophilia because the symptoms are expressed in the patient. The patient's partner is not a carrier for hemophilia. The abnormal trait present on the X chromosome of the mother will be expressed in the male offspring, because males receive X chromosome from the mother. Therefore the chance of having hemophilia in the male offspring is 100%. If the mother is a carrier for hemophilia, then there is a 50% chance of hemophilia in the male offspring. All the female offspring of the patient will be carriers for hemophilia, because the partner does not carry any abnormal X chromosome for hemophilia. The primary health care provider instructs the nurse to administer warfarin (Coumadin) to a child with venous thrombosis. What precaution should the nurse take to prevent possible severe adverse drug reactions in the child? Administer: The genotype-guided dose of the drug. The drug orally on an empty stomach. A test dosage before the medication. The drug by the intramuscular route. The genotype-guided dose of the drug Warfarin (Coumadin) is the drug of choice given to children for the treatment of thromboembolic events. However, for treatment to be effective and to prevent adverse effects, the dosage of warfarin (Coumadin) may have to be customized for each patient based on his or her genotype. This drug does not have to be given on an empty stomach. Warfarin (Coumadin) is not given as a test dose. Some antibiotics may be administered by testing a small dose first to determine hypersensitivity, but not warfarin (Coumadin). This medication is not given by the intramuscular route. It is an anticoagulant, and giving the medication through this route may cause bleeding What is the expected delivery date of a patient whose conception is reported on June 20, 2012? March 13, 2013 March 27, 2013 February 13, 2013 February 27, 2013 March 13, 2013 The gestation period of a fetus is 266 days from the date of conception and 280 days from the last menstrual period. Calculating the gestational period after conception from June 20, the expected date of delivery is March 13, 2013. March 27, 2013, is the expected date of delivery if June 20, 2012, is the first day of the last menstrual period. February 13 and 27 are not the expected date of delivery unless the baby is a preterm infant. The nurse is caring for a diabetic pregnant patient. Which conditions should the nurse expect to find in the patient's newborn? Hypoglycemic and overweight Hyperglycemic and overweight Hypoglycemic and underweight Hyperglycemic and underweight Hypoglycemic and overweight Maternal hyperglycemia produces fetal hyperglycemia by stimulating hyperinsulinemia and islet cell hyperplasia. This results in the impaired regulation of the insulin hormone in the fetus. Therefore the newborn of a diabetic pregnant patient may be hypoglycemic and overweight. This happens from the loss of a maternal glucose source after birth. Hyperglycemia is observed in the fetus before birth. The child born to a diabetic mother will never be underweight. Therefore the newborn will not be hyperglycemic and underweight. List the time span in lunar months, calendar months, weeks, and days that indicates the appropriate length for a normal pregnancy. Record your response as whole numbers separated by commas (ex. 2, 4, 6, 8). Pregnancy lasts approximately 10 lunar months, 9 calendar months, 40 weeks, 280 days. Length of pregnancy is computed from the first day of the last menstrual period (LMP) until the day of birth. What is the total count of chromosomes if the chorionic villus sampling report of a mother revealed the progeny to be in monosomic condition? Record your answer as a whole number. _____ chromosomes Aneuploidic conditions are the most common cause for genetic disorders in humans resulting in impaired cognitive levels. Monosomy is one such condition in which the chromosome count is observed to be 45. In this condition, the chromosomal number is reduced because of the union of gametes. Therefore the normal count of the chromosome is altered, which results in 45 chromosomes A patient in the eighteenth week of pregnancy visits a clinic to know about the development of the fetus. The patient says to the nurse, "I am excited, and I want to know what has developed in my child so far." What information should the nurse be able to tell to the patient about the fetus? The fetus has: "Hair on the scalp." "Some sweat glands." "Nasal cartilage." "Sebaceous glands." "Hair on the scalp." The laboratory reports of a patient in the eighth week of pregnancy show a very high level of human chorionic gonadotropin (hCG) hormone. What does the nurse infer from the reports? The pregnancy is normal and has no risk. There is risk for an impending miscarriage resulting from teratogenic exposure. The patient is at decreased risk for developing an ectopic pregnancy. There is the potential risk that the fetus will have Down syndrome There is the potential risk that the fetus will have Down syndrome A high level of hCG indicates abnormal gestation resulting from the fetus having Down syndrome or gestational trophoblastic disease. Human chorionic gonadotropin (hCG) is present at the onset of pregnancy and increases until 60 days and then starts to decline at about 16 weeks. The presence of high levels of hCG even at the eighth week of pregnancy is not a normal parameter. An abnormally low level of hCG may lead to ectopic pregnancy or impending miscarriage. Ectopic pregnancy is a complication in pregnancy in which the embryo implants outside the uterine cavity. The nurse has advised a pregnant female to always sleep on the right side-lying position while sleeping. What are the possible reasons for giving this
instruction? Select all that apply. This position: Increases the renal function. Increases the cardiac output. Increases the uterine blood flow. Increases the venous blood pressure. Increases the renal function. Increases the cardiac output. Increases the uterine blood flow. A side-lying position increases the renal perfusion, which increases urine output and decreases edema. In supine position the large and heavy uterus often impedes the venous return to the heart and affects the blood pressure. Right side-lying position helps in relieving the pressure on the heart, which helps in effective contraction of the heart. Increased contraction of the heart improves the cardiac output. As the cardiac output is reduced in supine position, the uterine blood flow is also reduced. Therefore the side-lying position would help in improving the uterine blood flow. Pulse rate is not affected by the position while sleeping. The pulse rate usually increases in week 20 of the gestation period, and side-lying position does not affect pulse. Supine-lying position increases the venous pressure, whereas the side-lying position helps in relieving the venous pressure. A patient during the second trimester of pregnancy asks the nurse about the date of delivery. Which sign would help the nurse to find the probable date of delivery? Ballottement Lightening Quickening Goodell sign Quickening The nurse should assess for quickening, which is the first sign of the recognition of fetal movements by the pregnant woman. The week in which quickening occurs provides a tentative clue about the duration of gestation. Ballottement, lightening, and Goodell sign are also the signs of pregnancy. However, these signs are not used in predicting the duration of gestation. Ballottement is the passive movement of the unengaged fetus that can be identified in weeks 16 to 18 of gestation. Lightening sign is observed at the start of labor between 38 and 40 weeks' gestation. Goodell sign is the probable sign of pregnancy at 5 weeks' gestation and is indicated by a velvet-bluish appearance of the cervix. When assisting a patient who has completed the first stage of labor, the nurse observes the patient for supine hypotension. What are the factors of supine hypotension that the nurse notes? Select all that apply. Obesity Hypervolemia Anxiety and pain Intrathoracic pressure Multifetal pregnancy Obesity Supine hypotension occurs when the ascending vena cava and descending aorta are compressed. Obesity, anxiety, pain, and multifetal pregnancy are factors that render a greater risk for supine hypotension in the laboring patient. Hypovolemia or dehydration and not hypervolemia can cause supine hypotension. If the patient uses the Valsalva maneuver, intrathoracic pressure increases and may lead to fetal hypoxia. When assisting a patient in labor, the nurse expects to observe the cardinal movements that lead to the birth of the baby. Arrange the movements in the order of their occurrence. The cardinal movements that occur in a vertex presentation are engagement, descent, flexion, internal rotation, extension, restitution (external rotation), and finally birth by expulsion. The fetal head is said to be engaged in the pelvic inlet when the biparietal diameter of the head passes through the pelvic inlet. During descent, the presenting part progresses through the pelvis. As soon as the descending head meets resistance from the cervix or pelvic wall or pelvic floor, it undergoes flexion. The fetus flexes such that the chin is brought into closer contact with the fetal chest. Internal rotation begins at the level of the ischial spines but is not completed until the presenting part reaches the lower pelvis. When the fetal head reaches the perineum for birth, it undergoes extension. It is deflected anteriorly by theperineum. Restitution occurs after the head is born.It rotates briefly to the position it occupied when it was engaged in the inlet.
The nurse is assessing the vital signs of a patient who is in the fourth stage of labor. The nurse finds that the patient's heart rate has decreased. What would be the most probable reason for the change in heart rate during labor? Increased cardiac output Postpartum hemorrhage Low systolic blood pressure Increased cardiac output the uterus releases blood into the maternal vascular system when it contracts during labor. This rise in the volume of blood in the maternal cardiovascular system causes increased cardiac output, leading to a decrease in heart rate. Heart rate returns to its prelabor levels within the first postpartum hour. The patient does not exhibit any signs of cardiac arrest such as shortness of breath, dizziness, or chest pain. Postpartum hemorrhage can cause an increase in heart rate, which is called reactive tachycardia. The blood pressure is slightly high or normal in the fourth stage of labor. Blood pressure changes in the fourth stage do not affect cardiac output. The nurse is briefing a nulliparous patient about the stages of labor. What are the forces affecting the descent of the fetus that the nurse will mention? Select all that apply. Pressure exerted by the amniotic fluid Pressure exerted by the contracting fundus Resistance from the cervix or pelvic wall Contraction of the maternal diaphragm Pressure exerted by muscles of the pelvic floor Pressure exerted by the amniotic fluid Pressure exerted by the contracting fundus Contraction of the maternal diaphragm The descent or the progress of the presenting part of the fetus through the pelvis depends on several forces. They include the pressure exerted by the amniotic fluid and direct pressure exerted by the contracting fundus on the fetus. The force of the contraction of the maternal diaphragm affects the descent in the second stage of labor. The descending head meets resistance from the cervix and pelvic wall resulting in flexion of the fetus. During flexion, resistance from the pelvic floor may also cause the fetus to bring its chin closer to the chest. The nurse notes that the fetus in a laboring patient is in brow presentation. What is the expected occipitomental diameter? 9.25 cm 9.5 cm 12.00 cm 13.5 cm 13.5 cm n a brow presentation, the presenting part is the mentum or chin. The occipitomental diameter is 13.5 cm at term, which is too large to permit the infant's head to enter the pelvis region of the mother. The biparietal diameter, which is about 9.25 cm at term, is the largest transverse diameter. The smallest anteroposterior diameteris, the suboccipitobregmatic diameter, which is about 9.5 cm at term, is in a vertex presentation. In a sinciput presentation, theoccipitofrontal diameter is about 12.00 cm at term, with moderate extension of the head. What are the factors that enable to baby to initiate respiration immediately postpartum?A number of factors have been implicated in the initiation of postnatal breathing: decreased oxygen concentration, increased carbon dioxide concentration and a decrease in pH, all of which may stimulate fetal aortic and carotid chemoreceptors, triggering the respiratory center in the medulla to initiate respiration.
Which are the factors that affect the onset of labor select all that apply quizlet?Which are the factors that affect the onset of labor? Select all that apply. Increasing intrauterine pressure, increasing estrogen levels, and decreasing progesterone levels affect the onset of labor.
What factors stimulate uterine contractions and birth quizlet?Estrogen, Progesterone, Prostaglandins, and Oxytocin are the primary hormones involved. An increase in fetal adrenocorticotropic hormone levels at term is speculated to have an effect on uterine sensitivity to oxytocin and prostaglandins thus stimulating the onset of labor.
What are the factors that speed up the dilation of the cervix?Dilation rates exceed 1 cm/h at a dilatation of 6-7 cm, but are very individual. Accelerating impact factors are multiparity, a greater amount of cervical dilation and fetal occipitoanterior position, whereas the use of epidural anesthesia, a higher fetal weight and head circumference decelerate dilation (P<0.001).
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