Ricci, Kyle & Carman: Maternity and
Pediatric Nursing, Second Edition:
Chapter 12: Nursing Management During
Pregnancy; PrepU
A 24-year-old pregnant woman reports excessive vaginal discharge. The discharge is
not associated with a strong odor, itching, or irritation, but she finds it messy and
unpleasant. What should the nurse advise her to do? - answer Use sanitary pads.
Vaginal discharge increases during pregnancy and is a concern for many women.
Encourage the client to keep clean and wear sanitary pads as needed. Douching may
be dangerous for the mother. STIs are not indicated simply by discharge. Pregnant
women should not decrease fluid intake.
A pregnant woman at her first prenatal visit asks the nurse if it is safe to have sex during
her pregnancy. Which client statement alerts the nurse to the need for further teaching?
- answer "I should substitute intercourse with nonsexual touch to avoid harming the
fetus."
Sexual needs may be met through sexual intercourse with a partner as long as the
pregnancy is healthy and there are no other risk factors, such as bleeding or rupture of
membranes. Pregnancy is a time of a heightened need for touch, which may be met
partially by sexual expression, but which can also be met through nonsexual touch,
such as massage, caressing, or holding.
A client has been confirmed to be pregnant. She gives a history of two previous full-term
normal pregnancies. How will the nurse classify the client's pregnancy history? - answer
G3, P2
Gravida (G) is the total number of pregnancies the client has had, including the present
one, and para (P) is the number of babies born at 20 or more weeks of gestation. Since
she gives a history of two previous normal deliveries, she is P2 and not P0, P1, or P3.
Because she has had a total of three pregnancies including the present one, she is G3
and not G2.
A nurse counsels a pregnant woman regarding her recommended daily allowance of
calories. She advises her to obtain her carbohydrate calories from complex
carbohydrates rather than simple carbohydrates. What is the best rationale for this
guidance? - answer More consistent regulation of glucose and insulin
Advise women to obtain their carbohydrate calories from complex carbohydrates
(cereals and grains) rather than simple carbohydrates (sugar and fruits) because
complex carbohydrates are more slowly digested. Doing so will help regulate glucose
and insulin levels more consistently. All carbohydrates contain roughly the same
,Ricci, Kyle & Carman: Maternity and
Pediatric Nursing, Second Edition:
Chapter 12: Nursing Management During
Pregnancy; PrepU
amount of calories per gram (4 kcal/g). Carbohydrates of any kind are not a significant
source of fatty acids.
During a routine prenatal visit, a client, 36 weeks pregnant, states she has difficulty
breathing and feels like her pulse rate is really fast. The nurse finds her pulse to be 100
beats per minute (increased from baseline readings of 70 to 74 beats per minute) and
irregular, with bilateral crackles in the lower lung bases. The nurse would develop a plan
of care identifying interventions to promote which area as the priority? - answer gas
exchange
Typically, heart rate increases by approximately 10 to 15 beats per minute during
pregnancy and the lungs should be clear. Dyspnea may occur during the third trimester
as the enlarging uterus presses on the diaphragm. However, the findings described
indicate that the woman is experiencing impaired gas exchange. There is no evidence
to support problems with tissue perfusion, activity, or anxiety.
A client in her second trimester of pregnancy has developed varicose veins and
experiences leg cramps. Which suggestion would be most appropriate? - answer
Elevate legs while sitting.
The nurse should encourage the client to elevate her legs while sitting; this will prevent
pooling and engorgement of veins in the lower extremities. Aerobic exercises do not
help in preventing varicose veins. Folic acid intake is recommended in the first trimester
to prevent congenital abnormalities. Increasing the intake of calcium helps in
strengthening bones.
A nurse is instructing a pregnant woman about monitoring fetal movements and informs
her that normally the fetus will move the same amount every day. The nurse adds that if
the client notices an unusual increase or decrease in movement, this is a sign of what? -
answer response to a need for oxygen
A fetus normally moves more or less the same amount every day. If there is an unusual
increase or decrease in movement, the client should be examined because such a
change suggests that the fetus is responding to a need for oxygen.
A nurse explains to a pregnant woman the importance of consuming adequate iodine in
her diet. Which of the following conditions can a deficiency in iodine lead to? - answer
Goiter
, Ricci, Kyle & Carman: Maternity and
Pediatric Nursing, Second Edition:
Chapter 12: Nursing Management During
Pregnancy; PrepU
Iodine is essential for the thyroid gland to be able to produce thyroxine (which is
necessary for overall body metabolism). As thyroid function increases during
pregnancy, a woman needs to be certain to ingest more iodine than usual to supply this
increased need. If iodine intake is inadequate, hypothyroidism (poorly functioning
thyroid gland) and thyroid enlargement (goiter) can occur. The other conditions listed
are not associated with iodine deficiency.
A pregnant client tells the nurse that she has a 2-year-old child at home who was born
at 38 weeks; she had a miscarriage at 9 weeks; and she gave birth to a set of twins at
34 weeks. Which documentation would be appropriate for the nurse? - answer gravida
4, para 2
Gravida (G) indicates the number of pregnancies. When a nurse calculates the GTPA of
a pregnant client, the current pregnancy counts and the three other pregnancies count
for a total of four pregnancies. Para (P) indicates the number of pregnancies carried to
viable gestational age. This client has had two viable pregnancies so far.
The client is 32 weeks pregnant and has been referred for biophysical profile (BPP)
after a nonreassuring nonstress test (NST). Which statement made by the client
indicates that the nurse's explanation of the procedure was effective? - answer The BPP
is an ultrasound that measures breathing, body movement, tone, and amniotic fluid
volume.
A biophysical profile uses a combination of factors to determine fetal well-being based
upon five fetal biophysical variables. An NST is done to measure FHR acceleration.
Then an ultrasound is done to measure breathing, body movements, tone, and amniotic
fluid volume. Each variable receives a score from 0 to 2 for a maximum score of 10. A
score of 6 or less indicates altered fetal well-being and indicates a need for further
assessment. A needle is not involved with the BPP. The BPP does not detect placental
problems, and the BPP is not a screening for neural tube defects.
During pregnancy the cardinal rule regarding taking medications and herbal remedies is
that all drugs cross the placenta and have a potential impact on the fetus. What is one
disease where treatment must continue during pregnancy? - answer asthma
Treatment, including medications, for certain diseases and conditions must continue
during pregnancy. Examples include epilepsy, asthma, diabetes, and depression.
Pediatric Nursing, Second Edition:
Chapter 12: Nursing Management During
Pregnancy; PrepU
A 24-year-old pregnant woman reports excessive vaginal discharge. The discharge is
not associated with a strong odor, itching, or irritation, but she finds it messy and
unpleasant. What should the nurse advise her to do? - answer Use sanitary pads.
Vaginal discharge increases during pregnancy and is a concern for many women.
Encourage the client to keep clean and wear sanitary pads as needed. Douching may
be dangerous for the mother. STIs are not indicated simply by discharge. Pregnant
women should not decrease fluid intake.
A pregnant woman at her first prenatal visit asks the nurse if it is safe to have sex during
her pregnancy. Which client statement alerts the nurse to the need for further teaching?
- answer "I should substitute intercourse with nonsexual touch to avoid harming the
fetus."
Sexual needs may be met through sexual intercourse with a partner as long as the
pregnancy is healthy and there are no other risk factors, such as bleeding or rupture of
membranes. Pregnancy is a time of a heightened need for touch, which may be met
partially by sexual expression, but which can also be met through nonsexual touch,
such as massage, caressing, or holding.
A client has been confirmed to be pregnant. She gives a history of two previous full-term
normal pregnancies. How will the nurse classify the client's pregnancy history? - answer
G3, P2
Gravida (G) is the total number of pregnancies the client has had, including the present
one, and para (P) is the number of babies born at 20 or more weeks of gestation. Since
she gives a history of two previous normal deliveries, she is P2 and not P0, P1, or P3.
Because she has had a total of three pregnancies including the present one, she is G3
and not G2.
A nurse counsels a pregnant woman regarding her recommended daily allowance of
calories. She advises her to obtain her carbohydrate calories from complex
carbohydrates rather than simple carbohydrates. What is the best rationale for this
guidance? - answer More consistent regulation of glucose and insulin
Advise women to obtain their carbohydrate calories from complex carbohydrates
(cereals and grains) rather than simple carbohydrates (sugar and fruits) because
complex carbohydrates are more slowly digested. Doing so will help regulate glucose
and insulin levels more consistently. All carbohydrates contain roughly the same
,Ricci, Kyle & Carman: Maternity and
Pediatric Nursing, Second Edition:
Chapter 12: Nursing Management During
Pregnancy; PrepU
amount of calories per gram (4 kcal/g). Carbohydrates of any kind are not a significant
source of fatty acids.
During a routine prenatal visit, a client, 36 weeks pregnant, states she has difficulty
breathing and feels like her pulse rate is really fast. The nurse finds her pulse to be 100
beats per minute (increased from baseline readings of 70 to 74 beats per minute) and
irregular, with bilateral crackles in the lower lung bases. The nurse would develop a plan
of care identifying interventions to promote which area as the priority? - answer gas
exchange
Typically, heart rate increases by approximately 10 to 15 beats per minute during
pregnancy and the lungs should be clear. Dyspnea may occur during the third trimester
as the enlarging uterus presses on the diaphragm. However, the findings described
indicate that the woman is experiencing impaired gas exchange. There is no evidence
to support problems with tissue perfusion, activity, or anxiety.
A client in her second trimester of pregnancy has developed varicose veins and
experiences leg cramps. Which suggestion would be most appropriate? - answer
Elevate legs while sitting.
The nurse should encourage the client to elevate her legs while sitting; this will prevent
pooling and engorgement of veins in the lower extremities. Aerobic exercises do not
help in preventing varicose veins. Folic acid intake is recommended in the first trimester
to prevent congenital abnormalities. Increasing the intake of calcium helps in
strengthening bones.
A nurse is instructing a pregnant woman about monitoring fetal movements and informs
her that normally the fetus will move the same amount every day. The nurse adds that if
the client notices an unusual increase or decrease in movement, this is a sign of what? -
answer response to a need for oxygen
A fetus normally moves more or less the same amount every day. If there is an unusual
increase or decrease in movement, the client should be examined because such a
change suggests that the fetus is responding to a need for oxygen.
A nurse explains to a pregnant woman the importance of consuming adequate iodine in
her diet. Which of the following conditions can a deficiency in iodine lead to? - answer
Goiter
, Ricci, Kyle & Carman: Maternity and
Pediatric Nursing, Second Edition:
Chapter 12: Nursing Management During
Pregnancy; PrepU
Iodine is essential for the thyroid gland to be able to produce thyroxine (which is
necessary for overall body metabolism). As thyroid function increases during
pregnancy, a woman needs to be certain to ingest more iodine than usual to supply this
increased need. If iodine intake is inadequate, hypothyroidism (poorly functioning
thyroid gland) and thyroid enlargement (goiter) can occur. The other conditions listed
are not associated with iodine deficiency.
A pregnant client tells the nurse that she has a 2-year-old child at home who was born
at 38 weeks; she had a miscarriage at 9 weeks; and she gave birth to a set of twins at
34 weeks. Which documentation would be appropriate for the nurse? - answer gravida
4, para 2
Gravida (G) indicates the number of pregnancies. When a nurse calculates the GTPA of
a pregnant client, the current pregnancy counts and the three other pregnancies count
for a total of four pregnancies. Para (P) indicates the number of pregnancies carried to
viable gestational age. This client has had two viable pregnancies so far.
The client is 32 weeks pregnant and has been referred for biophysical profile (BPP)
after a nonreassuring nonstress test (NST). Which statement made by the client
indicates that the nurse's explanation of the procedure was effective? - answer The BPP
is an ultrasound that measures breathing, body movement, tone, and amniotic fluid
volume.
A biophysical profile uses a combination of factors to determine fetal well-being based
upon five fetal biophysical variables. An NST is done to measure FHR acceleration.
Then an ultrasound is done to measure breathing, body movements, tone, and amniotic
fluid volume. Each variable receives a score from 0 to 2 for a maximum score of 10. A
score of 6 or less indicates altered fetal well-being and indicates a need for further
assessment. A needle is not involved with the BPP. The BPP does not detect placental
problems, and the BPP is not a screening for neural tube defects.
During pregnancy the cardinal rule regarding taking medications and herbal remedies is
that all drugs cross the placenta and have a potential impact on the fetus. What is one
disease where treatment must continue during pregnancy? - answer asthma
Treatment, including medications, for certain diseases and conditions must continue
during pregnancy. Examples include epilepsy, asthma, diabetes, and depression.
