COMPLICATIONS OF PREGNANCY

ABORTION Spontaneous also known as miscarriage; unintended pregnancy loss before 20 wks

gestation due to natural causes. a. Threatened b. Inevitable/Imminent c. Missed d. Habitual/Recurrent e. Complete f. Incomplete g. Septic

. Induced Abortion a. Therapeutic performed by a

doctor for a medical or a legal reason.

b. Illegal non-therapeutically done; never allowed in the Philippines

ECTOPIC PREGNANCY

HYDATIDIFORM MOLE/ H-MOLE/ Molar Pregnancy

INCOMPETENT CERVICAL OS

Shirodkar-Barter Mc Donald

PLACENTA PREVIA

ABRUPTIO PLACENTA /ABLATIO PLACENTA

Covert Overt

Premature Rupture of Membranes (PROM)

DYSTOCIA

PRECIPITATE LABOR

PROLAPSED UMBILICAL CORD

PREGNANCY-INDUCED HYPERTENSION

hypertension that develops after the 20th week

Types:Pre-eclampsia and Eclampsia B/P EDEMA PROTEURIA WT. GAIN

Postpartum Hemorrhage early&late

Puerperal Infection

P R A T

Thrombophlebitis

Mastitis

Psychological phases during postpartum period: Taking-in phase Taking-hold phase Letting - Go

What key psychosocial tasks must a woman accomplish during the third trimester?

a. Resolving grief over the loss of old roles b. Coping with common discomforts and

changes c. Developing a mother image d. Overcoming fears she may have about

the unknown, loss of control, and death

On her second visit to the prenatal facility, a client states, "I guess I really am pregnant. I've missed two periods now." Based on this statement, the nurse determines that the client has accomplished which psychological task of pregnancy?

a. Identifying the fetus as a separate being b. Assuming caretaking responsibility for the

neonate c. Preparing to relinquish the neonate through

labor d. Accepting the biological fact of pregnancy

QUESTIONS: The nurse uses nitrazine paper to

determine whether a pregnant client's membranes have ruptured. If the membranes have ruptured, the paper will turn which color?

1. Pink 2. Blue 3. Yellow 4. Green

The nurse is providing care for a pregnant client in her second trimester. Glucose tolerance test results show a blood glucose level of 160 mg/dl. The nurse should anticipate that the client will need to:

1. start using insulin. 2. start taking an oral antidiabetic drug. 3. monitor her urine for glucose. 4. be taught about diet.

A client has meconium-stained amniotic fluid. Fetal scalp sampling indicates a blood pH of 7.12; fetal bradycardia is present. Based on these findings, the nurse should take which action?

1. Administer amnioinfusion. 2. Prepare for cesarean delivery. 3. Reposition the client. 4. Start I.V. oxytocin infusion as

prescribed.

The nurse is reviewing a pregnant client's nutritional status. To determine whether she has an adequate intake of vitamin A, the nurse should assess her diet for consumption of:

fish. cereals. meat. dairy products.

During her first prenatal visit, a pregnant client admits to the nurse that she uses cocaine at least once per day. Which nursing diagnosis is most appropriate for this client?

1. Activity intolerance related to decreased tissue oxygenation

2. Risk for infection related to metabolic and vascular abnormalities

3. Imbalanced nutrition: Less than body requirements related to limited food intake

4. Impaired gas exchange related to respiratory effects of substance abuse

The nurse is developing a teaching plan for a client who's 2 months pregnant. The nurse should tell the client that she can expect to feel the fetus move at which time?

1. Between 10 and 12 weeks' gestation 2. Between 16 and 20 weeks' gestation 3. Between 21 and 23 weeks' gestation 4. Between 24 and 26 weeks' gestation

A client who's planning a pregnancy asks the nurse about ways to promote a healthy pregnancy. Which of the following would be the nurse's best response?

1. "Pregnancy is a human process; you don't have to worry."

2. "You practice good health habits; just follow them and you'll be fine."

3. "There is nothing you can do to have a healthy pregnancy; it's all up to nature."

4. "Folic acid, 400 mcg, improves pregnancy outcomes by preventing certain complications."

A client treated with terbutaline for premature labor is ready for discharge. Which instruction should the nurse include in the discharge teaching plan?

1. Report a heart rate greater than 120 beats/minute to the physician.

2. Take terbutaline every 4 hours, during waking hours only.

3. Call the physician if the fetus moves 10 times in an hour.

4. Increase activity daily if not fatigued.

The nurse is performing a physical examination of a primigravid client who's 8 weeks pregnant. At this time, the nurse expects to assess:

1. Hegar's sign. 2. fetal outline. 3. ballottement. 4. quickening.

The nurse is teaching a pregnant client how to distinguish prelabor contractions from true labor contractions. Which statement about prelabor contractions is accurate?

1. They're regular. 2. They're usually felt in the abdomen. 3. They start in the back and radiate to

the abdomen. 4. They become more intense during

walking.

A pregnant client in her third trimester asks why she needs to urinate frequently again, as she did during the first trimester. What should the nurse tell her?

1. This symptom is abnormal during the third trimester and may indicate a urinary tract infection.

2. This symptom is a normal variation and is easily managed by limiting fluid intake.

3. This symptom is normal and results from the fetus exerting pressure on the bladder.

4. This symptom is abnormal and should subside after the presenting part of the fetus is engaged.

A client, 30 weeks pregnant, is scheduled for a biophysical profile (BPP) to evaluate the health of her fetus. Her BPP score is 8. What does this score indicate?

1. The fetus should be delivered within 24 hours.

2. The client should repeat the test in 24 hours.

3. The fetus isn't in distress at this time.

4. The client should repeat the test in 1 week.

A client who's 7 months pregnant reports severe leg cramps at night. Which nursing action would be most effective in helping her cope with these cramps?

1. Suggesting that she walk for 1 hour twice per day

2. Advising her to take over-the-counter calcium supplements twice per day

3. Teaching her to dorsiflex her foot during the cramp

4. Instructing her to increase milk and cheese intake to 8 to 10 servings per day

During a routine prenatal visit, a pregnant client reports heartburn. To minimize her discomfort, the nurse should include which suggestion in the plan of care?

1. Eat small, frequent meals. 2. Limit fluid intake sharply. 3. Drink more citrus juice. 4. Take sodium bicarbonate.

The nurse determines that a client is in false labor. After obtaining discharge orders from the nurse-midwife, the nurse provides discharge teaching to the client. Which instruction is most appropriate at this time?

1. "Drink coffee or tea to maintain hydration." 2. "Apply cold compresses to relieve

discomfort." 3. "Maintain a supine position to promote rest." 4. "Return to the facility if fever occurs."

The nurse is preparing to auscultate fetal heart tones in a pregnant client. Abdominal palpation reveals a hard, round mass under the left side of the rib cage; a softer, round mass just above the symphysis pubis; small, irregular shapes in the right side of the abdomen; and a long, firm mass on the left side of the abdomen. Based on these findings, what is the best place to auscultate fetal heart tones?

1. Right lower abdominal quadrant 2. Right upper abdominal quadrant 3. Left upper abdominal quadrant 4. Left lower abdominal quadrant

Which findings would be considered positive signs of pregnancy?

1. Fatigue and skin changes 2. Quickening and breast

enlargement 3. Fetal heartbeat and fetal

movement on palpation 4. Abdominal enlargement and

Braxton Hicks contractions

A pregnant client in her second trimester visits the health care practitioner for a regular prenatal checkup. During the assessment, the nurse weighs the client, then compares her current and previous weights. During the second trimester, how much weight should the client gain per week?

1. 0.5 lb (0.23 kg) 2. 1 lb (0.45 kg) 3. 1.5 lb (0.68 kg) 4. 2 lb (.91 kg)

Several minutes after a vaginal delivery, nursing assessment reveals blood gushing from the client's vagina, umbilical cord lengthening, and a globular-shaped uterus. The nurse should suspect which condition?

1. Cervical or vaginal laceration 2. Placental separation 3. Postpartum hemorrhage 4. Uterine involution

A client in labor receives epidural anesthesia. The nurse should assess carefully for which adverse reaction to the anesthetic agent?

1. Hypotensive crisis 2. Fetal tachycardia 3. Renal toxicity 4. Increased beat-to-beat variability in the

fetal heart rate (FHR)

During the active phase of the first stage of labor, a client undergoes an amniotomy. After this procedure, which nursing diagnosis takes the highest priority?

1 . Deficient knowledge related to amniotomy

2. Ineffective fetal cerebral tissue perfusion related to cord compression

3. Pain related to increasing strength of contractions

4. Risk for infection related to rupture of membranes

A client in the first stage of labor enters the labor and delivery area. She seems anxious and tells the nurse that she hasn't attended childbirth education classes. Her husband, who accompanies her, is also unprepared for childbirth. Which nursing intervention would be most effective for the couple at this time?

1. Teach the client progressive muscle relaxation. 2. Instruct the husband on touch, massage, and

breathing patterns. 3. Use hypnosis on the client and her husband. 4. Teach the client and her husband about pain

transmission.

A primigravid client is admitted to the labor and delivery area, where the nurse evaluates her. Which assessment finding may indicate the need for cesarean delivery?

1. Insufficient perineal stretching 2. Rapid, progressive labor 3. Umbilical cord prolapse 4. Fetal prematurity

A client who's being admitted to labor and delivery has the following assessment findings: gravida 2 para 1, estimated 40 weeks' gestation, contractions 2 minutes apart, lasting 45 seconds, vertex +4 station. Which of the following would be the priority at this time?

1. Placing the client in bed to begin fetal monitoring

2. Preparing for immediate delivery 3. Checking for ruptured membranes 4. Providing comfort measures

A client has progressed through the first stage of labor. Which assessment finding suggests she's in the transition to the second stage?

A decreased urge to push Decreased bloody show Fetal heart rate (FHR)

accelerations Bulging of the vaginal introitus

A client is in the second stage of labor. During this stage, how frequently should the nurse assess her uterine contractions?

1. Every 5 minutes 2. Every 15 minutes 3. Every 30 minutes 4. Every 60 minutes

A client is recovering in the labor and delivery area after delivering a 6-lb, 3-oz boy. On assessment, the nurse finds that the client's fundus is firm and located two fingerbreadths below the umbilicus. Although she didn't have an episiotomy, her perineal pad reveals a steady trickle of blood. What is the probable cause of these assessment findings?

1. A boggy uterus 2. Normal involution 3. A vaginal laceration 4. A clotting problem

Initial client assessment information includes the following: blood pressure 160/110 mm Hg, pulse 88 beats/minute, respiratory rate 22 breaths/minute, reflexes +3/+4 with 2 beat clonus. Urine specimen reveals +3 protein, negative sugar and ketones. Based on these findings, the nurse would expect the client to have which of the following complaints?

1. Headache, blurred vision, and facial and extremity swelling

2. Abdominal pain, urinary frequency, and pedal edema

3. Diaphoresis, nystagmus, and dizziness 4. Lethargy, chest pain, and shortness of breath

After delivering a neonate, a client delivers the placenta. At this time, where does the nurse expect to palpate the uterine fundus?

1. At the midline, 0.4" to 0.8" (1 to 2 cm) above the umbilicus

2. At the midline, 0.4" to 0.8" (1 to 2 cm) below the umbilicus

3. Left of the midline, 0.8" to 1" (2 to 3 cm) above the umbilicus

4. Left of the midline, 0.8" to 1" (2 to 3 cm) below the umbilicus

The nurse is caring for a client who's in the first stage of labor. What is the shortest but most difficult part of this stage?

1. Active phase 2. Complete phase 3. Latent phase 4. Transitional phase

When caring for a client in the first stage of labor, the nurse documents cervical dilation of 9 cm and intense contractions lasting 45 to 60 seconds and occurring about every 2 minutes. Based on these findings, the nurse should recognize that the client is in which phase of labor?

1. Active phase 2. Latent phase 3. Descent phase 4. Transitional phase

A nulliparous client has been in the latent phase of the first stage of labor for several hours. Despite continued uterine contractions, her cervix hasn't dilated further since the initial examination. Her latent phase may be considered prolonged after:

1. 6 hours. 2. 10 hours. 3. 14 hours. 4. 20 hours.

A client, age 39, visits the nurse practitioner for a regular prenatal check-up. She's 32 weeks pregnant. When assessing her, the nurse should stay especially alert for signs and symptoms of:

a. pregnancy-induced hypertension (PIH). b. iron deficiency anemia. c. cephalopelvic disproportion. d. sexually transmitted diseases (STDs).

When determining maternal and fetal well-being, which of the following assessments is least important?

a. Signs of postural hypotension b. Fetal heart rate and activity c. The mother's acceptance of growing

fetus d. Signs of facial or digital edema

The nurse is teaching a breast-feeding client how to care for her engorged breasts. Which statement by the client indicates the need for further teaching?

a. "I'll use warm packs or a warm shower to ease engorgement."

b. "I'll use massage to help soften my breasts."

c. "If the baby feeds only on one side, I'll express milk from the other side."

d. "If my breasts are uncomfortable, I'll limit the time I spend breast-feeding."

A pregnant client asks how she can best prepare her 3-year-old son for the upcoming birth of a sibling. The nurse should make which suggestion?

a. "Tell your son about the childbirth about 1 month before your due date."

b. "Reassure your son that nothing is going to change."

c. "Reprimand your son if he displays immature behavior."

d. "Involve your son in planning and preparing for a sibling."

A client is experiencing an early postpartum hemorrhage. Which of the following actions would be inappropriate?

a. Inserting an indwelling urinary catheter b. Fundal massage c. Administration of oxytoxics d. Pad count

COMPLICATIONS OF PREGNANCYABORTION Slide Number 3ECTOPIC PREGNANCY HYDATIDIFORM MOLE/ H-MOLE/ Molar Pregnancy INCOMPETENT CERVICAL OS PLACENTA PREVIA ABRUPTIO PLACENTA /ABLATIO PLACENTAPremature Rupture of Membranes (PROM) DYSTOCIAPRECIPITATE LABOR PROLAPSED UMBILICAL CORD PREGNANCY-INDUCED HYPERTENSION Postpartum Hemorrhageearly&late Puerperal Infection Thrombophlebitis Mastitis Psychological phases during postpartum period:Slide Number 19Slide Number 20QUESTIONS:Slide Number 22Slide Number 23Slide Number 24Slide Number 25Slide Number 26Slide Number 27Slide Number 28Slide Number 29Slide Number 30Slide Number 31Slide Number 32Slide Number 33Slide Number 34Slide Number 35Slide Number 36Slide Number 37Slide Number 38Slide Number 39Slide Number 40Slide Number 41Slide Number 42Slide Number 43Slide Number 44Slide Number 45Slide Number 46Slide Number 47Slide Number 48Slide Number 49Slide Number 50Slide Number 51Slide Number 52Slide Number 53Slide Number 54Slide Number 55Slide Number 56Slide Number 57