Presentasi Singkat temntang Antepartum bleeding. Mencakup plasenta previa dan hemmorhagic post partumDeskripsi lengkap
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OB/GYN 2 – Antepartum 1. A nursing instructor is conducting conducting lecture and is reviewing reviewing the functions of the female reproductive reproductive system. She asks Mark to describe the follicle-stimulating hormone (FS! and the luteini"ing hormone (#!. Mark accurately responds by stating that$ 1. FS and # are released released from the anterior pituitary gland. %. FS and # are secreted secreted by the corpus corpus luteum of the ovary &. FS and # are secreted secreted by the adrenal adrenal glands '. FS and # stimulate the formation of milk during pregnancy. pregnancy. %.
A nurse nurse is describing the process process of fetal circulation circulation to a client during a
prenatal visit. he nurse accurately tells the client that fetal circulation consists of$ 1. wo umbilical veins and one umbilical artery %. wo umbilical arteries and one umbilical vein &. Arteries carrying carrying o)ygenated o)ygenated blood to the fetus '. *eins carrying deo)ygenated deo)ygenated blood to the fetus &.
+uring a prenatal visit at &, weeks a nurse assesses the fetal heart rate.
he nurse determines determines that the fetal heart rate is normal if which which of the following is noted 1. ,/ 0M 0M %. 1// 0M &. 12/ 0M '. 1,/ 0M '. A client client arrives arrives at a prenatal clinic for the 3rst prenatal prenatal assessment. assessment. he client tells a nurse that the 3rst day of her last menstrual period was September 14th %//2. 5sing 6agele7s rule the nurse determi determines nes the estimated date of con3nement as$ 1. 8uly %9 %//9 %//9 %. 8une 1% 1% %//: %//: &. 8une %9 %9 %//9 %//9 '. 8uly 1% %//: %//: 2.
A nurse is collecting collecting data during during an admission assessment of a client who is
pregnant with twins. he client has a healthy 2-year old child that was delivered at &: weeks and tells the nurse that she doesn7t have any history of abortion or fetal demise. he nurse would document the ; ;A# A# for this client as$
A nurse is performing an assessment of a primapira who is being evaluated in
a clinic during her second trimester of pregnancy. =hich of the following indicates an abnormal physical 3nding necessitating further testing 1. >onsistent increase in fundal height %. Fetal heart rate of 1,/ 0M &. 0ra)ton hicks contractions '. ?uickening :. A nurse is reviewing the record of a client who has @ust been told that a pregnancy test is positive. he physician has documented the presence of a ;oodell7s sign. he nurse determines this sign indicates$ 1. A softening of the cervi) %. A soft blowing sound that corresponds to the maternal pulse during auscultation of the uterus. &. he presence of h>; in the urine '. he presence of fetal movement ,. A nursing instructor asks a nursing student who is preparing to assist with the assessment of a pregnant client to describe the process of uickening. =hich of the following statements if made by the student indicates an understanding of this term 1. “Bt
is the irregular painless contractions that occur throughout pregnancy.C
2. “Bt
is the soft blowing sound that can be heard when the uterus is auscultated.C
3. “Bt
is the fetal movement that is felt by the mother.C
4. “Bt
is the thinning of the lower uterine segment.C
4. A nurse midwife is performing an assessment of a pregnant client and is assessing the client for the presence of ballottement. =hich of the following would the nurse implement to test for the presence of ballottement 1. Auscultating for fetal heart sounds %. alpating the abdomen for fetal movement &. Assessing the cervi) for thinning
'. Bnitiating a gentle upward tap on the cervi) 1.
1/. A nurse is assisting in performing an assessment on a client who suspects that she is pregnant and is checking the client for probable signs of pregnancy. Select allprobable signs of pregnancy.
1. 5terine enlargement %. Fetal heart rate detected by nonelectric device &. Dutline of the fetus via radiography or ultrasound '. >hadwick7s sign 2. 0ra)ton icks contractions 9. 0allottement 1. 11. A pregnant client calls the clinic and tells a nurse that she is e)periencing leg cramps and is awakened by the cramps at night. o provide relief from the leg cramps the nurse tells the client to$ 1. +orsiEe) the foot while e)tending the knee when the cramps occur %. +orsiEe) the foot while Ee)ing the knee when the cramps occur &. lantar Ee) the foot while Ee)ing the knee when the cramps occur '. lantar Ee) the foot while e)tending the knee when the cramps occur. 1. 1%. A nurse is providing instructions to a client in the 3rst trimester of pregnancy regarding measures to assist in reducing breast tenderness. he nurse tells the client to$ 1. Avoid wearing a bra %. =ash the nipples and areola area daily with soap and massage the breasts with lotion. &. =ear tight-3tting blouses or dresses to provide support '. =ash the breasts with warm water and keep them dry 1. 1&. A pregnant client in the last trimester has been admitted to the hospital with a diagnosis of severe preeclampsia. A nurse monitors for complications associated with the diagnosis and assesses the client for$ 1. Any bleeding such as in the gums petechiae and purpura. %. nlargement of the breasts &. eriods of fetal movement followed by uiet periods '. >omplaints of feeling hot when the room is cool 1. 1'. A client in the 3rst trimester of pregnancy arrives at a health care clinic and reports that she has been e)periencing vaginal bleeding. A threatened abortion is suspected and the nurse instructs the client regarding management of care. =hich statement if made by the client indicates a need for further education 1. “B
will maintain strict bedrest throughout the remainder of pregnancy.C
2. “B
will avoid se)ual intercourse until the bleeding has stopped and for % weeks
following the last evidence of bleeding.C 3. “B
will count the number of perineal pads used on a daily basis and note the
amount and color of blood on the pad.C 4. “B
will watch for the evidence of the passage of tissue.C
1. 12. A prenatal nurse is providing instructions to a group of pregnant client regarding measures to prevent to)oplasmosis. =hich statement if made by one of the clients indicates a need for further instructions 1. “B
need to cook meat thoroughly.C
2. “B
need to avoid touching mucous membranes of the mouth or eyes while
handling raw meat.C 3. “B
need to drink unpasteuri"ed milk only.C
4. “B
need to avoid contact with materials that are possibly contaminated with cat
feces.C 1. 19. A homecare nurse visits a pregnant client who has a diagnosis of mild reeclampsia and who is being monitored for pregnancy induced hypertension (B!. =hich assessment 3nding indicates a worsening of the reeclampsia and the need to notify the physician 1. 0lood pressure reading is at the prenatal baseline %. 5rinary output has increased &. he client complains of a headache and blurred vision '. +ependent edema has resolved 1. 1:. A nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes. =hich statement if made by the client indicates a need for further education 1. “B
need to stay on the diabetic diet.C
2. “B
will perform glucose monitoring at home.C
3. “B
need to avoid e)ercise because of the negative eGects of insulin production.C
4. “B
need to be aware of any infections and report signs of infection immediately to
my health care provider.C 1. 1,. A primagravida is receiving magnesium sulfate for the treatment of pregnancy induced hypertension (B!. he nurse who is caring for the client is performing assessments every &/ minutes. =hich assessment 3nding would be of most concern to the nurse 1. 5rinary output of %/ ml since the previous assessment %. +eep tendon reEe)es of %H &. Iespiratory rate of 1/ 0M
'. Fetal heart rate of 1%/ 0M 1. 14. A nurse is caring for a pregnant client with reeclampsia. he nurse prepares a plan of care for the client and documents in the plan that if the client progresses from reeclampsia to eclampsia the nurse7s 3rst action is to$ 1. Administer magnesium sulfate intravenously %. Assess the blood pressure and fetal heart rate &. >lean and maintain an open airway '. Administer o)ygen by face mask 1. %/. A nurse is monitoring a pregnant client with pregnancy induced hypertension who is at risk for reeclampsia. he nurse checks the client for which speci3c signs of reeclampsia (select all that apply! 1. levated blood pressure %. 6egative urinary protein &. Facial edema '. Bncreased respirations 1. %1. Iho (+! immune globulin (Iho;AM! is prescribed for a woman following delivery of a newborn infant and the nurse provides information to the woman about the purpose of the medication. he nurse determines that the woman understands the purpose of the medication if the woman states that it will protect her ne)t baby from which of the following 1. 0eing aGected by Ih incompatibility %. aving Ih positive blood &. +eveloping a rubella infection '. +eveloping physiological @aundice 1. %%. A pregnant client is receiving magnesium sulfate for the management of preeclampsia. A nurse determines the client is e)periencing to)icity from the medication if which of the following is noted on assessment 1. resence of deep tendon reEe)es %. Serum magnesium level of 9 mJ# &. roteinuria of H& '. Iespirations of 1/ per minute 1. %&. A woman with preeclampsia is receiving magnesium sulfate. he nurse assigned to care for the client determines that the magnesium therapy is eGective if$ 1. Ankle clonus in noted %. he blood pressure decreases &. Sei"ures do not occur '. Scotoma7s are present
1.
%'. A nurse is caring for a pregnant client with severe preeclampsia who is receiving B* magnesium sulfate. Select all nursing interventions that apply in the care for the client.
1. Monitor maternal vital signs every % hours %. 6otify the physician if respirations are less than 1, per minute. &. Monitor renal function and cardiac function closely '. Keep calcium gluconate on hand in case of a magnesium sulfate overdose 2. Monitor deep tendon reEe)es hourly 9. Monitor B and D7s hourly :. 6otify the physician if urinary output is less than &/ ml per hour. 1. %2. Bn the 1%th week of gestation a client completely e)pels the products of conception. 0ecause the client is Ih negative the nurse must$ 1. Admister Iho;AM within :% hours %. Make certain she receives Iho;AM on her 3rst clinic visit &. 6ot give Iho;AM since it is not used with the birth of a stillborn '. Make certain the client does not receive Iho;AM since the gestation only lasted 1% weeks. 1. %9. Bn a lecture on se)ual functioning the nurse plans to include the fact that ovulation occurs when the$ 1. D)ytocin is too high %. 0lood level of # is too high &. rogesterone level is high '. ndometrial wall is sloughed oG. 1. %:. he chief function of progesterone is the$ 1. +evelopment of the female reproductive system %. Stimulation of the follicles for ovulation to occur &. reparation of the uterus to receive a fertili"ed egg '. stablishment of secondary male se) characteristics 1. %,. he developing cells are called a fetus from the$ 1. ime the fetal heart is heard %. ighth week to the time of birth &. Bmplantation of the fertili"ed ovum '. nd of the send week to the onset of labor 1. %4. After the 3rst four months of pregnancy the chief source of estrogen and progesterone is the$ 1. lacenta %. Adrenal corte) &. >orpus luteum
'. Anterior hypophysis 1. &/. he nurse recogni"es that an e)pected change in the hematologic system that occurs during the %nd trimester of pregnancy is$ 1. A decrease in =0>7s %. Bn increase in hematocrit &. An increase in blood volume '. A decrease in sedimentation rate 1. &1. he nurse is aware than an adaptation of pregnancy is an increased blood supply to the pelvic region that results in a purplish discoloration of the vaginal mucosa which is known as$ 1. #adin7s sign %. egar7s sign &. ;oodell7s sign '. >hadwick7s sign 1. &%. A pregnant client is making her 3rst Antepartal visit. She has a two year old son born at '/ weeks a 2 year old daughter born at &, weeks and : year old twin daughters born at &2 weeks. She had a spontaneous abortion & years ago at 1/ weeks. 5sing the ;A# format the nurse should identify that the client is$ 1. ;' & % A1 #' %. ;2 % % A1 #' &. ;2 % 1 A1 #' '. ;' & 1 A1 #' 1. &&. An e)pected cardiopulmonary adaptation e)perienced by most pregnant women is$ 1. achycardia %. +yspnea at rest &. rogression of dependent edema '. Shortness of breath on e)ertion 1. &'. 6utritional planning for a newly pregnant woman of average height and weighing 1'2 pounds should include$ 1. A decrease of %// calories a day %. An increase of &// calories a day &. An increase of 2// calories a day '. A maintenance of her present caloric intake per day 1. &2. +uring a prenatal e)amination the nurse draws blood from a young Ih negative client and e)plain that an indirect >oombs test will be performed to predict whether the fetus is at risk for$ 1. Acute hemolytic disease
%. Iespiratory distress syndrome &. rotein metabolic de3ciency '. hysiologic hyperbilirubinemia 1. &9. =hen involved in prenatal teaching the nurse should advise the clients that an increase in vaginal secretions during pregnancy is called leukorrhea and is caused by increased$ 1. Metabolic rates %. roduction of estrogen &. Functioning of the 0artholin glands '. Supply of sodium chloride to the cells of the vagina 1. &:. A %9-year old multigravida is 1' weeks7 pregnant and is scheduled for an alpha-fetoprotein test. She asks the nurse L=hat does the alpha-fetoprotein test indicateC he nurse bases a response on the knowledge that this test can detect$ 1. Kidney defects %. >ardiac defects &. 6eural tube defects '. 5rinary tract defects 1. &,. At a prenatal visit at &9 weeks7 gestation a client complains of discomfort with irregularly occurring contractions. he nurse instructs the client to$ 1. #ie down until they stop %. =alk around until they subside &. ime contraction for &/ minutes '. ake 1/ grains of aspirin for the discomfort 1. &4. he nurse teaches a pregnant woman to avoid lying on her back. he nurse has based this statement on the knowledge that the supine position can$ 1. 5nduly prolong labor %. >ause decreased placental perfusion &. #ead to transient episodes of hypotension '. Bnterfere with free movement of the coccy) 1. '/. he pituitary hormone that stimulates the secretion of milk from the mammary glands is$ 1. rolactin %. D)ytocin &. strogen '. rogesterone 1. '1. =hich of the following symptoms occurs with a hydatidiform mole 1. eavy bright red bleeding every %1 days
%. Fetal cardiac motion after 9 weeks gestation &. 0enign tumors found in the smooth muscle of the uterus 4. “snowstormC
pattern on ultrasound with no fetus or gestational sac
1. '%. =hich of the following terms applies to the tiny blanced slightly raised end arterioles found on the face neck arms and chest during pregnancy 1. pulis %. #inea nigra &. Striae gravidarum '. elangiectasias 1. '&. =hich of the following conditions is common in pregnant women in the %ndtrimester of pregnancy 1. Mastitis %. Metabolic alkalosis &. hysiologic anemia '. Iespiratory acidosis 1. ''. A %1-year old client 9 weeks7 pregnant is diagnosed with hyperemesis gravidarum. his e)cessive vomiting during pregnancy will often result in which of the following conditions 1. 0owel perforation %. lectrolyte imbalance &. Miscarriage '. regnancy induced hypertension (B! 1. '2. >lients with gestational diabetes are usually managed by which of the following therapies 1. +iet %. 6 insulin (long-acting! &. Dral hypoglycemic drugs '. Dral hypoglycemic drugs and insulin 1. '9. he antagonist for magnesium sulfate should be readily available to any client receiving B* magnesium. =hich of the following drugs is the antidote for magnesium to)icity 1. >alcium gluconate %. ydrala"ine (Apresoline! &. 6arcan '. Iho;AM 1. ':. =hich of the following answers best describes the stage of pregnancy in which maternal and fetal blood are e)changed 1. >onception
%. 4 weeks7 gestation when the fetal heart is well developed &. &%-&' weeks gestation '. maternal and fetal blood are never e)changed 1. ',. ;ravida refers to which of the following descriptions 1. A serious pregnancy %. 6umber of times a female has been pregnant &. 6umber of children a female has delivered '. 6umber of term pregnancies a female has had. 1. '4. A pregnant woman at &% weeks7 gestation complains of feeling di""y and lightheaded while her fundal height is being measured. er skin is pale and moist. he nurse7s initial response would be to$ 1. Assess the woman7s blood pressure and pulse %. ave the woman breathe into a paper bag &. Iaise the woman7s legs '. urn the woman on her side. 1. 2/. A pregnant woman7s last menstrual period began on April , %//2 and ended on April 1&. 5sing 6gele7s rule her estimated date of birth would be$ 1. 8anuary 12 %//9 %. 8anuary %/ %//9 &. 8uly 1 %//9 '. 6ovember 2 %//2 A6S=IS 1. 1. FS and # when stimulated by gonadotropin-releasing hormone from the hypothalamus are released from the anterior pituitary gland to stimulate follicular growth and development growth of the graa3an follicle and production of progesterone. %. %. 0lood pumped by the embryo7s heart leaves the embryo through two umbilical arteries. Dnce o)ygenated the blood then is returned by one umbilical vein. Arteries carry deo)ygenated blood and waste products from the fetus and veins carry o)ygenated blood and provide o)ygen and nutrients to the fetus. &. &. he fetal heart rate depends in gestational age and ranges from 19/-1:/ 0M in the 3rst trimester but slows with fetal growth to 1%/-19/ 0M near or at term. At or near term if the fetal heart rate is less than 1%/ or more than 19/ 0M with the uterus at rest the fetus may be in distress. '. &. Accurate use of 6agele7s rule reuires that the woman have a regular %,-day menstrual cycle. Add : days to the 3rst day of the last menstrual period subtract
three months and then add one year to that date. 2. %. regnancy outcomes can be described with the acronym ;A#. ; is gravidity the number of pregnancies. is term births the number born at term (&,-'1 weeks!. is preterm births the number born before &, weeks gestation. A is abortions or miscarriages (included in gravida if before %/ weeks gestationN included in parity if past %/ weeks gestation!. # is live births the number of live births or living children. herefore a woman who is pregnant with twins and has a child has a gravida of %. 0ecause the child was delivered at &: weeks the number of preterm births is 1 and the number of term births is /. he number of abortions is / and the number of live births is 1. 9. %. he normal range of the fetal heart rate depends on gestational age. he heart rate is usually 19/-1:/ 0M in the 3rst trimester and slows with fetal growth near and at term the fetal heart rate ranges from 1%/-19/ 0M. he other options are e)pected. :. 1. Bn the early weeks of pregnancy the cervi) becomes softer as a result of increased vascularity and hyperplasia which causes the ;oodell7s sign. ,. &. ?uickening is fetal movement and may occur as early as the 19th and 1,th week of gestation and the mother 3rst notices subtle fetal movements that gradually increase in intensity. 0ra)ton icks contractions are irregular painless contractions that may occur throughout the pregnancy. A thinning of the lower uterine segment occurs about the 9 th week of pregnancy and is called egar7s sign. 4. '. 0allottement is a techniue of palpating a Eoating structure by bouncing it gently and feeling it rebound. Bn the techniue used to palpate the fetus the e)aminer places a 3nger in the vagina and taps gently upward causing the fetus to rise. he fetus then sinks and the e)aminer feels a gentle tap on the 3nger. 10.1 ' 2 and 9. he probable signs of pregnancy include uterine enlargement egar7s sign (softening and thinning of the uterine segment that occurs at week 9! ;oodell7s sign (softening of the cervi) that occurs at the beginning of the %nd month! >hadwick7s sign (bluish coloration of the mucous membranes of the cervi) vagina and vulva that occurs at week 9! ballottement (rebounding of the fetus against the e)aminers 3ngers of palpation! 0ra)ton icks contractions and a positive pregnancy test measuring for h>;. Positive signs of pregnancy include fetal heart rate detected by electronic device (+oppler! at 1/-1% weeks and by nonelectronic device (fetoscope! at %/ weeks gestation active fetal movements palpable by the e)aminer and an outline of the fetus via radiography or ultrasound. 11.1. #egs cramps occur when the pregnant woman stretches the leg and plantar Ee)es the foot. +orsiEe)ion of the foot while e)tending the knee stretches the aGected muscle prevents the muscle from contracting and stops the cramping. 1%.'. he pregnant woman should be instructed to wash the breasts with warm
water and keep them dry. he woman should be instructed to avoid using soap on the nipples and areola area to prevent the drying of tissues. =earing a supportive bra with wide ad@ustable straps can decrease breast tenderness. ight-3tting blouses or dresses will cause discomfort (especially on test days even if you7re not pregnant. Oo.!. 1&.1. Severe reeclampsia can trigger disseminated intravascular coagulation (+B>N remember the eds lecture! because of the widespread damage to vascular integrity. 0leeding is an early sign of +B> and should be reported to the M.+. 1'.1. Strict bed rest throughout the remainder of pregnancy is not reuired. he woman is advised to curtail se)ual activities until the bleeding has ceased and for % weeks following the last evidence of bleeding or as recommended by the physician. he woman is instructed to count the number of perineal pads used daily and to note the uantity and color of blood on the pad. he woman also should watch for the evidence of the passage of tissue. 12.&. All pregnant women should be advised to do the following to prevent the development of to)oplasmosis. =omen should be instructed to cook meats thoroughly avoid touching mucous membranes and eyes while handling raw meatN thoroughly wash all kitchen surfaces that come into contact with uncooked meat wash the hands thoroughly after handling raw meatN avoid uncooked eggs and unpasteuri"ed milkN wash fruits and vegetables before consumption and avoid contact with materials that possibly are contaminated with cat feces such as cat litter bo)es sand bo)es and garden soil. 19.&. Bf the client complains of a headache and blurred vision the physician should be noti3ed because these are signs of worsening reeclampsia. 1:.&. )ercise is safe for the client with gestational diabetes and is helpful in lowering the blood glucose level. 1,.&. Magnesium sulfate depresses the respiratory rate. Bf the respiratory rate is less than 1% breaths per minute the physician or other health care provider needs to be noti3ed and continuation of the medication needs to be reassessed. A urinary output of %/ ml in a &/ minute period is adeuateN less than &/ ml in one hour needs to be reported. +eep tendon reEe)es of %H are normal. he fetal heart rate is =6# for a resting fetus. 14.&. he immediate care during a sei"ure (eclampsia! is to ensure a patent airway. he other options are actions that follow or will be implemented after the sei"ure has ceased. %/.1 and &. he three classic signs of preeclampsia are hypertension generali"ed edema and protenuria. Bncreased respirations are not a sign of preeclampsia.
%1.1. Ih incompatibility can occur when an Ih-negative mom becomes sensiti"ed to the Ih antigen. Sensiti"ation may develop when an Ih-negative woman becomes pregnant with a fetus who is Ih positive. +uring pregnancy and at delivery some of the baby7s Ih positive blood can enter the maternal circulation causing the woman7s immune system to form antibodies against Ih positive blood. Administration of Iho(+! immune globulin prevents the woman from developing antibodies against Ih positive blood by providing passive antibody protection against the Ih antigen. %%.'. Magnesium to)icity can occur from magnesium sulfate therapy. Signs of to)icity relate to the central nervous system depressant eGects of the medication and include respiratory depression loss of deep tendon reEe)es and a sudden drop in the fetal heart rate and maternal heart rate and blood pressure. herapeutic levels of magnesium are '-: mJ#. roteinuria of H& would be noted in a client with preeclampsia. %&.&. For a client with preeclampsia the goal of care is directed at preventing eclampsia (sei"ures!. Magnesium sulfate is an anticonvulsant not an antihypertensive agent. Although a decrease in blood pressure may be noted initially this eGect is usually transient. Ankle clonus indicated hyperrele)ia and may precede the onset of eclampsia. Scotomas are areas of complete or partial blindness. *isual disturbances such as scotomas often precede an eclamptic sei"ure. %'.& ' 2 9 and :. =hen caring for a client receiving magnesium sulfate therapy the nurse would monitor maternal vital signs especially respirations every &/-9/ minutes and notify the physician if respirations are less than 1% because this would indicate respiratory depression. >alcium gluconate is kept on hand in case of magnesium sulfate overdose because calcium gluconate is the antidote for magnesium sulfate to)icity. +eep tendon reEe)es are assessed hourly. >ardiac and renal function is monitored closely. he urine output should be maintained at &/ ml per hour because the medication is eliminated through the kidneys. %2.1. Iho;AM is given within :% hours postpartum if the client has not been sensiti"ed already. %9.%. Bt is the surge of # secretion in midcycle that is responsible for ovulation. %:.&. rogesterone stimulates diGerentiation of the endometrium into a secretory type of tissue. %,.%. Bn the 3rst :-1' days the ovum is known as a blastocystN it is called an embryo until the eighth weekN the developing cells are then called a fetus until birth. %4.1. =hen placental formation is complete around the 19 th week of pregnancyN it produces estrogen and progesterone. &/.&. he blood volume increases by appro)imately '/-2/P during pregnancy. he
peak blood volume occurs between &/ and &' weeks of gestation. he hematocrit decreases as a result of the increased blood volume. &1.'. A purplish color results from the increased vascularity and blood vessel engorgement of the vagina. &%.&. 2 pregnanciesN % term birthsN twins count as 1N one abortionN ' living children. &&.'. his is an e)pected cardiopulmonary adaptation during pregnancyN it is caused by an increased ventricular rate and elevated diaphragm. &'.%. his is the recommended caloric increase for adult women to meet the increased metabolic demands of pregnancy. &2.1. =hen an Ih negative mother carries an Ih positive fetus there is a risk for maternal antibodies against Ih positive bloodN antibodies cross the placenta a nd destroy the fetal I0>7s. &9.%. he increase of estrogen during pregnancy causes hyperplasia of the vaginal mucosa which leads to increased production of mucus by the endocervical glands. he mucus contains e)foliated epithelial cells. &:.&. he alpha-fetoprotein test detects neural tube defects and +own syndrome. &,.%. Ambulation relieves 0ra)ton icks. &4.%. his is because impedance of venous return by the gravid uterus which causes hypotension and decreased systemic perfusion. '/.1. rolactin is the hormone from the anterior pituitary gland that stimulates mammary gland secretion. D)ytocin a posterior pituitary hormone stimulates the uterine musculature to contract and causes the Llet downC reEe). '1.'. he chorionic villi of a molar pregnancy resemble a snowstorm pattern on ultrasound. 0leeding with a hydatidiform mole is often dark brown and may occur erratically for weeks or months. '%.'. he dilated arterioles that occur during pregnancy are due to the elevated level of circulating estrogen. he linea nigra is a pigmented line e)tending from the symphysis pubis to the top of the fundus during pregnancy. '&.&. emoglobin and hematocrit levels decrease during pregnancy as the increase in plasma volume e)ceeds the increase in red blood cell production. ''.%. )cessive vomiting in clients with hyperemesis gravidarum often causes weight loss and Euid electrolyte and acid-base imbalances. '2.1. >lients with gestational diabetes are usually managed by diet alone to control their glucose intolerance. Dral hypoglycemic agents are contraindicated in pregnancy. 6 isn7t usually needed for blood glucose control for ;+M. '9.1. >alcium gluconate is the antidote for magnesium to)icity. en ml of 1/P calcium gluconate is given B* push over &-2 minutes. ydrala"ine is given for
sustained elevated blood pressures in preeclamptic clients. ':.'. Dnly nutrients and waste products are transferred across the placenta. 0lood e)change only occurs in complications and some medical procedures accidentally. ',.%. ;ravida refers to the number of times a female has been pregnant regardless of pregnancy outcome or the number of neonates delivered. '4.'. +uring a fundal height measurement the woman is placed in a supine position. his woman is e)periencing supine hypotension as a result of uterine compression of the vena cava and abdominal aorta. urning her on her side will remove the compression and restore cardiac output and blood pressure. hen vital signs can be assessed. Iaising her legs will not solve the problem since pressure will still remain on the ma@or abdominal blood vessels thereby continuing to impede cardiac output. 0reathing into a paper bag is the solution for di""iness related to respiratory alkalosis associated with hyperventilation. 2/.1. 6gele7s rule reuires subtracting & months and adding : days and 1 year if appropriate to the 3rst day of a pregnant woman7s last menstrual period. =hen this rule is used with April , %//2 the estimated date of birth is 8anuary 12 %//9.
