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OB Test 5 > Maternity Nursing Chap 19 > Flashcards

Maternity Nursing Chap 19 Flashcards

1
Q

True or False: The major outcome of antepartum testing is the detection of potential fetal compromise.

A

True

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2
Q

True or False: Oligohydramnios or a decrease in amniotic fluid amount has been associated with neural tube defects.

A

False – associated with renal agenesis (Potter Syndrome), premature rupture of membranes, prolonged pregnancy, uteroplacental insufficiency, maternal hypertensive disorders

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3
Q

True or False: After amniocentesis or chorionic villi sampling (CVS), an Rh-negative woman should receive Rho(D) immunoglobin (RhoGAM).

A

True

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4
Q

True or False: The major disadvantage of a nonstress test (NST) relates to its high rate of false negative results.

A

False – Disadvantages include the requirement for twice weekly testing and a high false positive rate. Is also slightly less sensitive in detecting fetal compromise than the CST or BPP

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5
Q

True or False: Research indicates that giving a woman orange juice or glucose during NST stimulates her baby to move.

A

False – Research has proven this to not be effective.

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6
Q

True or False: A lower than normal alpha fetoprotein level in the maternal serum and amniotic fluid has been associated with Down Syndrome.

A

True

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7
Q

True or False: To conduct a contraction stress test (CST), four uterine contractions in a 15 min period are required.

A

False –

  • nipple stimulated contraction test: uterine contractions lasting more than 90 sec or 5 or more contractions in 10 mins.
  • oxytocin stimulated contraction test: 3 contractions each lasting 40 to 60 sec within a 10 min period
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8
Q

True or False: A negative result on a CST means that at least 3 uterine contractions occurred in a 10 min period, with no associated late or significant variable decelerations.

A

True

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9
Q

True or False: When performing a daily fetal movement count, a pregnant woman should call her health care provider if she notes eight or fewer fetal movements in 1 hour.

A

False – except for establishing a very low number of daily fetal movements or a trend toward decrease motion, the clinical value of the absolute number of fetal movements has not been established, other than in the situation in which fetal movements cease entirely for 12 hours (the so called fetal alarm signal).
-a count of fewer than 3 fetal movements within 1 hour.

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10
Q

True or False: Fetal movements decrease temporarily if the mother smokes.

A

True

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11
Q

What role does the nurse play when caring for a high risk pregnant woman and her family who are required to undergo antepartal testing to determine fetal well being?

A
  • providing support and encouragement
  • providing information about the pregnancy problem and its management
  • providing opportunities to make as many choices as possible about the woman’s care
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12
Q

What is the probable reason for the performance of a vaginal ultrasound in a primigavida who is at 10 weeks, was treated for a pelvic inflammatory disease 2 years ago, and does not know when last menstrual cycle started?

A

-to determine location of the gestational sac because pelvic inflammatory disease could have resulted in a narrowing of the fallopian tube, increasing the risk for ectopic pregnancy

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13
Q

Preparation for a vaginal ultrasound:

A
  • explain the purpose of the test
  • how it will be performed
  • how it will feel
  • assist her into the lithotomy or supine position with hips elevated on a pillow
  • point out structures on the monitor as the test is performed
  • bladder does not have to be full for this type of ultrasound examination
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14
Q

Ally, a pregnant woman at 20 weeks of gestation, is scheduled for a series of abdominal ultrasound tests to monitor the growth of her fetus. Describe the nursing role as it applies to Ally and to ultrasound examinations.

A
  • instruct woman to come with a full bladder if appropriate
  • explain purpose and method of examination
  • assist woman into a supine position with head and shoulders elevated and hip slightly tilted to the right or left
  • observe for supine hypotension during the test and orthostatic hypotension when rising to an upright position after the test
  • indicate how the fetus is being measured and point out fetus and his or her movements during the examination
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15
Q

What are 2 risk factors for polyhydramnios?

A
  • diabetes mellitus

- fetal congenital anomalies

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16
Q

What are 2 risk factors for intrauterine growth restriction?

A
  • maternal causes:
    • hypertensive disorders
    • diabetes
    • chronic renal disease
    • collagen vascular disease
    • thrombophilia
    • cyanotic heart disease
    • poor weight gain
    • smoking, alcohol use, illicit drug use
    • living at a high altitude
    • multiple gestation
  • fetoplacental causes:
    • chromosomal abnormalities
    • congenital malformatins
    • intrauterine infection
    • genetic syndrome (trisomy 13 and trisomy 18)
    • abnormal placental development
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17
Q

What are 2 risk factors for oligohydramnios?

A
  • renal agenesis (Potter Syndrome)
  • premature rupture of membranes
  • prolonged pregnancy
  • uteroplacental insufficiency
  • maternal hypertensive disorders
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18
Q

What are 2 risk factors for chromosomal abnormalities?

A
  • maternal age 35 years or older

- balanced translocation (maternal and paternal)

19
Q

A(n) ____________ is a pregnancy in which the life or health of the mother or her fetus is jeopardized by a disorder coincidental with or unique to pregnancy.

A

-high risk pregnancy

20
Q

The major expect outcome of antepartum testing is the ________________, ideally before intrauterine asphyxia of the fetus occurs, so the health care provider can take measures to prevent or minimize adverse perinatal outcomes.

A

-detection of fetal compromise

21
Q

___________ or __________ is the assessment of fetal activity by the mother. It is a simple yet valuable method for monitoring the condition of the fetus.

A
  • daily fetal movement count

- kick count

22
Q

The fetal alarm signal refers to the cessation of fetal movements entirely for ___________.

A

-12 hours

23
Q

A count of less than _________ warrants further evaluation by nonstress test, contraction stress test, biophysical profile (BPP), or a combination of these.

A

-3 movements within 1 hour

24
Q

Fetal movements are usually not present during the ____________; they might be temporarily reduced if the woman is taking depressant medications, drinking alcohol, or smoking; they do no decrease as the woman nears term.

A
  • fetal sleep cycle
  • depressant medications
  • alcohol
  • smoking
  • decrease
25
Q

_________ is the use of sound having a frequency higher than that detectable by humans to examine structures inside the body.

A

-ultrasonography

26
Q

Ultrasonography can be done ___________ or __________ during pregnancy.

A
  • transabdominally

- transvaginally

27
Q

____________ is more useful after the first trimester when the pregnant uterus rises out of the pelvis.

A

-abdominal ultrasound

28
Q

___________, in which the probe is inserted into the vagina, allows pelvic anatomy to be evaluated in greater detail and pregnancy to be diagnosed earlier.

A

-vaginal ultrasound

29
Q

Vaginal ultrasound is optimally used in the first trimester to detect ___________ pregnancies, monitor the developing embryo, help identify abnormalities, and help establish gestational age.

A
  • ectopic
  • embryo
  • abnormalities
  • gestational age
30
Q

_________ is the noninvasive study of blood flow in the fetus and placenta. It is a helpful adjunct in the management of pregnancies at risk because of hypertension, intrauterine growth restriction, diabetes mellitus, multiple fetuses, or preterm labor.

A

-Doppler blood flow analysis

31
Q

________ is a noninvasive dynamic assessment of the fetus and his or her environment by ultrasonography and external fetal monitoring. This test includes assessment of five variables (i.e., fetal breathing movements, fetal movement, fetal tone, nonstress test, and amniotic fluid volume)

A

-BPP

32
Q

_________ is a noninvasive radiologic technique for obstetric and gynecologic diagnoses. It provides excellent pictures of soft tissue without ionizing radiation.

A

-magnetic resonance imaging

33
Q

___________ is performed to obtain amniotic fluid, which contains fetal cells. A needle is inserted transabdominally into the uterus, amniotic fluid is withdrawn, and various assessments are performed. Indications for this procedure are prenatal diagnosis of genetic disorders, assessment of pulmonary maturity, and diagnosis of fetal hemolytic disease.

A

-amniocentesis

34
Q

Direct access to the fetal circulation during the second and third trimesters is possible through ____________ or ___________, which is the most widely used method for fetal blood sampling and transfusion. It involves the insertion of a needle directly into a fetal umbilical blood vessel under ultrasound guidance.

A
  • percutaneous umbilical cord sampling

- cordocentesis

35
Q

__________ is a procedure that involves the removal of a small tissue specimen from the fetal portion of the placenta. Because this tissue originates from the zygote, it reflects the genetic makeup of the fetus. It is performed between 10 and 12 weeks of gestation.

A

-chorionic villus sampling

36
Q

Determination of the __________ level is used as a screening tool for neural tube defects in pregnancy. The test is ideally performed between 16 and 18 weeks of gestation.

A

maternal serum alpha fetoprotein (AFP)

37
Q

The __________ is a screening test for Down syndrome. It is performed between 16 and 18 weeks of gestation. The levels of 3 markers (i.e., maternal serum AFP, unconjugated estriol, and human chorionic gonadotropin) in combination with maternal age are used to determine degree of risk.

A

-triple maker test

38
Q

A _________ test is based on the fact that the heart rate of a healthy fetus with an intact central nervous system will accelerate in response to fetal movement.

A

-nonstress

39
Q

The purpose of a ________ test is to identify the jeopardized fetus who is stable at rest but shows evidence of compromise when exposed to the stress of uterine contractions. If the resultant hypoxia of the fetus is sufficient, a late deceleration of the FHR results. Two methods used for this test are the _____________ and the ________ test.

A
  • contraction stress
  • nipple stimulated contraction stress
  • oxytocin stimulated contraction stress
40
Q

A 34 year old woman at 36 weeks of gestation has been scheduled for a biophysical profile. She asks the nurse why the test needs to be performed. The nurse tells her that the test:

a. determines how well her baby breathes after he or she is born
b. evaluates the response of her baby’s heart to uterine contractions
c. measures her baby’s head and length
d. observes her baby’s activities to ensure that he or she is getting enough oxygen

A

d.

41
Q

As part of preparing a 24 year old woman at 42 weeks of gestation for an NST, the nurse:

a. tells the woman to fast for 8 hours before the test
b. explains that the test evaluates how well her baby is moving inside her uterus
c. shows her how to indicate when her baby moves
d. attaches a spiral electrode to the presenting part to determine FHR patterns

A

c.

42
Q

A 40 year old woman at 18 weeks of gestation is having a triple marker test performed. She is obese, and her health history reveals that she is Rh negative. The primary purpose of this test is to screen for:

a. spina bifida
b. down syndrome
c. gestational diabetes
d. Rh antibodies

A

b.

43
Q

During a CST four contractions lasting 45 to 55 seconds were recorded in a 10 min period. A late deceleration was noted during the third contraction. The nurse conducting the test documents which of the following results?

a. negative
b. positive
c. suspicious
d. unsatisfactory

A

c.

44
Q

A pregnant woman is scheduled for a transvaginal ultrasound test to establish gestational age. In preparing this woman for the test, the nurse:

a. places the woman in a supine position with her hips elevated on a folded pillow
b. instructs her to come for the test with a full bladder
c. administers an analgesics 30 mins before the test
d. lubricates the vaginal probe with transmission gel

A

a.

OB Test 5 (3 decks)

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