1
Q
What is the clinical definition of ‘infertility’?
A
The inability of a couple to conceive despite engaging in unprotected sexual intercourse for at least 12 months.
2
Q
How does ‘subfertility’ differ from infertility?
A
Subfertility is the potential of a couple to conceive with additional assistance, whereas infertility is the inability to conceive after 12 months.
3
Q
List four common factors associated with infertility.
A
Decreased sperm production, endometriosis, ovulation disorders, and tubal occlusions.
4
Q
At what age does fertility for an assigned female at birth begin to significantly decline?
A
Age greater than 35 is a risk factor.
5
Q
What is the purpose of a hysterosalpingography in an infertility workup?
A
It is an outpatient radiological procedure where dye is used to assess the patency of the fallopian tubes.
6
Q
Before a hysterosalpingography, the nurse should assess for a history of allergies to what two substances?
A
Iodine and seafood.
7
Q
The first test in an infertility workup is typically a _____ _____ because it is less expensive and less invasive.
A
semen analysis
8
Q
This procedure involves placing prepared sperm in the uterus at the time of ovulation.
A
Intrauterine insemination (IUI).
9
Q
In _____, a couple’s embryo is placed in another person who will carry the pregnancy, with the carrier having no genetic investment.
A
a gestational carrier (embryo host)
10
Q
What is the key difference between a gestational carrier and a surrogate?
A
A surrogate is inseminated with semen and is genetically related to the fetus, while a gestational carrier has no genetic investment.
11
Q
The use of medications to treat female infertility can increase the risk of multiple births by more than _____%.
A
25
12
Q
What is the primary danger of an ectopic pregnancy?
A
The fallopian tube can rupture, leading to extensive bleeding.
13
Q
What medication is prescribed to dissolve an ectopic pregnancy if it’s identified before rupture?
A
Methotrexate.
14
Q
Slight fluttering movements of the fetus felt by the client between 16 to 20 weeks are a presumptive sign of pregnancy known as _____.
A
quickening
15
Q
What are the three categories of signs of pregnancy?
A
Presumptive, probable, and positive.
16
Q
A deepened violet-bluish color of the cervix and vaginal mucosa is a probable sign of pregnancy called _____ sign.
A
Chadwick’s
17
Q
What is Goodell’s sign?
A
A probable sign of pregnancy characterized by the softening of the cervical tip.
18
Q
Hegar’s sign, a probable sign of pregnancy, is the softening and compressibility of the _____ _____.
A
lower uterus
19
Q
List the three positive signs of pregnancy.
A
Fetal heart sounds, visualization of the fetus by ultrasound, and fetal movement palpated by an experienced examiner.
20
Q
Higher than normal levels of hCG can indicate what conditions?
A
Multifetal pregnancy, ectopic pregnancy, hydatidiform mole, or a genetic abnormality like Down syndrome.
21
Q
Lower than normal blood levels of hCG might suggest a _____ or _____ pregnancy.
A
miscarriage, ectopic
22
Q
How is a client’s estimated date of delivery calculated using Nägele’s rule?
A
Take the first day of the last menstrual cycle, subtract 3 months, and add 7 days and 1 year.
23
Q
In the GTPAL acronym, what does the ‘G’ stand for?
A
Gravidity: the total number of pregnancies.
24
Q
In the GTPAL acronym, what does ‘parity’ refer to?
A
The number of pregnancies in which the fetus reaches at least 20 weeks of gestation.
25
What is the definition of a 'primigravida'?
A client in their first pregnancy.
26
During pregnancy, cardiac output increases by _____ to _____ percent to meet greater metabolic needs.
30% to 50%
27
Maternal hypotension and fetal hypoxia caused by the pressure of the gravid uterus on the vena cava when a client is supine is known as _____ _____ _____.
supine hypotensive syndrome
28
What is the recommended maternal position to alleviate supine hypotensive syndrome?
Left-lateral side, semi-Fowler's, or supine with a wedge under one hip.
29
What is chloasma?
An increase of pigmentation on the face during pregnancy, also known as the 'mask of pregnancy'.
30
What is the linea nigra?
A dark line of pigmentation from the umbilicus extending to the pubic area that can appear during pregnancy.
31
Stretch marks found on the abdomen and thighs during pregnancy are called _____ _____.
striae gravidarum
32
Prenatal visits are typically scheduled monthly for weeks 16 through _____, every 2 weeks from 29 through _____, and every week from _____ weeks until birth.
28, 36, 36
33
Why is an RhO(D) immune globulin injection given around 28 weeks of gestation?
It is administered to clients who are Rh-negative to prevent sensitization to Rh-positive blood.
34
What is the purpose of the Group B Streptococcus (GBS) test during pregnancy?
To assess for GBS infection by performing vaginal and rectal cultures at 36 to 37 weeks of gestation.
35
A 1-hour glucose tolerance test reading greater than _____ mg/dL requires follow-up.
140
36
A diagnosis of gestational diabetes requires _____ elevated blood-glucose readings on the 3-hour glucose tolerance test.
two
37
What is the significance of a low level of Maternal Serum Alpha-Fetoprotein (MSAFP)?
A low level may indicate a risk for Down syndrome.
38
What is the significance of a high level of Maternal Serum Alpha-Fetoprotein (MSAFP)?
A high level may indicate a risk for neural tube defects.
39
What is the recommended method for a client to perform fetal kick counts?
Count fetal activity two or three times a day for 2 hours after meals or bedtime.
40
What fetal movement count indicates a need for further evaluation?
Fetal movements of less than 3 per hour or movements that cease entirely for 12 hours.
41
What advice should be given to a pregnant client experiencing nausea and vomiting in the first trimester?
Eat crackers or dry toast before rising, avoid an empty stomach, and avoid spicy or greasy foods.
42
To reduce stress incontinence, a pregnant client can be taught to perform _____ exercises.
Kegel
43
What advice should be given to relieve backaches during the second and third trimesters?
Perform pelvic tilt exercises, use proper body mechanics, and use a side-lying position.
44
What are Braxton Hicks contractions?
False contractions that occur from the first trimester onward, which are typically relieved by a change of position or walking.
45
In the first trimester, abdominal cramping and/or vaginal bleeding are danger signs that could indicate a _____ or _____ pregnancy.
miscarriage, ectopic
46
Severe headaches, blurred vision, and edema of the face and hands are danger signs in the second and third trimesters that could indicate _____ _____.
gestational hypertension
47
A gush of fluid from the vagina prior to 37 weeks of gestation is a danger sign indicating what?
Rupture of amniotic fluid.
48
What is the general recommended weight gain for a client with a single pregnancy?
11.5 to 16 kg (25 to 35 lb).
49
An increase of _____ calories/day is recommended during the second trimester of pregnancy.
340
50
An increase of _____ calories/day is recommended during the third trimester of pregnancy.
452
51
How many mcg of folic acid is recommended for clients who become pregnant?
600 mcg.
52
What is the purpose of taking folic acid before and during pregnancy?
It is crucial for neurologic development and the prevention of fetal neural tube defects.
53
Iron supplements are best absorbed between meals and when given with a source of _____ _____.
vitamin C
54
What substances interfere with the absorption of iron supplements?
Milk and caffeine.
55
What is a good source of calcium for a pregnant client who dislikes milk?
Dark green leafy vegetables, fortified soy milk, nuts, or legumes.
56
The recommended daily fluid intake during pregnancy is _____ to _____ glasses.
8 to 10
57
What is pica?
A dietary complication of pregnancy involving the craving to eat nonfood substances like dirt or red clay.
58
Clients with maternal phenylketonuria (PKU) must avoid foods high in protein and the artificial sweetener _____.
aspartame
59
What is the primary advantage of a transvaginal ultrasound over an external abdominal ultrasound in the first trimester?
It provides a more accurate evaluation and does not require a full bladder.
60
What is the purpose of a Doppler ultrasound blood flow analysis during pregnancy?
To study maternal-fetal blood flow by measuring the velocity of red blood cells in uterine and fetal vessels.
61
A biophysical profile (BPP) combines FHR monitoring (nonstress test) and fetal _____ to assess fetal well-being.
ultrasound
62
What are the five variables measured in a biophysical profile (BPP)?
FHR (NST), fetal breathing movements, gross body movements, fetal tone, and qualitative amniotic fluid volume.
63
What is the interpretation of a BPP score of 8 to 10?
Normal, with a low risk of chronic fetal asphyxia.
64
What is the interpretation of a BPP score less than 4?
Abnormal, strongly suspecting chronic fetal asphyxia.
65
What defines a 'reactive' nonstress test (NST)?
The FHR accelerates at least 15/min for at least 15 seconds, occurring two or more times during a 20-minute period.
66
If an NST is nonreactive, what further assessments are indicated?
A contraction stress test (CST) or a biophysical profile (BPP).
67
During a nonstress test, a _____ _____ device may be used to awaken a sleeping fetus.
vibroacoustic stimulation
68
What is a negative contraction stress test (CST) and what does it indicate?
A normal finding where there are no late decelerations of the FHR with at least three contractions in a 10-minute period.
69
A positive contraction stress test (CST), indicated by _____ _____ with 50% or more of contractions, is suggestive of uteroplacental insufficiency.
late decelerations
70
What is a major risk of an oxytocin-stimulated contraction test (OCT)?
The contractions can be difficult to stop and may lead to preterm labor.
71
Tachysystole of the uterus is defined as a uterine contraction longer than _____ seconds or _____ or more contractions in 10 minutes.
90, five
72
An amniocentesis can be performed after _____ weeks of gestation.
14
73
What client education is necessary before an amniocentesis procedure?
The client should empty their bladder to reduce its size and the risk of inadvertent puncture.
74
High levels of alpha-fetoprotein (AFP) in amniotic fluid are associated with what type of defects?
Neural tube defects, such as spina bifida or anencephaly.
75
Low levels of alpha-fetoprotein (AFP) in amniotic fluid are associated with _____ _____.
chromosomal disorders (e.g., Down syndrome)
76
A lecithin/sphingomyelin (L/S) ratio of _____ indicates fetal lung maturity.
0.08402777777777781
77
The absence of _____ (PG) in amniotic fluid is associated with respiratory distress in the newborn.
phosphatidylglycerol
78
What is the most common method for fetal blood sampling and transfusion, which obtains blood from the umbilical cord?
Percutaneous umbilical blood sampling (cordocentesis).
79
What is chorionic villus sampling (CVS)?
An assessment of a portion of the developing placenta, performed at 10 to 13 weeks, to diagnose genetic abnormalities.
80
What is the primary advantage of CVS over amniocentesis?
It allows for an earlier diagnosis of abnormalities in the first trimester.
81
The Quad marker screen tests for what four substances?
Human chorionic gonadotropin (hCG), alpha-fetoprotein (AFP), estriol, and inhibin A.
82
In a Quad marker screen, levels higher than expected for hCG and inhibin A indicate a risk for what condition?
Down syndrome.
83
What is the clinical definition of 'infertility'?
The inability of a couple to conceive despite engaging in unprotected sexual intercourse for at least 12 months.
84
How does 'subfertility' differ from infertility?
Subfertility is the potential of a couple to conceive with additional assistance, whereas infertility is the inability to conceive after 12 months.
85
What are four common factors associated with infertility?
Decreased sperm production, endometriosis, ovulation disorders, and tubal occlusions.
86
In an infertility assessment for an assigned female at birth, an age greater than _____ is considered a risk factor.
35
87
What is the first diagnostic test typically performed in an infertility workup and why?
A semen analysis, because it is less expensive and less invasive than female infertility testing.
88
What is a hysterosalpingography used to assess?
It is an outpatient radiological procedure in which dye is used to assess the patency of the fallopian tubes.
89
Before a hysterosalpingography, the nurse must assess for a history of allergies to what two substances?
Iodine and seafood.
90
The assisted reproductive technology where prepared sperm is placed in the uterus at the time of ovulation is called _____.
Intrauterine insemination (IUI)
91
Describe the procedure of In Vitro Fertilization-Embryo Transfer (IVF-ET).
It is a procedure of collecting a client's eggs from the ovaries, fertilizing them in a laboratory with sperm, and transferring the embryo to the uterus.
92
What is the key difference between a 'gestational carrier' and a 'surrogate'?
A gestational carrier has no genetic investment in the embryo, while a surrogate is inseminated with semen and has a genetic link to the fetus.
93
A major complication of infertility treatments is an ectopic pregnancy. Where does the ovum implant in this condition?
The ovum implants in the fallopian tubes or abdominal cavity.
94
Changes that a client experiences that make them think they might be pregnant, such as amenorrhea or fatigue, are classified as _____ signs of pregnancy.
presumptive
95
Changes that make an examiner suspect a client is pregnant, such as Hegar's sign or a positive pregnancy test, are classified as _____ signs of pregnancy.
probable
96
Signs that can only be explained by pregnancy, such as fetal heart sounds or visualization of the fetus by ultrasound, are classified as _____ signs of pregnancy.
positive
97
What is Chadwick's sign, a probable sign of pregnancy?
It is a deepened violet-bluish color of the cervix and vaginal mucosa.
98
What is Goodell's sign, a probable sign of pregnancy?
It is the softening of the cervical tip.
99
What is Hegar's sign, a probable sign of pregnancy?
It is the softening and compressibility of the lower uterus.
100
What is quickening, a presumptive sign of pregnancy?
It is the slight fluttering movements of the fetus felt by the client, usually between 16 to 20 weeks of gestation.
101
Higher than normal levels of hCG can indicate what conditions?
Multifetal pregnancy, ectopic pregnancy, hydatidiform mole, or a genetic abnormality like Down syndrome.
102
How is the estimated date of delivery calculated using Nägele's rule?
Take the first day of the client's last menstrual cycle, subtract 3 months, add 7 days and 1 year.
103
What does 'gravidity' refer to in obstetric history?
The number of pregnancies a client has had.
104
What does 'parity' refer to in obstetric history?
The number of pregnancies in which the fetus or fetuses reach at least 20 weeks of gestation.
105
What does each letter in the GTPAL acronym stand for?
Gravidity, Term births, Preterm births, Abortions/miscarriages, and Living children.
106
During pregnancy, cardiac output increases by _____ to _____ percent to meet greater metabolic needs.
30% to 50%
107
What is supine hypotensive syndrome in a pregnant client?
Maternal hypotension and fetal hypoxia that occurs when the client lies in a supine position, causing the gravid uterus to compress the vena cava.
108
What is the recommended maternal position to prevent supine hypotensive syndrome?
The left-lateral side, semi-Fowler's position, or supine with a wedge placed under one hip.
109
What is chloasma, a skin change during pregnancy?
An increase of pigmentation on the face, also known as the 'mask of pregnancy'.
110
What is the linea nigra?
A dark line of pigmentation extending from the umbilicus to the pubic area that can appear during pregnancy.
111
In an uneventful pregnancy, how often are prenatal visits scheduled from 29 through 36 weeks?
Every two weeks.
112
What is the purpose of the RhO(D) immune globulin injection given around 28 weeks of gestation?
It is administered to clients who are Rh-negative to prevent sensitization to Rh-positive blood from the fetus.
113
What is the purpose of screening for Group B Streptococcus (GBS) during pregnancy?
Vaginal and rectal cultures are performed late in gestation to assess for GBS infection, which can be transmitted to the newborn during birth.
114
A 1-hour glucose tolerance test result greater than _____ requires follow-up.
140 mg/dL
115
What does a low level of Maternal Serum Alpha-Fetoprotein (MSAFP) suggest?
A low level may indicate a risk for Down syndrome.
116
What does a high level of Maternal Serum Alpha-Fetoprotein (MSAFP) suggest?
A high level may indicate a risk for neural tube defects.
117
What emotional response, characterized by conflicting feelings about the pregnancy, is considered normal and often occurs early in pregnancy?
Ambivalence.
118
What is one non-pharmacological measure a nurse can suggest for nausea and vomiting in the first trimester?
The client should eat crackers or dry toast before rising in the morning.
119
What are Kegel exercises and why are they recommended during pregnancy?
They are exercises involving alternating tightening and relaxation of the pubococcygeal muscles to reduce stress incontinence.
120
To relieve heartburn during the second and third trimesters, a client should be advised to eat _____ meals.
small, frequent
121
What advice should a nurse give to a client experiencing leg cramps during the third trimester?
The client should extend the affected leg, keep the knee straight, and dorsiflex the foot (toes toward head).
122
Braxton Hicks contractions can be differentiated from true labor because they are typically relieved by a _____ or _____.
change of position; walking
123
In the first trimester, abdominal cramping and/or vaginal bleeding are danger signs that could indicate a _____ or _____.
miscarriage; ectopic pregnancy
124
In the second and third trimesters, a sudden gush of fluid from the vagina before 37 weeks is a danger sign indicating what?
Rupture of amniotic fluid.
125
Severe headaches, blurred vision, and edema of the face and hands are danger signs during pregnancy that may indicate _____.
gestational hypertension
126
What is the general recommended weight gain for a client with a single pregnancy and a normal BMI?
11.5 to 16 kg (25 to 35 lb).
127
What is the recommended increase in daily calories during the second trimester of pregnancy?
An increase of 340 calories per day.
128
What is the recommended increase in daily calories during the third trimester of pregnancy?
An increase of 452 calories per day.
129
What is the recommended daily intake of folic acid for clients who become pregnant?
600 mcg of folic acid.
130
Why is adequate folic acid intake crucial during pregnancy?
It is crucial for neurologic development and the prevention of fetal neural tube defects.
131
Iron supplements are best absorbed when given with a source of _____.
vitamin C
132
What two substances interfere with the absorption of iron supplements?
Milk and caffeine.
133
For pregnant and nonpregnant clients aged 19 to 50, the daily recommendation for calcium is _____.
1,000 mg/day
134
What is the recommended daily fluid intake during pregnancy?
8 to 10 glasses (2.3 L).
135
What is pica, a dietary complication during pregnancy?
A craving to eat nonfood substances such as dirt or red clay.
136
For a client with maternal phenylketonuria (PKU), the PKU diet should be resumed for at least _____ before pregnancy and continued throughout.
3 months
137
What types of foods must be avoided by a pregnant client with phenylketonuria (PKU)?
Foods high in protein (fish, poultry, meat, eggs, nuts, dairy products) must be avoided due to high phenylalanine levels.
138
What is a key instruction for a client having an external abdominal ultrasound?
The client should have a full bladder for the procedure.
139
Which type of ultrasound is particularly useful in clients who are obese or in the first trimester to detect an ectopic pregnancy?
Transvaginal ultrasound.
140
A biophysical profile (BPP) assesses fetal well-being by measuring which five variables?
Fetal heart rate (FHR), fetal breathing movements, gross body movements, fetal tone, and qualitative amniotic fluid volume.
141
What is the interpretation of a biophysical profile (BPP) score of 8 to 10?
It is considered normal, indicating a low risk of chronic fetal asphyxia.
142
What is the interpretation of a biophysical profile (BPP) score of less than 4?
It is considered abnormal, strongly suspecting chronic fetal asphyxia.
143
A nonstress test (NST) is interpreted as _____ if the FHR accelerates at least 15/min for at least 15 seconds, two or more times in a 20-minute period.
reactive
144
What is the next step if a nonstress test (NST) is nonreactive?
A further assessment, such as a contraction stress test (CST) or a biophysical profile (BPP), is indicated.
145
During a nonstress test (NST), what is the purpose of using vibroacoustic stimulation?
It is used to awaken a sleeping fetus if there are no fetal movements.
146
What finding indicates a negative (normal) contraction stress test (CST)?
Within a 10-minute period with at least three uterine contractions, there are no late decelerations of the FHR.
147
What finding indicates a positive (abnormal) contraction stress test (CST)?
Late decelerations of the FHR occur with 50% or more of the contractions, suggestive of uteroplacental insufficiency.
148
What is a major risk of an oxytocin-stimulated contraction test (OCT)?
Contractions started with oxytocin can be difficult to stop and can lead to preterm labor.
149
What client education is crucial before an amniocentesis procedure?
The client should empty their bladder prior to the procedure to reduce the risk of inadvertent puncture.
150
High levels of alpha-fetoprotein (AFP) in amniotic fluid are associated with _____.
neural tube defects (like anencephaly or spina bifida)
151
Low levels of alpha-fetoprotein (AFP) in amniotic fluid are associated with _____.
chromosomal disorders (like Down syndrome) or gestational trophoblastic disease.
152
A lecithin/sphingomyelin (L/S) ratio of _____ indicates fetal lung maturity.
0.08402777777777781
153
The absence of _____ in amniotic fluid is associated with respiratory distress in the newborn.
Phosphatidylglycerol (PG)
154
What is chorionic villus sampling (CVS)?
The assessment of a portion of the developing placenta, which is aspirated for genetic testing, typically between 10 to 13 weeks of gestation.
155
What is percutaneous umbilical blood sampling (cordocentesis)?
A procedure to obtain fetal blood from the umbilical cord for blood sampling and transfusion.
156
The quad marker screen includes testing for which four substances?
Human chorionic gonadotropin (hCG), Alpha-fetoprotein (AFP), Estriol, and Inhibin A.
157
In a quad marker screen, levels higher than the expected range of hCG and inhibin A indicate a risk for _____.
Down syndrome
158
What is the definition of infertility?
The inability of a couple to conceive despite engaging in unprotected sexual intercourse for at least 12 months.
159
What is the term for the potential of a couple to conceive with additional assistance?
Subfertility.
160
List four common factors associated with infertility.
Decreased sperm production, endometriosis, ovulation disorders, and tubal occlusions.
161
For an assigned male at birth, fertility begins to slowly decline after what age?
Age 40.
162
For an assigned female at birth, what age is considered a risk factor for infertility?
Age greater than 35.
163
What is the first test typically performed in an infertility workup, due to it being less expensive and less invasive?
Semen analysis.
164
A _____ is an outpatient radiological procedure where dye is used to assess the patency of the fallopian tubes.
Hysterosalpingography.
165
Before a hysterosalpingography, the nurse should assess for a history of allergies to what substances?
Iodine and seafood.
166
What diagnostic procedure involves observing internal organs using gas insufflation under general anesthesia?
Laparoscopy.
167
The assisted reproductive technology that involves placing prepared sperm into the uterus at the time of ovulation is known as _____.
Intrauterine insemination (IUI).
168
Describe the process of In Vitro Fertilization-Embryo Transfer (IVF-ET).
Collecting a client’s eggs from the ovaries, fertilizing them in a lab with sperm, and transferring the embryo to the uterus.
169
In which assisted reproductive technology are oocytes and sperm placed together into the fallopian tubes via laparoscopy?
Gamete intrafallopian transfer (GIFT).
170
What is a gestational carrier?
A person who carries a pregnancy for a couple after an embryo from the couple's IVF process is placed in their uterus.
171
How does a surrogate differ from a gestational carrier?
A surrogate is inseminated with semen and carries the fetus until birth, having a genetic investment in the fetus.
172
An ovum implanting in the fallopian tubes or abdominal cavity is known as a(n) _____ pregnancy.
Ectopic.
173
What medication may be prescribed to dissolve an ectopic pregnancy if it is identified prior to rupture?
Methotrexate.
174
Changes that a client experiences that make them think they might be pregnant, such as amenorrhea or fatigue, are classified as what type of signs?
Presumptive signs.
175
Changes that make an examiner suspect a client is pregnant, such as Hegar's sign or a positive pregnancy test, are classified as what type of signs?
Probable signs.
176
Signs that can only be explained by pregnancy, such as fetal heart sounds or visualization of the fetus by ultrasound, are classified as what type of signs?
Positive signs.
177
What is Chadwick's sign?
A deepened violet-bluish color of the cervix and vaginal mucosa.
178
What is Goodell's sign?
Softening of the cervical tip.
179
What is Hegar's sign?
Softening and compressibility of the lower uterus.
180
The slight fluttering movements of the fetus felt by a client, usually between 16 to 20 weeks, are known as _____.
Quickening.
181
Higher than normal levels of hCG can indicate what conditions?
Multifetal pregnancy, ectopic pregnancy, hydatidiform mole, or a genetic abnormality like Down syndrome.
182
What is Nägele's rule for calculating the estimated date of delivery?
Take the first day of the client’s last menstrual cycle, subtract 3 months, add 7 days and 1 year.
183
Term: Gravidity
The number of pregnancies a client has had.
184
Term: Parity
The number of pregnancies in which the fetus or fetuses reach at least 20 weeks of gestation.
185
What does the 'T' in the GTPAL acronym stand for?
Term births (37 weeks 0 days and beyond).
186
What does the 'P' in the GTPAL acronym stand for?
Preterm births (from viability up to 37 weeks).
187
During pregnancy, cardiac output increases by _____ and blood volume increases by _____.
30% to 50%; 40% to 50%.
188
What is supine hypotensive syndrome?
Maternal hypotension and fetal hypoxia that occurs when the weight of the gravid uterus compresses the vena cava in a supine position.
189
What maternal position is recommended to alleviate or prevent supine hypotensive syndrome?
Left-lateral side, semi-Fowler’s, or supine with a wedge under one hip.
190
What is the normal baseline range for fetal heart tones?
110 to 160 beats per minute.
191
Term: Chloasma
An increase of pigmentation on the face during pregnancy, also known as the mask of pregnancy.
192
Term: Linea nigra
A dark line of pigmentation from the umbilicus extending to the pubic area during pregnancy.
193
Term: Striae gravidarum
Stretch marks most notably found on the abdomen and thighs during pregnancy.
194
In an uneventful pregnancy, how often are prenatal visits scheduled from 29 through 36 weeks?
Every 2 weeks.
195
An indirect Coombs' test is performed on Rh-negative clients to identify what?
Sensitization to Rh-positive blood.
196
At what gestational age is a vaginal and rectal culture for Group B Streptococcus (GBS) typically performed?
Between 36 0/7 and 37 6/7 weeks of gestation.
197
A one-hour glucose tolerance test is considered elevated if the result is greater than what value?
140 mg/dL.
198
A diagnosis of gestational diabetes requires how many elevated blood-glucose readings on a three-hour glucose tolerance test?
Two elevated readings.
199
Maternal serum alpha-fetoprotein (MSAFP) screening is used to rule out what two conditions?
Down syndrome (low level) and neural tube defects (high level).
200
What two substances are contraindicated during pregnancy due to their association with birth defects and low birth weight, respectively?
Alcohol (birth defects) and tobacco (low birth weight).
201
A feeling of _____ about the pregnancy, which involves conflicting feelings of joy and sorrow, is a normal response that might occur early in the pregnancy.
ambivalence.
202
A client should be instructed to count fetal kicks daily. Fetal movements of less than _____ per hour or movements that cease for _____ hours require further evaluation.
3; 12.
203
What non-pharmacological advice can be given to a client experiencing nausea and vomiting in the first trimester?
Eat crackers or dry toast before rising, avoid an empty stomach, and drink fluids between meals.
204
What exercises can be taught to a pregnant client to reduce stress incontinence?
Kegel exercises.
205
What advice can be given to relieve backaches during the second and third trimesters?
Perform pelvic tilt exercises, use proper body mechanics, and use a side-lying position for rest.
206
How should a client relieve a leg cramp during the third trimester?
Extend the affected leg with the knee straight and dorsiflex the foot (toes toward head).
207
What is a key danger sign in the first trimester that could indicate a miscarriage or ectopic pregnancy?
Abdominal cramping and/or vaginal bleeding.
208
In the second and third trimesters, a gush of fluid from the vagina prior to 37 weeks could indicate what?
Rupture of amniotic fluid.
209
Severe headaches, blurred vision, and edema of the face and hands are danger signs in the second and third trimesters that could indicate what condition?
Gestational hypertension.
210
What is the general recommended weight gain for a client with a single pregnancy and a normal pre-pregnancy weight?
11.5 to 16 kg (25 to 35 lb).
211
What is the recommended increase in daily calories during the second trimester of pregnancy?
An increase of 340 calories/day.
212
What is the recommended increase in daily calories during the third trimester of pregnancy?
An increase of 452 calories/day.
213
How many mcg of folic acid is recommended for clients who become pregnant?
600 mcg.
214
Folic acid intake is crucial for the prevention of what type of fetal defects?
Neural tube defects.
215
Iron supplements are best absorbed when given with a source of _____ and between meals.
vitamin C.
216
What two substances are known to interfere with the absorption of iron supplements?
Milk and caffeine.
217
What is the recommended daily fluid intake during pregnancy?
8 to 10 glasses (2.3 L).
218
The craving to eat nonfood substances such as dirt or red clay is known as _____.
Pica.
219
For a client with maternal phenylketonuria (PKU), the PKU diet should be resumed for at least how long prior to pregnancy?
3 months.
220
An external abdominal ultrasound is more useful after the first trimester and requires the client to have a _____ _____ for the procedure.
full bladder.
221
A _____ ultrasound is useful for obese clients, in the first trimester to detect ectopic pregnancy, or to evaluate for preterm labor.
transvaginal.
222
A biophysical profile (BPP) assesses fetal well-being by measuring what five variables?
FHR (via NST), fetal breathing movements, gross body movements, fetal tone, and qualitative amniotic fluid volume.
223
What is the scoring for a biophysical profile (BPP)?
Each of the five variables receives a score of 2 for a normal finding and 0 for an abnormal finding.
224
A total score of _____ on a biophysical profile (BPP) is considered normal and indicates a low risk of chronic fetal asphyxia.
8 to 10.
225
A total score of less than _____ on a biophysical profile (BPP) is abnormal and strongly suggests chronic fetal asphyxia.
4
226
What is a nonstress test (NST)?
A noninvasive procedure that monitors the response of the fetal heart rate (FHR) to fetal movement.
227
A nonstress test (NST) is interpreted as _____ if the FHR accelerates at least 15/min for at least 15 seconds, two or more times in a 20-min period.
reactive.
228
What is a nonreactive nonstress test (NST)?
A test that does not demonstrate at least two qualifying accelerations in a 20-minute window.
229
What is the term for uterine contractions lasting longer than 90 seconds or five or more contractions in 10 minutes?
Tachysystole.
230
A _____ Contraction Stress Test (CST) is a normal finding, indicated by no late decelerations of the FHR within a 10-min period with three contractions.
negative.
231
A positive Contraction Stress Test (CST) is an abnormal finding indicated by _____ _____ with 50% or more of the contractions.
late decelerations.
232
A positive Contraction Stress Test (CST) is suggestive of what condition?
Uteroplacental insufficiency.
233
When can an amniocentesis be performed?
After 14 weeks of gestation.
234
High levels of alpha-fetoprotein (AFP) in amniotic fluid are associated with what type of defects?
Neural tube defects (such as anencephaly or spina bifida).
235
Low levels of alpha-fetoprotein (AFP) in amniotic fluid are associated with what type of disorders?
Chromosomal disorders (such as Down syndrome).
236
A lecithin/sphingomyelin (L/S) ratio of _____ indicates fetal lung maturity.
2:1.
237
Following an amniocentesis, what should be administered to an Rh-negative client?
Rho(D) immune globulin.
238
What is chorionic villus sampling (CVS)?
The assessment of a portion of the developing placenta, aspirated through the abdominal wall or cervix under ultrasound guidance.
239
When is chorionic villus sampling (CVS) ideally performed?
At 10 to 13 weeks of gestation.
240
The quad marker screening blood test includes testing for what four substances?
hCG, alpha-fetoprotein (AFP), estriol, and inhibin A.
241
In a quad marker screen, higher levels of hCG and inhibin A, and lower levels of AFP and estriol, indicate a risk for what condition?
Down syndrome.
OB Proctor Exam ATI
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