During pregnancy, many women crave and eat substances that adults do not generally ingest. This condition is normal and is called pica. Often, the substances do not have high nutritional value. Examples are dirt, chalk, rocks, toothpaste, toilet paper, etc. It is important to determine the risks involved with ingesting these materials. For example, the nurse must determine that a woman who is eating dirt does not ingest potting soil mixed with fertilizer and other potentially toxic chemicals.

Late decelerations are caused by uteroplacental insufficiency. The nurse should anticipate many interventions to promote uteroplacental blood flow. Initially, the nurse should implement oxygen supplementation, stop the oxytocin infusion, reposition the mother to the left side, and introduce a fluid bolus of lactated Ringer's solution (LR).

A fetal heart rate (FHR) deceleration occurs when the FHR drops 15 bpm below baseline for a period of 15 seconds when the gestation is more than 32 weeks and 10 bpm below baseline for 10 seconds when gestation is less than 32 weeks. When the onset of the deceleration occurs at the onset of a new contraction and recovers with the end of the same contraction, the strip is demonstrating early decelerations, and the fetus is exhibiting head compression. Late decelerations occur when the deceleration begins after the start of a contraction and does not resolve until after the contraction has finished; late decelerations are the result of uteroplacental insufficiency. A variable deceleration is caused by cord compression, and appears as a brief drop in FHR from baseline that resolves quickly, creating a "V" shape on the strip.

A category II fetal heart rate tracing include all FHR tracings that are not category I or category III. Category I FHR tracings are as follows: baseline 110-160bpm, moderate variability, absent late or variable decelerations, present or absent early decelerations, and present or absent accelerations. Category III FHR tracings are as follows: absent baseline FHR variability, recurrent late decelerations, recurrent variable decelerations, bradycardia, and sinusoidal patterns.

Risk factors for gestational diabetes include: obesity, family history of diabetes, history of gestational diabetes, hypertension, pre-eclampsia/eclampsia, recurrent urinary tract infections, vaginitis, polyhydramnios, previous large infants (9lbs or greater than 4000g), glycosuria or proteinuria on two or more occasions. While poor diet may contribute to diabetic concerns, it is not directly associated with a higher risk of gestation diabetes as the other risk factors are. During the prenatal period, nurses are responsible for educating their patients on all of these risk factors as well as a proper prenatal diet.

An acceleration in fetal heart rate is defined as a visually apparent and abrupt increase in FHR, where the FHR increases from the onset of the acceleration to the peak in less than 30 seconds. At less than 32 weeks, the acceleration must peak at least 10 bpm above baseline and last at least 10 seconds. At more than 32 weeks, the acceleration must peak at least 15 bpm above baseline and last at least 15 seconds. A prolonged acceleration follows the same guidelines as an acceleration, but lasts more than 2 minutes and is not longer than 10 minutes in duration; after 10 minutes, it is a change in baseline FHR. A deceleration is a visually apparent decrease in FHR from the baseline, gradual or abrupt, that returns to the original baseline. Recurrent accelerations occur with more than 50% of contracts in any 20 minute window. Tachycardia is a baseline FHR of more than 160 bpm.

A sinusoidal pattern is a visually apparent, smooth, sine wave-like undulating pattern in fetal heart rate baseline with a cycle frequency of at least  that persists for more than 20 minutes. Variable describes an abrupt deceleration of visually apparent decrease and return in fetal heart rate (FHR) from baseline lasting less than 30 seconds. Bradycardia occurs when the baseline FHR is less than 110 bpm. Intermittent describes an acceleration or deceleration occurring with less than 50% of contractions in any 20 minute window. Recurrent describes an acceleration or deceleration occurring with more than 50% of contractions in any 20 minute window.

When considering where to hear fetal heart rate best, the nurse must consider the location of the fetal back. Weeks gestation or size may also effect the location of the best place to assess fetal heart rate. LOA, or left occiput anterior, is the most common fetal lie. A fetus in LOA is in vertex presentation with the fetal occiput on the mother's left side toward the front of her pelvis. In LOA, the FHR is best heard below the umbilicus on the mother's left side.

In LOP (left occiput posterior), the FHR is best heard on the mother's left side at the level of the umbilicus. In ROA (right occiput anterior): the mother's right side below the umbilicus. In ROP (right occiput posterior): the mother's right side at the level of the umbilicus. In LSA (left sacrum anterior): the mother's left side above the umbilicus. In RSA (right sacrum anterior): the mother's right side above the umbilicus.

The triad of presenting symptoms for endometriosis is dysmenorrhea (painful menses), infertility, and dyspareunia (pain on sexual intercourse). The most common presenting symptom is extreme, intense uterine cramps which may radiate to the back or down the thighs. Endometriosis is also a common cause of infertility due to a local paracrine effect. Pain on intercourse may be due to the implantation of endometrial cells in the vagina or the area around the cervix. Endometriosis will not necessarily result in menorrhagia, or excessively heavy bleeding. Hirsutism, infertility, and oligomenorrhea are symptoms commonly seen in polycystic ovarian syndrome (PCOS), rather than endometriosis. 

The incidence of endometriosis increases significantly in individuals with a family history of the condition. Other contributing factors are sedentary lifestyle (lack of exercise), presence of an intrauterine device, a diet high in fat, the presence of estrogen dominance, and liver dysfunction (due to decreased estrogen metabolism).