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Which of the following is a possible complication of amniocentesis?
There are several risks to amniocentesis, including (but not limited to) miscarriage, infection, needle injury, and RH sensitization. The rate of miscarriage due to amniocentesis is between 1 in 300 and 1 in 500. The other complications listed are relatively rare.
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Sarah is a seventeen-year-old female who has not gotten her first period and is visiting her doctor for an exam. She has displayed the normal growth and development of several secondary sex characteristics. The nurse would describe to the doctor that Sarah is showing signs of __________.
Primary amenorrhea occurs when a female is fourteen years old and has not gotten her first period and has not developed secondary sex characteristics. Primary amenorrhea also occurs when a female sixteen or older has not gotten her first period but has developed secondary sex characteristics. Primary dysmenorrhea refers to painful menstruation not linked to a physiological disorder. Secondary dysmenorrhea refers to painful menstruation due to an underlying cause such as endometriosis. Oligomenorrhea refers to the absence of a period, typically for at least 35 days.
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Amber is a 39-year-old woman who is experiencing secondary dysmenorrhea. The nurse knows that Amber could be suffering from which of the following?
Secondary dysmenorrhea refers to painful menstruation due to an underlying condition. Endometriosis, an example of a condition that frequently causes secondary dysmenorrhea, refers to the growth of uterine tissue in inappropriate places such as the ovary or rectum. High levels of prostaglandin are frequently found in women with primary dysmenorrhea which is painful menstruation without an underlying condition. Low levels of aldosterone would not likely cause painful menstruation. Turner syndrome is a chromosomal disorder that can frequently cause amenorrhea, or absence of a period.
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Anne, a 32-year-old woman, presents for her first prenatal visit. The doctor orders a CBC (complete blood count). Which of the following is not included in a CBC?
A separate test called a "type and screen" is needed to assess the blood type. Complete blood counts (CBC's) typically contain hemoglobin and hematocrit, platelet counts, white blood cell counts, and red blood cell counts among many other measures. They are among the most frequently ordered laboratory tests by providers. The physician will use this information to diagnose conditions such as anemia.
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Fundal height of a pregnant woman is measured from __________.
Fundal height (sometimes referred to as McDonald's rule) is measured in centimeters from the top of the pubic bone to the top of the uterus. The top of the uterus may also be called the fundus of the uterus. It is used to assess the growth and development of the fetus inside the womb.
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The nurse is assessing fetal heart rate in a pregnant patient. The nurse records a pulse of 82 beats per minute. The nurse should __________.
An 82 beat per minute reading could be the mother's heart rate, indicating that the nurse does not have the doppler in the correct position. A normal fetal heart rate is between 120 and 160 beats per minute. The nurse must always remember to take the mother's pulse before assessing the fetal heart rate. Before calling the physician, it is important to determine that the data is accurate. To increase oxygen perfusion to the fetus, ask the mother to lay on her left side.
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Alex is 17 weeks pregnant. She comes into the clinic to get a alpha-fetoprotein test. A low result could indicate all of the following except __________.
Alpha-fetoprotein is made by the fetus. Congenital abnormalities (fetal trisomy 18, fetal trisomy 21) are associated with low levels of this protein. Additionally, so is hydatidiform mole. Hydatidiform mole is the presence of an abnormal mass or growth inside the uterus. Based on a low result, the physician may want to conduct further testing. Preeclampsia is a dangerous medical condition characterized by high blood pressure. It is not associated with alpha-fetoprotein.
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Brittany is 40 weeks pregnant and calls because she is seeing pink-tinged discharge for the first time. The nurse should tell Brittany to __________.
This is most likely the normal "bloody show" at the beginning of labor. There is no need to immediately arrive at the hospital, change position, or eat a bland diet. The patient should continue to monitor and call back or seek care when she experiences regular contractions that are becoming more intense and frequent.
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The nurse is assessing a woman in labor. He knows that fetal bradycardia occurs when the heart rate drops below __________.
Fetal bradycardia is recognized when fetal heart rate drops below 110 beats per minute for 10 minutes or longer. The normal fetal heart rate is between 120 beats per minute and 160 beats per minute. Fetal tachycardia is a heart rate above 160 beats per minute.
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Hanna is a 21-year-old woman who is presenting at the emergency room for severe vaginal bleeding. She is 32 weeks pregnant. Upon further examination, she is found to be suffering from abruptio placentae. Which of the following assessment findings would be of least concern to the nurse?
Abruptio placentae is a serious condition where the placenta inappropriately and prematurely detaches from the uterus. Women with obstetric complications such as abruptio placentae can quickly develop disseminated intravascular coagulation (DIC). DIC is a clotting disorder in which the blood inappropriately clots. Severe bleeding can also occur as clotting proteins become scarce. Symptoms of DIC include blood clots, and bleeding into the tissues such as the skin and oral mucosa. A decreasing blood pressure is concerning due to the severe bleeding caused by the combination of DIC and abruptio placentae. Shortness of breath could indicate a the presence of a blood clot. Although uterine tenderness is of concern, it is common with abruptio placentae and does not indicate an immediately life-threatening condition.
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A nurse is assessing an 18-year-old woman who has come into the emergency department for bilateral abdominal pain. Which of the following should the nurse not consider a risk factor for ectopic pregnancy?
Uterine conditions such as endometriosis and uterine fibroids increase the risk of ectopic pregnancy. Endometriosis is the inappropriate growth of uterine tissue outside the uterus. Uterine fibroids are benign tumors within the uterus. Sexually transmitted infections can cause a condition called pelvic inflammatory disease which can result in scarring. Scarring of the reproductive system greatly increases the risk of ectopic pregnancy and infertility. Yeast infections are common after antibiotic therapy and are treated with an over-the-counter medication. They generally do not cause permanent damage to the body.
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A woman who is 20 weeks pregnant calls the clinic because she is experiencing pink-tinged discharge for the first time. The nurse should advise the patient to __________.
This woman could be experiencing pre-term labor. A 20 week pregnancy is not considered viable. She should be seen immediately to determine if there is a cause such as cervical insufficiency (premature dilation of the cervix).
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The nurse completes a cervical exam on her laboring patient. She determines that her patient's cervix is 1cm in length. How would the nurse describe this length?
The normal cervical canal is 2cm in length. Effacement is the thinning of the cervix as the body prepares for delivery. Thus, a 2cm cervix is 0% effaced and a 0cm cervix is 100% effaced.
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A woman arrives at the birthing center for evaluation. She thinks she may be in labor. She is multiparous and experiencing contractions every 3 minutes. Upon examination, the nurse notes that she is 5cm dilated and 50% effaced. Which stage and phase of labor is the woman experiencing?
The woman is experiencing the first stage labor and the second phase. The first stage of labor exists when the woman's cervix is dilating from 0-10cm. The second phase of the first stage occurs during dilation from 4-7cm and when the cervix is 40-80% effaced. The second stage of labor is when the cervix is dilated 10cm until the delivery of the baby. The third stage of labor is the delivery of the placenta. The first phase of labor is the onset of labor until the cervix is dilated 3cm. The third phase of labor is when the cervix fully dilates from 7cm to 10cm.
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The nurse is called to a room by a laboring patient. The patient complains of a backache and appears restless. Her fingers are trembling and beads of sweat fall from her forehead. The nurse suspects she might be experiencing which stage of labor?
During the third phase of the first stage of labor, the cervix dilates from 8-10 cm and effacement reaches 80-100%. The woman will be less able to focus on other things and may require more support from support persons. Labor may progress quickly and the nurse should be preparing for the second stage of labor, in which the cervix is fully dilated at 10cm.
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The nurse helps the healthcare team to deliver a healthy baby girl. Upon delivery of the placenta, the nurse notices that it is not 100% intact. What is the nurse's first concern?
If the placenta is not whole upon delivery, a piece may still be present in the uterus. This inhibits the ability of the uterus to shrink in size and may cause hemorrhage. The missing piece needs to be located immediately.
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While monitoring a laboring patient, the nurse notices that the fetal heart rate at baseline varies from 110-145 beats per minute. The nurse's first action would be which of the following?
Marked fetal heart rate baseline variability of 25 beats per minute or more may be cause for concern. Similar findings may indicate that there is poor oxygenation of the fetus. Turn the mother to her left side (to increase perfusion) and notify the physician. Note that this is still in the normal range for fetal heart rate for a laboring patient (about 130 beats per minute), and that the low end of this spectrum is of slightly more concern.
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Which of the following is not a risk factor for gestational diabetes?
Asian ethnicity is not considered a risk factor. Hispanic, Native American and African American ethnicities are considered risk factors for gestational diabetes. Others include maternal obesity, previous pregnancies with gestational diabetes, delivery of a very large baby, and a family history of diabetes.
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Andrea comes to the office for a prenatal visit. She mentions that lately she has been excessively hungry, thirsty, and very tired. Which of the following would the nurse suspect?
Polyphagia (excessive hunger), polydipsia (excessive thirst) and polyuria (excessive urination) are three hallmark signs that point to diabetes. While increased fatigue is common in pregnancy, combined with the other two symptoms, it may be concerning. Pre-eclampsia involves elevated blood pressure, swelling of the hands and feet, and protein in the urine. Toxoplasmosis results from infection by a parasite and can effect fetal development. A amniocentesis is performed to diagnose the infection of the fetus. Depending on the suspected duration of infection and the gestational age, drugs may be administered to decrease the chance of the parasite from infecting the fetus. Anemia, and parvovirus B19 are unlikely to cause all three of these symptoms occurring together.
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All of the following may trigger asthma in a pregnant woman except __________.
All those listed may be asthma triggers with the exception of moist air. Typically, cold air may trigger asthma exacerbation. Additional triggers include exercise, respiratory illness, smoke, and mold.
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