Concerning assessment of the fetus, the maternity nurse should be ...

[cookcarl]

Concerning assessment of the fetus, the maternity nurse should be aware that:
 
  1. the fetal heart tones are heard (in the second trimester) by a Doppler stethoscope, whereas the fetal heart rate (third trimester) is heard by the ultrasound fetoscope or stethoscope.
  2. the measure of fundal height on the woman's abdomen is a gross measure, and various techniques and procedures can be used on the same patient.
  3. there is no need to use ultrasound exams (sonograms) until later in the pregnancy unless there are indications of distress.
  4. expectant mothers should count fetal kicks after a meal.

Question 2

A woman presents to the emergency department complaining of bleeding and cramping. Initial nursing history is significant for a last menstrual period 6 weeks ago.
 
  On sterile spe-culum examination, the primary care provider finds that the cervix is closed. The anticipated plan of care for this woman would be based on a probable diagnosis of which type of spon-taneous abortion? 1. Incomplete
  2. Inevitable
  3. Threatened
  4. Septic

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Answer to Question 1

4
1. Incorrect. Fetal heart tones can be heard by a fetoscope in the first trimester; by the second trimester fetal heart rate can be heard by the Doppler stethoscope.
2. Incorrect. The fundal height is an important measure that should be determined with pre-cision, consistently using the same technique and positioning of the patient.
3. Incorrect. Routine use of ultrasounds is recommended in early pregnancy; it dates the pregnancy and provides useful information on the health of the fetus.
4. Correct. Regular fetal movement is a reliable indicator of fetal health. Four kicks an hour is a good benchmark.

Answer to Question 2

3
1. Incorrect. A woman with an incomplete abortion would present with heavy bleeding, mild to severe cramping, and cervical dilation.
2. Incorrect. An inevitable abortion presents with the same symptoms as an incomplete abortion: heavy bleeding, mild to severe cramping, and cervical dilation.
3. Correct. A woman with a threatened abortion presents with spotting, mild cramps, and no cervical dilation.
4. Incorrect. A woman with a septic abortion presents with malodorous bleeding and typi-cally a dilated cervix.