Author Question: The nurse understands that a client's pregnancy is progressing normally when what physiologic ... (Read 66 times)

biggirl4568 · **on:** Jun 27, 2018

The nurse understands that a client's pregnancy is progressing normally when what physiologic changes are documented on the prenatal record of a woman at 36 weeks' gestation? Note: Credit will be given only if all correct choices and no incorrect

choices are selected. Select all that apply. 1. The joints of the pelvis have relaxed, causing a waddling gait.
2. The cervix is firm and blue-purple in color.
3. The uterus vasculature contains one sixth of the total maternal blood volume.
4. Gastric emptying time is delayed, and the client complains of constipation and bloating.
5. Supine hypotension occurs when the client lies on her back.

Question 2

The couple has had an ultrasound at 19 weeks' gestation, and their fetus was found to have anencephaly. The nurse is completing counseling for the couple on the ultrasound findings. Which statement indicates that additional teaching is needed?

1. Our baby has an incomplete brain, and might not be born alive.
2. This problem is not caused by one of us having a genetic problem.
3. We won't know whether something is wrong until the baby's chromosomes are tested.
4. Waiting until our 30s did not cause this problem to develop.

ryansturges · **Reply #1 on:** Jun 27, 2018

Answer to Question 1

1, 3, 4, 5
Explanation: 1. The sacroiliac, sacrococcygeal, and pubic joints of the pelvis relax in the later part of the pregnancy, presumably as a result of hormonal changes. This often causes a waddling gait.
3. By the end of pregnancy, one sixth of the total maternal blood volume is contained within the vascular system of the uterus.
4. Gastric emptying time and intestinal motility are delayed, leading to frequent complaints of bloating and constipation, which can be aggravated by the smooth muscle relaxation and increased electrolyte and water reabsorption in the large intestine.
5. The enlarging uterus may exert pressure on the vena cava when the woman lies supine, causing a drop in blood pressure. This is called the vena caval syndrome, or supine hypotension.

Answer to Question 2

3
Rationale 1: Anencephaly is a condition in which the skull does not cover the brain completely, and the brain consists mostly of brain stem with little other brain development.
Rationale 2: Folic acid deficiency is a contributing factor, but genetic abnormalities in either parent are not related to anencephaly.
Rationale 3: Anencephaly is clearly visualized with ultrasound, and does not require genetic testing to verify a diagnosis.
Rationale 4: The parents' ages are not related to anencephaly.