The health care provider reports that the primigravida's fundus ...

[cherise1989]

The health care provider reports that the primigravida's fundus can be palpated at the umbilicus. Which priority question will the nurse include in the client's assessment?
 
  a. Have you noticed that it is easier for you to breathe now?
  b. Would you like to hear the baby's heartbeat for the first time?
  c. Have you felt a fluttering sensation in your lower pelvic area yet?
  d. Have you recently developed any unusual cravings, such as for chalk or dirt?

Question 2

Which physiologic findings are seen with respect to gallbladder function that might lead to the development of gallstones during pregnancy?
 
  a. Decrease in alkaline phosphatase levels compared with nonpregnant women
  b. Increase in albumin and total protein as a result of hemodilution
  c. Hypertonicity of gallbladder tissue
  d. Prolonged emptying time

[GCabra]

Answer to Question 1

ANS: C
Quickening is the first maternal sensation of fetal movement and is often described as a fluttering sensation. Quickening is detected at approximately 20 weeks in the primigravida and as early as 16 weeks in the multigravida. The fundus is at the umbilicus at 20 weeks' gestation. Lightening is associated with descent of the fetal head into the maternal pelvis and is associated with improved lung expansion. Lightening occurs approximately 2 weeks before birth in the primipara. Fetal heart tones can be detected by Doppler as early as 9 to 12 weeks of gestation. Pica is the craving for non-nutritive substances such as chalk, dirt, clay, or sand. It can develop at any time during pregnancy. It can be associated with malnutrition and the health care provider should monitor the client's hematocrit/hemoglobin, zinc, and iron levels.

Answer to Question 2

ANS: D
Prolonged emptying time is seen during pregnancy and may lead to the development of gallstones. In pregnancy, there is a twofold to fourfold time increase in alkaline phosphatase levels as compared with those in nonpregnant woman. During pregnancy, a decrease in albumin level and total protein are seen as a result of hemodilution. Gallbladder tissue becomes hypotonic during pregnancy.