Chapter 09 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Chapter 09 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Chapter 09_LO01_Q01

The nurse is listening to the fetal heart tones of a client at 37 weeks’ gestation while the client is in a supine position. The client states, “I’m getting lightheaded and dizzy.” The best action by the nurse is to:

1. Assist the client to sit up.
2. Remind the client that you need to hear the baby.
3. Help the client turn onto her side.
4. Check the client’s blood pressure.

Correct Answer: 3

Rationale:

1. The client is experiencing supine hypotension syndrome. The fetus is compressing the vena cava, which decreases blood flow to the left atrium, resulting in low blood pressure, dizziness, lightheadedness, pallor, and clamminess. Turn the client to her side to get the weight of the fetus off the vena cava.
2. This would not improve the situation, and is not therapeutic. The client is experiencing supine hypotension syndrome. The fetus is compressing the vena cava, which decreases blood flow to the left atrium, resulting in low blood pressure, dizziness, lightheadedness, pallor, and clamminess. Turn the client to her side to get the weight of the fetus off the vena cava.
3. The client is experiencing supine hypotension syndrome. The fetus is compressing the vena cava, which decreases blood flow to the left atrium, resulting in low blood pressure, dizziness, lightheadedness, pallor, and clamminess. Turn the client to her side to get the weight of the fetus off the vena cava, and she will feel better.
4. When a client in the third trimester is in a supine position, the vena cava becomes compressed by the fetus, causing supine hypotension syndrome. We know that the client is hypotensive because she is lying supine at the end of pregnancy. This compression of the vena cava decreases blood flow to the left atrium, resulting in low blood pressure, dizziness, lightheadedness, pallor, and clamminess. Turn the client to her side to get the weight of the fetus off the vena cava.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Implementation

Learning Outcome: 9.1 Identify the anatomic and physiologic changes that occur during pregnancy in providing nursing care to expectant women.

Chapter 09_LO01_Q02

The patient with a normal pre-pregnancy weight asks why she has been told to gain 25–35 pounds during her pregnancy, but her underweight friend was told to gain more weight. The nurse should tell the patient that recommended weight gain during pregnancy should be:

1. 25–35 pounds, regardless of a patient’s pre-pregnant weight.
2. More than 25–35 pounds for an overweight patient.
3. More than 25–35 pounds for an underweight woman.
4. The same for a normal-weight woman as for an overweight woman.

Answer: 3

Rationale:

1. Pre-pregnant weight determines the recommended weight gain during pregnancy. Women of normal weight should gain 25–35 pounds during pregnancy for optimal fetal outcome.
2. Overweight women should gain 15–25 pounds during pregnancy.

Underweight women are encouraged to gain the amount of weight needed to bring them to normal body weight plus 25–35 pounds.

4. Overweight women should gain 15–25 pounds during pregnancy.

Cognitive Level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Implementation

Learning Outcome: 9.1 Identify the anatomic and physiologic changes that occur during pregnancy in providing nursing care to expectant women.

Chapter 09_LO01_Q03

The nurse understands that the pregnancy is progressing normally when she sees which of the following physiologic changes documented on the prenatal record of a woman at 36 weeks’ gestation? Select all that apply.

1. The joints of the pelvis have relaxed, causing hip pain.
2. The cervix is firm and purplish–blue in color.
3. The uterine fundus is at a height of 35 cm above the pubic symphysis.
4. Gastric emptying time is prolonged, and the patient complains of gas and bloating.
5. Supine hypotension, creating dizziness, occurs when the patient lies on her back.

Answer: 1, 3, 4, 5

Rationale:

1. The pregnancy hormone relaxin creates softening of the ligaments, which in turn can lead to hip or pubic symphysis pain in late pregnancy.
2. Cervical changes during pregnancy include softening and purplish–blue discoloration.
3. The growing fetus causes an enlargement of the uterus; from 20 weeks until delivery, the fundal height measured in cm should be within 2–3 of the number of weeks’ gestation.
4. Gas and bloating are seen as the increased progesterone level causes smooth muscle relaxation, resulting in delayed gastric emptying and slowed peristalsis.
5. Supine hypotension occurs when the fetus compresses the vena cava against the vertebrae when the mother is supine.

Cognitive Level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Evaluation

Learning Outcome: 9.1 Identify the anatomic and physiologic changes that occur during pregnancy in providing nursing care to expectant women.