NUR114 CH19

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TomWruble
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184751
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NUR114 CH19
Updated:
2012-12-04 16:37:15
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nur114f Assessment High Risk Pregnancy
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Assessment of High Risk Pregnancy
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  1. A risk to pregnancy may be ___, ___, ___ or ___.
    • biophysical
    • psychosocial
    • sociodemographic
    • environmental
  2. The daily fetal movement count, also called the ___, is frequently used to monitor the fetus in pregnancies complicated by conditions that can affect fetal ___.
    • kick count
    • oxygenation
  3. A kick count of fewer than ___ in 1 hour warrants further evaluation.
    three
  4. Diagnostic ultrasonography provides information on ___, ___, ___, ___ and ___. It is perform at ___ weeks.
    • fetal activity
    • growth
    • anatomy
    • well-being
    • gestational age
    • 10
  5. The view provided by ___ scanning helps make invasive tests, such as ___, safer.
    • ultrasound
    • amniocentesis
  6. Using ___, an examiner can evaluate fetal structure and growth; the placenta; the quantity of amniotic fluid; maternal structures; the biochemical status of tissues and organs; and soft-tissue, metabolic, and functional anomalies.
    magnetic resonance imaging
  7. Indications for ___ include ___, ___, and ___.
    • amniocentesis
    • prenatal diagnosis of genetic disorders or congenital anomalies (especially neural tube defects)
    • assessment of pulmonary maturity
    • diagnosis of fetal hemolytic disease
  8. Because of advances in ___, the use of ___ and ___ is declining.
    • noninvasive screening techniques
    • amniocentesis
    • chorionic villus sampling
  9. The ___ is the most widely used technique for ___ evaluation of the fetus.
    • nonstress test
    • antepartum
  10. A woman who is at 36 weeks of gestation is having a nonstress test. Which statement by the woman would indicate a correct understanding of the test?

    A. “I will need to have a full bladder for the test to be done accurately.”
    B. “This test will help to determine whether the baby has Down syndrome or a neural tube defect.”
    C. “This test will observe for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby.”
    D. “I should have my husband drive me home after the test because I may be nauseous.”
    C. “This test will observe for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby.”
    (this multiple choice question has been scrambled)
  11. The ___ is one of the most widely used techniques to determine fetal well-being and is accomplished by monitoring ___ in conjunction with ___ and ___.
    • nonstress test
    • fetal heart rate
    • fetal activity and movements
  12. An ultrasound OR a nonstress test is the test that requires a full bladder.
    ultrasound
  13. A pregnant woman should be driven home after having an ___ test.
    amniocentesis
  14. A nonstress test may OR should not cause nausea.
    should not
  15. A ___ is used in conjunction with ___, and ___ helps to determine the presence of ___.
    • maternal alpha-fetoprotein test
    • unconjugated estriol levels
    • human chorionic gonadotropin
    • Down syndrome
  16. Which choice gives indicators for performing a contraction stress test?

    A. Increased fetal movement and small for gestational age
    B. Maternal diabetes mellitus and postmaturity
    C. Adolescent pregnancy and poor prenatal care
    D. History of preterm labor and intrauterine growth restriction
    B. Maternal diabetes mellitus and postmaturity
    (this multiple choice question has been scrambled)
  17. Decreased fetal movement is an indicator for performing a ___; the size (small for gestational age) is OR is not an indicator.
    • contraction stress test
    • is not
  18. Indications for performing a contraction stress test
    • Maternal diabetes mellitus
    • Postmaturity
    • Decreased fetal movement
    • Intrauterine growth restriction
    • History of a previous stillbirth
  19. T/F: Adolescent pregnancy and poor prenatal care are risk factors of poor fetal outcomes and are indicators for performing a contraction stress test.
    are not indicators
  20. The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has smoked throughout the pregnancy, and fundal height measurements now are suggestive of growth restriction in the fetus. In addition to ultrasound to measure fetal size, what would be another tool useful in confirming the diagnosis?

    A. Daily fetal movement counts
    B. Amniocentesis
    C. Doppler blood flow analysis
    D. Contraction stress test (CST)
    C. Doppler blood flow analysis
    (this multiple choice question has been scrambled)
  21. Doppler blood flow analysis allows the examiner to study the blood flow noninvasively in the fetus and the placenta. It is a helpful tool in the management of ___ because of ___, ___, ___, or ___.
    • high risk pregnancies
    • intrauterine growth restriction (IUGR)
    • diabetes mellitus
    • multiple fetuses
    • preterm labor
  22. Because of the potential risk of inducing labor and causing fetal distress, a CST is not performed on a woman whose fetus is ___.
    preterm
  23. A 40-year-old woman is 10 weeks pregnant. Which diagnostic tool would be appropriate to suggest to her at this time?

    A. Biophysical profile
    B. Amniocentesis
    C. Maternal serum alpha-fetoprotein (MSAFP)
    D. Transvaginal ultrasound
    D. Transvaginal ultrasound
    (this multiple choice question has been scrambled)
  24. A biophysical profile would be a method of biophysical assessment of fetal well-being in the ___.
    third trimester
  25. An amniocentesis is performed ___ week of pregnancy.
    after the fourteenth
  26. MSAFP below normal is associated with
    • Down syndrome
    • Trisomy 18
    • Diabetic patients also have lower levels.
  27. MSAFP above normal is seen in
    • Multiple gestation
    • Placental abruption
    • Neural tube defects
    • including spina bifida
    • anencephaly
    • abdominal wall defects
  28. What is a "MSAFP" test?
    Maternal serum AFP (MSAFP) varies by orders of magnitude during the course of a normal pregnancy. MSAFP increases rapidly until about 32 weeks gestation, then decreases gradually. After the pregnancy ends it decreases rapidly, with a half-life of about 5 days.
  29. What is "amniocentesis"?
    Fetal health and maturity - fetal DNA is examined for genetic abnormalities
  30. What is "Chorionic villus sampling (CVS)"?
     It entails sampling of the chorionic villus (placental tissue) and testing it for chromosomal abnormalities, usually with FISH or PCR. CVS usually takes place at 10–12 weeks' gestation, earlier than amniocentesis or percutaneous umbilical cord blood sampling. It is the preferred technique before 15 weeks.
  31. UPI
    Uteroplacental insufficiency - decline in placental function (exchange of gases, nutrients, and wastes) leading to fetal hypoxia and acidosis; evidenced by later decelerations.
  32. What is a "biophysical profile"?
    Noninvasive  ultasonography.
  33. An MSAFP (Maternal serum alpha-fetoprotein) test is performed from ___ of the gestation (___ are ideal).
    • week 15 to week 22
    • weeks 16 to 18
  34. Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy, including that:

    A. Chorionic villus sampling (CVS) is becoming more popular because it provides early diagnosis.
    B. Screening for maternal
    serum alpha-fetoprotein (MSAFP) levels is recommended only for women at risk for
    neural tube defects.
    C. Percutaneous umbilical blood sampling (PUBS) is one of the triple-marker tests for Down syndrome.
    D. MSAFP is a screening tool only; it identifies candidates for more definitive procedures.
    D. MSAFP is a screening tool only; it identifies candidates for more definitive procedures.
  35. Chorionic villus sampling (CVS) does provide ___, but it is declining in popularity because of advances in noninvasive screening techniques.
    a rapid result
  36. T/F: Screening for maternal serum alpha-fetoprotein (MSAFP) levels is recommended only for women at risk for neural tube defects.
    F: MSAFP screening is recommended for all pregnant women.
  37. T/F: Percutaneous umbilical blood sampling (PUBS) is one of the triple-marker tests for Down syndrome.
    F: MSAFP, not PUBS, is part of the triple-marker tests for Down syndrome.
  38. The nurse providing care for the antepartum woman should understand that the contraction stress test (CST):

    A. Is considered negative if no late decelerations are observed with the contractions.
    B. Sometimes uses vibroacoustic stimulation.
    C. Is an invasive test; however, contractions are stimulated.
    D. Is more effective than the nonstress test (NST) if the membranes have already been ruptured.
    A. Is considered negative if no late decelerations are observed with the contractions.
    (this multiple choice question has been scrambled)
  39. T/F: The nurse providing care for the antepartum woman should understand that the contraction stress test (CST) sometimes uses vibroacoustic stimulation.
    F: Vibroacoustic stimulation is sometimes used with the NST (nonstress test).
  40. The CST is invasive if stimulation is by ___ but not if by ___.
    • intravenous oxytocin
    • nipple stimulation
  41. T/F: The CST is contraindicated if the membranes have ruptured.
    True
  42. In the past factors to determine whether a woman was likely to develop a high risk pregnancy were evaluated primarily from a medical point of view. A broader, more comprehensive approach to high risk pregnancy has been adopted today. There are now four categories based on threats to the health of the woman and the outcome of pregnancy. These categories include all of the following except:

    A. Psychosocial.
    B. Environmental.
    C. Biophysical.
    D. Geographic.
    D. Geographic.
    (this multiple choice question has been scrambled)
  43. Biophysical is one of the broad categories used for determining risk. These include ___, ___, and ___.
    • genetic considerations
    • nutritional status
    • medical and obstetric disorders
  44. Psychosocial risks include ___. All of these adverse lifestyles can have a negative effect on the health of the mother or fetus.
    • smoking
    • caffeine
    • drugs
    • alcohol
    • psychologic status
  45. Sociodemographic risks stem from the mother and her family. ___ may be one of the risks to pregnancy; however, it is not the only factor in this category. ___, ___, ___, ___ and ___ are also included.
    • Ethnicity
    • Low income
    • lack of prenatal care
    • age
    • parity
    • marital status
  46. Environmental risks are those that can affect both ___ and ___. These include ___ (X6).
    • fertility
    • fetal development
    • infections
    • chemicals
    • radiation
    • pesticides
    • illicit drugs
    • industrial pollutants
  47. MSAFP levels have been used as a screening tool for ___ in pregnancy.
    neural tube defects
  48. All Rh-negative mothers get ___ administered ___ within ___ hours after birth of a ___. This is to ___. All Rh-negative mothers get the same drug after ___ and ___.
    • RhoGAM
    • intramuscularly
    • 72
    • Rh-positive baby
    • prevent sensitization, i.e. mom creating antibidoes
    • amniocentesis
    • CVS
  49. There are usually ___ in the umbillical cord and only ___. The ___ is the largest of these vessels.
    • 2 arteries
    • 1 vein
    • vein
  50. Nural tube defects are ___ via ___.
    • visible
    • ultrasonography
  51. A "positive" CST means that ___.
    late decelerations were confirmed

    Contraction Stress Test
  52. Tx for preeclampsia
    Delivery
  53. Dietary salt restriction is OR is not required for preeclampsia.
    is not

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