Chapter 28 Pregnancy and Human Development
1) A 30-year-old woman is admitted to the emergency room. Her husband, who rode in the ambulance with her, said that she had suddenly complained of severe pain in the right iliac region of her abdomen and then had collapsed. Upon examination, she was shown to have signs of internal hemorrhage and her abdominal muscles were rigid. Her menstrual history revealed that she had missed her last menstrual period. A diagnosis of ruptured tubal, or ectopic, pregnancy was made and surgery scheduled. What is an ectopic pregnancy, and why is it problematic?
Answer: An ectopic pregnancy occurs when the embryo implants in any site other than the uterus. In a tubal pregnancy the embryo tries to implant in the uterine tube. It is unable to establish a placenta or accommodate growth, and the uterine tube ruptures.
2) Mrs. Phang, eight months pregnant with her first child, makes an appointment with her obstetrician to investigate the cause of vaginal bleeding. Because it is actually more "spotting" than frank bleeding, and painless, she is becoming worried. Ultrasound visualization of her abdomen shows that the placenta is formed across the internal os of the cervix, and she is ordered to her bed for the remainder of the pregnancy. What name is given to Mrs. Phang's condition? Why is it an extremely serious condition? Why was she ordered to have complete bed rest for the remainder of her pregnancy?
Answer: Mrs. Phang's condition is called placenta previa. It is an extremely serious condition because as the uterus and cervix stretch, tearing of the placenta may occur. She was ordered to have complete bed rest to keep physical activity at a minimum so that the placenta would not tear away.
3) A mother who has been nursing her infant for over seven months is beginning to have problems throughout the day with nausea. Is there a connection?
Answer: The mother was not taking birth control pills because she assumed that she could not get pregnant while nursing. Under normal conditions that would be true, but after a few months some women do begin to ovulate again. This mother is probably pregnant again.
4) A 28-year-old woman has been in the first stage of labor for several hours. Her uterine contractions are weak, and her labor is not progressing normally. Because the woman insists upon a vaginal delivery, the physician orders that pitocin (a synthetic oxytocin) be infused. What will be the effect of pitocin? What is the normal mechanism by which oxytocin acts to promote birth?
Answer: Pitocin will act on the placenta, stimulating production and release of prostaglandins. The pitocin and prostaglandins are powerful uterine muscle stimulants. Oxytocin normally causes frequent and vigorous contractions of the uterine wall.
5) A 19-year-old, single, sexually active college student, who has not used birth control on a regular basis, is in her first trimester of pregnancy. She is at the OB/GYN clinic for her first prenatal visit. In assessing her nutrition, the nurse discovers that the patient drinks heavily on a regular basis. She also states she does not like milk. What information should the nurse give the patient regarding nutrition?
Answer: Because many potentially harmful substances can cross placental barriers and enter the fetal blood, the nurse should instruct the patient to not drink alcohol. The nurse should warn the patient that alcohol can cause serious permanent damage to the fetus. The nurse should inform the patient to take multivitamins containing folic acid to reduce the risk of birth defects. The patient should increase her daily calorie intake by 300 calories to sustain proper fetal growth.
6) The lactation nurse visits a first-time mother six hours after her delivery of a healthy 8-pound boy. The patient is giving the baby boy a bottle of sugar water. She tells the lactation nurse that she does not seem to be producing milk. What should the nurse say to the patient?
Answer: The nurse should explain that she won't produce true milk until two to three days later. During this delay, colostrum is produced that contains protein, vitamin A, and minerals and is rich in antibodies that are necessary for the baby. The nurse should explain that continual milk production depends on mechanical stimulation of the nipples, normally provided by the sucking infant.
7) The patient is in her first trimester of pregnancy. She complains of feeling nauseated and has vomited on occasion. She tells the nurse that she did not have this with her first pregnancy. She asks the nurse, "What is causing this and when will it end?" How should the nurse respond?
Answer: The nurse should explain that nausea is a common occurrence during the first trimester of pregnancy caused by elevated levels of progesterone and estrogen, and that the nausea should end once her body adjusts to the increased hormone levels.
If you have any questions or notice any mistakes,
Please message me. I will try to reply within 48 hours.
Thank you for taking the time to view my notecards!
Good luck in your class!