Suggested Answers to Assignments Chapter 12, Nursing Care During Pregnancy

Written Assignments Learning Objective(s) 1. Students’ answers should include the following: 4  Description of the procedure  Indications/rationale for procedure based on timing  Pre-procedural preparation: informed consent, ultrasound, emptying bladder, fetal monitoring, vital signs  Intraprocedural events: insertion of needle, aspiration of fluid and specimen collection, pressure to site, specimens to laboratory  Post-procedural care: comfortable position, RhoGAM if indicated, vital signs and FHR monitoring, assessment of puncture site, danger signs and symptoms to report, availability of test results 2. Students’ answers should include the following: 1  Description of initial visit (including health history, physical examination, and laboratory tests), follow-up visits, assessment of fetal well-being  Key terms to include: alpha-fetoprotein, amniocentesis, biophysical profile, chorionic villi sampling, gravida, high- risk pregnancy, natural childbirth, para, perinatal education, preconception care

Group Assignments Learning Objective(s) 1. Students’ answers should include: 2  Reason for seeking care  Past history  Reproductive history o Menstrual history, including date of LMP o Calculation of EDB o Obstetric history, including gravida and para status  Physical examination o Vital signs o Head-to-toe assessment o Pelvic examination: internal and external genitalia, pelvic shape, pelvic measurements  Laboratory tests: CBC, urinalysis, Rh status, rubella titer, hepatitis B surface antigen, HIV, VDRL, RPR, cervical smears 2. Students’ answers should include the following: 5  Personal hygiene  Dental care  Breast care  Clothing  Exercise  Sleep and rest  Sexual activity  Employment  Travel  Immunizations and medications

Clinical Assignments Learning Objective(s) 1. Students’ answers should include the following: 2, 3  Information obtained o Maternal status—assessment and physical examination results; fundal height measurements; reports of discomfort or signs and symptoms of problems o Laboratory tests completed o Assessment of fetal well-being: FHR, fetal movements o Scheduling of follow-up appointments and testing  Teaching o Fetal growth and development o Procedures o Danger signs and symptoms o Ways to relieve discomforts; self-care 2. Students’ answers should include the following: 6  Settings o Hospitals: delivery rooms, birthing suites o Birthing centers o Home births  Family involvement: varies depending on setting and facility’s policies and procedures  Pain relief methods: variable; primarily nonpharmacologic methods in home births  Client satisfaction: highly variable depending on client’s desires, expectations, and actual experiences 3. Students’ answers should include the following: 5  Discomfort o Description of why it is occurring o What is helpful o Determination of effectiveness of client-initiated measures o Additional suggestions for relief (see Teaching Guidelines 12-1)

Web Assignments Learning Objective(s) 1. Students’ answers should include the following: 6  Philosophy of Lamaze  Focus of beliefs about childbirth; view of normal childbirth and care practices  Tools and tips for decision making  Myths and facts about Lamaze  Techniques used  Rationale for techniques