Exam 19: Assessment of High Risk Pregnancy

In comparison to contraction stress tests (CSTs), the nonstress test (NST) for antepartum fetal assessment:

A 41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool would yield more detailed information about the fetus?

A woman arrives at the clinic seeking confirmation that she is pregnant. The following information is obtained: She is 24 years old and has a body mass index (BMI) of 17.5. She admits to having used cocaine "several times" during the past year and drinks alcohol occasionally. Her blood pressure (BP) is 108/70 mm Hg, her pulse rate is 72 beats/min, and her respiratory rate is 16 breaths/min. The family history is positive for diabetes mellitus and cancer. Her sister recently gave birth to an infant with a neural tube defect (NTD). Which characteristics place the woman in a high risk category?

A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although she has had irregular menstrual periods all her life. She has a history of smoking approximately one pack of cigarettes a day, but she tells you that she is trying to cut down. Her laboratory data are within normal limits. What diagnostic technique could be used with this pregnant woman at this time?

In the first trimester, ultrasonography can be used to gain information on:

Nurses should be aware that the biophysical profile (BPP):

A woman asks her nurse, "My doctor told me that he is concerned with the grade of my placenta because I am overdue. What does that mean?" The best response by the nurse is:

Risk factors tend to be interrelated and cumulative in their effect. While planning the care for a laboring woman with diabetes mellitus, the nurse is aware that she is at a greater risk for:

Intrauterine growth restriction is associated with what pregnancy-related risk factors? Choose all that apply.

A maternal serum alpha-fetoprotein (AFP) test indicates an elevated level. It is repeated and again is reported as higher than normal. What would be the next step in the assessment sequence to determine the well-being of the fetus?

At 35 weeks of pregnancy, a woman experiences preterm labor. Although tocolytics are administered and she is placed on bed rest, she continues to experience regular uterine contractions, and her cervix is beginning to dilate and efface. What would be an important test for fetal well-being at this time?

In the United States today:

A woman is undergoing a nipple-stimulated contraction stress test (CST). She is having contractions that occur every 3 minutes. The fetal heart rate (FHR) has a baseline of approximately 120 beats/min without any decelerations. The interpretation of this test is said to be:

In comparing the abdominal and transvaginal methods of ultrasound examination, nurses should explain to their patients that:

When nurses help their expectant mothers assess the daily fetal movement counts, they should be aware that: