NR 327 Task 2 Questions with 100% Correct
Answers
Chorionic Villus Sampling (CVS)
done at 10-13 weeks gestation to look for genetic abnormalities, have pt drink water before
procedure to help visualize the uterus
informed consent
Advantages:
Advantages of CVS
Advantages of CVS
During the first trimester what is ultrasonography used for?
Confirm pregnancy, verify location of pregnancy, identify multifetal gestation, gestational
age with crown-rump and head measurement, number and fiability of fetuses, identify
markers such as nuchal translucence, which suggests chromosome or other abnormalities,
determine location of uterus, cervix, and placenta for procedures as CVS.
During the second and third trimester what is ultrasonography used for?
Confirm viability, evaluate fetal anatomy, gestational age, serial fetal growth, compare
growth of multiple fetuses, evaulate four of five markers in a biophysical profile, locate
placenta during previa, determine presentation, and guide the needle for amniocentesis or
PUBS.
Disadvantages of CVS
,Rate of pregnancy loss after CVS, more than two attempts or bleeding during the week before
procedure increases risk for fetal loss, and reports of limb reduction defects.
After CVS, what are some things you should do as a nurse as far as monitoring and
discharge instructions?
FHR activity, maternal VS, and woman is allowed to void if needed. Woman should rest at
home for a couple of hours after procedure and sexual intercourse should be limited for a few
days. Rhogam is given to women who are Rh-negative.
how is ultrasound usually done in the first trimester?
Transvaginal
When is gestational diabetes screening done by random 50 gram oral glucose test?
what is considered an abnormal result?
24-28 weeks
abnormal is > 140 mg/dL
if it is over 200 mg/dL you treat it as diabetes
What is the gold standard for diagnosis of gestational diabetes
3 hour oral glucose
check at 1, 2, and 3 hours- must exceed 2 or more values to be considered postive test
single abnormal result means increased risk for macrosomia and neonatal morbidity- should
repeat test in 2-4 weeks and monitor blood glucose in the meantime
Signs and symptoms of gestational diabetes mellitus
,hypoglycemia
hyperglycemia
shaking clammy pale skin
shallow respirations.
rapid pulse
hyperglycemia
vomiting
excess weight gain during pregnancy.
Gestational Age Determination
CRL (Crown to Rump Length) most accurate measurement for determining gestational age;
made in the first trimester
Amniocentesis
done at 15-20 weeks gestation, performed to determine genetic disorders, metabolic defects,
and look at fetal lung maturity.
informed consent, <20 weeks-pt needs full bladder, >20 weeks-pt needs empty bladder,
ultrasound done before to locate the placenta
Nonstress test
looks at placental fx, oxygenation, fetal HR in response to movement
external transducer is placed on mom, lateral position, client presses button every time she
feels movement.
reactive-normal
nonreactive-abnormal
, Purposes for midtrimester amniocentesis
examine fetal cells and present in amiotic fluid to identify chromosome abnormalities,
evaluate fetal condition when the woman id sensitized to Rh- positive blood, diagnose
intrauterine infections, and investigate AFAFP when multiple marker test is done when
maternal serum is not normal
Purpose for third trimester amniocentesis
determine fetal lung maturity, and test for hemolytic disease
Procedure for amniocentesis
Woman placed in supine position, get baseline BP and FHR, ultrasound is used to find largest
pocket of fluid, a 3- to 4-inch, 20- or 21-gauge spinal needle is inserted into the pocket of
fluid, discard 1-2 mls then get 20 mls for sample.
Discharge instructions for woman who had amniocentesis
Resume normal activites after 24 hours, strenuous activities like jogging or cardio should be
resumed after 1 or 2 days, and she should report frequent contractions, vaginal bleeding,
leakage of amniotic fluid and fever.
Three tests done to determine fetal lung maturity
L/S ratio (2:1), PG, and PI
What are 4 ways to do kick counts?
1) Count fetal movements for 30 minutes three times per day. 2) Count fetal movements daily
for 1 hour; if fewer than 10 movements felt, continue for a second hour; fewer than 10 in 2
hours should be reported. 3) Count the first 10 movements and note the start time and end
Answers
Chorionic Villus Sampling (CVS)
done at 10-13 weeks gestation to look for genetic abnormalities, have pt drink water before
procedure to help visualize the uterus
informed consent
Advantages:
Advantages of CVS
Advantages of CVS
During the first trimester what is ultrasonography used for?
Confirm pregnancy, verify location of pregnancy, identify multifetal gestation, gestational
age with crown-rump and head measurement, number and fiability of fetuses, identify
markers such as nuchal translucence, which suggests chromosome or other abnormalities,
determine location of uterus, cervix, and placenta for procedures as CVS.
During the second and third trimester what is ultrasonography used for?
Confirm viability, evaluate fetal anatomy, gestational age, serial fetal growth, compare
growth of multiple fetuses, evaulate four of five markers in a biophysical profile, locate
placenta during previa, determine presentation, and guide the needle for amniocentesis or
PUBS.
Disadvantages of CVS
,Rate of pregnancy loss after CVS, more than two attempts or bleeding during the week before
procedure increases risk for fetal loss, and reports of limb reduction defects.
After CVS, what are some things you should do as a nurse as far as monitoring and
discharge instructions?
FHR activity, maternal VS, and woman is allowed to void if needed. Woman should rest at
home for a couple of hours after procedure and sexual intercourse should be limited for a few
days. Rhogam is given to women who are Rh-negative.
how is ultrasound usually done in the first trimester?
Transvaginal
When is gestational diabetes screening done by random 50 gram oral glucose test?
what is considered an abnormal result?
24-28 weeks
abnormal is > 140 mg/dL
if it is over 200 mg/dL you treat it as diabetes
What is the gold standard for diagnosis of gestational diabetes
3 hour oral glucose
check at 1, 2, and 3 hours- must exceed 2 or more values to be considered postive test
single abnormal result means increased risk for macrosomia and neonatal morbidity- should
repeat test in 2-4 weeks and monitor blood glucose in the meantime
Signs and symptoms of gestational diabetes mellitus
,hypoglycemia
hyperglycemia
shaking clammy pale skin
shallow respirations.
rapid pulse
hyperglycemia
vomiting
excess weight gain during pregnancy.
Gestational Age Determination
CRL (Crown to Rump Length) most accurate measurement for determining gestational age;
made in the first trimester
Amniocentesis
done at 15-20 weeks gestation, performed to determine genetic disorders, metabolic defects,
and look at fetal lung maturity.
informed consent, <20 weeks-pt needs full bladder, >20 weeks-pt needs empty bladder,
ultrasound done before to locate the placenta
Nonstress test
looks at placental fx, oxygenation, fetal HR in response to movement
external transducer is placed on mom, lateral position, client presses button every time she
feels movement.
reactive-normal
nonreactive-abnormal
, Purposes for midtrimester amniocentesis
examine fetal cells and present in amiotic fluid to identify chromosome abnormalities,
evaluate fetal condition when the woman id sensitized to Rh- positive blood, diagnose
intrauterine infections, and investigate AFAFP when multiple marker test is done when
maternal serum is not normal
Purpose for third trimester amniocentesis
determine fetal lung maturity, and test for hemolytic disease
Procedure for amniocentesis
Woman placed in supine position, get baseline BP and FHR, ultrasound is used to find largest
pocket of fluid, a 3- to 4-inch, 20- or 21-gauge spinal needle is inserted into the pocket of
fluid, discard 1-2 mls then get 20 mls for sample.
Discharge instructions for woman who had amniocentesis
Resume normal activites after 24 hours, strenuous activities like jogging or cardio should be
resumed after 1 or 2 days, and she should report frequent contractions, vaginal bleeding,
leakage of amniotic fluid and fever.
Three tests done to determine fetal lung maturity
L/S ratio (2:1), PG, and PI
What are 4 ways to do kick counts?
1) Count fetal movements for 30 minutes three times per day. 2) Count fetal movements daily
for 1 hour; if fewer than 10 movements felt, continue for a second hour; fewer than 10 in 2
hours should be reported. 3) Count the first 10 movements and note the start time and end
