Instructions All questions apply to this case study. Your responses should be brief and to the point. When asked to provide several answers, list them in order of priority or significance. Do not assume information that is not provided.
Scenario 1P.M. comes to the obstetric (OB) clinic because she has missed two menstrual periods and thinks she might be pregnant. She states she is nauseated, especially in the morning, so she completed a home pregnancy test and it was positive. As the intake nurse in the clinic, you are responsible for gathering information before she sees the physician.
1. What are the two most important questions to ask to determine possible pregnancy?
2. You ask whether she has ever been pregnant, and she tells you she has never been pregnant. How would you record this information?
3. What additional information would be needed to complete the TPAL record?
4. It is important to complete the intake interview. What categories will you address with P.M.?
Blood pressure 116/74 mm Hg
Heart rate 88 beats/min
Respiratory rate 16 breaths/min
Temperature 98.9° F (37.2° C)
5. Do any of these vital signs cause concern? What should you do?
6. P.M. tells you that the date of her last menstrual period (LMP) was February 2. How would you calculate her due date? What is her due date?
7. What is the significance of a gynecoid pelvis?
8. What specimens are important to obtain when the pelvic examination is done?
9. A psychological assessment is done to determine P.M.’s feelings and attitudes regarding her pregnancy. How do attitudes, beliefs, and feelings affect pregnancy?
10. P.M. asks you whether there are any foods she should avoid while pregnant. She lists some of her favorite foods. Which foods, if any, should she avoid eating while she is pregnant? (Select all that apply.)
a. Hot dogs
d. Deli meat
e. Cheddar cheese
11. As the nurse, you know what assessment and teaching are vital in the prenatal period to ensure a positive outcome. What information is important to include at every visit and at specific times during the pregnancy?
12. After her examination, P.M. states that she is worried because her sister had an ectopic pregnancy and had to have surgery. She asks you, “What are the signs of an ectopic pregnancy?” Which of these are correct? (Select all that apply.)
a. Fullness and tenderness in her abdomen, near ovaries
b. Pain, either unilateral, bilateral, or diffuse over the abdomen
d. Dark red or brown vaginal bleeding
e. Increased fatigue
13. P.M. asks the nurse about what should be reported to her doctor. List at least six of the “danger signs of pregnancy.”
14. Changes in the body caused by pregnancy include relaxation of joints, alteration to center of gravity, faintness, and discomforts. These changes can lead to problems with coordination and balance. In teaching P.M. about safety during pregnancy, what will you include in your teaching?
15. P.M. asks, “Is a vaginal exam done every visit?” What is your response? Explain your answer.