Worksheet for Lesson # 3: Intrapartal care Part 1

EXPLAIN

Name: Score:
Group No.: Date:

Explain the following using your own words.

1. Differentiate the different types of pelvis.

2. Why is it important for a pregnant mother to know what the possible complications of
pregnancy are and what they they are suppose to do when they occur?
3. What is your understanding on the importance of diagonal conjugate to the true conjugate?
How
is it related to one another?

EXTEND

Name: Score:
Group No.: Date:

Answer the following .( Write your interpretation.)

1. A diagonal conjugate measurement of 13.2 cm, What does it mean?

2.

2. A true conjugate of 8.5 cm , What does it mean?

Worksheet for Lesson #3 : Intrapaltal Care Part 1

EVALUATE

Name: Score:
Group No.: Date:

Multiple Choice: Encircle the correct answer.

Situation:Mrs. C., age 35, is pregnant for the first time. The physician schedules a
maternal serum alpha-fetoprotien (MSAFP) screening because of a history of neural tube defects
in her family.
1. Mrs. C.’s MSAFP screening should be performed between:
a. 6 and 10 week’s gestation
b. 11 and 14 week’s gestation
c. 15 and 20 week’s gestation
d. 21 and 25 week’s gestation

2. Mrs. C.’s MSAFP level is above normal. Which of the following anomalies is not a possible
cause?
a. Neural tube defects
b. Multiple gestations (twins)
c. Fetal demise
d. Myocardial defects

Situation: R., a 23-year-old black gravida 1 with class D diabetes, is admitted to the high-
risk antepratal unit at 32 weeks’ gestation with a diagnosis PIH and orders for complete bed rest.
She complains of headaches and increasing finger ankle edema over the last week. R. is
accompanied by her mother, who states that she had similar problems during her first pregnancy.
3. Which factors in R.’s health history predispose her to developing PIH?
a. Age and race
b. Age and history of diabetes
 c. History of diabetes and familial history of PIH
d. Race and gestational age

Situation:Mrs. E., a 30-year-old gravida 6 para 2305 with a history of chronic

hypertension, arrives at the labor and delivery area with dark red vaginal bleeding. She states that
the bleeding started suddenly and that she has severe abdominal pain. The physician diagnoses
abruptio placentae.
4. Which of Mrs. E.’s body systems should the nurse assess first?
a. Endocrine
b. Cardiovascular
c. Neuromuscular
d. Renal

Situation: Mrs. S., a 24-year old gravida 2 para 0010, for a clinic appointment during her
th
8 week of pregnancy. She states, “I can’t keep anything down, not even water. I’ve been
vomiting for 4 days.” Assessment of her vital signs reveals a temperature of 99.4˚ F, a pulse rate
of 100 beat/minute, a respiratory rate of 24 breaths/minutes, and a blood pressure of 98/60 mm
Hg. Urine testing reveals a high ketone level.
5. Mrs. S.’s vomiting subsides, and she is able to tolerate fluids. The nurse should not instruct
Mrs. S. to:
a. Eat small, frequent meals
b. Drink fluids 1 hour after meals
c. Avoid spicy of fried foods
d. Avoid a high protein intake

Situation: Mrs. F., a 32-year-old gravida 8 para 3224, arrives at the clinic for her first
prenatal visit during her 6th week of pregnancy. She reports to the nurse that she has class D
diabetes and takes regular and NPH insulin daily.
6. Mrs. F.’s nursing care plan for this initial visit should include:
a. Patient teaching regarding the probable need for increased insulin dosage and for stricter
control of her blood glucose level
b. Genetic counseling regarding the fetus’s risk of inheriting diabetes
c. Patient teaching regarding the complications of diabetic pregnancy, including the risk of
preterm labor and pregnancy-induced hypertension
d. Explanations of antepartal tests, such as the nonstress test and biophysical profile

7. During the first trimester, Mrs. F. should maintain a caloric intake of:
 a. 10 to 20 calories/kg
b. 20 to 25 calories/kg
c. 30 to 35 calories/kg
d. 45 to 50 calories/kg

8. Common complications of pregnancy in patients with diabetes include:

a. Polyhydramnios, fetal macrosomia, and preeclampsia
b. hypotension, fatigue, and urinary tract infection
c. Mitral valve prolapse, diabetic coma, and stillbirth
d. Placenta previa, diabetic ketoacidosis, and hypoglycemia

9. Which measure would not help Mrs. F. to prevent exercise-induced hypoglycemia?

a. Scheduling exercise before a meal
b. Carrying hard candy while exercising
c. Discussing her plans to exercise with her physician beforehand
d. Monitoring the effect of exercise on her blood glucose level

10. Mrs. F.’s insulin requirements probably will:

a. Decrease during the entire pregnancy
b. Decrease during the first half of the pregnancy and increase during the last half
c. Increase during the entire pregnancy
d. Increase during the first half of the pregnancy and decrease in the last half

Mrs. F. continues taking her insulin throughout her pregnancy. She arrives at the clinic at
34 week’s gestation for a routine checkup.
11. After examining Mrs. F., the physician administers a nonstress test (NST). The NST
indicates nonreactive results. Which procedure will the physician probably order next?
a. Serum estriol level assessment
b. Amniocentesis
c. Oxytocin contraction test
d. Ultrasonography

12. Mrs. F.’s physician schedules an amniocentesis and a cesarean delivery at 37 weeks’
gestation. In this situation, amniocentesis is performed primarily to:
a. Assess for congenital anomalies commonly associated with diabetic pregnancies
b. check the fetus’s glucose status before delivery
c. Determine the fetus’s lung maturity, which is commonly delayed in diabetic pregnancies
d. Assess for meconium-stained amniotic fluid

Situation: Mrs. C., a 38-year-old gravida 3 para 0111, is diagnosed with gestational
diabetes mellitus at 30 weeks’ gestation.
13. Mrs. C. asks whether she will have to use insulin. The nurses’s best response would be:
a. “Yes you’ll definitely need to use insulin to control your glucose level”
b. “No, only people with diabetes mellitus type II need to use insulin; you only need to
regulate your diet”
c. “That depends on how well your glucose level is controlled by diet”
d. “No, you’ll be able to take another medication to control your glucose level”

Situation: Mrs. M., a 36-year-old gravida 1, arrives at the clinic during her 4th week of
pregnancy. She has Type II diabetes mellitus and previously maintained her blood glucose level
through an 1, 800 calorie/day diet and 5 mg of glipizide(Glucotrol) P.O. daily. After assessing
Mrs. M.’s fasting and postprandial blood glucose levels, the physician immediately discontinues
her glipizide therapy and initiates insulin therapy.
14. Mrs. M. should monitor her blood glucose level:
a. Before breakfast and 2 hours after each meal
b. Before breakfast and lunch and at bedtime
c. Before lunch and dinner and 1 hour afterward
d. Before breakfast and dinner and 1 hour afterward

Situation: Mrs. W., a 29-year-old gravida 1 at 32 weeks’ gestation, has Type I diabetes
mellitus with no vascular involvement. She has maintained euglycemia during her pregnancy
through diet. She currently has a blood pressure of 114/70 mm Hg, a fasting blood glucose level
of 74 mg/dl, and 1 cm of dilation with no contractions or effacement; her NST had reactive
result.
15. The physician schedules Mrs. W. for a biophysical profile. Which factor is not assessed by
this test?
a. Fetal breathing
b. Reactive fetal heart rate
c. Qualitative amniotic fluid volume
d. Amniotic fluid phospholipid level