NUR 099 (Nursing Seminar 1)

STUDENT ACTIVITY SHEET BS NURSING / FOURTH YEAR

Session # 6

LESSON TITLE: OBGYN NURSING PART 3 Materials:

LEARNING OUTCOMES: Book, pen and notebook, index card/class list

Upon completion of this lesson, the nursing student can:

1. Review the nursing care of a family experiencing a sudden

pregnancy complications;
2. Assess the different signs and symptoms of complications References: Pillitteri, A. (2009). Maternal & Child
that may occur during pregnancy; Health Nursing: Care of the Childbearing &
3. Apply the nursing management in women who are Childrearing Family (6th Edition). Lippincott
experiencing complications of pregnancy. Williams & Wilkins
4.

LESSON PREVIEW/REVIEW (5 minutes)

MAIN LESSON (55 minutes)

I. Nursing care of a family experiencing a sudden pregnancy complication

a. Bleeding during pregnancy
b. Preterm labor
c. Preterm rupture of membranes
d. Hypertensive disorders during pregnancy
e. HELLP syndrome
f. Multiple pregnancy
g. Polyhydramnios
h. Oligohydramnios
i. Postterm pregnancy
j. Rh incompatibility

CHECK FOR UNDERSTANDING (25 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed. You
are given 25 minutes for this activity:

Multiple Choice

1. A client, 12 weeks’ gestation, comes to the prenatal clinic complaining of severe nausea and frequent vomiting.
The nurse suspects that this client has hyperemesis gravidarum and knows that this is frequently associated with
a. Excessive amniotic fluid
b. A GI history of cholecystitis
c. High levels of chorionic gonadotropin hormone
d. Slowed secretion of free hydrochloric acid
ANSWER: ________
RATIO:___________________________________________________________________________________________
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 2. A client in the thirty-third week of pregnancy begins to experience contractions. She is to be treated at home with
bed rest. The teaching plan for this client should include the information that the client
a. Needs to have the foot of the bed raised on blocks
b. Needs to sit in bed with several large pillows supporting her back
c. Should be placed on her side with her head raised on a small pillow
d. Should assume the knee-chest position every 2 hours for 10 minutes while awake

ANSWER: ________
RATIO:___________________________________________________________________________________________
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3. In the fifth month of pregnancy, ultrasonography is performed on a client. The results indicate that the fetus is
small for gestational age and there is evidence of a low-lying placenta. The nurse would use this information in
the last trimester of pregnancy by assessing the client for signs of possible
a. Placenta previa
b. Premature labor
c. Abruptio placenta
d. Precipitate delivery
ANSWER: ________
RATIO:___________________________________________________________________________________________
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4. A client experiences an episode of painless vaginal bleeding during the last trimester. The nurse realizes that this
may be caused by
a. Placenta previa
b. Abruptio placenta
c. Frequent intercourse
d. Excessive alcohol ingestion
ANSWER: ________
RATIO:___________________________________________________________________________________________
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5. The care of a client with placenta previa includes

a. Vital signs at least once per shift
b. A tap-water enema before delivery
c. Observation and recording of the bleeding
d. Limited ambulation until bleeding stops
ANSWER: ________
RATIO:___________________________________________________________________________________________
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6. A client is admitted with the diagnosis of possible placenta previa. Following the physician’s orders, the nurse
starts IV fluids, administers oxygen, and draws blood for laboratory tests. The client’s apprehension is increasing
and she asks the nurse what is happening. The nurse tells her not to worry, that she is going to be all right, and
everything is under control. The nurse’s statements are

a. Adequate, since all preparations are routine and need no explanation

b. Proper, since the client’s anxieties would be increased if she knows the dangers
c. Correct, since only the physician should explain why treatments are being done
d. Questionable, since the client has the right to know what treatment is being given and why

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ANSWER: ________
RATIO:___________________________________________________________________________________________
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7. A client comes to the clinic for a sonography at 36 weeks’ gestation. Before the test begins, the client complains
of severe abdominal pain. Heavy vaginal bleeding is noted and the client’s BP drops while her pulse rate
increases. The nurse should suspect that the client has
a. Hydatidiform mole
b. Endometriosis
c. Marginal placenta previa
d. Complete abruptio placenta

ANSWER: ________
RATIO:___________________________________________________________________________________________
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8. Which of the following would be the initial action of a nurse to a mother who is suffering from abruptio placenta?
a. Monitor for contractions
b. Obtain baseline vital signs and measure the abdominal girth
c. Monitor fetal heart tone
d. Measure the urine output of the mother

ANSWER: ________
RATIO:___________________________________________________________________________________________
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9. Abruptio placenta is most likely to occur in a woman with

a. Cardiac disease
b. Hyperthyroidism
c. Cephalopelvic disproportion
d. Pregnancy-induced hypertension

ANSWER: ________
RATIO:___________________________________________________________________________________________
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10. The nurse must anticipate for which of the following complications of the blood that may occur after abruptio
placenta?
a. Thrombosis
b. Disseminated intravascular coagulation
c. Cerebrovascular accident
d. Deep vein thrombosis

ANSWER: ________
RATIO:___________________________________________________________________________________________
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 11. The first assessable objective sign of a seizure in a client with eclampsia is frequently
a. Epigastric pain, nausea, and vomiting
b. Persistent headache and blurred vision
c. Spots or flashes of light before the eyes
d. Rolling of the eyes to one side with a fixed stare

ANSWER: ________
RATIO:___________________________________________________________________________________________
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12. Which of the following would be the definitive treatment for pregnancy-induced hypertension?
a. Oral antihypertensives
b. Magnesium sulfate
c. Diuretics
d. Delivery

ANSWER: ________
RATIO:___________________________________________________________________________________________
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13. When giving magnesium sulfate to a severely preeclamptic mother who is at 25 weeks AOG, the nurse must
prepare which of the following medications at the bedside in case magnesium toxicity occurs?
a. Potassium chloride
b. Aluminum hydroxide
c. Calcium gluconate
d. Spironolactone

ANSWER: ________
RATIO:___________________________________________________________________________________________
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14. Which of the following assessment findings from the patient would the nurse suspect for her to have pregnancy-
induced hypertension?
a. Nausea and vomiting usually felt by the mother in the morning
b. The mother tells you that she no longer can wear her wedding ring
c. Complains that she has difficulty defecating
d. Reports of frequency of urination especially in the afternoon

ANSWER: ________
RATIO:___________________________________________________________________________________________
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15. The nurse understands that the diabetic mother’s metabolism is significantly altered during pregnancy as a result
of
a. The lower renal threshold for glucose
b. The increased effect of insulin during pregnancy
c. An increase in the glucose tolerance level of the blood
d. The effect of hormones produced in pregnancy on carbohydrate and lipid metabolism

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ANSWER: ________
RATIO:___________________________________________________________________________________________
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16. Which of the following conditions may happen to the fetus in a mother who is diagnosed to have gestational
diabetes?
a. Small-for-gestational age
b. Hydrocephaly
c. Large-for-gestational age
d. Low birth weight
ANSWER: ________
RATIO:___________________________________________________________________________________________
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17. A mother was assessed for the type of abortion that she may have, the cervix is still closed, there is slight
bleeding and mild uterine contractions, the fetus is still in the womb of the mother. Which among the following is
happening?
a. Threatened abortion
b. Missed abortion
c. Complete abortion
d. Incomplete abortion

ANSWER: ________
RATIO:___________________________________________________________________________________________
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18. Which of the following is NOT a characteristic of ectopic pregnancy

a. Any gestation outside the uterine cavity
b. Most frequent in the fallopian tubes, where the tissue is incapable of the growth needed to accommodate
pregnancy, so rupture of the site usually occurs before 12 weeks.
c. Any condition that diminishes the tubal lumen may predispose a woman to ectopic pregnancy.
d. There is also a low lying placenta present during the ultrasonography
ANSWER: ________
RATIO:___________________________________________________________________________________________
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19. Which of the following laboratory findings would be significant in the mother who has ectopic pregnancy
a. Increased hematocrit and hemoglobin levels
b. Decreased hematocrit and hemoglobin levels
c. Elevated red blood cell count
d. Decreased white blood cell count
ANSWER: ________
RATIO:___________________________________________________________________________________________
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20. The characteristic pain of a mother who has ectopic pregnancy is

a. Pain felt just above the symphysis pubis of the mother
b. Pain felt during contractions of the uterus
c. Pain felt at one side of the abdomen
d. Pain felt at the right lower quadrant of the abdomen

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ANSWER: ________
RATIO:___________________________________________________________________________________________
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RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves.
Write the correct answer and correct/additional ratio in the space provided.
1. ANSWER: ________
RATIO:_______________________________________________________________________________________
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 RATIO:_______________________________________________________________________________________
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RATIO:_______________________________________________________________________________________
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LESSON WRAP-UP (10 minutes)

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

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AL Strategy: CAT 3-2-1 / EXIT TICKET/PASS

1. The instructor will instruct the students to record three things he or she learned from the lesson.
2. The students will record two things that they found interesting and that they like to learn more or if they still have
something to clarify about the topic.
3. After answering the question, station yourself at the door and collect the “exit pass” as students depart from the room.
Respond to students’ answer during the next class meeting or as soon as possible

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