A client enters the prenatal clinic. She states that she believes she is pregnant. Which of the following hormone elevations will indicate a high probability that the client is pregnant?

Correct Answer: A

Rationale: In pharmacology, understanding maternal monitoring during labor is crucial for providing optimal care to pregnant clients. In this scenario, the correct answer is A) Chorionic gonadotropin. Chorionic gonadotropin, specifically human chorionic gonadotropin (hCG), is a hormone produced by the placenta after implantation occurs. Elevated levels of hCG in a woman's blood or urine are a reliable indicator of pregnancy, making it a key hormone to test for in early pregnancy confirmation. Option B) Oxytocin is a hormone responsible for uterine contractions during labor and milk ejection during breastfeeding, but its elevation alone does not confirm pregnancy. Option C) Prolactin is a hormone that stimulates milk production in the mammary glands, primarily postpartum. Elevated prolactin levels are not specific to pregnancy confirmation. Option D) Luteinizing hormone (LH) is involved in the menstrual cycle and ovulation but does not reliably indicate pregnancy status. In an educational context, understanding the hormonal changes in pregnancy is essential for healthcare providers to accurately assess and monitor maternal health. By knowing which hormones are specific to pregnancy confirmation, healthcare professionals can effectively counsel and provide appropriate care to pregnant clients. This knowledge aids in early detection of pregnancy, prenatal care initiation, and overall management of maternal health during the labor and delivery process.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Leg cramping. During the second trimester of pregnancy, leg cramping is a common symptom due to factors such as increased weight and pressure on the legs, changes in circulation, and mineral imbalances. Leg cramping can be especially prevalent in multigravid clients who have been pregnant before, as their body may react differently compared to first-time pregnancies. Option A) Nausea is more commonly associated with early pregnancy (first trimester) due to hormonal changes and is less likely to be a prominent symptom at 22 weeks gestation. Option B) Dyspnea (shortness of breath) is often experienced in the later stages of pregnancy as the growing uterus puts pressure on the diaphragm and lungs. While dyspnea can occur, it is not typically a prominent symptom at 22 weeks. Option C) Urinary frequency is common in early pregnancy due to hormonal changes and later in pregnancy due to the growing uterus pressing on the bladder. At 22 weeks, urinary frequency may have improved compared to the first trimester but can vary among individuals. Educationally, understanding the timing and common symptoms of pregnancy is crucial for nurses caring for pregnant clients. By recognizing the expected symptoms at different stages of pregnancy, nurses can provide appropriate education, support, and interventions to promote the well-being of both the mother and the baby.

Correct Answer: A

Rationale: In the context of maternal monitoring during labor, the nurse should highlight the vital sign changes that indicate potential complications. Option A is the correct answer as it reflects a significant increase in blood pressure from the prepregnancy baseline to the third trimester, indicating gestational hypertension or preeclampsia, which are critical conditions requiring medical intervention. Option B is incorrect as a slight increase in respiratory rate can be a normal physiological adaptation to pregnancy due to increased oxygen demand, and it may not necessarily indicate a problem. Option C is incorrect because a modest increase in heart rate can also be normal during pregnancy as the body adapts to the increased demands of the growing fetus and placenta. Option D is incorrect as a slight elevation in temperature is not uncommon in pregnant women and may not be a cause for immediate concern unless it is accompanied by other symptoms of infection. Educationally, understanding the normal physiological changes during pregnancy and being able to identify abnormal vital sign trends are crucial for nurses caring for pregnant women. Highlighting the correct vital sign changes can help in early identification and management of complications, ensuring the well-being of both the mother and the baby.

Correct Answer: B

Rationale: In the context of maternal monitoring during labor, the correct position for a 31-week gestation client to lie on the examining table during a prenatal examination is the lateral-recumbent position (Option B). Explanation of why Option B is correct: 1. Lateral-recumbent position: This position is preferred during pregnancy as it helps prevent supine hypotensive syndrome by reducing pressure on the vena cava. This position allows for optimal blood flow to the uterus and placenta, promoting maternal and fetal well-being. Explanation of why the other options are wrong: 1. Orthopneic position (Option A): This position is more commonly used for patients experiencing respiratory distress, not for routine prenatal examinations. 2. Sims' position (Option C): Sims' position is typically used for rectal examinations or procedures, not for prenatal examinations. 3. Semi-Fowler's position (Option D): This position is a semi-upright position with the head of the bed elevated. While it can be used for some examinations, the lateral-recumbent position is more appropriate for prenatal examinations to avoid pressure on the vena cava. Educational context: Understanding the importance of positioning during prenatal examinations is crucial for nurses and healthcare providers caring for pregnant clients. Proper positioning not only ensures the comfort of the client but also promotes optimal maternal and fetal health by facilitating adequate blood flow and reducing the risk of complications. By selecting the appropriate position, nurses can contribute to a positive pregnancy experience and ensure the well-being of both the mother and baby.

Correct Answer: B

Rationale: In the context of maternal monitoring during labor, the correct answer is B) Rise in white blood cells from 5,000 cells/mm3 to 15,000 cells/mm3. This increase indicates a normal physiological response to stress and potential infection during pregnancy, known as leukocytosis. It signals the body's defense mechanism gearing up to protect both the mother and the fetus during labor. Option A) Rise in hematocrit from 34% to 38% is unlikely during pregnancy as there is a normal physiological hemodilution due to increased plasma volume. Option C) Rise in potassium from 3.9 mEq/L to 5.2 mEq/L is concerning as it could indicate hyperkalemia, which is not a typical finding during pregnancy. Option D) Rise in sodium from 137 mEq/L to 150 mEq/L is also abnormal and could indicate hypernatremia, which is not a typical finding during pregnancy. Understanding these physiological changes is crucial in maternal monitoring to differentiate between normal adaptations and potential complications during pregnancy and labor. It helps healthcare providers make informed decisions to ensure the well-being of both the mother and the baby.