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Essentials of Maternity, Newborn, and Women’s Health Nursing Chapter 11: Maternal Adaptation During Pregnancy 1. Jessica and Mike are new clients at your obstetrics office. You are asking them about the reason for their visit. Jessica says she thinks she is pregnant because she missed a period. Mike tells you Jessica is always nauseated in the morning and eats all the time the rest of the day. They have not been using birth control and have wanted to have children since they got married last summer. Jessica says her clothes are feeling tighter and her breasts seem tender. Mike says he has noticed that Jessica has been frequently getting up to go to the bathroom at night. (Learning Objectives 2 and 4) 2. Beth (age 18) is experiencing her first pregnancy and is now 24 weeks gestation. She tells you that she is “amazed by the changes that have happened to my body already.” Beth wants to understand what additional changes are going to occur to her “besides just getting a really huge belly.” Additionally, Beth relates to you that she is in her senior year of high school, is no longer involved with the baby’s father, and lives at home with her mother and 12-year-old brother. (Learning Objectives 3 and 5) Essentials of Maternity, Newborn, and Women’s Health Nursing Chapter 13: Labor and Birth Process 1. Emily, age 32, has an obstetrical history of G1, T0, P0, A0, L0. Emily’s week of gestation is 39.1. Emily telephones the health care provider’s office and tells the nurse she believes she is in labor. Based on her assessment, the nurse advises her to have her husband bring her to the labor and birth unit. Emily arrives and is admitted. She is talkative and excited about being in labor and describes her contractions and discomfort as mild. The following are the assessment findings of the examining nurse: Maternal vital signs are stable. Fetal heart tones with the external fetal monitor are reassuring. Vaginal exam indicates the cervix is 3 cm dilated, 40% effaced, membranes intact with the presenting part engaged. Ten minutes after the vaginal exam by the nurse, Emily says, “I think I just wet my pants.” (Learning Objectives 2, 6, 7, and 8) 2. Diane, age 22, has been in labor for 8 hours. Her cervical exam reveals she is 3 cm, 30% effaced and –1 station. Diane has been feeling most of her pain in her lower back. (Learning Objectives 3, 4, and 5)