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M6 13-005

Exam 9: Prenatal Care

Ante Before
Antepartum Of or occurring in the period before childbirth
Gravida Pregnancy
Nullipara No past pregnancy.
Primigravida A woman in her first pregnancy.
Para Births beyond 20 weeks of pregnancy
Gestational Age Age of the fetus in terms of development based on last day of last menstrual period (in terms of weeks)
Abortion Termination of pregnancy before 20th week of gestation.
Postpartum after childbirth
Multipara a woman who has delivered more than one viable infant
Primipara A woman who is pregnant for the first time
Multigravida Multiple births
TPAL system T-Term Infants P-Preterm Infants A-Aborted Pregnancies L-Living Children now.
Sue had two children at 40 weeks, one child at 32 weeks, no abortions or miscarriages and all three children are living. Gravida3Para2103
Presumptive Signs of Pregnancy Amenorrhea Nausea and vomiting Breast changes Urinary frequency Fatigue Quickening Change in shape of abdomen Skin changes Chadwick’s sign
Presumptive Signs of Pregnancy: Definition : indicators that a woman may be pregnant, but these signs may also be indicators of other conditions not related to pregnancy.
Presumptive Signs of Pregnancy:Other causes of amenorrhea must be ruled out 1)Strenuous exercise.   2)Low body weight.   3)Endocrine problems.   4)Early menopause.   5)Anovulation.   6)Fatigue.   7)Emotional stress.   8)Chronic disease.
Probable Signs of Pregnancy *Done by an examiner Goodell's sign Abdominal enlargement Hegar's sign Braxton-Hicks Ballottement Fetal outline Pregnancy tests
Probable Signs (objective signs)of Pregnancy: ): they are observable during the physical and obstetrical exam and can be documented by the examiner.
Positive Signs of Pregnancy: Accepted Signs Fetal Heartbeat Fetal Movements Visualization of Fetus
Goodell's sign softening of the cervix; a sign of pregnancy.
Hegar's sign softening of the lower uterine segment; indicative of pregnancy.
Braxton-Hicks contractions are sporadic uterine contractions that start about 6 weeks into your pregnancy, although you won't be able to feel them that early.
Ballottement increased fluid in the suprapatellar pouch over the patella at the knee joint
Duration of Pregnancy: Average 40 weeks
Duration of Pregnancy: Trimesters 13-week Parts
Nagele's Rule Identify the first day of the last normal menstrual period Count backward 3 months Add 7 days
Gestational Wheel an electronic calculator for this purpose, physical examination, ultrasound, or a combination of these methods.
Which is more accurate in determining a pregnancy, blood test or urine test? Blood Test
Amenorrhea is often the first sign of pregnancy. What are some other signs? N/V, ABD distension
What does trimester mean? 13 week
Name methods to determine the EDD? Gestational Wheel. Nagele's Rule.
Nurse’s Role in Prenatal Care: Objectives A safe birth for mom and baby Risk assessment Health education Counseling Social support Psychological support Adequate antepartum care
Initial Prenatal Visit Obtain demographic data Obtain obstetrical history Complete past and present medical/surgical history is obtained Physical examination
Follow-up Care Woman and her partner are encouraged to attend all prenatal appointments Educated about all health care options Prenatal visits provide for continuing assessment Normal activity should continue Nutrition is reviewed
Physiological Changes During Pregnancy Rest/Sleep Activity/Exercise Employment Planning Bathing Hot Tubs/Saunas Douching Clothing Travel
What is the recommendation for exercise during pregnancy? Normal Routine as long as not over exertion.
Pregnancy Common Discomforts Nausea Round Ligament Pain Urinary Frequency Backache Constipation Varicosities Hemorrhoids Heartburn Nasal Stuffiness and Epistaxis Dyspnea Ankle Edema
Principles of Proper Nutrition Nutrient needs greater during pregnancy Optimal nutrition reduces risk of complications Nutrient needs increase more than calorie needs
Important Nutrients Protein – 25 g/day Calcium – 1000mg/day Iron – 30 mg/day Folic Acid – 0.6mg/day Fluid intake - 8 glasses of fluid/day, mostly water
Special Considerations Pregnant Adolescents Sodium Intake Pica Lactose Intolerance Gestational Diabetes SUBSTANCE ABUSE
Name four key nutrients in pregnancy: Protein-Calcium-Iron-Folic Acid
How much weight should a normal weight woman gain during pregnancy? 25-35lbs
Psychological Adaptations: First Trimester Focus on self Uncertainty Ambivalence
Psychological Adaptations: Second Trimester Physical Evidence of pregnancy. Fetus as primary focus. Nascissism and introversion. Body Image. Changes in sexuality.
Psychological Adaptations: Third Trimester Velnerability. Increasing dependence. Preparation for birth.
Describe the impact on the mother during the first trimester. Focus on self Uncertainty Ambivalence Conflicting feelings.
Emotional Changes Impact on the father. Impact on the grandparents.
What is the impact on pregnancy on grandparents. Age Number of kids Generation Gap
Cultural Practices and Beliefs Communication is key Modesty is important, especially to Latinos, Middle Eastern, and Asian women Incorporate health beliefs into teaching as much as possible Accept and support practices that are harmless
How can you communicate with a patient that does not speak your language? Professional Interpreter Or other means. Family is an absolute last resort!
Is it okay for a pregnant woman to follow cultural traditions? Yes. But be mindful of the health and safety or the mother and baby.
Patients with Special Needs Absence of a Partner Adolescents Older couple
To whom does a single parent turn to for help? Anyone close to them. A parent. You.
Childbirth Preparation Prepared Childbirth Benefits Methods of Prepared Childbirth -Dick-Read Method -Bradley Method -Lamaze Types of Classes Content of Classes
Dick-Read Method a psychophysiological preparation for childbirth. This technique alleviates pain during childbirth by blocking feelings of fear and tension.
Bradley Method embraces the idea that childbirth is a natural process and that, with the right preparation, most women can avoid pain medication and routine interventions during labor and birth.
Created by: jtzuetrong