Exam 9: Prenatal Care
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| Ante | Before
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| Antepartum | Of or occurring in the period before childbirth
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| Gravida | Pregnancy
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| Nullipara | No past pregnancy.
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| Primigravida | A woman in her first pregnancy.
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| Para | Births beyond 20 weeks of pregnancy
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| Gestational Age | Age of the fetus in terms of development based on last day of last menstrual period (in terms of weeks)
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| Abortion | Termination of pregnancy before 20th week of gestation.
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| Postpartum | after childbirth
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| Multipara | a woman who has delivered more than one viable infant
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| Primipara | A woman who is pregnant for the first time
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| Multigravida | Multiple births
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| TPAL system | T-Term Infants
P-Preterm Infants
A-Aborted Pregnancies
L-Living Children now.
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| Sue had two children at 40 weeks, one child at 32 weeks, no abortions or miscarriages and all three children are living. | Gravida3Para2103
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| Presumptive Signs of Pregnancy | Amenorrhea
Nausea and vomiting
Breast changes
Urinary frequency
Fatigue
Quickening
Change in shape of abdomen
Skin changes
Chadwick’s sign
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| 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.
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| 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.
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| Probable Signs of Pregnancy | *Done by an examiner
Goodell's sign
Abdominal enlargement
Hegar's sign
Braxton-Hicks
Ballottement
Fetal outline
Pregnancy tests
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| Probable Signs (objective signs)of Pregnancy: | ): they are observable during the physical and obstetrical exam and can be documented by the examiner.
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| Positive Signs of Pregnancy: Accepted Signs | Fetal Heartbeat
Fetal Movements
Visualization of Fetus
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| Goodell's sign | softening of the cervix; a sign of pregnancy.
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| Hegar's sign | softening of the lower uterine segment; indicative of pregnancy.
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| 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.
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| Ballottement | increased fluid in the suprapatellar pouch over the patella at the knee joint
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| Duration of Pregnancy: Average | 40 weeks
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| Duration of Pregnancy: Trimesters | 13-week Parts
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| Nagele's Rule | Identify the first day of the last normal menstrual period
Count backward 3 months
Add 7 days
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| Gestational Wheel | an electronic calculator for this purpose, physical examination, ultrasound, or a combination of these methods.
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| Which is more accurate in determining a pregnancy, blood test or urine test? | Blood Test
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| Amenorrhea is often the first sign of pregnancy. What are some other signs? | N/V, ABD distension
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| What does trimester mean? | 13 week
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| Name methods to determine the EDD? | Gestational Wheel. Nagele's Rule.
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| 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
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| Initial Prenatal Visit | Obtain demographic data
Obtain obstetrical history
Complete past and present medical/surgical history is obtained
Physical examination
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| 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
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| Physiological Changes During Pregnancy | Rest/Sleep
Activity/Exercise
Employment Planning
Bathing
Hot Tubs/Saunas
Douching
Clothing
Travel
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| What is the recommendation for exercise during pregnancy? | Normal Routine as long as not over exertion.
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| Pregnancy Common Discomforts | Nausea
Round Ligament Pain
Urinary Frequency
Backache
Constipation
Varicosities
Hemorrhoids
Heartburn
Nasal Stuffiness and Epistaxis
Dyspnea
Ankle Edema
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| Principles of Proper Nutrition | Nutrient needs greater during pregnancy
Optimal nutrition reduces risk of complications
Nutrient needs increase more than calorie needs
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| 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
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| Special Considerations | Pregnant Adolescents
Sodium Intake
Pica
Lactose Intolerance
Gestational Diabetes
SUBSTANCE ABUSE
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| Name four key nutrients in pregnancy: | Protein-Calcium-Iron-Folic Acid
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| How much weight should a normal weight woman gain during pregnancy? | 25-35lbs
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| Psychological Adaptations: First Trimester | Focus on self
Uncertainty
Ambivalence
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| Psychological Adaptations: Second Trimester | Physical Evidence of pregnancy.
Fetus as primary focus.
Nascissism and introversion.
Body Image.
Changes in sexuality.
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| Psychological Adaptations: Third Trimester | Velnerability.
Increasing dependence.
Preparation for birth.
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| Describe the impact on the mother during the first trimester. | Focus on self
Uncertainty
Ambivalence
Conflicting feelings.
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| Emotional Changes | Impact on the father.
Impact on the grandparents.
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| What is the impact on pregnancy on grandparents. | Age
Number of kids
Generation Gap
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| 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
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| How can you communicate with a patient that does not speak your language? | Professional Interpreter
Or other means.
Family is an absolute last resort!
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| 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.
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| Patients with Special Needs | Absence of a Partner
Adolescents
Older couple
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| To whom does a single parent turn to for help? | Anyone close to them.
A parent.
You.
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| Childbirth Preparation | Prepared Childbirth Benefits
Methods of Prepared Childbirth
-Dick-Read Method
-Bradley Method
-Lamaze
Types of Classes
Content of Classes
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| Dick-Read Method | a psychophysiological preparation for childbirth. This technique alleviates pain during childbirth by blocking feelings of fear and tension.
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| 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.
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