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Maternity Ch4 CCC105
Maternity Chapter 4 CCC PN 105
| Question | Answer |
|---|---|
| 3 phases of pregnancy | antepartum, intrapartum, postpartum |
| antepartum | prenatal, before birth |
| intrapartum | during birth |
| postpartum | after birth |
| who provides prenatal care | obstetricians, family practice physicians, certified nurse midwives, nurse practitioners |
| goals of prenatal care | ensure safe birth for mother and child, teach health habits, educate self-care, provide physical care, prepare parents for responsibility of parenthood |
| role of nurse during prenatal care | collecting data, identify/evaluate risk factors, educate self care, provide nutirtion counseling, promote family adaptation to pregnancy |
| healthcare for pregnancy begins when | before conception |
| preconception care | identifies risk factors to be changed before conception to reduce impact on pregnancy |
| folic acid prior to pregnancy reduces | incidence of congenital abnormalities (neural tube defects) |
| esitmated date of delivery (EDD) is based upon | last normal menstrual period (LNMP) |
| prenatal visit schedule; conception to 28 wks | every 4 wks |
| prenatal visit schedule; 29 wks - 36 wks | every 2-3 wks |
| prenatal visit schedule; 37 wks - birth | weekly |
| regular prenatal care reduces... | low-birth weight and morbidity/mortality weight for mothers/newborns |
| gravida | any pregnancy |
| nulligravida | woman never been pregnant |
| primigravida | pregnant for first time |
| multigravida | has been pregnant before |
| para | has given birth to child that reached age of viability (20 wks gestation) |
| primipara | has given birth to first child that reached age of viability (20 wks gestation) |
| multipara | has given birth to 2 or more children that reached age of viability (20 wks gestation) |
| nullipara | no birth past point of viability (20 wks gestation) |
| abortion | termination of pregnancy before viability (20 wks gestation) |
| gestational age | prenatal age of fetus based on LNMP |
| fertilization age | prenatal age of fetus based on date of conception (2 wks less than gestational) |
| age of viability | fetus capable of living outside uterus (20 wks) |
| Nagele's Rule | determines EDD: date of LNMP, backwards 3 months, add 7 days, correct year |
| avergae duration of pregnancy | 40 wks from LNMP, plus of minus 2 wks |
| length of trimester | 13 wks |
| number of trimesters | 3 |
| 3 groups of pregnancy signs | presumptive, probable, positive |
| presumptive pregnancy signs | definite diagnosis cannot be made; amenorrhea, nausea, vomiting, breast changes, prgmentation changes, frequency/urgency of urination, fatigue/drowsiness, quickening |
| chloasma | mask of pregnancy; increased pigmentation of the face |
| linea nigra | line extending in midline of abdoment from just above the unbilicus to the sumphysis pubis |
| quickening | fetal movement felt by mother, usually around 16-20 wks gestation |
| probable pregnancy signs | goodells sign, chadwicks sign, hegars sign, mcdonalds sign, braxton hicks contractions, ballottement, fetal outline, abdominal striae |
| Goodell's sign | softening of cervix |
| Chadwick's sign | purplish/bluish discoloration of cervix, vagina, and vulva |
| Hegar's sign | softening of lower uterine segment |
| McDonald's sign | easily flex the uterine body again the cervix |
| Braxton Hicks contractions | irregular, painless uterine contractions that begin the the second trimester |
| ballottement | fetal part is displaced by light tap of examining finger on cervix |
| fetal outline | identified by palpataion after 24 wks gestation |
| abdominal striae | stretch marks |
| positive pregnancy signs | fetal heartbeat, uterine souffle, funic souffle, identification by ultrasound |
| fetal heartbeat rate | low of 110-120, high of 150-160; higher in early gestation and slows as term approaches |
| routine assessments at each prenatal visit | risk factors, vital signs, urinalysis, blood glucose screening, fundal height, leopolds maneuvers, fetal heart rate, nutrition intake, any discomforts/problems |
| common vaginal discharge problems | bacterial vaginosis (milky-white discharge), no toerh clinical symptoms, caused by hormonal changes |
| effects of pregnancy on vagina | increased blood supply causes bluish color, secretions increase, pH more acidic, higher clyucogen level promoting yeast growth |
| effects of pregnancy on respiratory system | O2 consumption increases by 15%, dyspnea can occure until fetus descends into pelvis, nasal stuffiness, epistaxis, voice changes, diaphragm rises 4cm |
| effects of pregnancy on cardiovascular system | blood volume increases by 45% for nutrient exhange, expanded maternal tissue, and birthing blood loss; pluse rate increases by 10-15 beats/min; orthostatis hypotension, palpitations, increased clotting factors (2nd/3rd trimesters) |
| effects of pregnancy on GI system | appetite/thirst increase, stomach/intestinal displacement, increased salivary secretions, delayed gastric emptying |
| effects of pregnancy on urinary system | secretes waste of both mother and fetus, water retention due to increased blood volume, more susceptible to UTI, 99% sodium reabsorbed leading to fluid retention; frequent urination in first and last trimester |
| effects of pregnancy on integumentary/skeletal systems | striae, spider nevi, postural changes (low back aches, pelvic joint relaxation, waddling gait in 3rd trimester, center of gravity change) |
| supine hypotension syndrome (aortocaval compression/vena cava symdrome) | uterus compresses inferior vena cava and reduces blood flow due to soman lying on her back |
| relieve/prevent supine hypotension by | turning to one side (preferably left) |
| nurtition changes for pregnancy | only 300 cal/day (500 cal/day breastfeeding) - not eating for two |
| normal pregnancy weight gain | 25-35 lbs |
| obese pregnancy weight gain | 11-20 lbs |
| overweight pregnancy gain | 31-50 lbs |
| multifetal pregnancy gain | 34-54 lbs |
| low weight gain can lead to | pre-term labor |
| special nutritional considerations inclue | adolescent pregnancies, sodium intake, vegetarians, pica (non-food substances), lactose intolerance, cultural preferences, gestational diabetes |
| exercise during pregnancy | for maintenance of fitness, not improvement or weight loss |
| problems with elevated temperature | impact fetal circulation and cardia function - do not exceed 100.4 (no saunas or hot tubs), can lead to miscarriage |
| problems with hypotension | reduces blood flow to fetus |
| take with your for travel during pregnancy | take copy of obstetric records; safest during 2nd trimester |
| common pregnancy discomforts | fatigue, nasal stuffiness, nausea, heartburn, constipation, hemorrhoids, vaginal discharge, backache, varicose veins, leg cramps, lower extremity edema |
| most important factor in dealing with pregnanct adolescent | establish trust |
| most imporatnt factor in dealing with single mother | no judgements made, may have unique emotional needs |
| most important factor in dealing with single father | may take active interest, mayh want to participate in plans for child, may be rejected by woman |
| drugs during pregnancy | category A is safe at any time,all drugs should only be taken if told by physician |
| immunizations during pregnancy | no live virus vaccines, no thimerosal due to mercury poisoning, avoid MMR one month prior to pregnancy |
Created by:
cmp12345
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