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N113 Prenatal

N113 - Prenatal Care

Race & ethnicity For prenatal genetic screening or counseling
Previous pregnancies Number, abortions, living children, length of previous pregnancies, labor and birth, type of birth, complications
Menstrual cycle Regularity, frequency and duration - significant in determining due date
Medical history Current medications, drug use, allergies, exposure to teratogens, presence of disease, history of blood clots
Lab tests Serological test for syphilis (STS), RBC and hemoglobin, Rh determination, blood type, urinalysis
Urinalysis Sugar & albumin - dipstick done every visit
Vaginal cultures Malignancy, gonorrhea, beta strep - 35-37 weeks
Rubella titer Immune - 1:10, not immune 1:8 - booster given AFTER delivery
Blood sugar Glucose load test @ 28 weeks, Glucose tolerance test done if >140
Alfa-feto protein Optional done between 15-21 weeks, gestational weeks must be accurate. Indicator, not diagnostic
Return visit schedule q4 weeks until 28 weeks, q2wks 28-36, qweek 36-delivery
Disproportion Maternal pelvis too small for fetal head
Vaginal bleeding, low abdominal pain Always report! Vaginal exam contraindicated w/bleeding, May have slight bleeding after routine exam or intercourse
3 stages of fetal growth Increase in cell number, increase in number & size, increase in size only
Increasing in number Nutrition is most important during increase in number of cells
Weight gain 25-35 lbs, depending on prepregnat weight
Normal weight gain 1 lb/month 1st three months, 1/2 to 1 lb/per week thereafter
Sudden increase in weight Could signify fluid retention and may indicate HTN
Weight loss 12-14 lbs with delivery - baby, fluid & placenta
Caloric intake 300 more than normal, same as 2 1/2 cups milk, 1 c ice cream, bagel w/cream cheese, tuna sandwich
Protein 50 grams non-pregnant, 60 grams pregnant
Folic acid Reduces neural tube defects by 50% - spinabifida & anencephaly, 400 micrograms daily - 1 month prior to pregnancy. Oranges
Avoid Alcohol, drugs (even OTC), tobacco, eliminate or cut down on caffeine
Created by: jrb265