Antenatal Flashcards
Naegle’s rule
First day of last menstrual period
+ 1 year
- 3 months
+7 days
Maternal adaptation to pregnancy
Accepting
Identifying role in mother
reordering relationships
establishing relationship with fetus
preparing for childbirth
Paternal adaptation to pregnancy
Accepting
Identifying with the role
reordering relationships
establishing relationship with fetus
preparing for childbirth
Siblings?
Preconceptual health in pregnancy
Teaching role for nurses to promote
pre-conceptual health of women & men of childbearing age before conception.
Ex. Prenatal health, iron stores, Folic Acid
Many women never really know the exact time when they become pregnant.
Ex. Fertilization, implantation, zygote formation
The first trimester is critical because it is the time of increased developmental risk.
Assessment: diet history, obstetrical & gynecological effects of nutrition, health history, usual maternal diet, physical examination, laboratory testing
Initial Visit when find out pregnancy
- Prenatal interview
- physical exam (pap smear)
- lab tests (urine C and S, blood samples, infectious diseases)
- Scheduling and dating
- Offer genetic testing ( down syndrome)
Each visit after initial assessment
- symphysis fundal height
- fetal heart tone
- blood pressure
- urine dipstick
- maternal weight
- leopold’s maneuver
- specific topics or tests
Specific tests with visits
Group B strep - 35-37 weeks
Gestational diabetes - 24-28 weeks
Ultrasound for anatomy - 18-20 weeks
Nursing education
Expected maternal and fetal changes (morning sickness, general fetal development and size)
Nutrition (quality, cravings, tolerance, iron-rich)
Personal hygiene (ph changes in mucosal linings increase risk vaginal infections (yeast) and oral cavities (gingivitis))
Prevention of urinary tract infections
Kegel exercises for perineal strengthening (Not only for childbearing but for support of pelvic structures)
Preparation for breastfeeding (Nipple type, hand expression (after 25 weeks), nutritional needs)
Dental health
Physical activity
Sexual activity
Weight gain in pregnancy
15-35ibs
Adverse fetal outcomes with obesity in pregnancy
Fetal macrosomia (associated to birth injuries)
Very low birthweight
Neural tube defects
Low birthweight is with increase risk of childhood and adult obesity and CV disease
Preterm birth
Who has the same risks as obese women?
Women who start with a normal BMI, but then gain >50ibs
Who are at risk for poor nutrition?
Adolescence or less than 2 years post menarch
Frequent pregnancies; 3 within 2 years
Poor fetal outcome in previous pregnancy
Poverty- Food insecurity
Poor diet habits with resistance to change
Use of tobacco, alcohol, or substances
Weight at conception under or over normal weight
Problems with weight gain
Multifetal pregnancies
Low hemoglobin (anemia)
Diabetes
Chronic illness (related to absorption)
Folic Acid Deficiency
=neural tube defects
incomplete closure of the neural tube
varying degrees of closure 1mg/day - 5 mg/day
Nutrition-related discomforts of pregnancy
Nausea and vomiting
Constipation
Pyrosis (heartburn) - very common
Increase hormones disrupts normal GI function
What med is used for nausea and vomiting?
Diclectin
