Antepartum Flashcards
Antepartum?
Before child birth
Also referred to as prenatal care
1st trimester?
Completion of 12 weeks
Organ, heart form
First prenatal visit should be within the first 12weeks
Lots of lab work
2nd trimester?
13 weeks to 27 weeks(3moths to 6months)
Organ develop
3rd trimester?
28 weeks to delivery (7-9months)
When is the unborn baby most at risk from teratogens?
During the embryonic stage
1st trimester
Sing of pregnancy
Subjective
= Presumptive
Symptoms, reports and experience
Fatigue, nausea
Urinary frequency
Amenorrhea
Beast change
Quickening
Sing of pregnancy
Objective
= Probable
Abdominal enlargement
Positive pregnancy test
Hegar’s sing, Chadwick sing
Ballottement
Sing of pregnancy
Diagnostic
= Positive
Urine test
Fetal heart sounds, Fetal movement
Baby can be hard, felt or seen!
Physiological change
Cardiovascular
Blood volume ↑
Cardiac output ↑
Heart rate ↑
Iron demand ↑
Plasma ↑ 50%
RBC’s demand ↑
Risk of blood clot ↑
Low BP
Normal hgb range during 1st to 3rd trimester?
1st trimester Hgb < 11.0
2nd trimester Hgb < 10.5
3rd trimester Hgb <11.0
Physiological change
Respiratory
Total lung capacity decrease(uterus enlarge) RR increase(due to O2 requirement)
What’s factors drastically impact oxygenation?
Smoking
Asthma
COVID
Physiological change
Gastrointestinal
Nauseas (hormone changes)
Constipation (elevated progesterone cause smooth muscle relax)
Gastric motility decreases
Language of OB
G
Gravida
The number of Pregnancies
Language of OB
Parity
The number of deliveries
Nullipara
Primapara
Mulitpara
Language of OB
G-T-P-A-L
T
Term # of deliveries that occurred starting from 38 weeks gestation
Language of OB
G-T-P-A-L
P
Preterm # of deliveries that occurred between 20 – 37 weeks gestation
Language of OB
G-T-P-A-L
A
Abortion # of deliveries before 20 weeks/spontaneous or elective
Language of OB
G-T-P-A-L
L
Living # of living children at the time of the interview
Clients last period was April 1st 2022.
When it will be the EDB?
January 8th,2023
She has a 4yo daughter and a 6yo son
The son was a term vaginal delivery at 39 weeks
The daughter came early at 35 weeks
She admits to having 2 abortions
GTPAL?
a)G - 5 P - 1 T - 1 A - 2 L - 2
Weight Gain
a) 1st trimester ideal gain?
b) after that?
a) 1.1 to 4.4lb
b) 1lb per week
Lacy is 135pound and she already gain 5pounds at week 14. what is the ideal range?
3.1-6.4lb
14-12=2
1st trimester range is 1.1 lb tp 4.4lb
add 2=3.1-6.4lb
What can we tell about iron pills?
They can cause constipation
Increase fluids and fiber
Best absorbed with vitamin C
Increase rich iron-food (meat, fish, liver, green leafy vege)
What can we tell about managing the morning sickness?
Crackers by the bed(dry food)
Small frequent meals
Snack before bed(avoid an empty stomach)
Avoid greasy foods
Ginger products
Notify vomiting more than once a day
What trimester is Lacey in at 16 weeks?
2nd
What is the dark line, vertically the length of her abdomen?
what is causing it?
Linea Nigra
Caused by the hormones
Lacey is 35 years old which puts her pregnancy at increased risk
What prenatal screening options do you suggest?
Quad marker Screen
What education can you provide Lacey regarding the Quad screen?
It is a Screening test
Can detect risk for Down syndrome and for neural tube defects.
Most accurate if done between 16-18 weeks.
What does a low AFP(the Alpha-fetoprotein )on Quad screen indicate?
What other test she can take?
Possible Down syndrome or other trisomy
Amniocentesis
What can you tell Lacey about amniocentesis?
Small amount of a)_________ is withdrawn from the b)______ to collect c)______
Amniocentesis is d)_______ test
There is a small risk for e______
a) amniotic fluid
b) uterus
c) fetal cells
d) diagnostic(99% accurate)
e) infection and miscarriage
What does the nurse need to do immediately after the amniocentesis?
Monitor the Fetal Heart Rate
How Preconception care important? 2
1) By the time the woman realizes she is pregnant, they already exposure to teratogen
2) General health status of the mother BEFORE pregnancy