Antepartum- EXAM 1 Flashcards
Nursing priorities during pregnancy
Address self care and discomforts
Perform ongoing assessments to ensure health and safety of women and fetus
Prepare women and family for childbirth
Antepartum
before birth
prenatal
Intrapartum
during birth
Postpartum
after birth
Prenatal health history
First day of last period
Contraceptive, meds used
Medical and surgical hx
Woman & partner family hx
Both woman and partners hx
Routine assessments at each visit
vital signs
urinalysis
Leopold meanuvers
fundal height
blood glucose
fetal heart rate
nutrition intake
any discomforts
objective of physical examination
Evaluate the woman’s general health
Determining baseline weight and VS
Evaluating nutritional status
Identifying current physical and social problems
Determining EDD
miscarriage time frame
before 24 week
abortion time frame
before 20
gravida
has been pregnant before
Nulligravida
never been pregnant before
primigravida
first time pregnant
multigravida
more then 1 pregnancy
para
delivered before 20 weeks
primipara
had a pregnancy over 20+ weeks
GTPAL
Gravida
Term: 37+ weeks
Preterm
Abortions
Living children
Nägele’s rule
Determining the estimated date of delivery
Identify first day of LNMP
Count backwards 3 month
Add 7 days
Update year if need be
FIRST TRIMESTER common discomforts
N&V: estrogen and HcG
Urinary frequency:pressure on the bladder
Fatigue: hormones,stress
Brest tenderness
Increased vaginal discharge
Nasal stiffness and epistaxis
SECOND & THIRD TRIMESTER common discomforts
heartburn
hemorrhoids
leg cramps
flatulence
backache
ankle edema
varicose veins
constipation
faintness
Pregnancies at risk include those who
Are under16 years or above 35 years
Have maternal history of stillbirth
Have had prior preterm birth
Have chronic illnesses: HTN, GDM, PC, HD
When does maternal assessment typically begin
28 weeks gestation
every 4 weeks visits
From conception to 28 weeks
every 2 to 3 weeks visits
From 29-36 weeks
weekly visits
From 37 weeks to birth
How long does pregnancy last and how is it divided
Lastas an average of 40 weeks plus or minus 2 weeks
Divided into 3 13 week parts
Reasons for prenatal tests
determine gestational age
evaluate fetal growth
detect congenital anomalies
assess fetal status
diagnose cardiac problems
assess fetal lung maturity
determine fetal presentation
Ultrasound and its types
noninvasive, painless and non radiating
helps visualize fetus and growth
Transabdominal and Transvaginal
Transabdominal ultrasound
moved across abdomen
full bladder needed to examine structures in relation to bladder
Transvaginal ultrasound
Probe inserted into vagina
Produces clearer, more defined image
Can be done with empty bladder
Detection of fetal anomalies
Nonstress test
Procedure & results
Evaluates fetal status aka oxygenation by looking at FHR reaction to movement, women must be still got 20 min
Px is semi Fowler, monitor placed on stomach
reactive: >2 accelerations of FHR at 15 beats/min
Desired
Nonreactive: reactive criteria not met
unsatisfactory: data cannot be interpreted or inadequate fetal movement
IF ANY DECELERATIONS, PROVIDER NOTIFIED ASAP
Contraction stress test
Done if NST results are non-reassuring
Used to identify risk for asphyxia
Evaluates respiratory function of placenta
Amniocentesis and the process
Amniotic fluid analysis
Done in third trimester, for fetal abnormalities
Ultrasound is used to identify fetal placental placement to insert the needle to withdraw amniotic fluid without puncturing fetus
Chronic Villus Sampling
Small sample of chronic villi is obtained from placenta
Performed at 10-12 weeks gestation, NOT done before 10 weeks due to possible association with birth defect
Does quadruple screen
Quadruple Screen
Blood test for Down syndrome, trisomy 18 and neural tube defect, but cannot detect early in pregnancy
First trimester Nutritional requirement for pregnant women
Increase by 300 kcal/day
Up to 4.4 pound weight gain
Second trimester Nutritional requirement for pregnant women
Increase by 40 to 340 kcal/day
1 pound a week during rest of pregnancy
Third trimester Nutritional requirement for pregnant women
Increase by 110 to 450 kcal/day
1 pound a week during rest of pregnancy
Ideal weight gain pattern
25-30 pounds in normal weight
15-25 in overweight women
11-20 in obese women
37-54 in multifetal carriers (4-6 in first trimester and 1.5 per week in 2 and 3 trimester)
iron defeciency anemia most common concern in who
Pica patients
Lacto-ovo-vegeterian
eat milk, dairy products and eggs
should eat 4 servings of B12 food daily
Lactovegeterians
eat dairy products, no eggs
Vegan
eat no food from any animal sources
should eat 4 servings of B12 food daily
Folic Acid
Assists in normal growth, reproduction and lactation
Prevents microcytic, megablastic anemia of pregnancy
No intake=fetal neuraltube defects
400 mcg daily
Artificial sweetener
Saccharin, aspartame safe if taken within guideline
Splenda, Truvia, safe for pregnant, lactating women
Mercury in fish
can be beneficial but can threaten developing nervous system of fetus and young child
Who has an increased risk for complications- higher incidences of fetal anomalies
obese women
height of fundus
10 and 12 ar low pelvis
16 between belly button and lower pelvis
20 at belly button
26 at wait
32
36 at sternum, top
important factors to assess in pregnant adolescents
low prepregant weight
low weight gain during pregnancy
smoking
excessive weight
unhealthy lifestyle
Prenatal exercises
pelvic tilt
abdominal exercise
perineal
inner thigh stretch
Environmental hazards
Bioterrorism
3: A-can be easily transmitted from person to person
b-can be oread via food and water
c-can be spread via manufactured weapons designed to spread disease
Substance abuse and alcohol
Key time frames
Abortion
Miscarriage
Preterm
Full term
Max weeks
Before 20 weeks
Before 24 weeks
Before 36 weeks
37 weeks and over
40 weeks max
