Ch. 12- Nursing Management During Pregnancy Flashcards
What is the most accurate method of dating a pregnancy?
Ultrasound
How would you describe the Lamaze method to control labor pains?
Control your response to the stimulus (pain). You will control your thought response to the pain using breathing and relaxation techniques
What is the Dick-Read method to control labor pain?
Reading and knowledge about the birth process will ease anxiety and fear of the process. Then use abdominal breathing techniques.
What is the vernix?
White, waxy coating present on the infant. Protects the skin.
What would normal amniotic fluid look like in an amniocentesis?
Clear with white flecks from the vernix. Lecithin–sphingomyelin ratio >2 and glucose <45.
What is Lecithin–sphingomyelin?
Phospholipids that play crucial roles in the formation of surfactant, a substance essential for proper lung function. (Surfactant lines the inner surface of the alveoli)
The first ultrasound is performed during the first trimester. When might some others be necessary?
A second scan may be performed at about 18 to 20 weeks to look for congenital malformations. A third one may be done at around 34 weeks to evaluate fetal size and verify placental position.
When would you ultrasound to assess for congenital malformations?
Second trimester. Usually 18-20 weeks.
What will biophysical profile assess?
A biophysical profile uses real-time ultrasound to allow assessment of various parameters of fetal well-being. This may include fetal movements, fetal tone, and fetal breathing, as well as assessment of amniotic fluid volume with or without assessment of fetal heart rate.
How would you teach a patient to count fetal movements?
The client should perform the counts in a relaxed environment and a comfortable position, such as a semi-Fowler’s or side-lying position. The woman needs to do fetal movement counts consistently, at approximately the same time each day. A woman should report a count of less than three fetal movements in an hour. A relaxed environment, a comfortable position, and consistency in performing the counts are important to identify changes.
Where would you expect the fundus to be in a patient that is at 20 weeks gestation?
At 20 weeks, the fundus can be palpated at the umbilicus. A fundus of 12 weeks’ gestation is palpated at the symphysis pubis. At 16 weeks’ gestation, the fundus is midway between the symphysis pubis and umbilicus. At 36 weeks’ gestation, the fundus can be palpated just below the ensiform cartilage.
What would assess for neural tube defects?
Alpha-fetoprotein is a substance produced by the fetus. AFP enters the maternal circulation by crossing the placenta. If there is a developmental defect, more AFP escapes into amniotic fluid from the fetus. The optimal time for AFP screening is 16 to 18 weeks.
What negative effect might chewing gum have for the patient in the first trimester that is feeling bloated?
Chewing gum causes them to swallow more air and worsen bloating. Opt for mints instead.
What vaccine type should be avoided when pregnant or when attempting to get pregnant?
Live virus vaccine- Risk for fetal transmission.
What would be the most simplistic method of teaching a pregnant patient to perform kick counts?
The most common method of kick counting is “Count to 10,” whereby a woman focuses her attention on her fetus’s movement and records how long it takes to document 10 movements. If it takes longer than 2 hours, the woman should contact her health care provider for further evaluation.
What teaching would you give for hemorrhoid relief?
Measures to prevent constipation, including increasing fiber intake and drinking at least 2 liters of fluid per day. The nurse should also teach the client about local comfort measures such as warm sitz baths, witch hazel compresses, or cold compresses. To minimize the client’s risk of straining while defecating, the nurse should suggest that she elevates her feet on a stool, and also encourage her to avoid prolonged sitting or standing. Engaging in exercise can help to reduce the risk for constipation which would lead to straining.
Why should a pregnant woman not use hot tubs?
The heat may cause fetal tachycardia as well as raise the maternal temperature. Exposure to bacteria in hot tubs that have not been cleaned sufficiently is another reason to avoid them during pregnancy.
