Ch. 14 Flashcards
What are the 5 psychological adaptations to pregnancy for the mother?
- Accepting the pregnancy
- Identifying with the mother role
- Reordering personal relationships
- Establishing a relationship with the fetus
- Preparing for birth
Psychological adaptations to pregnancy for the mother: What are some things that go on with “accepting the pregnancy”?
- Cognitive restructuring
- Emotional liability and mood changes
- Ambivalence
Psychological adaptations to pregnancy for the mother: Reordering personal relationships. What are the 2 most important relationships discussed here?
- Womans relationship with her mother is significant in adaptation to motherhood and pregnancy
- The relationship with the father of the child is the most important and there are 2 major needs: feeling loved and valued and having the child accepted by the partner
Psychological adaptations to pregnancy for the mother: What are the 3 parts to establishing a relationship with the fetus and what must the mother be able to say in each one?
- Accepts biologic fact of pregnancy. “I am pregnant”
- Accepts growing fetus as distinct from herself. “I am going to have a baby”
- Prepares realistically for birth and parenting of a child. “I am going to be a mother”
What are the frequency of clinic visits for a pregnant woman?
1-28 weeks: q 4 weeks
29-36 weeks: q 2 weeks
36 weeks- term: q 1 week
Post term: 2x/week with fetal monitoring
What is the exercise to help with back pain?
Pelvic tilt (rock)
How can a woman relieve leg cramps?
- Another person dorsiflex the foot with knee extended
2. Woman stands and leans forward, dorsiflexing foot of affected leg
How should woman lift things off floor ?
Use leg muscles to reach objects on or near the floor; bend at the knees, not at the back; feet 12-18 inches apart, lift with legs
How many fetal movements does the fetus make in the 3rd trimester?
~30 each hour and mom can recognize 70-80% of them
Kick counts: What is the fetal alarm signal?
Fetal movements cease entirely for 12 hours
A count fewer than __ fetal movements w/in one hour warrants further evaluation by a nonusers test or a contraction stress test and a complete biophysical profile
Fewer than 3 w/in an hour
What is it important to remember when doing kick counts?
Movements are NOT present during the fetal sleep cycle
Fetal movements may also be reduced if woman is taking depressant meds, drinking, alcohol, or smoking
Fetal movements DO NOT decrease near term
Obesity decreases perception of fetal movements
What does the biophysical profile include?
AFV
FBM
Fetal movements
Fetal tone reflecting current CNS status
Why is BPP used?
It is considered a physical exam of the fetus and is used frequently during the late 2nd and 3rd trimester because it is a reliable predictor of fetal well being
What is considered a normal BPP?
8 or 10 with normal AFV
What test is done to obtain amniotic fluid, which contains fetal cells and when is this test done?
Amniocentesis; possible to do this after week 14 of preg
What are the indications for amniocentesis?
Genetic concerns (congenital anomalies, NTD), fetal maturity, fetal hemolytic disease
The insertion of a needled directly into a fetal umbilical vessel, preferably the vein, under ultrasound guidance
PUBS (percutaneous umbilical blood sampling)
What is the most common indication for PUBS?
Evaluation of mosaic results found on amniocentesis or CVS when a sample of the fetal blood is required to determine the specific mutation
Removal of small tissue specimen from the fetal portion of the placenta. The tissue reflects the genetic makeup of the fetus
Chorionic villus sampling
Is fluid obtained from CVS?
No–a tissue specimen is; fluid is obtained from amniocentesis
When is CVS performed ideally?
10-13 weeks gestation
What is a screening tool for NTD in pregnancy?
Maternal serium alpha fetoprotein–Screening tool only!!
Diagnositc for it is amniotic fluid AFP
When is MSAFP done?
15-20 weeks gestation
What is the basis for the NST?
The normal fetus will produce characteristic HR patterns in response to fetal movement, uterine contractions, or stimulation
What is the purpose of the CST?
Identify the jeopardized fetus that was stable at rest but showed evidence of compromise after stress
Morning sickness occurs in 1st trimester. What are ways to help with this?
- Dry toast or crackers before rising in AM
- Small, frequent meals
- Avoid long periods w/o food
- Peppermint tea or peppermint candies
- Unisom 1/2 tab and Vit B6 25 mg bid
- Avoid strong odors
Fatigue occurs in 1st trimester. What is the intervention?
Plan a rest period in the day
Urinary frequency occurs in 1st tri and end of 3rd. What are the interventions?
- Increase daytime fluid intake
- Decrease evening fluid intake
- Empty bladder as soon as urge is felt
- Report any urgency, dysuria, or hemouria
Heartburn occurs in the 2nd and 3rd trimester. What are some interventions?
- Gum, mint, hard candy
- Remain in sitting position after eating
- Avoid fat, fried foods
- Avoid overeating
Heartburn
- The antacid amphoral can lead to ____.
- Maalox is okay, but can be ____.
- Zantac/tagamet..is this ok? any fetal problems?
- Amphoral–> constipation
- Maalox can get to be a habit
- Zantac/tagamet seems to be ok with not fetal ill results
What trimester does hemorrhoids and varicosities show up in?
3rd
Backache comes around 3rd trimester. What helps?
Pelvic tilt exercises to strength lower back and prevent LBP
What trimester may there be insomnia?
3rd
Leg cramps occur in 3rd trimester. What are some interventions?
- Straighten leg and dorsiflex foot
- Avoid extending toes
- Massage and warm packs
- Decrease milk to no more than 1 pint a day with a calcium carbonate supplement OR decrease milk to no more than 1 qt a day with AL hydroxide gel
What is the intervention for supine hypotensive syndrome?
Avoid sleeping on the back
What trimester is there the discomfort of vaginal discharge?
2nd
What trimester is there the discomfort of skin changes?
All
What are interventions for nasal stuffiness?
Cool air vaporizer
Avoid nasal sprays that contain oxytocin
Decreased fetal movement is a danger signal of pregnancy. What is the intervention we do?
Drink some OJ and if the baby still hasn’t moved by 30 minutes, go to the doc!
