ch 14 - psychosocial and nursing care Flashcards
framework for nursing process of care of pregnant women. assumption that theory is a developmental process, with outcome goal of bonding, competence and joy
maternal role attainment by rubin
4 tasks of mother during pregnancy in maternal role attainment
-seeking safe passage (safe pregnancy and delivery)
-ensuring acceptance of child by others
-bonding with fetus
-learning to give of herself
5 steps of maternal adaption to pregnancy theory
- accepting pregnancy (mood swings, ambivalence)
- identifying with the mother role (social and cultural influences)
- reordering personal relationships (mother, husband/partner)
- establishing relationship with fetus (phase 1: accepting biological fact, phase 2: accepts growing fetus as individual from herself, phase 3: prepares realistically for birth and parenting)
- preparing for childbirth
what is couvade syndrome
dad experiences symptoms of pregnancy along with wife (sympathetic pregnancy)
5 steps of paternal adaptation theory in pregnancy
- acceptance (announcement - accepting biological fact, moratorium - reality, focusing - negotiating role)
- identifying with father role (social and cultural)
- reordering relationships
- establishing relationship with fetus
- preparing for birth
traditional prenatal care (frequency of visits)
-1st visit within first trimester
-wks 16-28: monthly visits
-wks 29-36: q2wks visits
-wks 37-birth: weekly
recommended components for initial prenatal visit (5)
-interview for risk assessment (genetics, medical, nutritional, OB, environmental, psychosocial)
-calculate due dale
-physical exam
-labs and immunizations as appropriate
-pt education/health promotion
how to determine EDD with nagele’s rule
1st day of LMP - 3 months + 7 days + 1 year
when can you hear FHTs on doppler and fetascope
doppler: 10-12 wks
fetascope: 16-20 wks
most reliable due date predictor
1st trimester ultrasound
whats included in follow up prenatal visits
-physical exam
-fetal assessment
-labs/tests
contraindications to breastfeeding
-use of street drugs
-HIV
-rare Rx med
what does the pinch test confirm
inverted nipple
3 types of “lies” of baby during pregnancy
longitudinal
oblique
transverse
what to know about leopolds maneuvers
-use palms of hands
-smooth deep movements
-determines baby’s position in uterus
normal discomforts of pregnancy
-N/V
-heartburn
-round ligament pain
-leg cramps
-hemorrhoids
-constipation
-backache
-leukorrhea
-ptyalism
Tx suggestions for N/V
-diet recommendations (eat carbohydrate right in the morning)
-call dr when can’t keep anything down for 24 hrs
prevention of UTIs suggestions
-good hygiene practices
-vitamin C to acidify urine
-cotton lined underwear
-loose clothing
-urinate before and after intercourse, and q2h
-minimum 8 glasses water/day
S+S potential complications in 1st trimester
-severe vomiting
-chills, fever
-burning on urination
-diarrhea
-abdominal cramping, vaginal bleeding
S+S potential complications in 2nd/3rd trimester
-persistent severe vomiting
-increase or change vaginal discharge
-chills, fever, burning on urination, diarrhea
-severe backache/flank pain
-change in fetal movement
-uterine contractions, pressure, cramping before 37 wks
-visual disturbances
-swelling of face and hands
-headaches: very frequent or continuous
-muscular irritability or convulsions
-epigastric/abdominal pain
what is included in TORCH titre
toxoplasmosis
syphilis
rubella
cytomegalovirus
herpes complex
other: HIV, hep A and B, parvovirus, varicella
what is Rh disease
-Rh- mom produces antibodies to attack Rh+ baby
-red blood cells are too big to cross placenta, but antibodies can
what is indirect coombs test
tests for Rh antibodies in Rh- mothers blood
what med blocks maternal production of Rh antibodies in response to Rh antigen presence?
when does mom need to receive this med?
-RhoGam (Rho D immunoglobulin)
-within 72 hours after birth, trauma, amniocentesis, miscarriage, and at 28 wks gestation
STIs tested for during pregnancy (4)
syphilis
chlamydia
gonorrhea
HIV
microorganism found in vagina
can cause high neonatal morbidity, mortality, and premature labor
GBS
when are pregnant women tested for GBS
35-37 weeks
risk factors GBS
-positive prenatal cultures
-history or current preterm birth <37 wks
-PROM >18 hrs
-IP maternal fever >38 C
-positive history of early onset neonatal GBS
when are pregnant women tested for diabetes
26-28 weeks: 1 hr GST
3 hr GTT test if abnormal result
