ch 14 - psychosocial and nursing care

Question 1

framework for nursing process of care of pregnant women. assumption that theory is a developmental process, with outcome goal of bonding, competence and joy

Answer 1

maternal role attainment by rubin

Question 2

4 tasks of mother during pregnancy in maternal role attainment

Answer 2

-seeking safe passage (safe pregnancy and delivery)
-ensuring acceptance of child by others
-bonding with fetus
-learning to give of herself

Question 3

5 steps of maternal adaption to pregnancy theory

Answer 3

1. accepting pregnancy (mood swings, ambivalence)
2. identifying with the mother role (social and cultural influences)
3. reordering personal relationships (mother, husband/partner)
4. 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)
5. preparing for childbirth

Question 4

what is couvade syndrome

Answer 4

dad experiences symptoms of pregnancy along with wife (sympathetic pregnancy)

Question 5

5 steps of paternal adaptation theory in pregnancy

Answer 5

1. acceptance (announcement - accepting biological fact, moratorium - reality, focusing - negotiating role)
2. identifying with father role (social and cultural)
3. reordering relationships
4. establishing relationship with fetus
5. preparing for birth

Question 6

traditional prenatal care (frequency of visits)

Answer 6

-1st visit within first trimester
-wks 16-28: monthly visits
-wks 29-36: q2wks visits
-wks 37-birth: weekly

Question 7

recommended components for initial prenatal visit (5)

Answer 7

-interview for risk assessment (genetics, medical, nutritional, OB, environmental, psychosocial)
-calculate due dale
-physical exam
-labs and immunizations as appropriate
-pt education/health promotion

Question 8

how to determine EDD with nagele’s rule

Answer 8

1st day of LMP - 3 months + 7 days + 1 year

Question 9

when can you hear FHTs on doppler and fetascope

Answer 9

doppler: 10-12 wks
fetascope: 16-20 wks

Question 10

most reliable due date predictor

Answer 10

1st trimester ultrasound

Question 11

whats included in follow up prenatal visits

Answer 11

-physical exam
-fetal assessment
-labs/tests

Question 12

contraindications to breastfeeding

Answer 12

-use of street drugs
-HIV
-rare Rx med

Question 13

what does the pinch test confirm

Answer 13

inverted nipple

Question 14

3 types of “lies” of baby during pregnancy

Answer 14

longitudinal
oblique
transverse

Question 15

what to know about leopolds maneuvers

Answer 15

-use palms of hands
-smooth deep movements
-determines baby’s position in uterus

Question 16

normal discomforts of pregnancy

Answer 16

-N/V
-heartburn
-round ligament pain
-leg cramps
-hemorrhoids
-constipation
-backache
-leukorrhea
-ptyalism

Question 17

Tx suggestions for N/V

Answer 17

-diet recommendations (eat carbohydrate right in the morning)
-call dr when can’t keep anything down for 24 hrs

Question 18

prevention of UTIs suggestions

Answer 18

-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

Question 19

S+S potential complications in 1st trimester

Answer 19

-severe vomiting
-chills, fever
-burning on urination
-diarrhea
-abdominal cramping, vaginal bleeding

Question 20

S+S potential complications in 2nd/3rd trimester

Answer 20

-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

Question 21

what is included in TORCH titre

Answer 21

toxoplasmosis
syphilis
rubella
cytomegalovirus
herpes complex
other: HIV, hep A and B, parvovirus, varicella

Question 22

what is Rh disease

Answer 22

-Rh- mom produces antibodies to attack Rh+ baby
-red blood cells are too big to cross placenta, but antibodies can

Question 23

what is indirect coombs test

Answer 23

tests for Rh antibodies in Rh- mothers blood

Question 24

what med blocks maternal production of Rh antibodies in response to Rh antigen presence?
when does mom need to receive this med?

Answer 24

-RhoGam (Rho D immunoglobulin)
-within 72 hours after birth, trauma, amniocentesis, miscarriage, and at 28 wks gestation

Question 25

STIs tested for during pregnancy (4)

Answer 25

syphilis
chlamydia
gonorrhea
HIV

Question 26

microorganism found in vagina
can cause high neonatal morbidity, mortality, and premature labor

Answer 26

GBS

Question 27

when are pregnant women tested for GBS

Answer 27

35-37 weeks

Question 28

risk factors GBS

Answer 28

-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

Question 29

when are pregnant women tested for diabetes

Answer 29

26-28 weeks: 1 hr GST
3 hr GTT test if abnormal result