Ch.4 : Prenatal Care Flashcards
How often are prenatal visits scheduled?
Monthly for 7 months
Every 2 weeks for 8th month
Every week for last month
When can FHR be heard by Doppler?
10-12 weeks gestation
When can FHR be heard with ultrasound stethoscope?
16-20 weeks gestation
*listen at the midline, right above the symphysis pubis, by holding stethoscope firmly on abdomen
When do we measure fundal height?
After 12 weeks gestation
What are some common discomforts and concerns of pregnancy?
- NV
- Fatigue
- Backache
- Varicosities
- Heartburn
- Activity
- Sexuality
What does blood type, Rh factor, and preseence of irregular antibodies determine?
- Risk for maternal-fetal blood incompatibility
- Neonatal hyperbilirubinemia
What lab tests detects infection and anemia?
CBC with differential, Hgb, and Hct
What does Hgb electrophoresis determine?
Identifies SCA and thalassemia
What does the rubella titer determine?
Immunity to rubella
Why do we do Heb B screen?
Identify carriers of hep B
When is the GBS obtained?
35-37 weeks gestation
What all does urinalysis do?
Identifies:
- Preg
- Diabetes
- Gestational HTN
- Renal disease
- Infection
One hour glucose test..What is it and why do we do it?
Oral ingestion or IV of concentrated glucose with sample taken 1 hour later
- Identifies hyperglycemia
- Done at initial visit for at risk clients and at 24-28 weeks gestation for all preg women
- Dont have to fast
- Greater than 140 requires follow up!
What is the 3 hour glucose tolerance test and who gets it?
Fast overnight and do the same thing as one hour glucose test except here the sample is taken 1 hour, 2 hour, and 3 hours later
This is done on those with elevated 1 hour glucose test
How is a diagnosis of gestational diabetes done?
2 elevated blood glucose readings
Why would someone do a MSAFP?
Done 15-22 weeks gestation; used to rule out DS and NTD
Administer ______ IM around 28 weeks gestation for clients who are Rh-negative
RhO(D) immune globulin (RhoGam)
Exercise during pregnancy yields positive benefits and should consist of ____ of ____ daily if not medically or obstetrically contraindicated.
30 min of moderate exercise (walking, swimming)
What is experienced by many women with unpredictable mood changes and increasd irritability, tearfulness, and anger alternating with feelings of joy and cheerfulness?
Emotional liability
Is ambivalence about the pregnancy normal?
Yes
What does fetal movement/kick counts do?
Ascertain fetal well being
How should moms do the kick counts?
Count fetal activity 2-3 times a day for 60 minutes each time
Fetal movements of less than 3 per hour or movements that cease entirely for 12 hours indicate need for further eval
What can mom do to help with NV?
Eat crackers or dry toast 30 min-1 hr before rising in the morning
When does urinary frequency occur?
1st and 3rd trimesters
How can client prevent UTI?
- Wipe front to back
- Avoid baths
- Wear cotton underpants and avoid tight fitting ones
- Drink 8 glasses water/day
- Urinate before and after intercourse
- Urinate as soon as urge is there to prevent an environment for bacterial growth
- If urine is foul, contains blood, or appears cloudy, notify prescriber!
What can client do to help with fatigue?
Frequent rest periods
What can client do to help with heartburn?
- Small frequent meals
- Dont let stomach get too empty or too full
- Sit up for 30 min after meals
- Check with provider before starting OTC antacids
What can client do to help with constipation?
Drink plenty of fluid
Eat diet with lots of fiber
Exercise reg
What helps relieve discomfort of hemorrhoids?
Sitz bath
Withc hazel pads
Topical ointments
What exercise helps relieve backaches?
Pelvic tilt (alternatign arching and straightening the back)
How should preg lift things?
Use legs, not back
What can preg do to help leg cramps?
Dorsiflexion exercise
Heat over affected muscle or foot while leg is extended
How can preg with varicose veins rest and what else should be done?
- Rest with legs elevated
- Avoid constricting clothes
- Wear support hose
- Avoid sitting, standing in one position for too long
- Dont sit with legs crossed at knees
- Sleep left lateral
- Exercise moderately with frequent walking
What to do to help with gingivitis, nasal stuffiness, and epistaxis?
Gently brush teeth
Use humidifier
Normal saline nose drops or spray
How do Braxton Hicks contractions subside?
Change of position and walking
How should client lie to avoid supine hypotension?
Side lying or semi siting position with knees slightly flexed
Danger sign: What does gush of blood from vagina prior to 37 weeks mean?
Rupture of amnionic fluid
Danger sign: What does vaginal bleeding indicate?
Placental problems like abruption or previa
Danger sign: What can abdominal pain mean?
Premature labor
Abruptio placentae
Ectopic pregnancy
Danger sign: What would changes in fetal activity mean?
Fetal distress
Danger sign: What does persistent vomiting suggest?
Hyperemesis gravidarum
Danger signs: What are some of the danger signs that could mean gestational HTN?
Severe headache
Blurred vision
Edema of face and hands
Epigastric pain
Danger sign: What would an elevated temp mean?
Infection
Danger sign: What would dysuria mean?
UTI
A nurse is teaching a group of women who are pregnant about measures to relieve backache during pregnancy. The nurse should teach the women which of the following? (SATA)
A. Avoid any lifting
B. Perform Kegel exercises 2x/d
C. Perform the pelvic rock exercise every day
D. Use proper body mechanics
E. Avoid constrictive clothing
C, D
A client who is at 8 weeks gestation tells the nurse that she is happy about being pregnant. Which of the following is an appropriate response by the nurse to the client’s statement?
A. I will inform the provider about these feelings
B. It is normal to have these feelings during the first few months of pregnancy
C. You should be happy that you are going to bring new life into the world
D. I am going to make an appointment with the counselor for you to discuss these thoughts.
B
A nurse is caring for a client who is preg. and reviewing signs of complications that should promptly be reported to the provider. Which of the following should be included?
A. Vaginal bleeding
B. Swelling of ankles
C. Heartburn after eating
D. Lightheadedness when lying on back
A
A client who is at 7 weeks gestation is experiencing NV in the morning. The nurse in the prenatal clinic provides teaching that should include which of the following?
A. Eat crackers or plain toast before getting out of bed
B. Awaken during the night to eat a snack
C. Skip breakfast, and eat lunch after nausea has subsided
D. Eat a large evening meal
A
A nurse is teaching a group of clients who are pregnant about behaviors to avoid during pregnancy. Which of the following statements by a client indicates a need for further teaching?
A. I can have a glass of wine with dinner
B. Smoking is cause of LBW in babies
C. Signs of infection should be reported to my doc
D. I should not take OTC meds without checking with my obstetrician
A
