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Maternal- Newborn & Women's Health Nursing > Chapter 7 > Flashcards

Chapter 7 Flashcards

Exam 1

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1
Q

What are the goals of preconception?

A

To promote the health and well-being of a woman and her partner BEFORE pregnancy.

Identify and modify biomedical, behavioral, and social risks to a woman’s health or pregnancy outcome through prevention and management intervention.

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2
Q

Preconception Care- Immunization status

A

up to date

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3
Q

Preconception Care- Underlying medical conditions

A

DM; Asthma (controlled or uncontrolled)

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4
Q

Preconception Care- Reproductive Health Care Practices

A

Contraceptive habits

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5
Q

Preconception Care- Sexuality and Sexual Practices

A

At risk for STIs

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6
Q

Preconception Care- Nutrition

A

Prenatal vitamin usage

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7
Q

Preconception Care- Environment Health Assessment

A

Environmental hazards

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8
Q

Preconception Care- Psychosocial Issues

A

Stress level

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9
Q

Preconception Care- Medication and Drug Use

A

OTC and Prescription

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10
Q

Preconception Care- Support System

A

Partner, spouse, family member, friend

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11
Q

1st Prenatal Visit

A

-Establishment of trusting relationship
-Verify or rule out pregnancy
-Establish baseline data for comparison with future visits
*Testing- labs, pregnancy test
-Evaluate psychosocial needs
*do they want a baby?

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12
Q

Comprehensive Health History

A

-Reason for seeking care
*Suspicion of pregnancy
*Date of last menstrual period
*Signs and symptoms of pregnancy
*Urine or blood test for hCG
-Past medical, surgical, and personal history
-Woman’s reproductive history: menstrual, obstetric, and gynecologic history

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13
Q

Obstetric History

A

Gravida
-Gravida 1 (primigravida): first pregnancy
-Multigravida: pregnant more than once
Para
-Primapara: Given birth once after at least 20 wks gestation (“primip”)
-Multipara: Two or more pregnancies of at least 20 wks gestation (“multip”)

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14
Q

Gravida

A

the total number of times a woman has been pregnant

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15
Q

Term Births

A

the number of pregnancies ending >37 wks gestation, at term

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16
Q

Preterm Births

A

the number of preterm pregnancies ending >20 wks or viability but before completion of 37 wks

17
Q

Abortions

A

the number of pregnancies ending before 20 wks or viability

18
Q

Living Children

A

number of children currently living

19
Q

GTPAL

A

G- Gravida
T- Term births
P- Preterm births
A- Abortions
L- Living Children

20
Q

Menstrual History

A

-Date of LAST MENSTRUAL PERIOD (LMP)
-Calculation of estimated or EXPECTED DATE OF BIRTH (EDB) OR ESTABLISHED DUE DATE (EDD)
-Nagele’s Rule
*Use first day of LMP
*Subtract 3 months
*Add 7 days
*Add 1 year
Gestational or birth calculator or wheel
Ultrasound is best method of dating a pregnanct

21
Q

LMP

A

Last Menstrual Period

22
Q

EDB

A

Expected Date of Birth

23
Q

EDD

A

Expected Due Date

24
Q

Nagele’s Rule

A

*Use first day of LMOP
*Subtract 3 months
*Add 7 days
*Add 1 year

25
Q

Murmur

A

Can be a normal occurrence during pregnancy

26
Q

Physical Examination: Abdomen

A

-Fundal height if approp. and FHR (@10-12 wks)- Uterine measurements include the distance between the upper border of the symphysis pubis and the top of the fundus- in centimeters

27
Q

Physical Examination- Pelvic Exam

A

-Examination of external and internal genitalia
-Pelvic shape: gynecoid, android, anthropoid, platypelloid
-Pelvic measurements: done to determine whether the shape and size of the bony pelvis are adequate for a normal birth

28
Q

Lab Tests (table 7.1)

A

-Urinalysis
-CBC
-Blood typing
-Rh factor
-Rubella titer
-Hep B surface antigen (HbsAg)
-HIV, VDRL, and RPR testing
-Cervical smears
-Ultrasound (abd & transvag)

29
Q

F/U Visit Schedule

A

*Conception to 28 wks: Every 4 wks
*29 to 36 wks: every 2 wks
*37 wks to birth: weekly

30
Q

fundal height

A

Uterine measurements include the distance between the upper border of the symphysis pubis and the top of the fundus (in cm)

31
Q

F/U appt: Assessment

A

-Weight and BP- compare to baseline
-Urine testing for protein, glucose, ketones, and nitrites
-Fundal height
-Quickening/ fetal movement: 16- 20 wks
-Fetal Heart rate (FHR): 110-160 bpm
-Teaching: danger signs
-Screening for Gestational Diabetes: 24- 28 wks

32
Q

Signs of Possible Pregnancy Complications

A

*Vaginal bleeding with or without discomfort: Spontaneous abortion, placenta previa, placental abruption, lesions of the cervix or vagina, “bloody show”
*Escape of fluid from the vagina: Rupture of membranes
*Swelling of the fingers (rings become tight) or puffiness of the face or around the eyes: Excessive edema, preeclampsia
*Continuous pounding headache: Chronic hypertension or preeclampsia
*Visual disturbances (such as blurred vision, dimness, flashing lights, spots before the eyes): Worsening preeclampsia
*Seizures: Eclampsia
*Persistent or severe abdominal or epigastric pain: Ectopic pregnancy (if early), worsening preeclampsia, placental abruption
*Chills or fever: Infection
*Painful urination: Urinary tract infection, pyelonephritis
*Persistent vomiting: Hyperemesis gravidarum
*Change in frequency or strength of fetal movements: Fetal compromise or death
*Signs or symptoms of preterm labor: Uterine contractions, cramps, constant or irregular low backache, pelvic pressure, watery vaginal discharge: Labor onset

33
Q

Table 7.3 Factors and the Associated Problems

A

read over

34
Q

1st Trimester Discomforts

A

*Nausea and vomiting
*Heartburn
*Fatigue
*Breast tenderness
*Constipation
*Nasal stuffiness, bleeding gums, epistaxis (nose bleed)
*Urinary frequency
*Leukorrhea (white discharge- normal)

35
Q

2nd Trimester Discomforts

A

*Backache
*Varicosities of the vulva and legs
*Hemorrhoids
*Flatulence with bloating

36
Q

3rd Trimester Discomforts

A

*Return of 1st trimester discomforts
*Shortness of breath and dyspnea
*Heartburn and indigestion
*Dependent edema
*Braxton Hicks contractions

37
Q

Nursing Management to Promote Self-Care

A

*Personal hygiene
*Avoidance of saunas and hot tubs
*Perineal care
*Dental Care
*Breast care
*Clothing
*Exercise
*Sleep and rest
*Sexual activity and sexuality
*Employment
* Travel
*Exposure to teratogens
*Immunizations and medications

38
Q

Prep for Labor, Birth, and Parenthood-
Education Classes

A

*Perinatal education: goal is to reduce fear of unknown and help parents make informed decisions
*Parenting or Sibling Classes
*Childbirth Education
-Lamaze (pyschoprophylatic) method: focus on breathing and relaxation techniques to block pain
-Labor partner or coach
-Birth plan (Box 7.3) (Box 7.4)
*Options for birth setting
-Hospitals: delivery room, birthing suite
-Birth centers
-Home birth
*Options for care providers
-Obstetrician
-Midwife
-Doula
*Feeding choices
-breast-feeding: advantages and disadvantages
-bottle feeding: advantages and disadvantages
-Teaching
*Final Prep for labor and birth

39
Q
A

Maternal- Newborn & Women's Health Nursing (16 decks)

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