chapter 7: promoting a healthy pregnancy ppt Flashcards
1
Q
focus on the pt
A
- the pregnant woman will experience a lot of hormonal and physiological changes in her body that will cause physical discomfort
- she will have questions on: maintaining her health, managing the discomforts of pregnancy, providing self care, ensuring safety for herself and her fetus, relief of common discomforts of pregnancy
2
Q
promotion of self care during pregnancy
A
- self care is personal, medical care performed voluntarily by the pt
- most pregnant women are motivated to learn self care by reading and researching, but some may be inaccurate
- nurses have an important role in supporting self care by providing accurate information
- empowers the woman to make healthy lifestyle choices to maintain or improve her health and of her fetus
- personal hygiene: excessively hot showers/baths may cause hyperthermia and may cause neural tube defects
- breast care
- clothing
- exercise
3
Q
breast care
A
- daily shower or bath for breast cleanliness
- colostrum may crust on the nipples during late pregnancy and can be removed with a washcloth and warm water
- avoid using strong soap due to its drying effect
- wear a well fitting bra to prevent back strain and to retain breast shape
4
Q
clothing
A
- loose enough to allow movement and circulation
- avoid high heeled shoes due to risk of falling
5
Q
exercise
A
- safe and beneficial
- prevents excess in maternal weight gain
- promotes normal fetal growth
- prevents gestational diabetes
- decreases the risk of preeclampsia
- stop exercising and see your provider if you experience: dizziness, fluid leaking from vagina, bleeding from vagina, chest pain, headache, increased sob, decreased fetal movement
- yoga: avoid hot yoga classes, avoid lying flat on the abdomen or back, avoid twisting, hopping, and jumping, maintain adequate hydration
6
Q
sleep and rest
A
- fatigue increases as fetus gets larger
- incorporate rest periods during the day and have at least 8 hours of sleep at night
- use of additional pillows to support the uterus and remove the strain of the lower back
7
Q
employment
A
- pregnant women without complications can continue to work throughout the pregnancy
- avoid environmental hazards to fetal wellbeing, prolonged standing, heavy lifting
8
Q
seatbelts
A
- should be worn to protect both the mother and the fetus
- belt should be placed across the abdomen and the hip bones
- shoulder strap should be between the breasts and over the clavicle
- keep abdomen 10 in away from the air bag
9
Q
travel restrictions
A
- second trimester is the safest time
- prolonged sitting may cause thrombosis
- ambulate every 2 hours and maintain adequate hydration to decrease the risk of developing thrombosis
10
Q
dental care
A
- gums are commonly edematous and may bleed easily
- if tx is required, the dentist should be informed of the pregnancy
- x ray only if necessary and appropriate abdominal shield must be worn
11
Q
sexual activity
A
- limit or avoid sex with preterm labor; has had more than one miscarriage; has placenta previa, an infection, or bleeding; or has ruptured amniotic membranes
- try different positions for comfort as pregnancy advances
- the nurse needs to initiate the conversation w/ open ended questions and a matter of fact approach if the patient feels uncomfortable asking questions
12
Q
avoiding infections
A
- infections are major causes of maternal and fetal morbidity and mortality
- the fetus usually acquires infection by transmission through the placenta
- infections causing congenital defects are known as TORCH: toxoplasma, others, rubella, cytomegalovirus, herpes
- signs and symptoms may be apparent at birth or not until years later
13
Q
toxoplasmosis
A
- from raw or undercooked meat or through exposure to cat feces
- body aches, headache, fatigue, sore throat
- infants may develop chorioretinitis: the inflammation of the choroid and retina of the eye that can lead to blindness; obstructive hydrocephalus; mental retardation; seizures, motor delays; developmental delays
14
Q
parvovirus b19
A
- causes erythema infectiosum (fifth disease), rash with fever
- transmission is by respiratory route, through blood products, or by the placenta
- woman is often asymptomatic; neonate may have liver swelling, heart failure, jaundice, and edema of the body
15
Q
varicella-zoster virus
A
“chickenpox”
- a medical emergency in pregnancy
- airborne
- causes fever, anorexia, itchy vesicles, and pneumonitis in the pregnant patient
- causes life threatening respiratory complications, spontaneous abortion, chorioretinitis, cataracts, limb malformations, and brain dysfunction in fetus
- health teaching includes avoiding people with teh disease and keeping immunization up to date for children in the home
16
Q
rubeola (measles)
A
- causes severe consequences for the pregnant woman
- airborne route of coughing and sneezing
- symptoms include fever, cough, conjunctivitis, and rash
- may cause pneumonitis, spontaneous abortion, premature labor, and low birthweight
- travel outside of north America increases the risk o fexposure
- teach about avoiding of people with the disease and following vaccination guidelines
17
Q
HIV
A
- major cause of infant and child mortality worldwide
- CDC recommends routine 3rd trimester screening on women with high risk behaviors or symptoms of the disease
- women with HIV should be counseled on highly active antiretroviral therapy to reduce the risk of transmission to the fetus
- risk of transmission is linked to the mother’s viral load
Zidovudine is the most common medication used to reduce viral load - HAART does not show any negative effects on pregnancy and must be started as soon as possible to reduce the risk of transmission to less than 2%
- health teachings include getting tested for HIV; if positive, inform the provider; take antiretroviral medications as described; and avoida high risk lifestyle
18
Q
syphilis
A
- a sti that can cause miscarriage, premature birth, and stillbirth when acquired during pregnancy
- symptoms include painless lesions on the genitals, mouth, or rectum after unprotected sex
- patient teaching includes avoiding unprotected sex; maintaining a monogamous relationship; notifying the provider if symptoms occur
19
Q
West Nile Virus
A
- transmitted by mosquitoes
- symptoms include high fever, headache, stiff neck, tremors, seizures, and coma
- health teaching includes control of mosquitoes; use of insect repellant; and wearing long sleeved shirts and pants
