Confirmation of pregnancy

Question 1

PRESUMPTIVE SIGNS

Answer 1

Subjective signs
Amenorrhea (most common cause of secondary amenorrhea is pregnancy)
Fatigue
N/V
Urinary frequency
Breast and skin changes
quickening/fetal movement (feels like little gas bubbles) usually around 20 weeks

changes the woman experiences

Period absent
Really tired
Enlarged breast
Sore breast
Urination increasred
Movement perceived (quickening)
Emesis & Nausea

Question 2

PROBABLE SIGNS

Answer 2

Objective signs **
Abdominal enlargement
Chadwick’s sign **→ bluish color of vagina (6-8wks)
Goodell’s sign → softening of cervix (5wk)
Ballottement ( If the fetus is present and floating, it will move away from the touch and then “bounce” back to the original position.) (16 wks)
Hegar’s sign ( early clinical sign of pregnancy that refers to the softening of the lower part of the uterus (the isthmus) around 6 to 12 weeks of gestation)
Braxton Hicks contractions
Palpation of baby
Pregnancy tests

Objective findings that can be documented

Positive pregnancy test
Returinging of fetus when uterus pushed w/finger (ballottement)
Outline of fetus palpated
Braxton Hick’s Contractions
A softening of cervix “goodell sign”
Bluish color vagina, cervix “Chadwick sign”
Lower uterine segment soft “Hegar’s sign”
Enlarged uterus

Question 3

POSITIVE SIGNS

Answer 3

Associated w/ fetus
Visualization of baby by ultrasound
Auscultation of baby’s heartbeat
Palpation of baby
THESE ARE THE ONLY ACCURATE WAYS TO DETERMINE PREGNANCY → NEED TO VISUALIZE FETUS

Only caused by the pregnancy, conclusive

Fetal movement
Electronic device detect
The delivery of baby
Ultrasound detects baby
See visibly see baby

Question 4

PRECONCEPTION CARE

Answer 4

initial vist: determine the EDC
history intake
determine gravida and para
perform physical exam
take VS, BP should remain NO MORE than 30 pts systolic and 15 pts diastolic from preg baseline
test urine for protein/glucose** EACH VISIT**
check FHT

Question 5

PRENATAL CARE

Answer 5

Conception until 28 wks: every month ( 4 wks)
28 wks until 36 wks: every 2 wks
36 wks until delivery: weekly

Timing of visits

nursing care for each visits includes:
gestational age
urine dipstick for glucose/protein
maternal BP and weight ( to assess gain)
Fundal height
FHT
Fetal movement

Question 6

LAB DATA

Answer 6

CBC: Hgb (>11) & Hct (>33), Plt
WBC diff ( for baseline)
Hgb electrophoresis ( for sickle cell pts)
PAP and cytology ( for gonorrhea and chlamydia)
Antibody screens: HIV, Hep B, toxoplasmosis, rubella titer (.1.10 = immunity) PPD, CMV
Rh and blood type: important

Question 7

Rho Gam

Answer 7

Rh - mom will recieve Rho -GAM at 26-28 wks as precaution for possible Rh + fetus
inhibts sensitization against any fetal Rh+ antigen which may enter maternal bloodstream
given 72 hours after birth of infant is Rh +

Question 8

Pyschological adaptation

Answer 8

Mom: varies by trimester
Dad/Partner: wide variations
Sibilings: Toddler < 2unaware, 3-12yrs:listen to HR, questions on fetal develop, include school age in preparations, Adolescents: embarrassed about sexuality

Question 9

Couvade

Answer 9

also known as sympathetic pregnancy, is a phenomenon where a male partner experiences symptoms similar to those of his pregnant partner.

Question 10

Maternal Response by trimester

1st trimester

Answer 10

uncertainty
ambivalence ( in the middle: not showing a lot of emotions)
primary focus is on herself

Question 11

Maternal Response by trimester

2nd trimester

Answer 11

Pregnancy is REAL/ quickening occurs. focus on baby
introverted about ability to care for herself/her baby
body image/sexualtiy

more happy and feel life herself during this trimester

Question 12

Maternal Response by trimester

3rs trimester

Answer 12

Vulnerable/Dependent
prepare for the birth ( CBE classes: encourage partner also)