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MATERNAL AND CHILD NURSING (RLE) > Module 01: Antenatal Care > Flashcards

Module 01: Antenatal Care Flashcards

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1
Q

This is known as the comprehensive health supervision of a pregnant woman before delivery. It is planned examination, observation and guidance given to the pregnant woman from conception until the time of delivery.

A

Antenatal Care

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2
Q

What are the importance of antenatal care?

A

(1) To ensure that the pregnant woman and her fetus are in the best possible health.
(2) To detect early and treat properly complications.
(3) Offering education for parenthood.
(4) To prepare the woman for labor, lactation, and care for her infant.
(5) To reduce the maternal and perinatal mortality and morbidity rates.
(6) To improve the physical, emotional, and mental health of women and children
(A) Stress = cortisol release = higher BP = vasoconstriction = fetal demise

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3
Q

When is the first schedule of antenatal care?

A

The first visit should be made as early is pregnancy made possible. This is essential for early assessment and planning.

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4
Q

What are the number of return visits for antenatal care?

A

(1) Once every month until 28 weeks
(2) Once every two weeks until 36 weeks
(3) Once every week until labor

DOH : 6 visits within pregnancy
WHO: 8 visits within pregnancy

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5
Q

What constitutes assessment in antenatal care?

A

(1) History
(2) Examination
(3) Investigation

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6
Q

What should the nurse take note of when obtaining data regarding patient history?

A

(1) Personal history
(2) Family history
(3) Medical and surgical history
(4) Menstrual history
(5) Obstetrical history
(6) History of present pregnancy

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7
Q

What tool is utilized when obtaining in the obstetrical history of the patient?

A

OB SCORE: GT PALM
(Gravida, Term, Preterm, Abortion, Live, Multiple Pregnancies)

(A) Gravida: Number of pregnancies
(B) Term: Full term pregnancies (37 to 40 weeks)
(C) Preterm deliveries: 20 to 36 weeks)
(D) Abortions and miscarriages (before 20 weeks)
(E) Living Children
(F) Multiple pregnancies

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8
Q

What tools are utilized when obtaining the age of gestation (AOG) in weeks?

A

(1) Bartholomew’s rule
(2) Mc Donald’s rule

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9
Q

Based on Bartholomew’s rule. the age of gestation is concluded to be three months assuming that the case is normal when?

A

Above the symphysis 1/2 from the umbilicus.

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10
Q

Based on Bartholomew’s rule. the age of gestation is concluded to be four months assuming that the case is normal when?

A

3/4 from the umbilicus

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11
Q

Based on Bartholomew’s rule. the age of gestation is concluded to be five months assuming that the case is normal when?

A

Level of the umbilicus.

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12
Q

Based on Bartholomew’s rule. the age of gestation is concluded to be six months assuming that the case is normal when?

A

1/4 from the umbilicus to the xyphoid process

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13
Q

Based on Bartholomew’s rule. the age of gestation is concluded to be seven months assuming that the case is normal when?

A

1/2 from the umbilicus to the xyphoid process

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14
Q

Based on Bartholomew’s rule. the age of gestation is concluded to be eight or ten months assuming that the case is normal when?

A

3/4 from the umbilicus to the xyphoid process

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15
Q

This rule utilized to attain the patient’s age of gestation (AOG) in weeks focuses on the level of fundus uteri at different weeks.

A

McDonald’s rule

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16
Q

Based on Bartholomew’s rule. the age of gestation is concluded to be nine months assuming that the case is normal when?

A

Just at the xiphoid process

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17
Q

How is fundal height measured?

A

From the pubic symphysis to the top most portion of the uterus (measured in centimeters).

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18
Q

How do you compute for the number of months under the McDonald’s rule?

A

Fundic height in cm/3.5 = months

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19
Q

Based on physical examination under antenatal care, what height is an indication of an average sized pelvis?

A

Height of over 150cm

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20
Q

What is the approximate weight gain during pregnancy?

A

20kg
(A) 2kg in the first 20 weeks
(B) 10kg in the remaining 20 weeks
(C) 1.5kg per week until term

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21
Q

The fundal height should be measured and recorded at each antenatal appointment from how many weeks?

A

24 weeks (Should be recorded at each antenatal appointment to check along with the Mcdonald’s rule. If no weight gain, the baby may not be growing or malnourished, it can be genetics or unwanted pregnancy)

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22
Q

Fetal presentation should be assessed by abdominal palpation at how many weeks?

A

36 weeks

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23
Q

Under physical examination, fetal heart sounds should be heard as early as which week of pregnancy?

A

10th week of pregnancy (using a sonicaid or a doppler)

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24
Q

Under physical examination, fetal heart sound should be heard by a Pinard’s heart stethoscope after what week of pregnancy?

A

20th week of pregnancy

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25
Q

How many fetal kick count should a pregnant woman report in 12 hours?

A

At least 10 movements in 12 hours

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26
Q

What happens when there is an absence of fetal movement?

A

Absence of fetal movements precedes intrauterine fetal death by 48 hours.

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27
Q

The mother’s urine should be tested for what?

A

Urine should be tested for ketones and protein.

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28
Q

What does the WHO ANC guideline state?

A

An ultrasound scan before 24 weeks of gestation is recommended for all pregnant woman.

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29
Q

Why is an ultrasound scan before 24 weeks of gestation recommended for all pregnant woman?

A

(1) Estimate gestational age
(2) Detect fetal anomalies and multiple pregnancies
(3) Enhance the maternal pregnancy experience

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30
Q

When is an ultrasound scan after 24 weeks of gestation (late gestation) is not recommended for pregnant women?

A

When the pregnant woman already conducted an early ultrasound scan.

(Early stakeholders should consider offering a late ultrasound scan to pregnant women who have not hand an early ultrasound scan)

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31
Q

What should be included under the nurse’s health teaching during the first trimester?

A

(1) Physiological changes during pregnancy
(2) Weight gain
(3) Fresh air and sunshine
(4) Rest and sleep
(5) Diet
(6) Daily activities, exercises, and relaxation
(7) Hygiene and teeth
(8) Bladder and bowel
(9) Sexual counseling
(10) Smoking
(11) Medications
(12) Infection and Irradiation
(13) Occupational and environmental hazards
(14) Travel
(15) Follow-up
(16) Minor discomforts and signs of potential complications

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32
Q

This is known as the abdominal palpation for the fetal position. This is a systematic method of observation and palpation to determine fetal presentation and position and are done as a part of physical examination during the prenatal period.

A

Leopold’s Maneuver

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33
Q

What does the Leopold’s maneuver determine?

A

(1) Fetal position
(2) Fetal presentation
(3) Engagement
(4) Number of fetuses

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34
Q

What consists the Leopold’s maneuver?

A

It consists of four distinct actions that determine the position and estimate the birth weight of a fetus inside the uterus, and the shape of the maternal pelvis. It can also indicate whether the delivery is going to be complicated, or whether a caesarean section is necessary.

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35
Q

What are the purpose of the Leopold’s maneuver?

A

(1) Determine the position of the baby in the uterus.
(2) Determine the expected presentation during labor and delivery.
(3) To aid in location of fetal hear rates.
(4) TO aid in assessment of fetal size.
(5) To determine a single vs multiple gestation.

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36
Q

This is known as the relationship between the long (cephalocaudal) axis of the feal body and the long axis of the woman’s body. In other words, this states whether the fetus is lying horizontal (transverse) or vertical (longitudinal).

A

Fetal Lie

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37
Q

This type of fetal lie is when the long axis of the baby is parallel to the long axis of the woman. This is the only normal position

A

Longitudinal (These are commonly classified as cephalic, which means that the fetal head will be the first part to be contact to the cervix, or breech, with a foot or buttocks as the first portion to contact the cervix)

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38
Q

This type of fetal lie is when the log axis of the fetus is perpendicular to that of the mother’s.

A

Transverse

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39
Q

This type of fetal lie is when the long axis of the fetus is 0 to 90 degrees (or 90 to 180 degrees) to that of the mother’s.

A

Oblique

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40
Q

This denotes the body part that will first contact the cervix or be born first and is determined by the COMBINATION OF FETAL LIE AND THE DEGREE OF FETAL FLEXION (ATTITUDE).

A

Fetal Presentation

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41
Q

This type of presentation is the most frequent type of presentation, occurring as often as 96% of the time. With this type of presentation, the fetal head is the body part that first contacts the cervix.

A

Cephalic Presentation

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42
Q

What are the four (4) types of cephalic presentation?

A

(1) Vertex
(2) Brow
(3) Facial
(4) Mentum

43
Q

Why is vertex presentation known as the most ideal?

A

Because the skull bones are capable of effectively molding to accommodate the cervix. This exact fit may actually aid in cervical dilatation as well as prevent complications such as a prolapsed cord.

44
Q

This condition is characterized when a portion of the cord passes between the presenting part and the cervix and enters the vagina before the fetus.

A

Prolapsed Cord

45
Q

This type of cephalic presentation occurs when the head is sharply flexed, making the parietal bones or the space between the fontanelles (the vertex) the presenting part.

A

Vertex (allows the suboccipitobregmatic diameter to present to the cervix)

46
Q

This type of cephalic presentation occurs when the head is only moderately flexed, the brow or sinciput becomes the presenting part.

A

Brow or Sinciput

47
Q

This type of cephalic presentation may occur when the fetus has extended the head to make the face the presenting part. From this position, extreme edema and distortion of the face may occur.

A

Facial

48
Q

This type of cephalic presentation occurs when the fetus has highly extended the head to make the chin the presenting part.

A

Mentum

49
Q

This condition occurs when the fetal skull that contacts the cervix becomes edematous from the continue pressure.

A

Caput succedaneum

50
Q

This type of presentation means that either the buttocks or the feet are the first body parts that will contact the cervix. AFFECTED BY FETAL ATTITUDE OR VERTEX PRESENTATIONS.

A

Breech Presentations

51
Q

What does a good attitude bring or mean in breech presentation?

A

A good attitude brings the fetal knees up against the fetal abdomen.

52
Q

What does a poor attitude bring or mean in breech presentation?

A

A poor attitude means the knees and legs are extended.

53
Q

This type of breech presentation occurs when the fetus has the thighs tightly flexed on he abdomen; both buttocks and the tightly flexed feet present to the cervix.

A

Complete Breech Presentation

54
Q

This type of breech presentation occurs when neither the thighs nor lower legs are flexed. One or both feet extended downward and may enter the birth canal

A

Footling (If one foot presents, it is a single-footling breech; if both present, it is a double- footling breech.)

55
Q

This type of breech presentation occurs when the the hips are flexed, but the knees are extended to rest on the chest. The buttocks alone present to the cervix.

A

Frank Breech Presentation

56
Q

This pertains to the relationship of the fetal parts to each other.

A

Attitude
(May be flexed or extended)

57
Q

This is known as the relationship of the presenting part to a specific quadrant and the side of a woman’s pelvis.

A

Fetal position (Four parts of a fetus are typically chosen as landmarks to describe the relationship of the presenting part to one of the pelvic quadrants.)

58
Q

In the vertex presentation, the _______ is the chosen point.

A

Occiput (O)

59
Q

In a face presentation, it is the _______ known as the chosen point.

A

Chin (mentum [M])

60
Q

In a breech presentation, it is the ______ known as the chosen point.

A

Sacrum (Sa)

61
Q

In a shoulder presentation, it is the ____________ known as the chosen point.

A

Scapula or the acromion process (A).

62
Q

What does the first and last letter denote under fetal position?

A

(1) The first letter defines whether the landmark is pointing to the mother’s right (R) or left (L).
(2) The last letter defines whether the landmark points anteriorly (A), posteriorly (P), or transversely (T).

63
Q

What are the two (2) most common fetal positions?

A

(1) Left Occipitoanterior (LOA) position
(2) Right Occipitoanterior (ROA) position

64
Q

This is usually determined by the amount of head that is above or below the pelvic floor.

A

Engagement

65
Q

How is engagement determined?

A

This is usually done by dividing the head into fifths. If the head is still palpable abdominally, it is 2/5 or less engaged.

66
Q

What should you do to your patient prior to executing the Leopold’s maneuver?

A

Explain the procedure and instruct the patient to empty their bladder.

(Explanation reduces anxiety and enhances cooperation. Am empty bladder promotes comfort and allows for more productive palpation because fetal contour will not be obscured by distended bladder)

67
Q

Why should the nurse wash their hands using warm water and provide privacy prior to the procedure?

A

Handwashing prevents the spread of infection. Using warm water aids in patient comfort and prevents tightening of abdominal muscles during palpation.

68
Q

What is the rationale of positioning the patient supine with knees slightly flexed and placing a small pillow or rolled towel under their left side?

A

Flexing the knees relaxes the abdominal muscles. Using a pillow or a towel tilts the uterus off the vena cava, preventing supine hypertension syndrome

69
Q

What is the rationale of observing the woman’s abdomen as to which is the longest diameter and where fetal movement is apparent?

A

The longest diameter is the length of the fetus. The location of activity most likely reflects the position of the effect.

70
Q

How should the first maneuver be executed?

A

Stand at the foot of the woman, facing her, and place both hands flat on her abdomen. Palpate the superior surface of the fundus.

71
Q

What should you determine during the first maneuver?

A

Fetal presentation (Consistency, shape and mobility)

Head: Round, Hard, and Firm
Buttocks: Soft
Shoulder: Flattened, broad mass

72
Q

This maneuver determines whether the fetal head or breech is in the fundus. A head is more firm and is round and hard, and move independently of the body while the breech feels softer and moves in conjunction with the body.

A

First maneuver

73
Q

How should you execute the second maneuver?

A

Face the woman, hold the left hand stationary on the left side of the uterus while you palpate with the right hand on the opposite side of the uterus from top to bottom. Repeat palpation using the opposite side.

74
Q

What does the second maneuver locate?

A

The second maneuver locates the back of the fetus. The fetal back feels like a smooth, hard and resistant surface.

75
Q

This maneuver locates the back of the fetus. The fetal back feels like a smooth, hard, and resistant surface; the knees and elbows of the fetus on the opposite side feel more like a number of angular bumps or nodules.

A

Second Maneuver

76
Q

How should you perform the third maneuver

A

Gently grasp the lower portion of the abdomen just above the symphysis pubis between the thumb and fingers and try to press the thumb and finger together. Determine any movement and whether the part feels firm or soft.

77
Q

What does the third maneuver determine?

A

This maneuver determines which part of the fetus is at the inlet and its mobility.

78
Q

Under the third maneuver, what does it indicate when the presenting part moves upward so your fingers and thumb can be pressed together?

A

The presenting part is not engaged (not firmly settled into the pelvis).

79
Q

Under the third maneuver, what does it indicate if the part is firm?

A

If the part is firm, it is the head; if soft, then it is the breech.

80
Q

How do you execute the fourth maneuver?

A

Place fingers on both sides of the uterus approximately 2 in. above the inguinal ligaments, pressing downward and inward in the direction of the birth canal. Allow fingers to be carried downward.

81
Q

The fourth maneuver can only be executed when the fetus is in what presentation?

A

In a cephalic presentation because it determines fetal attitude and degree of fetal extension into the pelvis.

(The position of the fetal brow should correspond to the side of the uterus that contained the elbows and knees of the fetus.)

82
Q

Under the fourth maneuver, what does it indicate if the fetus is in a poor attitude?

A

The examining fingers will meet an obstruction on the same side as the fetal back; that is, the fingers will touch the hyperextended head.

83
Q

Under the fourth maneuver, what does it indicate if the brow is very easily palpated?

A

The fetus is probably in a posterior position (the occiput is pointing toward the woman’s back).

84
Q

What is the normal duration for pregnancy?

A

Normal Duration: 38 weeks to 40 weeks
Concern: Pregnancies before 37 weeks or beyond 40 weeks may indicate complications.

85
Q

This is characterized as the first pregnancy with an uncomplicated pregnancy.

A

Nulliparous (first time pregnant women) with a schedule of 10 appointments to monitor and ensure a healthy pregnancy as this is their first experience.

86
Q

This is characterized as multiple pregnancies or women who have not pregnant before with an uncomplicated pregnancy.

A

Parous (women who have been pregnant before) with a schedule of 7 appointments to monitor pregnancy (which often lead to fewer complications).

87
Q

This data includes the general health information, lifestyle factors and any other personal data relevant to pregnancy.

A

Personal history. (e.g. Age, allergies, past medications, gender, race, blood type, anthropometric, income and employment)

88
Q

This data includes any information on genetic conditions, inherited disorders, and any significant familial health issues.

A

Family history

89
Q

This data includes details on past medical conditions, surgeries, and any treatments that might impact pregnancy.

A

Medical and surgical history (e.g incisions, respiratory problems)

90
Q

This significant data includes information regarding the woman’s menstrual cycle patterns, last menstrual period, and any abnormalities.

A

Menstrual History

91
Q

This significant data includes information on the woman’s previous pregnancies, outcomes, and any complications experienced, and the details of childbirth.

A

Obstetrical History (e.g. pregnancies, abortion, and OB score)

92
Q

This significant data includes information on the current pregnancy details, any complications so far, and how the pregnancy went.

A

History of Present Pregnancy

93
Q

This is known as the death or loss of a baby before or during delivery.

A

Stillbirth

94
Q

What happens when a mother is due and has not conducted any physical examination or antenatal appointment at 37 weeks?

A

An emergency C section will be performed if there are no antenatal appointments at 37 weeks.

95
Q

What should occur at 41 weeks time span?

A

Prior to the formal induction of labor, the woman should be offered a vaginal examination for membrane sweeping or cervix stimulation.

96
Q

What should occur at 42 weeks time span?

A

Check the meconium stain which is indication that fluids are infected with fecal discharges

97
Q

This pertains to the orientation of the fetus in the uterus (e.g. transverse or longitudinal).

A

Fetal Position

98
Q

This pertains to whether the fetal head or the other presenting part is engaged in the pelvic inlet.

A

Engangement

99
Q

This pertains to the part of the fetus that is presenting in the pelvic inlet (e.g. head or breech).

A

Fetal presentation

100
Q

What are the different types of fetal attitude?

A

(A) Flexed
(B) Deflexed
(C) Extended

101
Q

This fetal attitude occurs when the fetal head is flexed with the chin near the chest. This is the most favorable attitude for delivery.

A

Flexed

102
Q

This fetal attitude occurs when the head is neither fully flexed nor extended. It can be more challenging for delivery.

A

Deflexed

103
Q

This fetal attitude occurs when the fetal head is extended backward, with the face or brow presenting. This is characterized to be complicated for delivery.

A

Extended

104
Q

This type of breech presentation occurs when one or both legs are extended and the buttocks are presenting in the pelvis. The fetal position is not fully flexed.

A

Incomplete Breech

MATERNAL AND CHILD NURSING (RLE) (3 decks)

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