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Semester Three - Half Two - Nursing 212 > Module 4 - Antepartal Considerations (Exam 2) 1 > Flashcards

Module 4 - Antepartal Considerations (Exam 2) 1 Flashcards

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1
Q

Holistic Nursing Care General Considerations

A
  1. Age
  2. History
  3. Medications
  4. Emotional Health
  5. Medical Concerns
  6. Nutrition and Exercise
  7. Lifestyle and cultural influences
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2
Q

Subjective (presumptive) signs of pregnancy

A

Symptoms experienced and reported

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3
Q

Objective (probable) signs of pregnancy

A

Signs that suggest pregnancy

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4
Q

Diagnositc (positive) signs of pregnancy

A
  1. Indications percieved by CNM, NP, physician
  2. Attributable only to pregnancy
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5
Q

When does quickening happen?

A

16-18 weeks, for sure by 20 weeks

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6
Q

Subjective Signs of Pregnancy

A
  1. Fatigue
  2. Quickening
  3. Amenorrhea (no period)
  4. Breast tenderness
  5. Urinary frequency
  6. Nausea and vomiting
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7
Q

Quickening

A

Sensation of movement of the fetus

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8
Q

Objective Signs of Pregnancy

A
  1. Ballottment
  2. Skin changes
  3. Uterine enlargement
  4. Positive pregnancy test
  5. Changes in reproductive organs
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9
Q

Diagnositc Signs of Pregnancy

A
  1. Fetal Heart Sounds
  2. Fetal movement felt by examiner
  3. Ultrasonography
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10
Q

Diagnostic - Fetal Heart Sounds

A
  1. At 8-12 weeks by electronic doppler
  2. At 17-20 weeks by fetoscope
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11
Q

Diagnositc - Fetal movement felt by examiner

A

At approximately 20 weeks

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12
Q

Diagnostic - Ultrasonography

A

Fetal heart activity at ~8 weeks

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13
Q

Menstrual History

A
  1. Dating the pregnancy
  2. Conception ~ 2 weeks AFTER menses (28 day cycle)
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14
Q

Previous Pregnancy (Gravida) History

A
  1. Prenatal Course
  2. Outcomes
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15
Q

Previous Delivery (Para) History

A
  1. Intrapartal course
  2. Neonatal status
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16
Q

Gravida

A

The number of times a woman has been pregnant, regardless of duration or outcome

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17
Q

Para

A

The number of pregnancies that have ended at 20 or more weeks. Multifetal gestations are considered one birth.

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18
Q

G TPAL

A
  1. T=Term
    1. 38-42 weeks gestation
  2. P=Preterm
    1. 20-37 weeks gestation
  3. A=Abortion
    1. Either sponaneous (SAB) or elective (TAB)
  4. L=Living Children
    1. At time of assessment
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19
Q

TPAL

A

May describe pregnancies delivered. Multiple gestationscounted as one parous experience

OR

May describe infants born. Multple gestations are counted individually.

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20
Q

Gestational Age

A

Approximately 280 days or 40 weeks following the last menstrual period

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21
Q

Fertilization Age

A

Approximately 266 days or 38 weeks following fertilization

22
Q

Ways to date a pregnancy

A
  1. Nagele’s Rule
  2. Quickening
  3. Fetal Heart Tones
  4. Fundal Height
  5. Ultrasonography
23
Q

Nagele’s Rule

A
  1. Determine the first day of thelast normal menstrual period
  2. Subtract 3 months
  3. Add seven days
24
Q

Demographic Risk Factors

A
  1. <16 or >35 years of age
  2. Low socioeconomic status
25
Q

Social and/or personal Risk Factors

A
  1. Tabacco
  2. ETOH/Social illegal drug use
  3. Low pre-pregnancy weight
  4. Obesity
26
Q

Obstetrical Risk Factors

A
  1. Greater than or equal to 6 deliveries of viable infants
  2. Rh sensitization
  3. Previous Fetal/neonatal death
27
Q

Medical Risk Factors

A
  1. Diabetes
  2. Concurrent infections
  3. Hypertension
28
Q

Uterine Fundal Height 10-12 weeks

A

Above symphysis (out of pelvis, abdominal organ)

29
Q

Uterine Fundal Height at 16 weeks

A

1/2 way between symphysis and umbilicus

30
Q

Uterine Fundal Height at 20-22 weeks

A

At umbilicus

31
Q

Uterine Fundal Height at 36 weeks

A

Below xiphoid process

32
Q

If 16-38 weeks gestation than..

A

Funal height in cms ~ gestational age (within 3 cms)

33
Q

Chadwick’s Sign

A
  1. Reproductive Adaptation
  2. Bluish coloration of vagina, cervix, labia
  3. R/t vascular congestion
34
Q

Goodell’s Sign

A
  1. Reproductive System Adaptation
  2. Softening of the cervix
  3. Due to progesterone
35
Q

Hegar’s Sign

A
  1. Reproductive System Adaptation
  2. Softening of the lower uerine segment
36
Q

Increased blood volume

A
  1. Cardiovascular System Adaptation
  2. 40-50% increase
37
Q

Physiologic Anemia

A
  1. Cardiovascular System Adaptation
  2. Plasma volume increases by ~50%
  3. RBC increase by ~25%
  4. Resolves in early PP
38
Q

Respiratory System Adaptations

A
  • Volume of air breathed increased
    • Oxygen consumption increases
  • Airway resistance decreases
    • Progesterone relaxes respiratory structures
  • Displacement of diaphragm
    • Respiratory symptoms decrease close to term with lightening(lightening reduces pressure on diaphragm but replaces that pressure with pressure on the bladder)
39
Q

Urinary Frequency

A
  1. Renal System Adaptation
  2. 1st and 3rd Trimesters
40
Q

Renal System Adaptations

A
  1. Urinary Frequency
  2. Increased glomerular filtration r/t kidneys working harder
  3. Glycosuria (excessive glucose load)
  4. Increased risk of UTI
    1. r/t urine stasis, correlates with preterm labor
41
Q

Gastrointestinal System Adaptations

A
  1. Nausea/vomiting of pregnancy (NVP)
    1. Hormonal Changes
    2. Altered carbohydrate metabolism
    3. Generally resolves by early second trimester
  2. Smooth muscle relaxation
    1. Delayed gastric emptying
    2. Decreased peristalsis
42
Q

Straie gravidarum

A
  • Skin Adaptation
  • Stetch marks
43
Q

Linea nigra

A
  • Skin Adaptation
  • Pigmentation from umbilicus to publis
44
Q

Chloasma

A
  • Skin Adaptation
  • Mask of pregnancy
45
Q

What does a maternal physical exam include?

A
  1. Baseline VS
  2. Height and Weight
  3. Thyroid
  4. Heart and lung sounds
46
Q

What does a maternal gynecologic exam include?

A
  1. Pelvic measurements
  2. Uterine size
47
Q

Complete Maternal Physical Assessment

A
  1. Complete maternal physical exam
  2. Gynecologic exam
  3. Fetal Heart Tones
48
Q

Maternal Laboratory Testing

A
  • Serologic Testing
    • Blood Type and Rh
    • CBC and Hgb
    • Syphilis testing
      • Venereal Disease Research Lab
      • Rapid Plasma Reagin
    • Rubella titre
    • HIV screen
    • Hep. B screen
    • Genetic Testing
  • Urinalysis
    • Glucose
    • Protein
      • Trace is acceptable
    • Ketones
      • Suggests inadequate nutrition
    • Bacteria, WBCs, nitrites, casts
      • Suggests UTI
  • Pap smear
  • Cultures
    • Gonorrhea
    • Chlamydia
  • Wet prep
    • Monilia (yeast)
    • Bacterial vaginosis
  • Illicit drug screen (if history indicates)
49
Q

Warning Signs of Pregnancy

A
  1. Dysuria
  2. Vaginal bleeding
  3. Persistent vomiting
  4. Presistent headache
  5. Preterm labor
  6. Decreased fetal movement
  7. Abdominal or epigastric pain
  8. Rupture of membranes (ROM)
50
Q

Prenatal Visits

A
  1. Every 4 weeks until 28 weeks (first and second trimesters)
  2. Every two week between 28 and 36 weeks (third trimester)
  3. Every week until delivery
51
Q

Routine Assessments for Prenatal Visits

A
  1. Vital signs
  2. U/A
  3. Weight
  4. Uterine Height
  5. Fetal Heart Rate and Fetal Activity
52
Q

Trimester Specific Screening Prenatal Visits

A
  1. U/S
  2. Glucose tolerance Test (GTT)
  3. Multiple Marker Screen
  4. Group B Strep (GBS)

Semester Three - Half Two - Nursing 212 (41 decks)

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