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Maternal OB > Nursing Management During Pregnancy > Flashcards

Nursing Management During Pregnancy Flashcards

1
Q

Preconception Care and Diagnostic Testing

A
  • Amniocentesis
  • Biophysical profile (BPP)
  • Chorionic villus sampling (CVS)
  • Natural childbirth
  • Perinatal education
  • Preconception care
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2
Q

Risk Factors for Adverse Pregnancy Outcomes

A
  • Isotretinoins
  • Alcohol misuse
  • Antiepileptic Drugs
  • Diabetes (preconception)
  • Folic Acid Deficiency
  • HIV/AIDs
  • Hypothyroidism
  • Maternal Phenylketonuria (PKU)
  • Rubella Seronegativity
  • Obesity
  • Oral Coagulation
  • STI
  • Smoking
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3
Q

Reproductive Health Care Practices

Preconception Care

A
  • Pelvic exams
  • Use of contraceptives
  • STIs
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4
Q

Sexuality and Sexual practices

Preconception Care

A
  • Safer-sex practices
  • Body image issues
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5
Q

Lifestyle Practices

Preconception Care

A

Occupation and recreational activities

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6
Q

Psychosocial Issues

Preconception Care

A
  • Levels of stress
  • Exposure to abuse and violence
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7
Q

Medication and Drug use

Preconception Care

A
  • Use of tobacco
  • Alcohol
  • OTC and prescription medications
  • Illicit drugs (cocaine, heroine)
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8
Q

Support System

Preconception Care

A

friends , family and community

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9
Q

What happens during a prenatal visit?

A
  • Establishment of trusting relationship
  • Focus on education for overall wellness
  • Detection and prevention of potential problems
  • Comprehensive health history, physical exam and laboratory tests: CBC, STI, Urine analysis, Glucose
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10
Q

What are the glucose recommendations for pregnant women during fasting, 1hr and 2hr after meals?

First Prenatal Visit

Postprandial = After Meals

A

Glucose:
* Fasting: <95 mg/dL
* 1hr postprandial: <140 mg/dL
* 2hr postprandial: <120 mg/dL

*fasting and postprandial self-monitoring of blood glucose are recommended to achieve glycemic control

*Insulin is the preferred treatment for hyperglycemic in OB patients

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11
Q

What to do document for reasons for seeking care?

Comprehensice Health History

A
  • Suspicion of pregnancy
  • Reports of missing menstrual period or positive result on home pregnancy test
  • Date of last menstrual period (LMP)
  • S/S of pregnancy
  • Urine or blood test for hCG; confirms pregnancy
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12
Q

What to do document for past medical, surgical and personal history?

Comprehensive Health History

A
  • Conditions in the past may recur or exacerbated during pregnancy (ex. UTI)
  • Ask about chronic illnesses (diabetes or heart disease)
  • Any history of allergies to medications, food, or environmental substances
  • Ask about mental health problems (depression or anxiety)
  • Personal history is important too (occupation, exposure to teratogens, exercise, activity level and recreational activity such as alcohol, drugs etc.)
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13
Q

What to document about women’s reproductive history?

A
  • Menstrual
  • Obstetric
  • Gynecological history
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14
Q

What to document for pregnant women’s mentrual history?

A
  • Menstrual cycle
  • Age at menarche
  • Number of days in cycle
  • Flow characteristics
  • Discomforts
  • Use of contraception; when did they last use it
  • Date of LMP (can be seen in prenatal history)
  • *Calculation of estimated or expected date of birth (EDB), delivery (EDD) or confinement (EDC)

Nagele’s Rule

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15
Q

Obstetric History

Gravida I

(Primigravida or Primipara)

A

First Pregnancy

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16
Q

Obstetric History

Gravida II

(Secundugravida)

A

Second pregnancy (+)

17
Q

Obstetric History

Primipara

(Primip)

Para: woman who has produced one or more viable offspring carrying a pregnancy 20 weeks or more

A

one birth after a pregnancy of at least 20 weeks

18
Q

Obstetric History

Multipara

(Multip)

A

two or more pregnancies resulting in viable offspring

19
Q

Obstetric History

Nullipara

A

no viable offspring; para = 0

20
Q

Obstetric History

GTPAL

Calculates the number of times the mother is pregnant.

A
  • G (gravida): total number of pregnancies; includes current pregnancies
  • T (term births): number of pregnancies delivering between 37-40 weeks 6/7 days, at term
  • P (preterm births): number of preterm pregnancies ending <20 weeks or viability but before completion 37 weeks
  • A (abortion):number of pregnancies ending before 20 weeks or viability
  • L (living children): number of children currently
21
Q

GTPAL Practice Example 1

38 weeks 2/7 days
2 term births
1 at 34 weeks
7 miscarriages
3 living children

Obstetric History

A

G: 11
T: 2
P: 1
A: 7
L:3

22
Q

GTPAL Practice Example 2

Currently pregnant with 4th child
2 at term
1 at 35 weeks
3 living children

Obstetric History

A

G: 4
T: 2
P: 1
A: 0
L: 3

23
Q

GTPAL Practice Example 3

20 year old, currently 8 weeks
Miscarriage at 12 weeks
No living childre

A

G: 2
T: 0
P:0
A:1
L: 0

Maternal OB (12 decks)

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