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NU314 OB > Nursing Management during Pregnancy > Flashcards

Nursing Management during Pregnancy Flashcards

1
Q

Goals of Preconception Care

A
  • promote the health and well being of a women and her partner before pregnancy
  • Identify and modify biomedical, behavioral, and social risks to a woman’s health or pregnancy
  • CDC guidelines
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2
Q

Risk Factors for Adverse pregnancy

A
  • isotretinoin’s-Retina, Accutane
  • alcohol/smoking
  • antiepileptic drugs
  • obesity/diabetes
  • folic acid deficiency
  • STI’s-HIV/AIDS
  • hypothyroidism
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3
Q

What can the mother take to help prevent a miscarriage?

A

anticoagulants

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4
Q

When is the greatest environmental sensitivity and consequent risk for a developing embryo?

A

days 17-56 after conception

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5
Q

What is the number 1 cause of miscarriage in the first trimester?

A

UTI

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6
Q

What will happen at the first prenatal visit?

A
  • establishment of trust
  • focus on education of overall wellness
  • detection and prevention of potential problems
  • comprehensive health history, physical exam, and laboratory tests
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7
Q

What would be a women’s reason for seeking care?

A
  • suspicion of pregnancy
  • date of last menstrual period
  • signs and symptoms of pregnancy
  • urine or blood test for hCG
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8
Q

What will you ask the patient about her menstrual cycle?

A
  • Age at menarche
  • Days in cycle
  • Flow characteristics
  • Discomforts
  • Use of contraception
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9
Q

What rule is often used to estimate the baby’s date of delivery?

A

Nagele’s Rule

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10
Q

Nagele’s Rule

A

subtract 3 months from her last menstrual period and then add 7 days to the first day of the last period and then correct the year by adding 1 to it when necessary

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11
Q

What is the best method of dating a pregnancy?

A

ultrasound

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12
Q

What are the terms for obstetric history?

A 
G-gravida
T-term births
P-preterm births
P-para
A-abortions 
L-living children
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13
Q

Gravida

A

count of pregnancies; including current pregnancy

  • primigravida- first pregnancy
  • secundigravida-second pregnancy, etc.
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14
Q

Para

A

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

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15
Q

Primipara

A

one birth after a pregnancy of at least 20 weeks

“primip”

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16
Q

Multipara

A

two or more pregnancies resulting in viable offspring

“multip”

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17
Q

Nullipara

A

no viable offspring; para 0

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18
Q

Term births

A

the number of pregnancies ending > 37 weeks gestation at term

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19
Q

Preterm Births

A

the number of preterm pregnancies ending >20 weeks or viability but before completion of 37 weeks

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20
Q

Abortions

A

number of pregnancies ending before 20 weeks or viability

elected or spontaneous

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21
Q

Living children

A

number of children currently living

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22
Q

What will happen during the pelvic examination?

A
  • examine internal and external genitalia
  • bimanual examination
  • pelvic shape
  • pelvic measurements
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23
Q

What are the 4 types of pelvic shapes?

A

gynecoid, android, anthropoid, platypelloid

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24
Q

What are the 3 pelvic measurements?

A

diagonal conjugate
true (obstetric) conjugate
ischial tuberosity

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25
Q

What laboratory tests will be used for pregnant women?

A

urinalysis, CBC, blood typing, Rh factor, Rubella titer, Hep B surface antigen, HIV/VDRL/RPR testing, cervical smears, ultrasound

26
Q

How often will the mom have follow-up visits?

A

q 4 weeks up 28 weeks
q 2 weeks from 29-36 weeks
q week from 37 weeks to birth

27
Q

What assessments are completed at each subsequent prenatal visit?

A
  • weight and BP compared w/ baseline
  • urinalysis for protein, glucose, ketones, and nitrites
  • fundal height
  • quickening/fetal movement
  • fetal heart rate
  • teaching; danger signs
28
Q

If Nitrites are found during urine testing during pregnancy what will it automatically indicate?

A

UTI

29
Q

What will ketones in the urine indicate?

A

dehydration

30
Q

Amniocentesis

A

involves a transabdominal puncture of the amniotic sac to obtain a sample of amniotic fluid for analysis

  • chromosomal abnormalities and hereditary metabolic defects
  • women 35 years old and up
31
Q

Fundal Height

A

the distance between the top of the pubic bone to the top of the fundus with the client lying on her back with her knees slightly flexed
-provides gross estimate of duration of pregnancy

32
Q

Ultrasound

A

used to confirm placental location during amniocentesis and to provide visualization chorionic villus sampling

33
Q

Chorionic villus sampling

A

a prenatal test in which a sample of chorionic villi is removed from the placenta for testing. The sample can be taken through the cervix or the abdominal wall

34
Q

Doppler flow studies

A
  • measure the velocity of blood flow via ultrasound
  • can detect fetal compromise in high risk pregnancy
  • evaluate the blood flow through other fetal blood vessels
35
Q

Alpha-fetoprotein (AFP)

A

glycoprotein produced initially by the yolk sac and fetal gut, and later predominately by the fetal liver

36
Q

Maternal serum screening can

A

help identify fetal risk for complications, chromosomal disorders and anomalies

37
Q

Nuchal translucency screening

A

done in the 1st trimester

-allows for early detection and diagnosis of some fetal chromosomal and structural abnormalities

38
Q

Increase nuchal translucency is a marker for what?

A

chromosomal abnormalities, structural anomalies, genetic syndromes, and high risk of abortion and fetal death

39
Q

What can be identified by chorionic villus sampling?

A

down syndrome, cystic fibrosis, enzyme deficiencies, gender, hemophilia, sickle cell anemia, tay-sachs disease

40
Q

Nonstress Test

A

an indirect measurement of uteroplacental function

41
Q

Biophysical profile

A
  • uses ultrasound and NST

- performed in an effort to identify infants who may be at risk of poor pregnancy outcome

42
Q

First trimester discomforts

A
  • urinary frequency/incontinence
  • fatigue
  • nausea/vomiting
  • breast tenderness
  • constipation
  • nasal stuffiness, bleeding gums, epistaxis
  • cravings
  • leukorrhea
43
Q

Second trimester discomforts

A
  • backache
  • varicosities of vulva and legs
  • hemorrhoids
  • flatulence w/ bloating
44
Q

Third trimester discomforts

A
  • return of 1st trimester discomforts
  • shortness of breath/dyspnea
  • heartburn/indigestion
  • dependent edema
  • Braxton hicks contractions
45
Q

Important Personal Hygiene during Pregnancy

A
  • perineal care
  • dental care
  • breast care
  • avoid hot tubs and saunas
46
Q

Why should you advise pregnant women to avoid hot tubs and saunas?

A

The heat can cause fetal tachycardia and raise the maternal temperature

47
Q

Perineal Care

A

advise women to shower frequently and wear all cotton underwear to minimize effects of excess secretions

  • do NOT douche, or wear panty liners
  • avoid perfumed soaps, lotions, perineal sprays, and harsh laundry detergent
48
Q

Breast Care

A

stress the need to wear a firm, supportive bra with wide straps to balance the weight

  • anticipate buying a larger sized bra
  • avoid using soap on the nipple area because it can by very drying
49
Q

Clothing

A

advise to avoid wearing constricting clothes and girdles that compress the growing abdomen

  • avoid knee high hose which may impede circulation
  • low heeled shoes and layered clothing
50
Q

Other self-care during pregnancy

A

exercise, sleep and rest, employment, sexual activity, travel, immunizations and medications

51
Q

Reassure the women that sexual activity during pregnancy is ok as long as there is not a history of?

A 
vaginal bleeding
placenta previa 
risk of preterm labor
cervical insufficiency 
premature rupture of membranes
presence of infection
52
Q

Traveling while pregnant:

A

For long car rides make sure to stop and walk every hour

For planes request and aisle seat and walk every 2 hours

53
Q

What are the 3 most common types of child birthing classes?

A

Lamaze
Bradley
Dick-Read

54
Q

Lamaze Classes

A

a psychoprophylactic (“mind prevention”) method of preparing for labor and birth that promotes the use of specific breathing and relaxation

55
Q

Bradley Method

A

“partner-coached childbirth”

focuses on exercises and slow, controlled abdominal breathing

56
Q

Dick-Read Method

A

focuses on fear reduction via knowledge and abdominal breathing techniques

57
Q

Advantages of Breast-feeding

A
  • promotes bonding
  • decreases mothers risk of ovarian and breast cancer
  • decreases risk of obesity and diabetes for mom and baby
  • gives baby immunities for certain diseases and infections
58
Q

Disadvantages of Breast-feeding

A
  • breast discomfort
  • sore nipples
  • mastitis
  • engorgement
  • milk stasis
  • vaginal dryness
  • decreased libido
59
Q

Disadvantages of Bottle-feeding

A

babies will have an increased risk of otitis media, diabetes, asthma, atopic dermatitis, reflux diarrhea, colic, constipation, and lower respiratory infections

60
Q

Hospitals

A

delivery rooms and birthing suits

recommended for high risk pregnancies

61
Q

Birth Center

A

good choice for a woman who wants more personalized care than in a hospital, but does not feel comfortable with a home birth
-women with low risk pregnancies

62
Q

Homebirths

A

believed that home births increase privacy, comfort, and convenience
facilitate family involvement an a relaxed, peaceful environment

NU314 OB (21 decks)

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