Pregnancy Care Fundamentals Flashcards
Presumptive Signs of Pregnancy
Changes experience by woman
- amenorrhea
- fatigue
- breast changes
- nausea and vomiting
Probably Signs of Pregnancy
Changes observed by examiner
- Goodell’s sign (softening of cervix due to increased vascularity)
- beta hCG
- Braxton-Hicks contraction
Positive Signs of Pregnancy
Signs related to fetal presence
- fetal heart tones
- visualization of fetus
- palpation of fetal movement
Nagele’s rule
First day of LMP
- 3 months
+ 7 days
+ 1 year
Alternative way to calculate EDB
First day of LMP
+ 7 days
+ 9 months
How can EDB be confirmed?
T1 ultrasound at 8-10 weeks gestation
within 3-5 days of accuracy
Why is EDB significant?
All decisions in care are based on the EDB and gestational age of baby
What nursing interventions are suitable for pregnancy care?
a. assess coping and adaptations
b. informational support
c. active listening, validation, reassurance
d. data collection
e. resource referrals
f. anticipatory guidance
g. interprofessional collaboration
h. documentation
What are typical interventions that take place during 1st Trimester (1-12 weeks)?
- Resource referrals
- Informational support
- Blood draw
- Antenatal care
What are interventions that take place during 2nd Trimester (13 to 26 weeks)?
- Teaching around discomforts
- Discuss concerning signs
- Coaching around work requirement
- Familiarizing with prenatal classes
What interventions take place during 3rd Trimester (27 to end of pregnancy)?
- Dealing with discomforts
- Normal vs Abnormal
- Preparation for baby
- Prenatal classes
Rubella Immunity
Non-immune mothers need rubella vaccine post delivery
- rubella vaccine is LIVE and cannot be given during pregnancy
Rh Incompatibility
Rh - mother and Rh + baby
Rh antigens enter mother’s body and trigger production of Rh antibodies. Mother’s blood could possibly reject a second Rh + baby
What is the protocol for Rh Incompatibility?
Rhogam (blood product) given to mother, IM at 26-28 weeks
- prevents antibody formation
- given again within 72 hours postpartum if fetus is Rh +
What are some normal symptoms associated with pregnancy?
- Constipation (no laxatives, could cause contractions)
- Bleeding gums when brushing (due to vascular congestion)
ABO Incompatibility
Mother is O but baby is A, B or AB
- can cause hyperbilirubinemia
- hemolytic disease of the newborn
- early detection
Parental Developmental Tasks
- accepting the pregnancy
- identifying with role of parent
- re-ordering personal relationships
- establishing a relationship with the fetus
- preparing for childbirth
What are some healthy behaviours of client adjusting to pregnancy?
- asking appropriate questions
- wanting to know the due date
- taking an interest in pregnancy-related activities
Prenatal Care Goals
- Promote client, fetal, family health and well being
- Monitor client-fetal health status
- Identify and minimize risk factors
- Provide appropriate and holistic education and support
Key Components of Pre-conception & Prenatal education
a. Healthy diet and hydration (folic acid 0.4 to 1 mg taken one month prior to conception, PNVs)
b. Exercise and rest
c. Optimum weight
d. Supporting relationships
e. Reduce risk (flu shot, medications, smoking, alcohol, workplace hazards)
Prenatal Visit Schedule
T1: initial visit, monthly
T2: monthly
T3: q2weeks until 36 weeks
q1week until birth
What takes place at a prenatal visit?
a. medical & ob/gyn history
b. social and family history
c. physical assessment
d. fetal assessment
e. diagnostic (initial screening, biophysical and biochemical testing)
f. health education, illness prevention
g. do’s, don’ts and red flags
Focused assessments at prenatal visit
- subjective (interview/history)
- weight
- vitals (bp especially)
- urinanalysis
- fundal height
- fetal movement
- FHR auscultation
Fundal Height Measurement
Corresponds to gestational age, estimates duration of pregnancy
i.e. 28 weeks gestation - 26-30cm
RED FLAGS
- severe vomiting
- signs of infection
- vaginal bleeding
- signs of pre-eclampsia (headache, visual disturbances, epigastric pain)
- decreased fetal movement
- accidents/falls/injuries
- SOB, chest pains
The DON’Ts of pregnancy
- Raw food
- Smoking, alcohol
- Substance abuse
- Hot Sauna
- Avoid risky actibities
- Avoid cat litter
- Certain medications
Examples of Prenatal Community Resources
- Toronto Public Health
- Health Babies Healthy Children
- Homeless At Risk Prenatal program (HARP)
- Canada Prenatal Nutrition Program
- Community Health Centres
- Prenatal classes
Weight Gain
Underweight: 28-40lbs
Average weight: 25-35lbs
Overweight: 15-25lbs
