Pregnancy Care Fundamentals

Question 1

Presumptive Signs of Pregnancy

Answer 1

Changes experience by woman

• amenorrhea
• fatigue
• breast changes
• nausea and vomiting

Question 2

Probably Signs of Pregnancy

Answer 2

Changes observed by examiner

• Goodell’s sign (softening of cervix due to increased vascularity)
• • beta hCG
• Braxton-Hicks contraction

Question 3

Positive Signs of Pregnancy

Answer 3

Signs related to fetal presence

• fetal heart tones
• visualization of fetus
• palpation of fetal movement

Question 4

Nagele’s rule

Answer 4

First day of LMP
- 3 months
+ 7 days
+ 1 year

Question 5

Alternative way to calculate EDB

Answer 5

First day of LMP
+ 7 days
+ 9 months

Question 6

How can EDB be confirmed?

Answer 6

T1 ultrasound at 8-10 weeks gestation

within 3-5 days of accuracy

Question 7

Why is EDB significant?

Answer 7

All decisions in care are based on the EDB and gestational age of baby

Question 8

What nursing interventions are suitable for pregnancy care?

Answer 8

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

Question 9

What are typical interventions that take place during 1st Trimester (1-12 weeks)?

Answer 9

• Resource referrals
• Informational support
• Blood draw
• Antenatal care

Question 10

What are interventions that take place during 2nd Trimester (13 to 26 weeks)?

Answer 10

• Teaching around discomforts
• Discuss concerning signs
• Coaching around work requirement
• Familiarizing with prenatal classes

Question 11

What interventions take place during 3rd Trimester (27 to end of pregnancy)?

Answer 11

• Dealing with discomforts
• Normal vs Abnormal
• Preparation for baby
• Prenatal classes

Question 12

Rubella Immunity

Answer 12

Non-immune mothers need rubella vaccine post delivery

- rubella vaccine is LIVE and cannot be given during pregnancy

Question 13

Rh Incompatibility

Answer 13

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

Question 14

What is the protocol for Rh Incompatibility?

Answer 14

Rhogam (blood product) given to mother, IM at 26-28 weeks

• prevents antibody formation
• given again within 72 hours postpartum if fetus is Rh +

Question 15

What are some normal symptoms associated with pregnancy?

Answer 15

• Constipation (no laxatives, could cause contractions)

- Bleeding gums when brushing (due to vascular congestion)

Question 16

ABO Incompatibility

Answer 16

Mother is O but baby is A, B or AB

• can cause hyperbilirubinemia
• hemolytic disease of the newborn
• early detection

Question 17

Parental Developmental Tasks

Answer 17

• accepting the pregnancy
• identifying with role of parent
• re-ordering personal relationships
• establishing a relationship with the fetus
• preparing for childbirth

Question 18

What are some healthy behaviours of client adjusting to pregnancy?

Answer 18

• asking appropriate questions
• wanting to know the due date
• taking an interest in pregnancy-related activities

Question 19

Prenatal Care Goals

Answer 19

• 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

Question 20

Key Components of Pre-conception & Prenatal education

Answer 20

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)

Question 21

Prenatal Visit Schedule

Answer 21

T1: initial visit, monthly
T2: monthly
T3: q2weeks until 36 weeks
q1week until birth

Question 22

What takes place at a prenatal visit?

Answer 22

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

Question 23

Focused assessments at prenatal visit

Answer 23

• subjective (interview/history)
• weight
• vitals (bp especially)
• urinanalysis
• fundal height
• fetal movement
• FHR auscultation

Question 24

Fundal Height Measurement

Answer 24

Corresponds to gestational age, estimates duration of pregnancy
i.e. 28 weeks gestation - 26-30cm

Question 25

RED FLAGS

Answer 25

• 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

Question 26

The DON’Ts of pregnancy

Answer 26

• Raw food
• Smoking, alcohol
• Substance abuse
• Hot Sauna
• Avoid risky actibities
• Avoid cat litter
• Certain medications

Question 27

Examples of Prenatal Community Resources

Answer 27

• Toronto Public Health
• Health Babies Healthy Children
• Homeless At Risk Prenatal program (HARP)
• Canada Prenatal Nutrition Program
• Community Health Centres
• Prenatal classes

Question 28

Weight Gain

Answer 28

Underweight: 28-40lbs
Average weight: 25-35lbs
Overweight: 15-25lbs