Prenantal Flashcards
What does gravida mean
number of pregnancies including current
What does Para mean
number of births over 20wks even if the baby is stillborn
What does term delivery mean
What does preterm mean
What are abortions
What is considering living
> 37wks
20 but <36.6 wks
<20wks
still alive
Does labor typically speed up or slow down with high G and Pās
speeds up
What is considered a geriatric pregnancy
after 35
Most malformations occur when
3-8wks
When do most CNS or genitalia usu happen
> 8 wks
What are some presumptive signs of pregnancy
tiredness
What are some probable signs of pregnancy
feelibg nof movement in body
amenorhea
What are some diagnostic tests for pregnancy
ultrasound
heartsounds
provider feels movement
How long do pregs last
Lasts 40 weeks or 280 days
What is the 1st trimester
conception to 12wks
Wha tis 2nd trimester
13 to 27 wks
What is 3rd trimester
28-40 wks
How many visits will a patient likely have durign the course of the pregnancy
12-16 visits
What can we do if a preg pat doesnt have much food access
we can offer snap/wic
What is nageleās rule
subtract 3mo from the first day of her last menstraul period, add 7 days and then adjust for the year
What are the timelines for prenatal care for meetings
Monthly until 28 wks
Bi weekly from 28 to 36 wks
Weekly 36 wks to delivery
When does fetal movement start (quickening)
18-22 wks
Ultrasounds are accurate for due date determination between
12-16wks of pregnancy
Visit with mother should be how ling
1-1.5 hrs
What do we need to get on the first visit prenatal
health hx med hx OB hx Surg hx Physical exma
What are the thigns in the physical exam for the first visit
pelvic exam
labs
ultrasound
What kinds of labs are we going to get on the first prenatal exam
CBC CMP Type/screen HIV TB Rubella Vaginal cultures and VDRL (vanerial disease screen) Varicella screen CF
When do we typically do a genetic screen
8-20 wks
When do we do a quadruple screen
15-20 wks
How much does the resp increase in the third trimester
10 bpm bec on fetus size
When do you never take a blood pressure
when they are in a contraction
When taking a BP where shoudl you doing it
at the level of the heart
What is normal BP
135/85 or less
How much does the HCT and Hgb decrease
33.8-39%
10-11mg
How much does WBC increase
1500-5000
What is normal RBC count
3.8 to 4.4
When do you give Rhogam in pregnancy
28wks
When do we get a group B culture
28-35wks
When do we get a glucose screen
24-28wks
When do we do a multiple marker (quad screen) screen and wahts in it
15-20 wks Alpha feto protein HCG Unconjugated estriol Inhibin A
What are some signs of pregnancy comps
vag bleeding excess fluid escaping the vag excessive edema continuous pounding HA convulsions visual disturbances persistent or severe AbP chills or fever painful urinationi changes in freq or strength of fetal movement persistent vomiting signs of preterm labor
What are the signs of preterm labor
contractions
cramps
constant low back pain
pelvic pressure
Normal fluid amount in fetus
500-800 ml
What are some comps of amniotic fluid
oligohyramnios
hydramnios
What does oligohydramnios indicate
renal abnormalities? Aging placenta
What damamge are we concerned with fall s
damage to the fetal membrane
What does hydramnios (polyhydramnios) indicate
GI and other malformations
Are the arteries and veins normal in the cord
no their opposite
What type of immunity does the mother dive the babay
passive
What might you see inthe placenta of a smoker mother
a calcified placenta
When does the placenta start to break down
after 40 wks
How is the placenta perfused
by the mothers BP
What is preeclampsia in pregnancy associated with
improper implanted placenta
When does progestorene and estrogen start to increase
when the placenta is implanted
When will a HcG test work
8 days after conception
What does estrogen do
Increased uterine muscle mass
Increased vascularity
What are pats at higher risk for as the pregnancy progresses and why
falls because of relaxin
What does progesteroen do
Maintains pregnancy
Smooth muscle relaxant
Breast develop for lactation
Whats the main job of progest and estro
maintain preg after implantatioin
What is HCGs main funct
maintain preg before implantation
What does relaxin do
Inhibits contractions
Remodels collagen
Relaxes joints
How can we reduce straie
hydration
lotion
What should we say about facial mask of pregnancy
it will go away
When does urinary changes happen
1st and 3rd trimester
What are some nursing actions for urinary changes
Restrict evening fluids
Restrict coffee, tea, natural diuretics
Teach Kegel exercises
When do resp changes happen mostly
third trimester
If the pat is out of breathe third trimester
rest
explain its normal
assess vitals
Do we use nasal meds for nasal stuffness
no
What is leukoffhea
Pregnancy Discharge
What are nursing interventions for leukorrhea
Cotton underwear
Pad to absorb (not tampon)
Report odor or color, bleeding or leaking of amniotic fluid
Is a little edema in pats normal
yes
What are some nursing interventions for dependent edema and variscosities
rest q2h with feet up
wear support stockings
Sit and lie with legs elevated
Walk frequently to stimulate circulation
If the pat does all the nursing intervntions for edema and its not improving what should you suspect
HTN
How much does blood volume increase
30%
What is vena cava syn and when does it happen
towards late preg the fetus can squeeze off the vena cava
How to reduce vena cava syn
lay on your side
What changes happen to breast
aeriolas become darker
What are some recommendations for breast changes
use sports bra
dont use lotions or soap on the nipple
What are some interventions for GI probs
drink milk
small freq meals
CAM ā ginger safe in 1st trimester
Avoid empty or overfull stomach
What is PICA
cravigngs for non-foods
what are common cravings for PICA
dirt, clay, laundry starch
What might be the cause of PICA
Nutritional deficiency
Culture
Mental health
Interventions for constapation
8-10 glasses water
Increase dietary roughage
Moderate exercise
No stool softners, laxatives, enemas w/o checking with care giver first
What is Ptyalism
increased mucus secretion
What are interventions for ptylism
Astringent mouthwash
Chew gum
Eat hard candy as comfort measures
What is a common neuor mus prob
carpal tunnel
When does carpal tunnel typically disappeear
3 mo
What are intervention for low back pain
stretch
massage
rest q2h
baths
