PRENATAL ASSESSMENT Flashcards
prenatal visit for the first 28 weeks
every 4 weeks
prenatal visit through the 36 weeks
every 2 weeks
prenatal visit from 36 weeks until birth
every week
- establish rapport
- setting: quiet
- introducing self
- gain information about a woman’s
physical & psychosocial health
initial interview
components of prenatal assessment
- extensive health hx
- P.E.
- lab assessment
- lmp
- pregnancy test
- signs of early preg.
- discomforts
- danger signs
chief concern
- age, occupation, educ
- partner’s age, occupation, educ
- marital status
- support persons
- house size, locations
family profile
- heart, kidney disease
- uti, htn, dm
- asthma, infectious diseases
- immunizations
- allergies
- surgical procedures
history of past illness
- cardiovascular
- renal
- cognitive
- blood disorders
- genetically inherited diseases
- congenital anomalies
history of family illness
- nutrition
- elimination
- sleep/rest, exercise
- recreation, hobbies
- interpersonal interactions
- habits
- involvement in abusive relationship
- medication Hx
day hx / social profile
- menarche
- usual menstrual cycle & discomforts
- monthly perineal self-examination
- past reproductive tract surgery
- Hx of frequent D & C
- FP methods
- sexual hx
- stress incontinence
gynecologic hx
- previous pregnancy
- previous miscarriages or therapeutic abortions
- blood transfusion
- GTPALM
obstetric hx
ROS headache, injury, seizures, dizziness, fainting
head
ROS vision, glasses, diplopia, infection, glaucoma, cataract, pain, recent changes
eyes
ROS infection, discharge, earache, hearing loss, tinnitus, vertigo
ears
ROS epistaxis, colds, allergies, postnasal discharge, sinus pain
nose
ROS dentures, teeth condition, toothache, bleeding gums, hoarseness, dysphagia, tonsillectomy, last dental exam
mouth and pharynx
ROS stiffness
neck
ROS lumps, secretion, pain tenderness
breasts
ROS cough, wheezing, asthma, SOB, pain, TB, pneumonia
respiratory system
ROS rashes, acne, psoriasis
skin
components of physical examination
- baseline height, weight, and VS
- assessment of systems
- measurement of fundal height and fetal heart sounds
- pelvic exam and estimating pelvic size
✓posture
✓manner of dressing
✓manner of speaking
✓facial expression
✓ presence of bandages & dressings
general appearance and mental status
estimates AOG by the relative position of the uterus in the abdominal cavity.
bartholomew’s rule
measuring fundal height
mcdonald’s rule
determines the length of the fetus in centimeters.
haase’s rule
haase’s rule
which half of pregnancy - square the number of month (example: 1x1 = 1 cm)
first half
haase’s rule
which half of pregnancy - multiply the month by 5
second half
listening for fetal heart sounds start at
10-12 weeks
an examination of the woman’s genital system
pelvic exam
performed:
- During a yearly physical exam
- When a woman is pregnant
- When a doctor is checking for an infection (such as chlamydia, vaginosis, trichomoniasis, and others)
- When a woman is having pain in her pelvic area or low back
pelvic exam
position for pelvic exam
lithotomy
true or false: ask the pt to void before the pelvic exam
true
instrument to use for internal visual exam
speculum
swiping a small wand to collect a sample of cervical fluids
pap smear
the measurement of the female pelvis to identify CPD, which is when the capacity of the pelvis is inadequate to allow the fetus to negotiate the birth canal
assessment of pelvic adequacy / clinical pelvimetry
12.5 cms pelvic size
diagonal conjugate
10.5-11 cms pelvic size
true conjugate or conjugate vera
11 cms pelvic size
ischial tuberosity diameter
