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Maternal/Child Nursing SN > Prenatal Care > Flashcards

Prenatal Care Flashcards

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1
Q

What are the presumptive signs of pregnancy?

A

“self reported”
1) Amenorrhea (no period)
2) N/V
3) Quickening (movement)
4) Urinary frequency
5) Breast tenderness & fatigue

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2
Q

What are the probable signs of pregnancy?

A

“objective signs”
1) Goodell’s Sign: cervical softening

2) Chadwick’s Sign: blue/purple birth canal

3) Hegar’s Sign: softening of lower uterine segment

4) Ballottement

5) + HCG Test: elevated levels of HCG
can also be caused by gestational trophoblastic disease

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3
Q

What are the positive signs of pregnancy?

A

“diagnostic”
1) Fetal heartbeat heard by Doppler device at 10-12 weeks

2) Ultrasound visualiziation of the fetus

3) Fetal movement (palpated or observed by HCP)

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4
Q

What is EDB?

A

“Expected Date of Birth”

Formula: 1st day of LMP - 3 months + 7 days = EDB

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5
Q

Uterine Growth & Fundal Height

A

12 weeks: above symphysis pubis

16 weeks: halfway between symphysis pubis and umbilicus

20 weeks: at umbilicus
fundal height in cm should = weeks of gestation + or - 2 weeks

36 weeks: xiphoid process

38 - 40 weeks: fetus engages & fundal height drops

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6
Q

GPTPAL Assessment

A

G: Gravida
number of pregnancies including abortion, miscarriage & current pregnancy
Nulligravida: 0
Primigravida: 1st pregnancy
Multigravida: more than once

P: Para
number of deliveries after 20 weeks gestation

T: Term Births
number of deliveries over 37 weeks gestation

P: Preterm Births
number of births between 20-37 weeks

A: Abortion
miscarriage

L: Living Children
live births

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7
Q

What medications should we avoid during pregnancy?

A

1) NSAIDS
N: Naproxen
S: Salyslic acid
A: Aspirin
I: Ibuprofen & Indomethacin
K: Ketorolac

2) ACE & ARBs
“-pril” (NO Prils during Pregnancy)
“-sartan” (Sartans = Satan to pregnancy)

3) Doxycycline & Tetracycline
Cycling on a bike is dangerous during pregnancy

4) Carbamazepine

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8
Q

Safe vaccines during pregnancy

A

Inactive influenza (flu shot)

Tdap vaccine 27 - 36 weeks
T: Tetanus
D: Diphtheria
P: Pertussis

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9
Q

Not safe vaccines during pregnancy

A

NO LIVE Vaccines
due to suppressed immune system and increased risk for illness.
no live vaccines given during & up to 1-3 months before pregnancy.
can cause serious birth defects
safe after pregnancy

Varicella - zoster
Rotavirus
Live or activated influenza
MMR: measles, mumps, rubella

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10
Q

General patient education

A

Avoid ETOH / tobacco
Obtain testing for rubella immunity
Scheduale dental wellness appt

2nd trimester:
gestational diabetes & preecampsia screening
anticipate quickening “light fetal movements”
abdominal ultrasound evaluation

Weight Gain:
expected weight gain: 25-35 lbs during pregnancy
maintian BMI of 18.5-24.9 kg
gain of 1 lb per week if pre pregnancy BMI was normal during 2nd/3rd trimester

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11
Q

Vitamins & Minerals Patient Education

A

Folic acid 400 mcg / day –> prevents neural tube defects
Calcium 500 mg / day
Iron (ferrous sulfate) –> prevent anemia
take on empty stomach
increase Vit C to aid absoprtion
risk for constipation

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12
Q

Food Patient Education

A

Protien foods rich w/ calcium, iron, & B vits
ex: grilled chicken, turnip greens, peanut butter, & juice

Avoid:
unhealthy: excess salt, butter, fat, margarine
unsafe dairy: unpasteurized
deli-made egg salad

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13
Q

Types of Anemia

A

1) Iron Deficiency
low iron

2) Sickle Cell

3) Pernicious
cannot absorb B12

4) Aplastic
impairment in bone marrow

5) Hemolytic
destruction of RBCs

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14
Q

Anemia Causes

A

Blood loss: surgery, truama, excessive menstruation
Chemo & Immunosuppressants: suppress bone marrow –> aplastic anemia
Lack of iron, B12 & other building blocks –> iron def & pernicious anemia

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15
Q

Hemoglobin Values

A

Normal 12 +
Bad: 8-9
Less than 7 = heaven

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16
Q

Iron Deficiency Anemia - Causes

A

Diet low in: meat, fish, poultry
Gastric Bypass surgery
Pregnancy: fetus stores iron
Pica: LOW hemetocrit & hemo levels

Other:
Low B 12
Hypochlorhydria (low stomach acid)
Gastric atrophy (atrophic gastritis)

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17
Q

Iron Def Anemia - Causes in Infant/Children

A

Premature birth
Insufficient oral intake
Excess milk intake
Preterm infants exclussively bottle fed w/ breast milk

18
Q

Iron Def Anemia: Diet for Vegans

A

Fortified breads & cereals
HIGH iron foods w/ HIGH vit C
Calcium & Vit D

19
Q

Txt for Iron Deficiency Anemia

A

Food rich in iron: meat, fish, poultry, green leafy veggies (spinach), whole grains

Iron + Vit C (alongside not with)

20
Q

Txt of Fe Def Anemia for Infant/Children

A

limit EXCESSIVE milk intake

21
Q

Pharmacology for Fe Def Anemia

A

Ferrous Sulfate (oral)

Iron Dextran (IV/IM)

dark or black stools are normal. IS NOT GI bleed.

empty stomach one hour before medications (Fe blocks other meds).

22
Q

Sickle Cell Anemia

A

Distorted shape RBCs. They die quicker, carry less O2, & get clogged in tiny blood vessels –> ischemia to organs.

23
Q

Sickle Cell Anemia S/S

A

Blood Clot Manifestations
- one sided arm weakness
- swelling of feet and hands (Dactylics)

New onset paralysis of ext
Sudden inability to be aroused

24
Q

Sickle Cell Anemia Complications

A

Splenic sequestration crisis:
rapidly enlarging spleen
low blood pressure

25
Q

Sickle Cell Anemia Txt

A

Hydration: IV fluids
Bed Rest
Pain Control: PCAP

26
Q

Pernicious Anemia S/S

A

Glossitis: inflamed red smooth tongue
Extreme weakness
Jaundice

27
Q

Pernicious Anemia Txt

A

B12 - injection: IM or IV // NOT orally

28
Q

Discomforts of Pregnancy

A
  • Morning Sickness
  • Hyperemesis Gravidarum
  • Constipation
  • Intrahepatic Cholestasis
  • UTI
  • Heartburn
29
Q

Morning Sickness

A

Nausea during the first trimester

30
Q

Morning Sickness Interventions

A
  • consume high protein snacks upon awakening
  • small frequent meals
  • drink fluids between meals (30 mins before or after)
  • ginger
  • vit B6
31
Q

Hyperemesis Gravidarum

A

persistent n/v PAST 12 weeks –> considerable weight loss, fluid/electro imbalance, & malnutrition.

32
Q

Hyperemesis Gravidarum S/S

A
  • excessive vomiting –> dehydration
  • electrolyte imbalance (hypokalemia)
  • urine analysis: Ketonuria and high specific gravity
  • weight loss & nutrition deficits
33
Q

Hyperemesis Gravidarum Interventions

A
  • monitor: weight and I&Os
  • IV fluids
  • Antiemetics: Ondansetron // B6 vit
  • increase –> dairy, lemon water, & protein
34
Q

Constipation

A

increased progesterone levels decreased GI motility & slowed further by iron supplementation

35
Q

Constipation: Avoid what

A
  • dairy: 2 hrs before & 1 hr after iron supplement –> decreases absorption
  • laxatives & stool softeners: dehydration & electrolyte imbalance
  • caffeine: limited to 200-300 mg daily
36
Q

Constipation Txt

A

Increase fiber, fluids (10-12 cups daily), and exercise

37
Q

Intrahepatic Cholestasis

A
  • liver disorder during pregnancy:
  • generalized itching on hands and feet that worsens at night w/ not rash.
  • increases risk of fetal death
38
Q

Intrahepatic Cholestasis Interventions

A
  • bile acid testing
  • fetal monitoring
  • ursodeoxycholic acid
39
Q

UTI S/S

A
  • urinary frequency, urgency, burning & foul smelling urine
  • pyelonephritis (kidney infection)
  • report fever or pain in lower back or flank area –> increase risk for preterm labor
40
Q

Heartburn (Pyosis) Education

A
  • eat several small meals each day (6)
  • eliminate fried fatty foods
  • keep HOB elevated (pillows)
  • avoid lying down right after eating
  • avoid tight fitting clothes
  • no caffeine, chocolate, peppermint & spicy food

Maternal/Child Nursing SN (5 decks)

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