Prenatal Care and STD's (& Culture) Flashcards
What is a critical indicator of health of a population ?
infant mortality
Where does the zygote implant in the mother ?
the uterine lining
Where does the placenta start to develop ?
wherever the egg implants
Where is the best part for the placenta to grow ?
high and on posterior part of uterus
When do miscarriage typically occur ?
4-6 weeks
What does GTPAL stand for ?
- Gravida
- Term
- Preterm
- Abortions/Miscarriages
- Living children
Gravida
a woman who is pregnant
Nulligravida
woman who has never gotten pregnant
Multigravida
woman who has had two or more pregnancies
Term Pregnancy
pregnancy from 38 weeks to 42 weeks
- after you finish your 37 weeks
Post Term
pregnancy that goes beyond 42 weeks
Preterm
pregnancy that is at least 20 weeks to 37 weeks
Viability
capacity to live outside uterus, around 22-25 weeks
Congenital Defect
abnormality during development
- you can see these (cleft foot/palate, spina bifida)
Genetic Defect
problems that occur during conception
- not as obvious and take some investigation
How do you calculate GTPAL ?
- G: number of pregnancies including this one
- T: babies taken to full term (38-42 weeks)
- P: babies taken to preterm (20-37 weeks)
- A: number of abortions/miscarriages
- L: how many living children currently
During what trimester do we want do to prenatal vaccines ?
3rd trimester
How do we calculate the due date ?
- determine first day of their last normal menstrual period
- subtract 3 months
- add 7 days
- may need to change year
EDD
estimated date of delivery
EDC
estimated date of confinement
-due date
LMP
first day of last menstrual period
What do pregnancy tests detect for ?
presence of hCG (human chorionic gonadotropin)
- have to have fertilized egg that has implanted into the uterine lining for the hCG to be released
What is Chadwick’s sign ?
bluish or cyanotic color of cervix and upper vagina that (objective data) is caused by pregnancy
What is Piskacek’s sign ?
asymmetrical, softened enlargement of the uterine corner caused by placental development
What is quickening ?
objective detection of fetal movements
When testing for blood type, whose RH factor is most relevant ?
the mothers
What RH factor must mom be to intervene ?
RH (-)
How do we treat differing RH factors with mom and baby ?
if mom is RH (-) then you give them a shot in the 3rd trimester and again within 72 hours after giving birth
What does the TORCH screening test for ?
5 teratogenic infections
- these infections in mom can cause negative outcomes for the baby’s development
- Toxoplasmosis
- Other/hepatitis B
- Rubella
- Cytomegalovirus
- herpers simplex
What is Colostrum ?
thick, yellowish “premilk” fluid that can be present by 14 weeks
- provides nourishment for infant until milk comes in day 3-4 postpartum
What is the treatments for constipation ?
- increase water and fiber intake
- fiber supplements or stool softeners
What is the cause of heartburn and treatments ?
reflux of gastric contents as uterus enlarges
- avoid fried & spicy foods
- avoid lying down right after eating
- eat smaller meals more often
- avoid a large meal before bedtime
What are some treatments of nausea/vomiting ?
- dry crackers before rising in morning
- high protein for evening meal
- small, frequent meals
- avoid strong smelling foods & sudden position changes
What are the recommended weight gains for the different BMI levels ?
- Underweight: 28-40 pounds
- Normal: 25-35 pounds
- Overweight: 15-25
- Obese: 11-20 pounds
What is the cause of the GI issues during pregnancy ?
smooth muscle relaxation and decreased motility of GI tract due to increase in progesterone
What are is the pattern of weight gain ?
1st trimester: 2-4 pounds
2nd and 3rd trimester: 1 pound per week
Why is folic acid important for pregnancy ?
- helps prevents neural tube defects
- reduces risk of miscarriages
What is PICA (non-nutritive cravings) and what is it indicative of ?
when you crave things like chalk, dirt, clay
- indicates mineral deficiency
What is Vena Cava Syndrome or Supine Hypotension Syndrome ?
occurs when lying down on back
- resolves if lying on left side (left lateral or left tilt)
What are some Viral STDs ?
- HSV (herpes simplex virus)
- HPV (human papilloma virus)
What are some Bacterial STDs ?
- chlamydia
- gonorrhea
- syphilis
What are some curable STDs ?
- chlamydia
- gonorrhea
- syphilis
- trichomoniasis
What are some incurable STDs ?
HSV and HPV
What are some STDs that are transmitted through fluids ?
- chlamydia
- gonorrhea
- syphilis
- trichomoniasis
- also Hep B
What are some STDs that are transmitted through skin to skin ?
HSV and HPV
What STDs are condoms effective in protecting ?
bacterial and protozoa STDs
What is a Protozoa STD ?
trichomoniasis
What does Syphilis lead to if not treated ?
neurological damage which will lead to death
What does Trichomoniasis lead to if not treated ?
infertility in females
What does HSV lead to if not treated ?
continued spread
What does HPV lead to if not treated ?
cervical cancer in females and all its complications
What STDs may have no clear symptoms in females ?
chlamydia and gonorrhea
What are some primary prevention strategies for STDs ?
- condoms
- abstinence
- immunizations
- limiting partners
What are some secondary prevention strategies for STDs ?
get tested/screenings
What are some tertiary prevention strategies for STDs ?
managing through antibiotics or managing by cultural differences
What are some symptoms of Chlamydia ?
- discharge and painful irritation (M)
- may have no clear symptoms, vaginal discharge, burning, itching, painful irritation (F)
What are some symptoms of Syphilis ?
painless skin lesions, fever, headache, malaise
What are some symptoms of trichomoniasis ?
discharge,dysuria (painful urination), inflammation
What are some symptoms of HSV ?
painful skin lesions
- also flu like symptoms (fever, chills, malasie, severe dysuria)
What are some symptoms of HPV ?
painless skin lesions (genital or veneral warts)
- flush colored skin tags
- soft papillary swelling occuring singly or in clusters
Group B Streptococcus (GBS)
may be considered normal vaginal flora in a non-pregnant woman
- when pregnant not a problem for baby because of walls of protection and we will treat it during birth
What does HIV cause and how is it exchanged ?
causes a severe depression of the cellular immune system
- exchanged through body fluid
- lab tests focus on HIV antibodies
- leads to AIDS if not treated
Culture
A pattern of shared attitudes, beliefs, self-definitions, norms, roles and values that can occur among those who speak a particular language or live in a defined geographical region
Cultural Desire
interest to understand people different than yourself
Self-Awareness
identifying and understanding one’s own cultural identity
Knowledge
exposing one’s self to other culture & willingness to learn
Skill
built the nurse-patient relationship
- communication is key
Why is the RESPECT model used for ?
cultural assessment that helps a nurse gain an understanding of the meaning of illness to the patient, expectations for treatment and care, and patient’s perception
Race
institutionalized ideas and practices that associates differential value, power, and privilege and establishes a social status ranking among the different groups
Ethnicity
a collective identity, a sense of uniqueness within the larger society, and a distinction from nonmembers
Minority Group
Consists of people who are living within a society in which they are disadvantages in relation to power, control of their own lives, and wealth
Who’s at the highest risk for STIs ?
young adults
- aged 20-24
How can Heroin and Methadone affect a baby ?
- prematurity
- long term cognitive/behavioral problems
- respiratory distress
- congenital anomalies
How can Cocaine affect a baby ?
placental abruption
What are signs of narcotic withdrawal in infants ?
- tremors
- irritability
- vomiting
- diarrhea
- sweating
- poor feeding
- convulsions
How can maternal marijuana use affect a baby ?
- fetal immunological problems
- issues with CNS development
How can Mercury affect a baby ?
- affects fetal baby development
- no more than 12 oz cooked fish weekly
How can Lead affect a baby ?
- stillbirths
- spontaneous abortions
- preterm births
- impaired neurodevelopment
How can Radiation affect a baby ?
- chromosomal changes
- spontaneous abortions
- impaired brain function
- microcephaly
- malignancy
What can differing RH factors affect a baby ?
- can lead to anemia
- hyperbilirubinemia
- even fetal death
When are glucose tolerance tests done ?
28 weeks gestation
How do you find out due date by ultrasound ?
measuring crown rump length
- from top of head to butt
- in 1st trimester
When can fetal heart rate be heard ?
at 10-12 weeks w/ doppler
Should you give the Rubella vaccine during pregnancy ?
do not give during pregnancy and avoid pregnancy for 3 months post vaccine
What are the benefits of Braxton-Hicks contractions ?
increases uterine blood flow and oxygen to fetus
When does the fundus react maximum height ?
38 weeks
What are some presumptive signs (subjective) of pregnancy ?
- sensations, symptoms that patient is telling us
- nausea/vomiting,
- change in breast size
- missed menstrual period
- increased urination frequency
What are some probable signs (objective) of pregnancy ?
- enlargement of uterus
- Chadwick sign
- Goodell sign
- Piskacek sign
- changes in skin pigmentation (chloasma and linea nigra)
What are positive signs of pregnancy ?
- actual verification of pregnancy
- measurement of fundal height
- detection of fetal heart tones by auscultation
- palpation of fetal body movement using Leopold Maneuvers
- quickening
What is Hegar’s sign ?
softening of the uterine isthmus
What is Goodell’s sign ?
softening of the cervix
How does your uterus change during pregnancy ?
- changes in size, shape, and position
- it enlarges and muscle walls become thin and change shape to accommodate fetus
What happens if you use opioids during pregnancy ?
result in neonatal abstinence syndrome (NAS)
- baby goes through withdrawal after birth
What do you use to determine EDD ?
Naegel’s Rule
