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Maternal Infant > Prenatal Care & Nutrition > Flashcards

Prenatal Care & Nutrition Flashcards

1
Q

What is health promotion?

A

process that enables & empowers individuals to improve & increase control over their health.

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2
Q

What is health promotion & Illness prevention?

A

emphasis community-based health promotion = collaborative efforts of community network to achieve public-health goals.

Important to maternal–newborn health, which is affected by multiple public-health issues (i.e. Maternal smoking, substance abuse, obesity)

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3
Q

List 4 reasons why should women enter the HC system?

A
  1. Well-woman care
  2. Fertility control & infertility
  3. Preconception counseling and care
    4 Pregnancy
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4
Q

What does Well-women Care Provide within the HC system?

A

Provides HC needs for lifetime

Within primary health care delivery system

Provides contraception / Pap

Needs vary by age, culture, religion, and personal differences

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5
Q

What does Fertility control and infertility offer within the HC system?

A

40% of all pregnancies are unplanned.

Education for family-planning/ choices.

Health promo applied to contraception, STI’s

Infertility and emotional pain, stress

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6
Q

What does Preconception counseling and care provide within the HC system?

A

Promotes healthy behaviours to optimize normal fetal growth

Preconception Care Should Include:

 - Health promotion
 - Risk assessment
 - Interventions
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7
Q

Why is it important for pregnant women to enter into the HC system?

A

Prenatal care in first 12 weeks identifies women at risk and initiates preventive/ treatment measures.

Goals of Care:
-Health stat. of mom/fetus 
-Gestational age of fetus 
  and monitor fetal 
  development.
-Identify women at risk for 
 complications and 
 min. risk
-Assess for social support 
 and previous loss.
-Assess learning needs.
-Provide appropriate education and counseling.
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8
Q

What factors affect health in theChild-bearing Years?

A
  1. Socioeconomic difference
  2. Cultural factors
  3. Substance Use
  4. Poor Nutrition
  5. Lack of physical fitness
  6. Stress
  7. Psychological Health
  8. Violence against woman
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9
Q

Preconception Care includes?

A

***PRENATAL CARE SHOULD BEGIN BEFORE A WOMAN BECOMES PREGNANT

Identify the risks/educate, help to access services if necessary.

Address psychological, social, & cultural concerns early

Remind her to keep appointments – develop relationship with care provider and catch any problems early

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10
Q

Gravida

A

Women who is pregant

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11
Q

Gravidity

A

pregnancy

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12
Q

Multigravida

A

woman who has had two or more pregnancies

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13
Q

Multipara

A

woman who has completed two or more pregnancies to 20 weeks gestation or more

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14
Q

Nulligravida

A

woman who has never been pregnant

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15
Q

Nullipara

A

woman who has not completed a pregnancy with fetus or fetuses beyond 20 weeks of gestation

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16
Q

Parity

A

number of pregnancies in which fetus or fetuses have reached 20 weeks of gestation, not number of fetuses (e.g., twins) born. Parity is not affected by whether the fetus is born alive or is stillborn (i.e., showing no signs of life at birth).

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17
Q

Postdate or postterm

A

pregnancy that goes beyond 41 weeks of gestation

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18
Q

Preterm

A

pregnancy that has reached 20 weeks of gestation but before completion of 36 weeks of gestation

19
Q

Primigravida

A

woman who is pregnant for the first time

20
Q

Primipara

A

woman who has completed one pregnancy with fetus or fetuses who have reached 20 weeks of gestation

21
Q

Term

A

pregnancy from beginning of week 37 of gestation to end of week 40 plus 6 days of gestation

22
Q

Viability

A

capacity to live outside the uterus; about 22 to 25 weeks of gestation

23
Q

GTPALS SYSTEM

A 
G: Gravida - # times uterus gravid 
T: Term – after 37 completed weeks
P: Preterm – before 37 completed weeks
A: Abortion – therapeutic or spontaneous prior to 20 weeks
L: number of living children

Example: 5th pregnancy, two miscarriages, one set of twins at 32 weeks, one full term child: G_T_P_A_L_

24
Q

NAGALES RULE

A

Nagele’s rule – 1st day LMP subtract 3 months, add 7 days,

Eg. LMP: January 10.
Subtract 3 months (October 10) and add 7 days. Therefore due date is: Oct 17
Assumes 28-day menstrual cycle
Only 5% of women deliver on due date

25
Q

Fetal Development

A 
-Influenced by genetics, 
 exposure to teratogens, 
 maternal nutrition
-Most susceptible – days 15-60 greatest/fastest cell differentiation
-Teratogens may be:
     *Drugs or chemicals 
      (thalidomide, alcohol)
     *Infections 
     *Exposure to radiation
     *Maternal conditions 
      (diabetes)
26
Q

Drug Classifications

A

Classified by effect on fetal development:
A – proven to be ok - controlled human studies
B – proven ok - animal studies only
C – probably ok - no studies to prove otherwise animal or human
D – causes some harm – benefit outweighs risk
X – definitely not used – risk outweighs benefits
Herbs are meds – not regulated or tested

27
Q

Placenta: Structure

A 
-Starts forming at 
 implantation
-Consists of 15-20 
 cotyledons 
-Each is a functional unit
-Maternal-placental-
 embryonic circulation in 
 place day 17 (embryonic 
 heart starts to beat)
-Structure complete by 
 12th week but continues 
 to grow until 20th week
-Ends up covering half of 
 uterine surface
-Only one cell width 
 b/w maternal and 
 fetal blood
28
Q

Placenta Endocrine Function (protein hormones)

A 
1. hCG human chorionic 
 gonadotropin – preserves corpus luteum to produce progesterone and estrogen to maintain pregnancy
2. hCS- human 
 somatomammotropin / hPL/human placental lactogen: 
  *helps maternal 
   metabolism supply 
   nutrients for fetal growth
  *increases insulin 
   resistance
  *facilitates glucose 
   transport across placenta-
  *breast development for 
   lactation
29
Q

Placenta Endocrine Function (steroid hormones)

A 
Progesterone – (decreases near end) 
 *maintains endometrium
 *Reduces uterine 
  contractility
 *Stimulate development 
  of breast alveoli and 
  maternal metabolism
Estrogen (Estriol)- (peaks at end of pregnancy)
 *Stimulates uterine growth 
   and uteroplacental blood 
   flow
 *Increase in breast gland 
  tissue
 *Increases uterine 
  contractility
30
Q

Placenta: Metabolic Function

A 
Respiration (lung):
 -O2 diffuses from 
  maternal across 
  placental membrane into 
  fetal blood, CO2 
  opposite direction
Nutrition:
-Water, inorganic salts, 
 carbs, proteins, fats, 
 vitamins pass across 
 placental membrane
-Nutrition passes in 
 different ways depending 
 upon molecular weight – 
 hydrostatic and osmotic 
 pressures, facilitated and 
 active transport, 
 pinocytosis
31
Q

Placenta: Metabolic Function

A 
Respiration (lung):
 -O2 diffuses from 
  maternal across 
  placental membrane into 
  fetal blood, CO2 
  opposite direction
Nutrition:
-Water, inorganic salts, 
 carbs, proteins, fats, 
 vitamins pass across 
 placental membrane
-Nutrition passes in 
 different ways depending 
 upon molecular weight – 
 hydrostatic and osmotic 
 pressures, facilitated and 
 active transport, 
 pinocytosis
Excretion:
-Waste crosses from fetal 
 to maternal blood across 
 the membrane
-Maternal kidneys then 
 excrete it
-Viruses/some bacteria 
 and protozoa can infect 
 fetus
-Drugs can cross 
 membrane

Storage:
-Carbohydrates, proteins,
calcium and iron stored
for fetus

32
Q

What is involved in the First trimester- initial visit for physical exam and lab testing?

A 
Physical Exam:
-Provides a baseline for 
 future changes.
-Vital Signs (incl ht/ wt.)
-Physical Assess-risks, 
 screen, confirm 
 pregnancy, urine, blood 
 test for hCG.
-note fundal ht after 1st tri.
-Immunizations (No live 
 viruses)
-Pelvic Exam  
Lab tests: 
-Provides baseline 
-Hct, hgb, glucose test, 
 blood group antibody 
 screen, rubella titre, Hep 
 B,  VDRL
-Controversial Screenings: 
 Chlamydia, gestation 
 diabetes, U/S, HIV/AIDS, 
 maternal serum marker 
 screening.
33
Q

What is involved in the First trimester- initial visit for interview/ assessments?

A 
Interview: 
-Overview role of HCP 
-Standardized record 
  used by all HCP’s
-History (family hx, 
 previous pregnancy, 
 social, emotional 
 concerns)
-EDB - Nagle’s rule 
-Establish GTPALS

Psychosocial assessment – ALPHA tool- # risk factors indicate poor family outcome – woman abuse, child abuse, PPD, couple dysfunction, increased chance of illness

Assess – adjustment to pregnancy, support or lack of it (child abuse, PPD), stress and anxiety – life events, death, move, job change, father receiving support

34
Q

Subsequent Assessment -

A 
Frequency of visits: 
  *Every 4 weeks until 30 
    weeks then 
  *Every 3 weeks until 36 
               then 
   *Every week till delivery
Assess for:
-BP /edema 
-Urine for proteinuria, 
 glucose (GTT between 
 24-28 weeks)
-Weight gain: 25-35 pds
-Fundal height above symphysis pubis at 12 weeks, @ umbilical at 20 weeks then 1 centimeter per week after
35
Q

Subsequent Assessment CONT:

A

-Fetal tones – 120-160 bpm
-Health teaching –
emotional assessment
-Pelvic assessment 3-4
weeks from EDB -
Evaluate cervix
-Lab tests to redo – Hct &
16-18 weeks triple marker
– hCg, estriols, and
Alpha feto protein – is
elevated for neuraltube,
decreased for Down’s
syndrome
-Culture GBS at 35-37
weeks
-Antibody titre Coombs
Test: Rh negative at 22
weeks & 28 weeks

36
Q

What are some warning signs during pregnancy?

A

-Severe vomiting
-Epigastric pain (severe
stomach ache)
-Sudden swelling in face,
hands, arms
-Headaches
-Blurred Vision
-Vaginal bleeding
-A fall, accident
-Sudden sharp abdominal
pain
-Chills or fever
-Burning on urination
-Abdominal cramping
-Change in fetal
movement

37
Q

Role of the Nurse

A

ADVOCATE:
Political, economic, social cultural, environmental, behavioural & biological factors can all favour health or be harmful to it.
Health promotion action aims at making these conditions favourable through advocacy for health.

ENABLE:
Health promotion action aims at reducing differences in current health status & ensuring equal opportunities & resources to enable all people to achieve their fullest health potential.
This includes a secure foundation in a supportive environment, access to information, life skills & opportunities for making healthy choices.
Must apply equally to both men & women.

38
Q

What are some important nutritional requirements during pregnancy?

A 
Fluids
Protein
Vitamins & Minerals
Iron
Calcium
Folate
Vit A
Calcium
 Omega-3 Fatty Acids
39
Q

Nutrition / Weight gain

A 
-Consider pre-pregnancy 
 weight
-Calculate BMI = 
 weight/height²
-18.5.8-24.9 BMI normal for 
 single fetus
-16-20 for twin
-Normal weight gain 11.5-
 16kg (25-35lbs) 
-Underweight: gain 12.5 – 
 18kg (28-40lbs)
-Overweight: gain 7-11.5 kg 
 (15-25lbs)
-Obese: gain 5-9 kg (11-20lbs)
40
Q

What are some nutritional risks during pregnancy?

A 
Adolescents
Frequent pregnancies
Poverty
Poor diet habits
Weight at conception: obesity
Food choices & cravings: Pica, lactose intolerance, vegetarians
41
Q

Role transition includes the ways in which parents respond to the birth of their child are influenced by various factors including:

A

-Age
-Social networks
-Culture
-Socioeconomic conditions
-Personal aspirations for
the future.

42
Q

How is the transition into parenthood viewed?

A

Historically seen as a life crisis

Current perspective:
-Developmental transition
-Viewed as an opportunity 
 to try new roles, new 
 coping strategies, reach 
 new developmental stages
-
43
Q

First-time parents tend to perceive the first 4 to 10 weeks of parenthood in much the same way.Viewed as a period characterized by:

A

-Uncertainty
- Increased responsibility
- Disruption of sleep
- Inability to control the time needed to care for
the infant and reestablish the marital dyad

44
Q

BARRIERS TO EFFECTIVE TRANSITION

A

Some parents have limited knowledge of what being a parent entails.

New parents often require information about:

  • Infant care
  • Relationship changes
  • Views on parenting

Women generally have more support systems (i.e. Female relatives, postnatal groups, friends) than men

Need to reconcile the actual child with the fantasy and dream child (i.e. coming to terms with the infant’s physical appearance, sex, innate temperament, & physical status)

Maternal Infant (5 decks)

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