Unit 6: Reproduction and Family Dynamics Flashcards
What is Naegele’s Rule?
from the start of last menstruation cycle:
subtract 3 months
add 7 days
adjust year if needed
What is the family adaptation to the pregnancy?
Accepting
Identifying with role of the mother
Reordering personal relationships
Establishing a relationship with the fetus
Preparing for the birth
What 2 major needs do most women have?
Feeling loved and valued
Having the child accepted by partner
What is prenatal care?
A period of physical and psychologic preparation for birth and parenthood
To access the family, see if the woman wants them at the prenatal visits
To provide health promotion, risk reduction, and disease prevention
What are barriers to prenatal care?
Financial
Culture norms
Transport
Access
Availability
Time of day for appointments
What are key components of the prenatal interview?
Desire for current pregnancy accessed
Reproductive and Sexual history
Health history
Medication, herbal use, substance use, immunizations
Nutrition
Family History
Social, experiential, and occupational history - access about possible changes in situation
Mental health history/screening
Risk of partner violence
Review of systems
What are medical conditions that affect pregnancy?
Diabetes
HTN
Renal disease
Seizures
Cardiac disease
Gastrointestinal disease
Blood disease
Pulmonary disease
What is the physical exam?
Access height and weight, calculate BMI
Vital signs - watch BP
Thorough head-to-toe assessment
Fundal height assessment - correlate with weeks, unless amniotic fluid is off
What laboratory tests are performed?
Clean catch urine test for glucose, protein, nitrates, and leukocytes
Culture of urine, cervical & vaginal smears, and blood tests – yeast infection, Group B strep (beginning and 35-37 weeks), STIs
Blood tests (anti-Rh and rubella immunity)
Hemoglobin/hematocrit 28-32 weeks
Glucose 24-28 weeks
Why is Rhogam given?
For maternal neg-Rh to stop the antibodies from attacking an Rh-pos fetus
What happen during a fetal assessment?
Gestational age (ask about quickening)
Fetal heart tones
Fetal movement
Ultrasound examination
What happens in follow up visits?
Interview (not as extensive)
Physical assessment - fundal height
Fetal assessment
Routine tests: Group B cultures, genetic screening, blood tests (MSAFP), amniocentesis
What categorizes a high risk pregnancy?
Multifetus
Developmental abnormalities
Low BP pregnancy
Diabetes
How often should prenatal visits happen?
Monthly
then weekly
What is common with multifetus pregnancy?
Low fetus birth weight
Prematurity births
Miscarriage
Preeclampsia
HTN
Hemorrhage
Maternal death
What are multifetal pregnancies prenatal care appointments like?
More often
Nutritional intake observed (200+ cal increase)
Education - more expected weight gain
What self-management education should be given to mothers by the nurse?
Assist them to make informed, safe decisions
Help find reliable information
Prenatal vitamins (folic acid and iron)
Avoid alcohol and limit caffeine
Increase nutrition by 200 cal during and 500 cal during breastfeeding
Educate about food-borne illness and pica
What dental, UTI, and hygiene care education needs to be given?
No bubble baths
Avoid extreme temps on stomach
Proper wiping
Drink water
2nd tri for dental care
Oral health decreases during pregnancy
Bad oral health increases preeclampsia
What travel education needs to be given?
Low-risk can travel (avoid malaria, zika, poor medical care, and poor water treatment countries)
Stand for 10 mins for every 2 hours of sitting during travel
Only 6hrs length for driving
What breastfeeding education needs to be given?
Benefits of breastfeeding: decrease bleeding, infection, and risk for breast cancer
Provide early education and breast hygiene information
*nipple stimulation can cause contractions
What education should be given for physical/sexual activity?
May need to decrease intensity of workout third trimester
Contractions can be caused by: orgasm and unprotected sex (semen softens cervix)
Normal to see spotting after intercourse
Libido decreases
Woman can’t be on her back - supine hypotension
What medication is safe during third trimester?
Tylenol; NSAIDs can cause closure of ductus arteriosus (bypasses lungs)
What are 1st tri S/S to report?
Severe vomiting - hyperemesis gravidarum
Chills/fever - infection
Buring of urination - infection
Diarrhea - infection
Cramping, vaginal bleeding - miscarriage
What about the 2nd and 3rd tri S/S to report?
Severe vomiting
Sudden discharge of fluid (before 37 weeks)
Vaginal bleeding, abdominal pain
Severe backache or flank pain
Changes in fetal movement (absence or unusual)
Absence of FHR
Uterine contractions, pelvic pressure, cramping before 37 weeks
Visual disturbances -preeclampsia
Swelling of face, fingers - preeclampsia
Headaches (severe, frequent, or continuous) - preeclampsia
Muscular irritability or seizures - preeclampsia
Heartburn or stomachache - preeclampsia
Glycosuria
What cultural influences and variations are seen in prenatal care?
Need for modesty
Respect for sexuality of parents
Fear of having a man invade personal space
When healthcare is needed
