Unit 6: Reproduction and Family Dynamics

Question 1

What is Naegele’s Rule?

Answer 1

from the start of last menstruation cycle:
subtract 3 months
add 7 days
adjust year if needed

Question 2

What is the family adaptation to the pregnancy?

Answer 2

Accepting
Identifying with role of the mother
Reordering personal relationships
Establishing a relationship with the fetus
Preparing for the birth

Question 3

What 2 major needs do most women have?

Answer 3

Feeling loved and valued
Having the child accepted by partner

Question 4

What is prenatal care?

Answer 4

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

Question 5

What are barriers to prenatal care?

Answer 5

Financial
Culture norms
Transport
Access
Availability
Time of day for appointments

Question 6

What are key components of the prenatal interview?

Answer 6

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

Question 7

What are medical conditions that affect pregnancy?

Answer 7

Diabetes
HTN
Renal disease
Seizures
Cardiac disease
Gastrointestinal disease
Blood disease
Pulmonary disease

Question 8

What is the physical exam?

Answer 8

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

Question 9

What laboratory tests are performed?

Answer 9

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

Question 10

Why is Rhogam given?

Answer 10

For maternal neg-Rh to stop the antibodies from attacking an Rh-pos fetus

Question 11

What happen during a fetal assessment?

Answer 11

Gestational age (ask about quickening)
Fetal heart tones
Fetal movement
Ultrasound examination

Question 12

What happens in follow up visits?

Answer 12

Interview (not as extensive)
Physical assessment - fundal height
Fetal assessment
Routine tests: Group B cultures, genetic screening, blood tests (MSAFP), amniocentesis

Question 13

What categorizes a high risk pregnancy?

Answer 13

Multifetus
Developmental abnormalities
Low BP pregnancy
Diabetes

Question 14

How often should prenatal visits happen?

Answer 14

Monthly
then weekly

Question 15

What is common with multifetus pregnancy?

Answer 15

Low fetus birth weight
Prematurity births
Miscarriage
Preeclampsia
HTN
Hemorrhage
Maternal death

Question 16

What are multifetal pregnancies prenatal care appointments like?

Answer 16

More often
Nutritional intake observed (200+ cal increase)
Education - more expected weight gain

Question 17

What self-management education should be given to mothers by the nurse?

Answer 17

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

Question 18

What dental, UTI, and hygiene care education needs to be given?

Answer 18

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

Question 19

What travel education needs to be given?

Answer 19

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

Question 20

What breastfeeding education needs to be given?

Answer 20

Benefits of breastfeeding: decrease bleeding, infection, and risk for breast cancer
Provide early education and breast hygiene information
*nipple stimulation can cause contractions

Question 21

What education should be given for physical/sexual activity?

Answer 21

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

Question 22

What medication is safe during third trimester?

Answer 22

Tylenol; NSAIDs can cause closure of ductus arteriosus (bypasses lungs)

Question 23

What are 1st tri S/S to report?

Answer 23

Severe vomiting - hyperemesis gravidarum
Chills/fever - infection
Buring of urination - infection
Diarrhea - infection
Cramping, vaginal bleeding - miscarriage

Question 24

What about the 2nd and 3rd tri S/S to report?

Answer 24

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

Question 25

What cultural influences and variations are seen in prenatal care?

Answer 25

Need for modesty
Respect for sexuality of parents
Fear of having a man invade personal space
When healthcare is needed