Week 1 intrapartum assessment Flashcards
How much folic acid is recommended pre-conception?
400 ug
What are the 6 pregnancy specific components of an intrapartum assessment? (before physical assessments)
EPGPLB
- EDD
- Prenatal care
- G/P
- Preg History
- Labor Status
- Birth Plan
What are some unique aspects of Dick-Read childbirth education?
- One of the first to use relaxation
- Fear of child birth causes tension and pain which is bad for baby
- Slow abdominal breathing in labor
- Rapid chest breathing in labor
- First to be called “natural” childbirth
How fast can iron anemia be corrected and what doses of iron are used to do so?
can increase hemoglobin by 2g/dl over one month
60-120mg of iron are used.
What are two common neural tube defects?
- Spina bifida
- Anencephaly
What should be obtained in pregnancy history during a intrapartum assessment?
- Any problems experienced during previous preg.
- Past deliveries vag/c-section
- Any current problems
How many additional calories should a lactating mother receive?
500/day (170 from stores)
What is the goal of perinatal education?
Help parents become more knowledgeable consumers, take and active role in managing health during pregnancy and birth, and learn coping techniques for pregnancy, childbirth, and parenting
What does GPTAL stand for?
- Gravida
- Para
- Term
- Abortion
- Living
If a mother claims no pre-natal care during the intrapartum assessment, what should be suspected?
Drug use or some other issue causing the mother not to seek care
What is a teaching tip to decrease intolerance to iron supplements?
Take at night with PNV, vit c, and dry cereal snack
How is the fetal eval done?
Through FHR monitoring
What are the four physical aspects of the intrapartum assessment?
- Fetal Eval
- Labor Status
- Physical exam
- Labs
Nausea is very common in the ___ trimester. This is also known as _____
first
Morning sickness
What are the non-pregnancy specific components of the intrapartum assessment?
AFRMT (before physical assessments)
- Allergies
- Food Intake
- Recent Illnesses
- Medications
- Tobacco/Alcohol use
What are the two belts placed on the pregnant mother during the intrapartum assessment?
1st- Fetal HR monitor
2nd- Transducer (measures contractions)
What is the main focus of perinatal education in the third trimester?
- Pharm vs non-pharm methods of pain management
- Physical/psychological changes in late preg
- Labor and birth
- coping techniques for labor
- complications
- High-risk preg
What are some aspects of family centered care related to childbirth?
- it is usually a normal healthy event
- It affects the entire family
- Families can make decisions about care if they are well informed
- It is beneficial to focus on family
What are some sources of folate?
Avocado, bananas, OJ, dry cereal, asparagus, fruits, green leafy veg, nuts, liver, dried beans, peas
What is a Multipara?
Delivered two or more pregnancies of at least 20 weeks
What information is collected in the labor status portion of the intrapartum assessment?
- When did the contractions become regular
- What is the contraction pattern
- What is your membrane status
What are the disadvantages of birthing centers?
They are not equipt for major obstetric emergencies
What are some aspects of Bradley childbirth education?
- First to include father support
- Abdominal breath support and relaxation
- Avoidance of medications or other interventions
A pregnancy at or beyond ___ weeks is term
38
What is the normal healthy weight gain during pregnancy for a woman of normal BMI?
25-35lbs total
0.35- 0.5kg/week in the 2 and 3 trimesters
What 5 lab tests on done during the intrapartum assessment?
- Mid-stream urine
- CBC
- Blood type with Rh factor
- STI tests
- Drug screen if applicable
What are some aspects of Lamaze childbirth education
- Psychoprophylaxis to prevent pan
- Concentration and conditioning to help respond to contractions with relaxations
- Most common
What is tested for with the mid-stream urine collection during the intrapartum assessment?
-Protein and glucose
What is the DRI for iron during pregnancy?
27mg/day
What is Gravidity?
Number of time pregnant regardless of length
How do you calculate EDD using Naegele’s rule?
Subtract 3 months from the date of the beginning of the LNMP add 7 days and correct for the year.
What is the RDI of folate during pregnancy?
400-800/day
What physical exam in done during the intrapartum assessment?
A full H2T
How is membrane status checked during the intrapartum assessment?
- Hx of water break
- pH (AF will turn paper blue (pH >6.5))
- Fern presentation seen with microscopy
What are the expected values for the CBC taken during the intrapartum assessment? what does it mean if these values are low?
- Hgb 11g/dl and HCT less than 33 increased RBC and plasma volume
- Physiologic anemia
What is a Nullipara?
Never been pregnant or never completed a pregnancy at or beyond 20 weeks
What are the 4 common types that deliver babies?
Certified nurse midwife, Nurse practitioner, Physician
How many months does the infants iron store last?
6
How is a labor status assessment done during a intrapartum assessment?
- Via a sterile Vag. exam
- Membrane status
- Pain level
- Leopold’s maneuvers
What is Para?
Number of pregnancies that ended at 20 or more weeks
What is the importance of folic acid?
-Prevention of neural tube defects
What does GTPAL stand for?
- Gravida
- Term
- Preterm
- Abortion
- Living
What is the focus of perinatal education in the first trimester?
- Adapting to the pregnancy
- Understanding what to expect
- Physical changes
- Self-care
- Infant care
- Birth
Weight gain recommendations in pregnancy are based off of ____
The mothers BMI
____ is very important for any woman preparing for a natural birth. Specifically because they need to know what to expect during labor
Perinatal education
What should be asked about pre-natal care during the intrapartum assessment?
- Who provides your prenatal care (obtain their contact info if not in system)
- Where do you receive the care
Why do most women stop taking iron supplements?
Intolerance
Why are pregnant woman at high risk for iron def. anemia?
Because during pregnancy, maternal blood volume expands and requires more iron for hemoglobin production.
How do you know the days in a month?
If the month is on a knuckle, it has 31 days. Otherwise is has 30 or less days.
Starting with the 1st knuckle as January.
What are the three most common perinatal education models?
-Dick-Read
-Bradley
Lamaze
What is the focus of perinatal education at preconception?
- Helping with a healthy pregnancy
- Nutrition before conception
- Healthy lifestyles
- S/s of pregnancy
- choosing caregiver
What is the focus of perinatal education during the second trimester?
Changes that occur during middle pregnancy
-Exercise if approved
What is the very first thing that is done during the physical aspects of the intrapartum assessment?
Fetal Eval
How is iron deficiency diagnosed?
A ferritin level of < 15 ug/L
When is the most important time for a pregnant mother to have adequate iron? Why?
During the 3rd trimester.
Because this is when the fetus begins to store iron it will use for the first months of its life
Iron needs ___ during pregnancy
double
What is a Primipara?
Delivered one pregnancy of at least 20 weeks
When is the sterile vag. exam not done?
- If rupture occured with no active labor
- If actively bleeding
- If pre-term (under 38 weeks)
- PROM or PPROM (premature rupture of membranes/Pretemr premature……)
What does the sterile vag. exam determine?
- Cervical Dilation
- Cervical effacement
- Fetal presentation, position, station
What is one issue with the availability of perinatal education?
it can be very expensive.
If a patients LNMP started on Aug 30th 2018 when is their EDD? (using Naegele’s rule)
June 6th 2019
How many para’s in a multiple gestation?
still 1
Why is iron important during fetal development?
Deficiency in infancy and early childhood is associated with impaired memory function and changes in temperament that may mimic ADD
Important for neurological development
