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NURS202 Summary > week 12: antenatal assessment in pregnancy > Flashcards

week 12: antenatal assessment in pregnancy Flashcards

1
Q

antenatal

A

Prenatal, before birth

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2
Q

conception

A

Fertilization in oviduct; sperm + egg = blastocyst

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3
Q

implantation

A

Blastocyst’s chorionic villi attach to uterus, develops into membranes
Placenta = Chorion + Amnion

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4
Q

preg test

A

Human Chorionic Gonadotropin (hCG) is the earliest indicator of pregnancy
Comes from the placenta and tests recognize its presence
Otherwise, Progesterone is responsible for pregnancy maintenance - but it’s always there

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5
Q

gravidity

A

pregnancy

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6
Q

gravida

A

Woman who is pregnant

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7
Q

primigravida

A

1st pregnancy

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8
Q

multigravida

A

2+ pregnancies

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9
Q

nulligravida

A

Never been pregnant

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10
Q

parity

A

Number of pregnancies (not fetuses) where the fetus/es reaches 20 gestational weeks
- Legal viability is reaching 20 weeks pregnancy - whether the fetus is born alive or still
- Twins would still being 1 parity, if a fetus suddenly dies at 30 weeks it’s still parity

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11
Q

primi/multi/nullipara

A

One, 2+, 0 pregnancies reach viability
For multi, it’s really 22-25 weeks as they’re more likely to survive
Lungs aren’t mature at 20 weeks; past 24 weeks it’s better

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12
Q

preterm

A

Pregnancy delivered between 20-36 weeks

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13
Q

term

A

Delivered from wks 37-42 (42 is late)

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14
Q

postdate/term

A

Pregnancy beyond 41 weeks (Canada) or 42 weeks (US)

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15
Q

viable

A

Capable of living outside of the uterus; from 22-25 weeks

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16
Q

GTPAL Scale

A

3-1-0-1-3
Gravidity: Number of all pregnancies (regardless of term, birth, miscarriage)
Term Births: Number of deliveries from wks 36-42
Preterm Births: Number of deliveries from wks 20-36 (viability -> 36)
Abortions/Miscarriages: Total number of miscarriages/abortions
Living Children: Number of living children
In the above example:
The woman has only given birth once - therefore triplets
She has miscarried once at another pregnancy
There is no outcome for her 3rd pregnancy: She is currently pregnant

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17
Q

pregnancy

A

Spans 9 months or 10 lunar months (28 days each; 280 days)
Trimesters:*
1st: Wks 1-13
2nd: Wks 14-26
3rd: Wks 27-40 (term babies)

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18
Q

presumptive signs of preg

A

Felt by the woman
Missed periods
Home pregnancy test positive
Morning sickness, breasts tender, fatigue, peeing urgency/frequency
Quickening: 14-20 weeks in, woman feels fetal movement

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19
Q

probable signs of preg

A

Observed by the examiner
Uterine enlargement (measured from the pubic symphysis up)
Positive hospital pregnancy tests for hCG
Braxton Hicks contractions: Irregular tightenings of muscular uterine layer; birth prep
Changes in pigmentation
Chadwick’s Sign (Colour): Labia, vagina, cervix turn purple/blue; fill with blood, signs of vascular congestion due to changing hormones
Goodell’s Sign (Growth): Hypertrophy (growing) and engorgement of vessels resulting in significant softening of the cervix - as always, due to hormones
Hegar’s Sign: Examiner palpates softening of lower uterine segment; 6-8th week

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20
Q

positive signs of preg

A

Actually from the fetus
Fetal heartbeat that isn’t the mother’s (110-160bpm)
Fetal movement felt by the examiner
Visualization (ultrasound)
Cord, amniotic volume, baby breathing, tone, etc… # of fetuses

21
Q

naegele’s rule

A

Used to calculate; not totally exact
Take the first day of last period - 3 months + 7 days + 1 year
Or first day of last period + 9 months + 7 days
Ex., April 2nd, 2019 -> January 9th, 2020 - most give birth in +/- 7 days of that number

22
Q

prenatal data

A

biological data
gynecological data
obstetric history
genetic history
medical history
infectious diseases
nutritional habits
personal habits
exercise habits
enviro habits
family roles/relationships
psychosocial considerations
cultural/spiritual considerations
developmental considerations

23
Q

objective data in women preg

A

Diluted haemoglobin, but levels remain the same (because of higher BV)
Lower BP, Higher HR
Peripheral edema
Normal if standing for a while
Problem if swollen after lying down - check BP; body isn’t coping properly

24
Q

preg lab tests

A

Rubella Titre (MMR test)
Complete Blood Count (CBC); for anemia, infection
Blood Type & Rhesus factor - abnormal antibodies
Rhesus Positive blood has an extra protein; if dad is + and mom is -, she can form antibodies against Rh+ blood which is a risk for the next pregnancy
STI Tests: Syphilis, Gonorrhea, Chlamydia, HSV, CMV, HBV
Serum glucose (for gestational diabetes), Glucose tolerance test (sugary drink)
Urinalysis and culture (check for UTI, urine contents)
HIV/AIDS screening

25
Q

preg uterus

A

Changes in size, shape, position (starts to rise from the pubic symphysis at 12 weeks)
Braxton Hicks contractions (caused by OXT)
Measure Uteroplacental Blood Flow - HTN, Intrauterine Growth Restriction, Diabetes, Twins
HTN will inhibit ability of fetus to grow
Cervical Changes (Chadwick’s, Goodell’s signs); mucus plug
Quickening (fetal movements)

26
Q

preg breasts

A

Fullness, heaviness - larger because of hormones
Heightened sensitivity; tingling and pain
Areolae are more pigmented (So baby can find it)
Montgomery’s Tubercles: Bumps around areola; secrete bacteriostatic; keeps infections low
Colostrum: Pre-milk substance by last trimester; prepares for production
High in antibodies and seals baby’s gut

27
Q

preg CV

A

BP is the same, BV increases (though Hb dilutes), Cardiac Output increases
Circulation, Coagulation times - Increased risk of clotting

28
Q

preg resp

A

Pulmonary function (breathing)
BMR increase (because the fetus is a parasite)
Nasal stuffiness due to hormone changes

29
Q

preg kidneys

A

Higher output of urine - drink fluids + electrolytes to replace
Higher filtration

30
Q

preg skin

A

Chloasma: Mask of pregnancy (hyperpigmentation on face)
Linea nigra: From pubic symphysis up to uterus
Striae gravidarum: Stretch marks
Palmar erythema: Redness in hands

31
Q

chloasma

A

Mask of pregnancy (hyperpigmentation on face)

32
Q

linea nigra

A

From pubic symphysis up to uterus

33
Q

striae gravidarum

A

Stretch marks

34
Q

palmar erythema

A

Redness in hands

35
Q

MSK preg

A

Joints loosen up to adapt to load; wider stance and waddling

36
Q

Neuro preg

A

No change unless BP increases, Pain, numbness (due to pressure), headaches

37
Q

GI preg

A

Fluctuations in appetite (starts with decrease)
Pica: Craving non-food; chalk, dirk
Swelling gums - Check dental care for calcium (Does NOT affect teeth)
Displacement of intestines, stomach -> Acid reflux, constipation, ab pain
Gallbladder, liver impact

38
Q

endocrine

A

Hormonal state; increased metabolism, ++PRL, OXT, Cortisol …

39
Q

weight gain preg

A

Recommended around 25-35lbs* on average
Fetus = 7.5 lbs, Placenta = 1.5lbs, Amniotic Fluid = 2lbs, Uterus = 2.5lbs
Breasts = 3lbs (one cup size), Blood Volume = 2-4lbs, Fluid/Fat = 4-9lbs
Decreases after delivery

40
Q

fetal assessment

A

Quickening (movements at 14-22 weeks)
Heart sounds (10-12wks with Doppler ultrasound, Fetoscope)
Fetal Crown to Rump measurement (with ultrasound)
Biparietal diameter (Widest transverse diameter of head at 12-13 weeks with ultrasound)
Fundal height (where the uterus is)

41
Q

maternal and paternal roles

A

Accepting pregnancy (father is delayed until they actually hold the baby)
Identifying mother/father role
Smoking, habit changes, nesting (mother), doing what’s “good for the baby”
Reordering personal relationships
Emotional relationship with fetus (mother moreso; softening hormones like Progest./Est)
Preparing for childbirth

42
Q

sibling adaptation

A

Sibling jealousy; normal

43
Q

grandparent adaptation

A

Some are happy, unhappy about it

44
Q

1st trimester discomforts of preg

A
  • Nausea, vomiting - Hormones change, fatigue, emotional factors, carbohydrate metabolism
    Have a dry cracker/toast before rising - keep blood sugar regular
    Small, frequent meals, avoid greasy, flavourful food
  • Nasal stuffiness (hormones): Use a vaporizer
  • Breast tenderness: Have a well-fitting bra
  • Urinary frequency/urgency: Due to bladder pressure (wks 1-12, 3rd trimester)
    Limit fluids in evening, caffeine
    Respond to voiding urgencies immediately
    Kegel exercises to strengthen pelvic floor
    Report symptoms of UTI
  • Increase vaginal discharge (leucorrhea):
    Have good hygiene, wear cotton underwear (reduces chances of UTI)
45
Q

2nd and 3rd trimester discomforts of preg

A
  • Heartburn (displacement and relaxed sphincters)
    Have antacids with no sodium (ask HCP), small meals, upright, avoid fat/fried
  • Constipation (from iron supps, intestinal displacement + sluggish bowels)
  • Increase fluids and fibre
  • Hemorrhoids (due to pressure on pelvic veins)
    Treat constipation, don’t stand for too long, wear constrictive clothing
  • Backaches (at lumbosacral curve):
    Avoid heels, have good posture + body mechanics
  • Leg cramps (pressure, poor circulation, fatigue)
    Rest with legs up, warm clothing and exercise
  • Shortness of Breath (dyspnea) (due to diaphragmatic pressure)
    Semi-Fowler’s position (15-45° upright), change posture
  • Ankle Edema (due to poor venous return)
    Rest with legs up, avoid tight clothing
46
Q

nursing care management preg

A

Identify existing risk factors/deviations from normal to promote health
Emphasize preventative and self-care
Prenatal care is often sought by middle, wealthy SES
Impoverished women may not have as much access to public, private care (lower SES)
SDH; lack of culturally-sensitive care, commute, travel/transport
Fewer positive outcomes and more complications

47
Q

follow up visits preg

A

Monthly until last month; then every 2 weeks
First one is an interview
Subsequent ones are physical examinations, fetal assessments
Fundal height, gestational age, health status
Fetal development

47
Q

follow up visits preg

A

Monthly until last month; then every 2 weeks
First one is an interview
Subsequent ones are physical examinations, fetal assessments
Fundal height, gestational age, health status
Fetal development

NURS202 Summary (12 decks)

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