Ch.8 - Nursing Care of the Family During Pregnancy Flashcards
Great deal responsibility as nurses during pregnancy
is education
Pregnancy
Trimesters
Nursing care during pregnancy
Spans 9 calendar months
10 lunar months of 28 days (280 days total) - carried to 40 weeks
Pregnancy
First: weeks 1 through 13
Second: weeks 14 through 26
Third: weeks 27 through 40
Trimesters
Estimating date of birth (EDB)
Formulas for calculating EDB but none infallible
Estimated date of confinement (EDC)
Estimated due date
IT IS AN ESTIMATE
Not know when sperm and egg met exactly
Nägele rule
Diagnosis of pregnancy
LMP - first day started bleeding; beginning of cycle; pregnant during that cycle
Determine first day of last menstrual period (LMP), subtract 3 months, add 7 days plus 1 year depending when LMP OR Alternatively count forward 9 months from the LMP and add 7 days
ADD 7 days either way because Most women give birth from 7 days before to 7 days after EDB - guess because not there for conception
Nägele rule
Maternal adaptation
Partner adaptation
Sibling adaptation
Grandparent adaptation
Adaptation to pregnancy
Accepting the pregnancy
Identifying with the mother role
Reordering personal relationships
Establishing a relationship with fetus
Preparing for childbirth
Maternal adaptation
Maybe little denial but then pregnancy - something stretch and then transition that going to be mother - differently for women - some ready for it, some not
First thing have do
Not everyone do same
50% pregnancies unplanned
Some not accept readily
Want baby excited
Accepting the pregnancy
Nurturing, loving
Ready for it
Some not have relationship
Narcissist; abandoned her; relative raise
Terrified - not want be same mother; not know how be mother - who mothered - not know if how supposed be mother
Therapeutic communication - easy tunnel vision and exciting event
Not every woman okay with it; most maternal nursing - happy nursing - bonding - first person every supported her; beautiful but terrifying ordeal
Giving birth traumatizing - traumatic birth, no support sys, chronic conditions, how got pregnant - consider therapeutic communication - emotional intelligence
Wanted pregnancy - husband left or died
Be neutral as a nurse
Identifying with the mother role
Not go out anymore
Friend group change - decline invitation eventually stop
Who home with baby
Relationships start changing; career and fam hard
Huge transition and some not prepared
Reordering personal relationships
Bonding
Not everybody talking to baby and in love - not mean mental health disorder - see baby to find bond
See where are in attachment of fetus - diff parts of pregnancy for woman
Emotional attachment
Establishing a relationship with fetus
Nursery
Wash clothes
Santize everything
Nesting
Tell everybody what roles are - nurse can do this as well
Preparing for childbirth
Go through same type phases in diff phases
Couvade Syndrome
Accepting the pregnancy
Identifying with father role
Reordering personal relationships
Establishing relationship with fetus
Preparing for childbirth
Partner adaptation
Get same type symptom that women; psychological thing
Couvade Syndrome
Three phases (announcement - ok go announce and tell everybody that going to be a parent - may take awhile, moratorium - acceptance of and adjust to reality, focus - period of active involvement, carseat, most direct route to hospital, childbirthing class)
Not all do same
Accepting the pregnancy
Men not have present father
No relationship with dad
Not know how be dad
Terrified
Identifying with father role
Successful relationships they do
Takes more than 1 person
Invitations less and less - identify with and accepting of it
Reordering personal relationships
Depends on person
Some may be just as excited or terrified
Sometimes later on when feel child and interaction and see what happens and see belly moving see human moving; some talking to belly nonstop
Establishing relationship with fetus
Nesting
Apprehension high closer to due date
Do everything can
Great outcome - cannot fix pain - mess - huge issues; painful - great outcome - high anxiety - cannot fix the problem and very upsetting for them
Preparing for childbirth
Sibling rivalry
Upset and issue going into sibling role
Sibling adaptation
First grandbaby - react amazing
Find role; not parents; still mothering and giving ideals how feed and bathe and love and read
Give advice and need respect roles
Grandparent adaptation
Goal of prenatal care is to promote the health and well-being of the pregnant woman, the fetus, the newborn, and family - health promotion, disease prevention - LOT in 9 months
Emphasis on preventive care and optimal self-care - lot self-management
Prenatal care is sought routinely by women of middle or high socioeconomic status - access to care
Women in poverty or lacking health insurance may not have access to public or private care
Barriers to obtaining prenatal care include:
Care management
Lack of culturally sensitive care and communication interferes with access to care
Immigrant women may not seek prenatal care - not do in culture - not necessary
Birth outcomes are less positive if not get prenatal care, with higher rates of maternal and newborn complications
Problems with low birth rate and infant mortality associated with inadequate prenatal care
Want them to seek care
Women in poverty or lacking health insurance may not have access to public or private care
Lack of motivation to seek care
Inadequate finances
Lack of transportation
Unpleasant clinic personnel
Unpleasant facilities or procedures
Inconvenient clinic hours
Problems with child care
Personal and cultural attitudes
Barriers to obtaining prenatal care include:
Not realize importance
Had many babies - can do it
Lack of motivation to seek care
Sometimes lot money
Inadequate finances
Not get to appt
Telehealth - cannot measure to fundus or listen to fetal heart tones
Lack of transportation
Disrepsectful; non inclusive
Unpleasant clinic personnel
