Antepartum I

Question 1

barriers to seeking healthcare

Answer 1

financial issues
cultural issues
gender issues
gender of HCP
sexual orientation

Question 2

preparing for parenthood

Answer 2

choosing a provider, birth setting, type of labor, sibling prep, prenatal classes, adolescent parenting classes, prep for c-section, prep for vaginal

Question 3

Does IPV increase or decrease with pregnancy?

Answer 3

increase

Question 4

What are some reproductive system physical changes in pregnancy?

Answer 4

uterus, cervix, ovaries, vagina, breasts

Question 5

What are some uterine changes in pregnancy?

Answer 5

enlargement due to hypertrophy
fibrous tissue increase
increase in blood flow
Braxton Hicks contractions

Question 6

What are some cervical changes in pregnancy?

Answer 6

development of mucous plug
Goodell’s sign - softening
Chadwick’s sign - bluish-purple discoloration
Hegar’s sign

Question 7

Changes in ovaries during pregnancy?

Answer 7

stop producing ova, secretes progesterone until 7th week to maintain the endometrium, stops and placenta assumes task

Question 8

vaginal changes during pregnancy?

Answer 8

mucosa thickens, increase in secretions, loosening of connective tissue

Question 9

breast changes during pregnancy?

Answer 9

glandular hyperplasia and hypertrophy, areolae darken and superficial veins prominent, striae may develop, colosseum is secreted

Question 10

respiratory changes during pregnancy?

Answer 10

oxygen consumption increase, subcostal angle and AP diameter increase, breathing changes from abdominal to thoracic, nasal stuffiness and epitaxis

Question 11

cardiac changes during pregnancy?

Answer 11

blood volume increases 40-50%, physiologic anemia, decrease in systemic and pulmonary vascular resistance, increase in cardiac output, somewhat hypercoaguable state

Question 12

GI changes during pregnancy?

Answer 12

N/V, softening and bleeding of gums, increase in saliva, constipation, heartburn, gallstones, hemorrhoids

Question 13

urinary changes during pregnancy?

Answer 13

pressure on bladder causes frequency, dilation of kidneys and ureters, increased GFR and renal plasma flow

Question 14

skin changes during pregnancy?

Answer 14

hyperpigmentation, striae, facial chloasma, vascular spider nevi, decreased hair growth, hyperactive sweat and sebaceous glands

Question 15

musculoskeletal changes during pregnancy?

Answer 15

pelvic joint relax, center of gravity changes, separation of rectus abdominus

Question 16

weight gain if normal weight

Answer 16

25-35lbs

Question 17

weight gain if overweight

Answer 17

15-25lbs, if obese then 11-20lbs

Question 18

weight gain if underweight

Answer 18

28-40lbs

Question 19

normal weight gain pattern

Answer 19

1.1-4.4lb during 1st trimester
1lb per week during the last two trimesters

Question 20

eye, cognitive, and metabolic changes

Answer 20

decreased intraocular pressure, thickening of cornea, reports of decreased attention/concentration/memory, extra water/fat/protein stored, fats are more completely absorbed

Question 21

endocrine changes

Answer 21

thyroid gland enlarges, concentration of parathyroid hormone increase, prolactin is responsible for lactation, secretion of oxytocin and vasopressin, increased aldosterone

Question 22

presumptive signs of pregnancy

Answer 22

amenorrhea
N/V
excessive fatigue
urinary frequency
breast changes
quickening

Question 23

probable signs of pregnancy

Answer 23

changes in pelvic organs
enlargement of abdomen
Braxton Hicks contractions
abdominal striae
uterine souffle
changes in pigmentation
positive pregnancy tests
palpation of fetal outline

Question 24

positive signs of pregnancy

Answer 24

auscultation of fetal heartbeat
fetal movement
visualization of fetus

Question 25

mother's response to pregnancy

Answer 25

ambivalence acceptance introversion mood swings fear changes in body image

Question 26

Rubin's Tasks of Pregnancy

Answer 26

ensuring sage passage thru pregnancy, labor and birth seeking acceptance of this child by others seeking of commitment and acceptance of self as mother to infant learning to give of oneself on behalf of one's child

Question 27

father's response to pregnancy

Answer 27

confused by partner's mood changes feels left out resents attention given to woman resents changes in relationship needs to resolve conflicts about fathering couvade

Question 28

siblings response to pregnancy

Answer 28

rivalry feel of changing parent relationship may need reassurance

Question 29

grandparents response to pregnancy

Answer 29

closer relationship with expectant couple clarify role of helping grandparent

Question 30

What is an antepartal assessment?

Answer 30

use of information provided on a prenatal history to identify risk factors for the mother and/or fetus

Question 31

What is prenatal history?

Answer 31

current and past pregnancies gynecologic history current and past medical history history of substance abuse family medical history religious/cultural history partner history social history and preferences

Question 32

GTPAL

Answer 32

g- total pregnancies t- term (37 weeks or later) p- preterm (20-36+6 weeks) a- abortions l- living children

Question 33

factors related to father's health

Answer 33

family hx of genetic conditions significant health problems blood type and rh factor occupation best learning method attitude towards pregnancy

Question 34

psychosocial factors

Answer 34

hx of abuse hx of emotional problems support systems overuse/underuse of healthcare acceptance of pregnancy personal preferences about birth plans for care of child feeding preference

Question 35

cultural/religious factors

Answer 35

factors that influence the woman's expectations of experience beliefs/practices that maintain spiritual wellbeing ask about practices

Question 36

Naegele's Rule

Answer 36

minus 3 months plus 7 days plus 1 year

Question 37

major prenatal screening tests

Answer 37

pap smear complete blood count hemoglobin rubella titer ABO and rh typing hep B screening STIs

Question 38

danger signs of pregnancy

Answer 38

gush of fluid from vagina vaginal bleeding abdominal pain fever dizziness/blurred vision/spots persistent vomiting absence of fetal movement

Question 39

During subsequent visits, what do you continue to gather data about?

Answer 39

course of pregnancy woman's responses adjustment of support person preparations for new baby discomfort physical changes