ch 14 - psychosocial and nursing care Flashcards
(29 cards)
framework for nursing process of care of pregnant women. assumption that theory is a developmental process, with outcome goal of bonding, competence and joy
maternal role attainment by rubin
4 tasks of mother during pregnancy in maternal role attainment
-seeking safe passage (safe pregnancy and delivery)
-ensuring acceptance of child by others
-bonding with fetus
-learning to give of herself
5 steps of maternal adaption to pregnancy theory
- accepting pregnancy (mood swings, ambivalence)
- identifying with the mother role (social and cultural influences)
- reordering personal relationships (mother, husband/partner)
- establishing relationship with fetus (phase 1: accepting biological fact, phase 2: accepts growing fetus as individual from herself, phase 3: prepares realistically for birth and parenting)
- preparing for childbirth
what is couvade syndrome
dad experiences symptoms of pregnancy along with wife (sympathetic pregnancy)
5 steps of paternal adaptation theory in pregnancy
- acceptance (announcement - accepting biological fact, moratorium - reality, focusing - negotiating role)
- identifying with father role (social and cultural)
- reordering relationships
- establishing relationship with fetus
- preparing for birth
traditional prenatal care (frequency of visits)
-1st visit within first trimester
-wks 16-28: monthly visits
-wks 29-36: q2wks visits
-wks 37-birth: weekly
recommended components for initial prenatal visit (5)
-interview for risk assessment (genetics, medical, nutritional, OB, environmental, psychosocial)
-calculate due dale
-physical exam
-labs and immunizations as appropriate
-pt education/health promotion
how to determine EDD with nagele’s rule
1st day of LMP - 3 months + 7 days + 1 year
when can you hear FHTs on doppler and fetascope
doppler: 10-12 wks
fetascope: 16-20 wks
most reliable due date predictor
1st trimester ultrasound
whats included in follow up prenatal visits
-physical exam
-fetal assessment
-labs/tests
contraindications to breastfeeding
-use of street drugs
-HIV
-rare Rx med
what does the pinch test confirm
inverted nipple
3 types of “lies” of baby during pregnancy
longitudinal
oblique
transverse
what to know about leopolds maneuvers
-use palms of hands
-smooth deep movements
-determines baby’s position in uterus
normal discomforts of pregnancy
-N/V
-heartburn
-round ligament pain
-leg cramps
-hemorrhoids
-constipation
-backache
-leukorrhea
-ptyalism
Tx suggestions for N/V
-diet recommendations (eat carbohydrate right in the morning)
-call dr when can’t keep anything down for 24 hrs
prevention of UTIs suggestions
-good hygiene practices
-vitamin C to acidify urine
-cotton lined underwear
-loose clothing
-urinate before and after intercourse, and q2h
-minimum 8 glasses water/day
S+S potential complications in 1st trimester
-severe vomiting
-chills, fever
-burning on urination
-diarrhea
-abdominal cramping, vaginal bleeding
S+S potential complications in 2nd/3rd trimester
-persistent severe vomiting
-increase or change vaginal discharge
-chills, fever, burning on urination, diarrhea
-severe backache/flank pain
-change in fetal movement
-uterine contractions, pressure, cramping before 37 wks
-visual disturbances
-swelling of face and hands
-headaches: very frequent or continuous
-muscular irritability or convulsions
-epigastric/abdominal pain
what is included in TORCH titre
toxoplasmosis
syphilis
rubella
cytomegalovirus
herpes complex
other: HIV, hep A and B, parvovirus, varicella
what is Rh disease
-Rh- mom produces antibodies to attack Rh+ baby
-red blood cells are too big to cross placenta, but antibodies can
what is indirect coombs test
tests for Rh antibodies in Rh- mothers blood
what med blocks maternal production of Rh antibodies in response to Rh antigen presence?
when does mom need to receive this med?
-RhoGam (Rho D immunoglobulin)
-within 72 hours after birth, trauma, amniocentesis, miscarriage, and at 28 wks gestation
