Chapters 13 & 15 - 2

Question 1

preconceptual visit

Answer 1

Auscultation of fetal heart sounds
Fetal movements by the examiner
Visualization of the fetus- by ultrasound
-lower level of folic acid increase levels of neurotube defects

Question 2

antepartal care

Answer 2

Considers the physical, emotional and social needs of the woman, fetus, father of the child and other child
Aims are to stabilize and maintain health of mother to be , educate and support the family
Frequency of visits: q4 weeks thru 28 weeks(7mos), q2 weeks Thru 36wks. (8mos.),q1 week after 36 wks.
-term 40 wks - 10 month preg. with 4 equal wks in every month

Question 3

1st visit

Answer 3

Establish rapport with pregnant woman and family
Types of questions- closed vs more open ended
Content of Interview on First Visit
Obstetrical/Gyn History including contraception, abortions, STD’s, menstrual history,etc.

Question 4

to determine estimated due date

Answer 4

To determine EDD, EDC, EDA
First day of last LMP
           minus
    Three months
           plus
    Seven days
(nigels rule)

Question 5

medical surge history -

Answer 5

autoimunne, RH positive, genetic problems, what drugs? smoke? cats?, toxoplasmism so while pregnant no chagning litter or yard work without gloves, allergies? work? black? - sickle cell anemia (recessive)

Question 6

psych -

Answer 6

ecomonics? children already? thoughts about pregnancy?

Question 7

vitals

Answer 7

pulse rate increase, respiration is more difficult to read but no real change, bp changes - usually a little rise bc of increase plasma volume in vascular system, temp remains constant

Question 8

cardiovascular

Answer 8

HR increases, SV increases, edema, pregnant women can look anemic but not actually anemic

Question 9

musculoskeletal

Answer 9

height and weight, not only total amount of weight gain but also how she gained it

Question 10

abdomen

Answer 10

fondus height, fetal HR

Question 11

neurologic

Answer 11

only deep tendon reflex if think problem

Question 12

Skin

Answer 12

hyperpendation, breast darkening, stai, palor (edema), jaundice (hepatic disease)

Question 13

GI

Answer 13

looking at bowel sounds, and talk about changes in bowel pattern

Question 14

urinary

Answer 14

clean catch every visit

Question 15

reproductive

Answer 15

colostrum (premilk), speculum exam (opens up vagina to see cervix), pap smear 1st visit, bimenual (feel size, postion, with fingers can even feel ovaries)
if pap smear positive don’t intervene until after the baby is born

Question 16

what to do at other visits

Answer 16

(see what has changed)

V.S.
Weight
Urinalysis
Fundal Height
Leopold’s - 38 wks/3rd trimester
FHR
Fetal activity

Question 17

additional screenings

Answer 17

Ultrasound (12-20 wks)
Glucose screening (24-28 wks)
RH antibody ( 26-28 wks)
Pelvic exam ( 9TH month)

Question 18

n/v -

Answer 18

r/t starvation at night, recommend to eat dry toast/crackers before rising, eat smaller more frequent meals, drink between meals not with meals

Question 19

heart burn -

Answer 19

pyrosis, small meals, 2 pillows instead of one, don’t drink/eat before bed, check MD before take antacid

Question 20

backache -

Answer 20

become larger and center of gravity is changed, teach proper posture, sit with feet up, wear stable shoes not heels, apply heat to sore place

Question 21

urinary frequency -

Answer 21

don’t overdue fluid intake, if involuntary release of fluid then do kegal exercises

Question 22

varicosities -

Answer 22

(of lower extremities) can affect blood flow, avoid constricting clothing, elevate legs, MD order modified, TED hose, if car trip get out and walk around

Question 23

hemorrhoids -

Answer 23

medications can be prescribed, can apply ced clothes

Question 24

constipation -

Answer 24

bc of decrease peristalsis, good diet with fiber, exercise

Question 25

leg cramps -

Answer 25

elevate legs, adequate exercises, usually at night

Question 26

bathing

Answer 26

promote comfort and safety, bath has higher risk of UTI then showers, not really hot water can prolong fetal development

Question 27

douching

Answer 27

no need for

Question 28

breast care

Answer 28

supportive bra good idea, breast tissue increase throughout pregnancy

Question 29

clotting

Answer 29

clothes should not be tight, no heels

Question 30

exercise

Answer 30

make sure hydrated, use common sense, keep up with nutrition

Question 31

sleep

Answer 31

finding comfortable positions becomes harder

Question 32

sex

Answer 32

generally safe, won’t hurt baby

Question 33

employment

Answer 33

frequent rest periods, avoid heavy lifting, dress appropriately with proper shoes

Question 34

travel

Answer 34

car - safe but walk around

plane - safe but usually MD doesn’t wan you far from home after 36 wks

Question 35

immunizations

Answer 35

no live vaccines while pregnant

Question 36

life style changes

Answer 36

morning sickness can be so bad that they can’t smoke
smoking - con have growth retardation, smaller babies, less blood flow to fetus so baby starves in utero
alcohol - leading cause of mental retardation, fetal alcohol syndrome - flat nose

Question 37

maternal adaptation

Answer 37

ACCEPTING THE PREGNANCY
IDENTIFYING WITH THE MOTHER ROLE
REORDERING PERSONAL RELATIONSHIPS - relationships with father of child and moms own mother (how they react will affect moms feelings about baby) mom will think of ways to be like/differ than own mother
ESTABLISHING RELATIONSHIP WITH THE FETUS (good to have emotional attachment with baby)
PREPARING FOR CHILDBIRTH (reading, taking classes, will my baby be alright)
-always ambelience with the joy of pregnancy and uncertainty
-during early part women ten to be about themselves (ex. how to get rid of morning sickness) , still not completely confirmed about the idea of baby in head (no kicking)
-when fetal movement know really pregnant and moms look at role of mothering, try to do things to protect baby

Question 38

paternal adaptation

Answer 38

ACCEPTING THE PREGNANCY
IDENTIFYING WITH THE FATHER ROLE
REORDERING PERSONAL RELATIONSHIPS
ESTABLISHING A RELATIONSHIP WITH
   THE FETUS
PREPARING FOR CHILDBIRTH