Chapters 13 & 15 - 2 Flashcards Preview

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Flashcards in Chapters 13 & 15 - 2 Deck (38):
1

preconceptual visit

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

2

antepartal care

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

3

1st visit

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.

4

to determine estimated due date

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

5

medical surge history -

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)

6

psych -

ecomonics? children already? thoughts about pregnancy?

7

vitals

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

8

cardiovascular

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

9

musculoskeletal

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

10

abdomen

fondus height, fetal HR

11

neurologic

only deep tendon reflex if think problem

12

Skin

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

13

GI

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

14

urinary

clean catch every visit

15

reproductive

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

16

what to do at other visits

(see what has changed)

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

17

additional screenings

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

18

n/v -

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

19

heart burn -

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

20

backache -

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

21

urinary frequency -

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

22

varicosities -

(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

23

hemorrhoids -

medications can be prescribed, can apply ced clothes

24

constipation -

bc of decrease peristalsis, good diet with fiber, exercise

25

leg cramps -

elevate legs, adequate exercises, usually at night

26

bathing

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

27

douching

no need for

28

breast care

supportive bra good idea, breast tissue increase throughout pregnancy

29

clotting

clothes should not be tight, no heels

30

exercise

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

31

sleep

finding comfortable positions becomes harder

32

sex

generally safe, won't hurt baby

33

employment

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

34

travel

car - safe but walk around
plane - safe but usually MD doesn't wan you far from home after 36 wks

35

immunizations

no live vaccines while pregnant

36

life style changes

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

37

maternal adaptation

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

38

paternal adaptation

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