Maternity 2 Flashcards
Describe developmental task of adolescents challenged by pregnancy
o Establish sense of self-worth/value system
• Maintain sense of self and schooling
o Emancipate from parents
• Often requires financial support / health
• Feelings of complete dependency
• Encourage practice responsibility/independence
• Maintain confidentially / privacy
o Adjust to body image
• Weight gain and fatigue
o Choose a vocation
Describe strategies to assess and engage with pregnant youth
o Considered high risk r/t HTN, anemia, premature labour, decreased pelvic size, intimate partner violence risks
o Health Hx, Family Hx, Physical (maybe without parent present)
o Propensity to avoid prenatal assessment and care
o Sell it as a “growth experience”, provide extra education
o Social and financial supports
o Consider limiting number of care providers ( INc trust)
o Peer support groups may be helpful
o Pregnant teens generally emancipated (make own decisions)
7 complications likely in adolescent pregnancy
Gestational HTN Iron deficient Anemia Preterm Labour Cephalopelvic disproportion, postpartum hemorrhage (uterus not fully developed) inability to adapt postpartally knowledge deficit of infants High risk of hemorrhoids high rate of intimate partner violence
What are the prominent risks of advanced maternal age
o Gestational HTN- blood vessel inelasticity
o Failure to progress in labour (cervical dilation not as spontaneous)
o Difficulty accepting the event
o Postpartum Hemorrhage (inelasticity and tears)
o Also in box 22.7 hemorrhoids, varicose veins, thrombophlebitis
What is substance dependance and what might the complications be
Inability to meet role obligations, legal problems, risk behavious d/t addictive substance. Withdrawal symptoms present
• May be less willing to seek prenatal care out of concern of judegment or baby been taken away
• May be under financial burden r/t addiction
• Fetus often has drug conc 50% that of mother, may have withdrawal symptoms at birth, preterm or variable heart rate
• Breastfeeding may be contraindicated if drug conc. remain high
Cocaine and pregnancy
vasoconstriction limits uterine circulation
o baby – intercranial hemorrhage, withdrawal, long term defecits
o During preg, vasoconstriction → severely compromised placental circ + premature separation of the placenta → preterm labour or fetal death
o abstinence syndrome of tremulousness, irritability, muscle rigidity
o Possible social + learning deficits in long term (not well documented)
o Signs- Can be detected in Urine for 1 week
Amphetamines and pregnancy
o Methanphetamine = neurostimulant + neurotoxin
o Cheap, made in home labs
o Effects similar to cocaine
o Baby- jittery, poor feeding, poor growth
o Signs- Blackened infected teeth (smoking), measurable in blood
• Phencyclidine (PCP) and pregnancy
• Phencyclidine (PCP)- IV anesthetic originally, now rave culture
o In circulation, concentrate in fetal cells, injurious to fetus
Narcotics and pregnancy
includes opioids like heroin
o Abstinence symptoms: NVD, abdm pain, shivering, insomnia, body aches, muscle jerks – can begin as soon as 6 hrs after last dose + continue for several days
o Babies small, inc fetal distress + meconium aspiration
o Baby- neonatal dependency, distress, withdrawal, low weight,
o SIGNS- Gestational HTN, Blood pathogen r/t IV use (HIV, Hep risk)
Inhalants and pregnancy
o Effects similar to ETOH but with respiratory and Cardiac irregulaties that can effect fetal circulation
o Glue, Gas, sprays, computer keyboard cleaner
Alcohol and risks in pregnancy
Fetal alcohol spectrum disorder (facial features, cognitive challenges, memory defecits. Any drinking isn’t safe, but binge drinking is major risk
the 4 P’s Labour
Power, Passenger, Passage, Psyche
Two PHASES of Labour
Latent- Last up to 2 days, regular contraction pattern established, 3-4 cm dilated cervix, nap when possible, eat a bit
Active- Contractions are strong and regular (~every 2-3mins for 60s), 3-10cm dilated. This is Labour.
Stages of Labour
• Stages are of Labor (active phase)
1) First contraction to complete dilation
2) Pushing, descent and delivery
3) placenta delivery
4) hemeostasis established after delivery
What is normal intrauterine pressure
50mmhg measured by IUP Catheter
Why is it important for uterus muscle to contract with the right force
Uterus is a muscle (overexertion may be traumatic, under exertion may be exhausting)
