Part II Flashcards
(23 cards)
When do pelvic/cervical exams start?
Pelvic/cervical exams starting at 37 weeks.
*Don’t mess around with the cervix when not sure how far along mother is (could send them into preterm labor)
What is the recommended total weight gain in pregnancy for a normal weight, overweight, underweight, and obese mother?
- 25-35 pounds if normal weight
- 15-25 pounds if overweight
- 28-40 pounds if underweight
- 11-20 pounds if obese
A pregnant woman needs ______ additional calories during pregnancy and ________ more calories during lactation.
- 300 additional calories daily during pregnancy
- 500 more daily calories during lactation.
What other food precautions must a pregnant woman be aware of?
*Avoid deli meats and hotdogs (or heat them!)
- Eat a max. of 2 weekly servings of canned tuna, shrimp, salmon, lobster, sole, tilapia, cod, haddock, & catfish.
- 8-8-ounce glasses fluid (6 should be water); stay hydrated
- Mixed research regarding caffeine.
- Heat any deli meat/hot dogs to 165 degrees.
- Avoid unpasteurized milk and soft cheese products.
- Vegetarian women-close attention to protein, iron, Ca, & B12.
What are first trimester pregnancy danger signs?
- Any spotting/bleeding
- Painful urination (UTIs can cause the uterus to start contracting; UTIs are more common with pregnancy)
- Severe persistent vomiting (ex: vomiting multiple times a day)
- Fever >100 F
- Lower abdominal pain with dizziness/shoulder pain (could indicate ectopic/tubal pregnancy)
What are second trimester pregnancy danger signs?
- Regular contractions (happening in a predictable way)
- Calf pain (don’t message it)
- Gush or vaginal leakage fluid (with any fluid leakage, pt should go to hospital)
- Absence of fetal movement for 12 hours
What are third trimester pregnancy danger signs?
- Sudden weight gain/facial swelling
- Severe upper abdominal pain (preeclampsia hurting the liver; DO NOT PALPATE)
- H/A, visual disturbances
Any of the first and second-trimester danger signs/symptoms can be present in the final trimester!!
What are some Changes in the Cervix/Vagina during Pregnancy?
- Mucous plug forms in the cervix. (keeps bacteria from going where the baby is)
- Increase in vaginal discharge-at times profuse & acidic.
- Increased Candida albicans and vaginitis. (esp. in women with high glucose)
- Goodell sign
- Chadwick sign (chad is blue)
what is the difference between Goodell sign and Chadwick sign?
- Goodell sign - softening of the cervix.
- Chadwick sign - bluish discoloration of vagina & cervix.
What are some Changes in the Cardiovascular System during Pregnancy?
- Heart rate increases by 10-15 beats starting at 14-20 weeks.
- By 32 weeks-40-50% more blood volume. (Plasma increases by an average of 50%; RBCs increase only by 20-30%=physiologic anemia of pregnancy “pseudoanemia.”)
- BP remains stable in most cases. (Remains the same in 1st trimester; BP drops slightly in 2nd semester; BP begins to elevate slightly at 32 weeks and beyond;140/90 or more =gestation HTN.)
- Difficult venous return=swollen lower extremities and varicosities.
- Faintness-due to changes in blood volume.
- Postural hypotension-due to pooling of blood in dependent veins.
- Lower Extremity edema and varicosities.
explain - Supine hypotensive syndrome
- mother is sweaty, dizzy (vena cava is compressed)
*this can happen when pregnant women lays on their back; lay pregnant ladies on left side if this happens).
What are some Changes in the Gastrointestinal system during Pregnancy?
- Nausea & vomiting from multiple factors-highest incidence between 6-12 weeks’ gestation (Diclegis approved FDA; primarily vitamin B12)
- Gum tissue may soften and bleed easily.
- Delayed gastric emptying and peristalsis=constipation (sometimes hemorrhoids).
- Pyrosis (heartburn) from relaxed cardiac sphincter
- Increased flatulence and belching.
What are some Changes in the Urinary Tract during pregnancy?
- Urinary frequency in first and third trimesters (Increased GFR and uterine pressure on the bladder)
- Increased risk of UTI’s (incomplete emptying when further along in pregnancy)
What regarding exercise should be taught to a pregnant woman?
Exercise - pelvic tilts for backache, Kegels are recommended for most women for a healthy pregnancy.
Exercise limits should be discussed with care provider. Typically recommended!!
What regarding Dental Care should be taught to a pregnant woman?
- Important to have regular exams and cleanings. Notify staff of pregnancy to avoid x-ray risks/toxins.
What regarding Immunizations should be taught to a pregnant woman?
- No vaccines with attenuated live viruses should be given such as rubella or varicella.
What regarding Medications should be taught to a pregnant woman?
Must ask care provider before taking any OTC or prescription meds.
*Tobacco/Alcohol/Illicit drugs- All are contraindicated.
What regarding bathing should be taught to a pregnant woman?
Caution with dizziness and slipping with a tub. Water should not be too hot.
What regarding employment should be taught to a pregnant woman?
Can work up until delivery if no complications. Must be careful of work toxins.
What regarding travel should be taught to a pregnant woman?
Should stop and walk every 2 hours-Wear seatbelts!
Aisle seat best for airline travel (always have someone with you and a copy of your prenatal record.)
What regarding sexual activity should be taught to a pregnant woman?
Ok entire pregnancy in an uncomplicated pregnancy.
What regarding nose bleeds should be taught to a pregnant woman?
Tip head forward and pinch nostrils (not unusual to have this problem due to estrogen.)
What regarding leg cramps should be taught to a pregnant woman?
Normal and common especially as pregnancy continues. Straighten leg and dorsiflex foot for relief. (not pointing toes)
