Prenatal Care & Nutrition in Pregnancy Flashcards
What are common discomforts of pregnancy and the reasons they occur?
Nausea and vomiting might occur during the first trimester
The client should eat crackers or dry toast before rising in the morning to relieve discomfort
Avoid having an empty stomach and ingesting spicy, greasy, or gas-forming foods
Fluids between meals
Breast tenderness might occur during the first trimester
Wear a bra that provides adequate support.
Urinary frequency might occur during the first and third trimesters
Empty the bladder frequently, decrease fluid intake before bedtime, and use perineal pads
Kegel exercises
Urinary tract infections (UTIs) are common during pregnancy because of renal changes and the vaginal flora becoming more alkaline
Fatigue might occur during the first and third trimesters
Frequent rest periods.
Heartburn might occur during the second and third trimesters due to the stomach being displaced by the enlarging uterus and a slowing of gastrointestinal tract motility and digestion brought about by increased progesterone levels
Eat small, frequent meals, and do not allow the stomach to get too empty or too full
Should not immediately lie down after eating, as this can exacerbate reflux.
Constipation might occur during the second and third trimesters
Drink plenty of fluids, eat a diet high in fiber, and exercise regularly
Hemorrhoids might occur during the second and third trimesters. A warm sitz bath, witch hazel pads, and application of topical ointments will help relieve discomfort.
Backaches are common during the second and third trimesters
Exercise regularly, perform pelvic tilt exercises (alternately arching and straightening the back), use proper body mechanics by using the legs to lift rather than the back, and use the side-lying position
Shortness of breath and dyspnea might occur because of the enlarged uterus, which limits inspiration
Maintain good posture, sleep with extra pillows, and contact the provider if manifestations worsen.
Leg cramps during the third trimester might occur due to the compression of lower-extremity nerves and blood vessels by the enlarging uterus
Extend the affected leg, keeping the knee straight, and dorsiflex the foot (toes toward the head)
Application of heat
Varicose veins and lower-extremity edema can occur during the second and third trimesters
Gingivitis, nasal stuffiness, and epistaxis (nosebleed) can occur as a result of elevated estrogen levels causing increased vascularity and proliferation of connective tissue
Supine hypotension occurs when a client lies on their back and the weight of the gravid uterus compresses the vena cava
Braxton Hicks contractions, which occur from the first trimester onward, might increase in intensity and frequency during the third trimester
Change of position and walking should cause contractions to subside.
Foods/drinks/substances to avoid in pregnancy?
Fish that are high in mercury
Unpasteurized dairy
Deli meat
Marijuana
Alcohol (fetal defects)
Tobacco (low birth weight)
What are examples of pica?
Craving to eat non-food substances like dirt or clay
What medications are contraindicated in pregnancy? Medications contraindicated while lactating? What are category X drugs? What are examples of category X drugs?
Aspirin, NSAIDs, ACE inhibitors, antineoplastic drugs, warfarin, lithium, phenytoin, quinolones, retinoic acid, tetracycline, efavirenz
Category X demonstrates fetal abnormality
Atorvastatin
Simvastatin
Methotrexate
Finasteride
Codeine, decongestants, and aspirin are not recommended during lactation
danger signs in first trimester
Burning on urination (infection)
Severe vomiting (hyperemesis gravidarum)
Diarrhea (infection)
Fever or chills (infection)
Abdominal cramping and/or vaginal bleeding
danger signs in second and third trimester
A gush of fluid from the vagina (rupture of amniotic fluid) prior to 37 weeks of gestation
Vaginal bleeding (placental problems such as abruption or previa)
Abdominal pain (premature labor, abruptio placentae, or ectopic pregnancy)
Changes in fetal activity (decreased fetal movement might indicate fetal distress)
Persistent vomiting (hyperemesis gravidarum)
Severe headaches (gestational hypertension)
Elevated temperature (infection)
Dysuria (urinary tract infection)
Blurred vision (gestational hypertension)
Edema of face and hands (gestational hypertension)
Epigastric pain (gestational hypertension)
Concurrent occurrence of flushed dry skin, fruity breath, rapid breathing, increased thirst and urination, and headache (hyperglycemia)
Concurrent occurrence of clammy pale skin, weakness, tremors, irritability, and lightheadedness (hypoglycemia)
In pregnancy where is the uterus located at 12 weeks? At 14? At 20? At 34? At 38 weeks?
12 weeks at the pubic bone
14 weeks at the lower abdomen, right above the pelvic bone
20 weeks at the bellybutton
34 weeks 5 inches above the belly button
38 weeks is at the sternum
Which of the following recommendations should the nurse make to a patient with diabetes who is interested in becoming pregnant
A. “Achieving excellent glycemic control now will help ensure positive pregnancy outcomes.”
B. “Because of your diabetes, you will not be able to deliver vaginally.”
C. “Pregnancy risks for diabetic mothers are caused by macrosomic infants.”
D. “You will need to make sure to have good control of your blood sugars as soon as you find out you are pregnant.”
A
A pregnant woman with an asthma exacerbation tells the nurse she stopped taking her medication because she didn’t want it to affect her baby. What is the best response by the nurse?
A. “You are right to stop taking any medications while you are pregnant.”
B. “You should still take your asthma medication while you are pregnant to help control your asthma.”
C. “You should only take your asthma medications when you have an exacerbation.”
D. “You probably won’t need your medication because asthma always improves with pregnancy.”
B
Elevated glucose levels in the first weeks of pregnancy can cause what congenital anomalies?
Spina bifida, cleft palate/lip, cardiac anomalies, etc.
urgent assessment before 37 weeks
Cramping – Like period cramping
Rhythmic contractions 6X/hr or more
Gush or Trickle of Fluid
Pelvic Pressure
Vaginal Bleeding or Bloody show (from cervix starting to open)
Reduced fetal activity
S/S Pre-eclampsia =Headache, Rt upper quadrant abdominal Pain, or Visual disturbances
contradicted vaccines in pregnancy
Live influenza (nasal spray)
Measles
Mumps
Rubella
Varicella (chicken pox)
BCG (tuberculosis)
Meningococcal (B)
Typhoid
measuring the fundal height
After 20 weeks, the fundus should be as many cms from the symphysis pubis as plus or minus 2 cms
daptone
Heart tones first heard @ 10 wks which should be between 110-160 and best heard after Leopold’s maneuver
Fetoscope
first heart tones heard @ 20 wks
