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26 Cards in this Set
- Front
- Back
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Frequency of office visits from 4-28 weeks |
Every 4 weeks |
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Frequency of visits from 28-36 weeks |
every 2 weeks |
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Frequency of visits from 36 weeks to birth |
every week |
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First prenatal visit |
Establish relationship Comprehensive history Physical Exam Labs and sonograms ordered health promotion anticipatory guidance for continuing care |
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Current Themes of prenatal Care |
direction of communication between provider/pt focus on physical rather psychosocial attentiveness to risk additive expectations lack of health promotion lack of education lack of consistent attention to parts |
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Goals of prenatal care |
Risk assessment determine gestational age and EDB (or confirm) initiate plan for continuing care (carry out, adjust) establish relationship (build on) |
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Routine Prenatal Labs: |
CBC Rh and type antibody screen RPR or VDRL HBsAG HIV Rubella Urine C & S Gonorrhea, chlamydia, DNA probe |
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Client specific Labs |
Pap smear (depends on age and if more than year) Wet mount (if complaint or discharge) Tb test (if risk) 1 hour glucola (if obese or high risk) hgb electrophoresis (if risk for sickle cell) |
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Optional Labs |
Genetic screening tests cystic fibrosis (if appropriate) |
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Teaching |
anticipatory guidance (what to expect, next visit, fetal development) nutrition relief from common discomforts genetic testing options understanding of practice providers (1st visit) how and when to call childbirth ed (late visits) how we will contact with lab results |
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subsequent visits |
interval history (what happened since) follow up on last visit health promotion adjustments emotional abd exam (FHT and fundal height) BP, weight, common discomforts (why, what to do, when resolve) fetal growth and development anticipatory guidance positive feedback |
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gestation <12 weeks |
fundal height bimanual exam at first visit only until 12 weeks |
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gestation 12 weeks |
fundal height at symphysis |
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gestation 16 weeks |
fundal height 1/2 way between symphysis and umbilicus |
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gestation 20 weeks |
fundal height @ umbilicus |
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gestation >20 weeks |
fundal height: use tape measure, +or - 2 cm of gestational age |
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fetal exam late pregnancy |
fetal weight and position |
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15-20 week visit |
Quad screen (optional) genetic anomaly scan schedule (optional) |
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24-28 week visit |
1 hr. glucose (for those with risk factors) Hct and Hgb recheck (biggest hemodilution time pd.) childbirth prep classes educate on s/s of preterm labor Antibody screen and Rhogam for Rh negative @28 weeks |
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3rd trimester visits |
Provide birth resources as needed anticipatory guidance risk assessment interval history |
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34-36 week visit |
fetal movement counting/ awareness |
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35-37 week visit |
Group B strep screening @36 weeks repeat STD screening if at risk |
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36-40+ weeks |
fetal growth, weight, position fetal surveillance after 40 weeks |
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5 Digit number system |
gravida term preterm abortion living multiple births (just number of events not babies) |
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confounding variables for uterine size in 1st trimester |
maternal habitus bladder status uterine position |
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2nd and 3rd trimester fundal height confounding variables |
different examiners maternal habitus bladder position maternal position fetal position |
