First Trimester Of Pregnancy

Front 1

What is term pregnancy?

Back 1

38 to 42 weeks gestation.

Front 2

What is Preterm?

Back 2

less than 38 weeks gestation.

Front 3

Post Datism (post term)

Back 3

greater than 42 weeks gestation.

Front 4

When a pregnant women is asked for a Hx?

Back 4

Medical problems, Presenting signs and symptoms, allergies, childhood illnesses, accidents, family hx, and OB Hx.

Front 5

What is checked during a physcial exam?

Back 5

Reproductively oriented!
Baseline Heart Rate, blood pressure, and weight. Possible head to toe exam (usually only reproductively based)

Front 6

Physical Exam continued...

Back 6

Check the breasts
Thyroid (hypo or hyperthyroidism can affect fertility)
Pelvic check: including PAP, cultures.

Front 7

Pelvimetry

Back 7

Usually checked if the pt has been in some sort of accident that has caused injury to the pelvis.

Front 8

Lab Work

Back 8

Dip stick check:
Albumin (PIH)
glucose(DM)
client is instructed to bring in first morning urine sample.
H & H
Blood type, Rh factor
STORCH... etc..

Front 9

Teaching

Back 9

Teach about prenatal vitamins. Warning signs to check for
Hygiene (increased sweating, and vaginal discharge)
Employment (how to not overwork, proper rest is a must)
Nutrition (sm. frequent meals)
Visit schedules
and explanation of EDC, delivery date.

Front 10

Nageles Rule

Back 10

most frequently used method of determining the EDC.
subract 3 months from the first day of the LMP and then add 1 year and 7 days.

Front 11

Other methods to determine the EDC

Back 11

Wheel method: take the 1st day of the LMP, and line up the dates.
Also you can use ultrasound.

Front 12

Maternal Task

Back 12

to be able to say I am pregnant and accept the fact. Ambivalance is normal.

Front 13

Ectopic Pregnancy

Back 13

gestation implantation outside of the uterus. Can occur in the fallopian tubes, ovaries, or abdomen. Statistics are 16/1000 pregnancies.

Front 14

Causes of Ectopic Pregnancy

Back 14

PID and Endometriosis.
Use of IUDS
Tubal surgery
Congenital tubal anomalies
tubal tumors
Hx of previous ectopic pregnancies
Abdominal or pelvic surgery
Appendicitis/therapeutic abortion/infertility

Front 15

S & S of ectopic Pregnancy

Back 15

Abdominal pain and localized pain to the L or R pelvic area, amenorrhea, abnormal vaginal bleeding (may or may not be present)

Front 16

S&S of ectopic preg. continued

Back 16

If a rupture occurs;
Abd. pain, N&V, diarrhea, unilateral palpable pelvic mass, dizziness, and hypovolemic shock.

Front 17

Spontaneous Abortions

Back 17

early; occurs before 12 weeks gestation
late; occurs between 12 and 20 weeks gestation
Habitual: when a women has 3 or more consecutive spon. abortions.

Front 18

Threatened abortion

Back 18

suggested when a woman experiences vaginal spotting or bleeding early in pregnancy (occurs approx. in 20% of all diagnosed pregnancies; half abort)

Front 19

Inevitable

Back 19

occurs when the cervix has begun to dilate, uterince contractions are uncomfortable, and vaginal bleeding increases. The membranes rupture as the process proceeds. This type cannot be prevented.

Front 20

Incomplete

Back 20

occurs when cervical dilation results in partial expulsion of the products of conception, with some of these products retained in the uterus. Excessive vaginal bleeding results; risk of infection is increased.

Front 21

Complete

Back 21

all products of conception are entirely expelled. Very few physical complications that occur but emotional support is necessary.

Front 22

Septic

Back 22

immediate termination of pregnancy by methods appropriate to the duration of the pregnancy. Cervical culture and sensitivity studies are done and broad-spectrum antibiotic therapy is started. Treatment for septic shock is initiated if necessary.

Front 23

Hyaditform Mole AKA Trophoblastic Disease AKA Molar Pregnancy

Back 23

developmental error of the placenta, ovum disintegrates. Two types:
Complete mole (empty egg no chromosomes)
Partial Mole (has part of amniotic sac or fetus)
Occurs in 1/1000 pregnancies. Occurs in women over 45 10 times more often than women 20-40

Front 24

S&S of Hyaditform Mole

Back 24

uterine bleeding is most outstanding sign
iron deficiency anemia often seen d/t bleeding
Uterine Size (often exceeds what is expected for gestational age)
Fetal activity and heart tones are absent
hyperemesis gravidarum
PIH notably develops prior to 20 weeks gestation
very high levels of hCG
ultrasound can confirm this.

Front 25

Care of pt with Hyaditform

Back 25

immediate evacuation of the mole and follow up for prevention and early detection of malignant transformations.
Serum hCG levels monitored q1-2 weeks until normal nonpregnancy levels achieved.
Then they are check every 6 mons, and then every 2 mos for 1 year.
Pregnancy should be avoided during the one year follow up
Baseline X-Ray of lungs taken and compared to pre-evacuation x-ray.

Front 26

Hyperemesis Gravidarum

Back 26

increased or prolonged N&V in pregnancy affecting the health of mom and baby.

Front 27

Etiology of Hyperemesis Gravidarum

Back 27

likely caused by a combination of factors. It appears to be related to high or rapidly increasing levels of hCG or estrogen. Evidence of transient hyperthyroidism has been noted. Psychological and social factors, as family conflict can all play a role.

Front 28

Care of a client with Hyperemesis Gravidarum

Back 28

hospitalization is often required to change womens enviornment if psychosocial factors are contributing.
IV therapy initiated to treat dehydration; adequacy of hydration assessed by measuring Urinary Output.
Sm. frequent feedings ad lib. High calorie tube feedings are an option.
Sedatives may be used to relax hyperactive GI tract.
Acupressure has been used successfully.