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57 Cards in this Set
- Front
- Back
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Weeks of trimesters...
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1 = weeks 1-13
2 = weeks 14-26 3 = weeks 27-40 |
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Subjective data of presumptive indicators to pregnancy
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amenorrhea (1 of 2 cycles)
N/V breast tenderness urinary frequency fatigue quickening |
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Objective data of presumptive indicators to pregnancy
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elevated basal body temp (BTT)
breast/ab enlargement uterine/vag changes skin |
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Why are presumptive indicators not enough for a positive pregnancy diagnosis?
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b/c they could be caused by other things
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Probable indicators of pregnancy found by an examiner
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uterine enlargement
braxton hicks contractions uterine souffle ballottement positive pregnancy test (tumors can secrete HcG) |
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Positive indicators are attributed to the fetus and they are...
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fetal heartbeat (6wk, doppler; 16-20wk fetoscope
fetal movement (felt by others, not just mom) visualization of the fetus during ultrasound (8-9wks) |
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3 terms used for expected delivery date:
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estimated date of confinement (EDC)
estimated date of delivery (EDD) estimated date of birth (EDB) |
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Explain Nagele's rule for calculating EDB based on a regular 28 day cycle and accurate LMP
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subtract 3 calendar months and add 7 days to first day of LMP
or add 7 days to LMP and count forward 9 calendar months |
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When do most women give birth in r/t the EDB? How many deliver on the EDB?
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7 days before or after ; 5%
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What term describes the process by which first step in adapting to the maternal role is accepting the idea of pregnancy and assimilating the pregnant state into the woman's way of life?
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cognitive restructuring
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Where is the degree of acceptance of pregnancy found?
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reflected in the woman's emotional response
ambivalence is not abnormal |
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What are 2 common nursing interventions provided during prenatal visits r/t personal relationships?
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effective communication b/w expectant mom and her mom & expectant mom and her partner
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What are 3 important components in the pregnant woman's relationship with her own mother?
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mother's availability
reactions to daughter's pregnancy respect for her daughter's autonomy |
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What are the 2 major needs a pregnant woman needs from her partner?
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feeling loved & acceptance of the child
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3 phases of maternal emotional attachment with fetus
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1. "i'm pregnant"
2. ack fetus is separate from self (dad may feel left out of her introspection) 3. "I'm gonna be a mom" |
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WHat's it called when dad has similar symptom to mom's pregnancy?
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couvade syndrome
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3 phases of paternal acceptance of the pregnancy and explain them
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1= announcement phase (joy, dismay, ambivalence; affairs, violence)
2= moratorium phase (introspection) 3= focusing phase (active involvement, defining role in labor) |
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WHat is the partner's main roles during pregnancy?
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nurture, support the woman
respond to her feelings of vulnerability |
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How do dad's establish a relationship with the fetus?
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talking, singing, playing, naming, learning about newborn
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explain the traditional schedule for prenatal care
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1st visit in 1st trimester
month visits through week 28 then every 2 weeks til week 36 then every week til birth |
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What is the "CenteringPregnancy" model all about?
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group prenatal care; the woman has authority, not the health care provider
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How does the first prenatal visit compare to the future visits and why?
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longer and more detailed; comprehensive health history (I mean EVERYTHING)
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Follow up visits go as scheduled if there are no complications, but what specifically should be assessed in the 3rd trimester interview?
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current family situations & their effect on her
any areas they have concerns about need for education of maternal/fetal changes |
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What things are done during every dr visit in r/t physical examinations?
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BP
weight urine dipstick edema fundal height |
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What BP ranges would require close monitoring for the pregnant chick?
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rise of SBP>30 over baseline or
DBP>15 (and duh, hypertension) |
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When does the uterus become an abdominal organ?
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during the second trimester
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Explain the relationship b/w fundal height and the gestational weeks.
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from weeks 18-32, the height of the fundus should be approx the same as the weeks of gestation (+/-2 GW) if the woman's bladder is empty
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5 things that are used to tell gestational age
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uterine size
FHT (fetal heart tones) quickening fundal height ultrasound |
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2 things used to assess fetal health
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fhr (fetal heart rate?
fetal movement |
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What lab tests are done during followup visits, and what weeks?
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urine at each
MSAFP at 15-22 wks (16-18 ideal) (maternal seum alpha fetoprotein) urine Glucose at each GBS at 35-37 chromosomal abnormalities at 11-14wks |
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When is it okay to tub bath during pregnancy?
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anytime you damn well please unless the membranes have ruptured.
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What is the pinch test used for?
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to determine if the mom's nipple is inverted or can stand erect
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contraindications to breastfeeding
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HIV
use of street drugs / meds life-threatening illnesses medical complications |
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Is maternal dental care harmful to the fetus?
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no, most is not; but if untreated could lead to LBW and preeclampsia
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What are the vaccines that can be administered during pregnancy?
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tetanus
diphtheria recombinant hep B influenza (inactivated) |
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What immunizations can NOT be given during pregnancy?
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live-virus types:
MMR chickenpox polio (not used in US) |
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What should you do for the patient to make sure they understand the potential complications for pregnancy?
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give written literature at the appropriate literacy level
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Why is it important to teach patients about preterm labor and early intervention?
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preterm labor causes contractions and then dilation of the cervix, and if not treated early enough, it is not possible to stop the delivery
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What are cultural prescriptions?
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cultural norms that tell a woman what to do
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What are cultural proscriptions?
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cultural norms that tell a woman what not to do (establishes taboos)
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What is one cultural belief on food?
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pregnant women should eat only warm food
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Stats on adolescent pregnancies
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1 mil in US (4/10)
56% end in live birth 29% IAB 15% miscarry 500,000 births (highest in industrialized world, but declining) |
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What are babies of adolescents more at risk for?
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LBW
disability death in first year |
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Who is more likely to receive adequate prenatal care?
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older women (not adolescents)
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6 examples of increased risk of maternal morbidities in 35-40yr old primiparous women
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hemorrhage
infection embolism HTN cardiomyopathy strokes |
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7 signs that there is a likelihood of a multifetal pregnancy
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history of twins in lineage
fertility drugs rapid uterine growth for number of weeks gestation polyhydraminios palpate more than expected number of small or large parts asynchronous fetal heart beats or more than one fetal ECG tracing ultrasonographic evidence of more than one |
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WHy is multifetal pregnanty a risk for mom and baby?
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increase volume
anemia enlarged placenta that separates early prematurity preterm rupture of membranes congenital malformations 2x more common two vessel cords most common in monozygotic twins |
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what 2 things should counseling be provided for during a multifetal pregnancy?
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modification of weight gain & nutritional intake
selective reduction if more than 2 |
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When are prenatal visits scheduled for throughout a multifetal pregnancy?
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every 2 weeks
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what are 4 common perinatal education programs offered?
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preconception
pregnancy through childbirth breastfeeding parenting |
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What does the coalition to improve maternity services (CIMS) believe and preach?
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birth is normal, natural and healthy
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What are the 4 types of perinatal care provider choices?
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physicians (OB&FP 91.4%)
nurse midwives (8%) direct entry midwives (<1%, home birth) doulas |
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3 birth setting choices
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LDR or LDRP
birth centers (homelike) home birth |
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What's the most effective non-pharmacologic strategy for labor stress?
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relaxation
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What is taught in biofeedback education programs?
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recognizing body's reaction to stress and relaxing to cope
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How many births are by cesarean, and when is it more common to see them?
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30%
with epidurals VBAC candidates |
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What are the 3 positive outcomes of childbirth education?
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improved confidence
birth satisfaction better family relationships |
