Maternity Module 6

Front 1

first trimester nursing care

Back 1

history and physical, screening test, psychosocial wellbeing, fetal assessment

presumptive: loss of period, nausea, fatigue

probable: pregnancy test and uterus changes

positive: auscultation of fetus and heart rate

needs 300 extra calories per day

need 3-5 pounds in first trimester and 12- 15 pounds in second and third trimester

Front 2

prenatal history

Back 2

what outcomes has she experienced in past pregnancy (hypertension, hemorrhage, postpartum depression)

nutritional intake- caffeine, alcohol

children at home

exercise

OTC or perscription

contraception

pelvic inflammation

rH factor, blood type, allergy, accidents, diabetes, cardiac defects, asthma

vaccines, childhood diseases

surgical history, ethnicity and culture, family history

tabbos, restrictions

Front 3

factors related to father's health

Back 3

toxins he is exposed to that might affect him or child, educational level, attitude toward the pregnancy

Front 4

screening tests

Back 4

pap smear, CBC, HIV screening (can opt out, but needs to sign paper), rubella titer, ABO and Rh typing, hepatitis B and sexually transmitted infection

genetic for cystic fibrosis, down syndrome (nuchal translucency)

Front 5

when can fetal heart beat be detected

Back 5

10-12 days after LMP

can be done with doppler

Front 6

second trimester

Back 6

decreasedd fatigue, screening test, wellbeing, decreased morning sickness

Front 7

quad screen

Back 7

looks at trisomy profile

includes maternal age (over 35 is increased chromosomal abnormality)

maternal serum alpha fetal protein (maternal blood protein excreted by fetal liver. if elevated, higher risk of neural tube defects, multiples, or dating issue (further along pregnancy than expected), down's syndrome has decrease of this protein)

screening tool- not diagnostic until you look at chromosome

15-21 weeks

gestational diabetes between 24-28 weeks

group b streptococcus is examined around term

Front 8

fundal height

Back 8

mcdonald's method- fundal height equals about how many weeks she is along in cm

tells you how far along she is, and if there is excess fluid

Front 9

fetal development assessment

Back 9

quickening-fetal movements felt by mother (gas bubbles popping, butterfly movements) (15-22 weeks)

fetal heart beat- gestational age assessment- 10-12 weeks with doppler 110-160 bpm

Front 10

cultural considerations

Back 10

ask expectations of childbirth (who will be with her and what is their role), preparations currently for baby.

if they value boys, some prefer female relative, some want husband.

Front 11

signs of psychological problems

Back 11

anxiety about small things, depression, unable to communicate, inappropriate actions, denial, inability to cope, preocupation with sex/ health of baby, fails to acknowledge quickening or doesn't want to get ready for baby, can be substance abuse

Front 12

third trimester

Back 12

ongoing assessment

danger signs need to be addressed

measure her well being, ask for concerns, see her consistently (every 4 weeks at first, from 28-36 weeks is every 2 weeks, and then every week until delivery)

review history, physical, lab tests, hemoglobin, hematocrit, knowledge deficit

Front 13

danger signs of pregnancy

Back 13

gush of fluid from vagina, bleeding, abdominal pain, fever, dizziness, blurred vision, vommitting, headache, edema, irritable muscles, epigastric pain, oliguria, dysuria, absence of fetal movement

Front 14

signs of preterm labor

Back 14

menstrual cramps, dull low backache, pelvic pressure, diarrhea, uterine contractions more than 4 times in an hour, leaking of water from vagina

Front 15

nausea and vomiting

Back 15

due to rise in HCG and estrogen levels

could be due to change in carbohydrate levels, fatigue, emotional levels

Front 16

urinary frequency

Back 16

enlarging uterus on bladder

Front 17

fatigue

Back 17

presumptive sign, increased progesterone

Front 18

breast sensitivity

Back 18

increasing estrogen, progesterone

Front 19

leukorrhea

Back 19

vaginal mucosal changes and yeast infections can occur

Front 20

nasal stuffiness, discharge, nosebleeds

Back 20

increased vascular congestion

Front 21

ptyalism

Back 21

bitter salivation, or excessive salivation

potato chips and lemonade are helpful

potassium from potatos and acid from lemons

Front 22

common discomforts second and third trimester

Back 22

heartburn, ankle edema, varicose veins, flatulence, hemorrhoids, constipation, backache, leg cramps, feeling faint, shortness of breath, sleep disturbances, round ligament pain

Front 23

heartburn

Back 23

displacement of stomach from uterus, increase in progesterone, decrease in GI motility

recommend tums

Front 24

ankle edema

Back 24

increase in difficulty of venous returns of lower extremities

uterus

Front 25

varicose veins

Back 25

weakening of walls of veins or faulty valves. complicated by increasing weight

Front 26

flatulence

Back 26

decreased gi motility and pressure from uterus

Front 27

hemorrhoids

Back 27

pressure of increasing uterus

Front 28

constipation

Back 28

increasing progesterone and oral iron supplement

Front 29

backache

Back 29

increased curvature of spine

Front 30

leg cramps

Back 30

increased pressure from pelvic pain, potassium phosphorus imbalance

Front 31

feeling faint

Back 31

combination of blood volume changes and postural hypotension

Front 32

shortness of breath

Back 32

from enlarging uterus

Front 33

sleep disturbances

Back 33

from pain and discomfort

Front 34

round ligament pain

Back 34

stretching of uterus as it pulls forward

Front 35

pregnancy over 35

Back 35

high cost of living, work on career before starting families

increased risk of down's syndrome

well educated, financially secure, aware of reality of having child, informed decision,

risks of medical conditions, cardiovascular, diabetes, increased low-birth-weight, preterm, miscarriage, c section, chromosomal abnormalities