NURS 2866 Ch. 8 - Nursing Care of the Family During Pregnancy *

Overview of pregnancy duration and trimesters?

Pregnancy lasts ~40 weeks and is divided into three trimesters: 1st (weeks 1–13), 2nd (weeks 14–26), 3rd (weeks 27–40).

Categories of pregnancy signs and symptoms?

Presumptive, probable, and positive signs (details in Chapter 7).

Goal of prenatal care?

To promote the health and well-being of the pregnant woman, fetus, newborn, and family.

Ways to estimate the Date of Birth (EDB)?

Based on last menstrual period (LMP) and first ultrasound exam.

Importance of estimating EDB?

For accurate prenatal care planning, screening, growth assessment, and managing complications.

Nägele’s Rule for EDB calculation?

First day of LMP → Subtract 3 months + Add 7 days.

Maternal adaptation stages?

Accepting pregnancy, identifying with mother role, reordering relationships, bonding with fetus.

What changes might fathers experience during pregnancy?

Psychological and emotional changes; increasing support and involvement needed.

What is assessed during the initial prenatal visit?

Surgical/medical history, allergies, medications, immunizations, nutrition, BMI.

Risks of obesity during pregnancy?

Miscarriage, anomalies, gestational diabetes, preeclampsia, preterm birth, labor issues, infections.

Why is medication and drug use important to review?

Because substances can transfer to the fetus via the placenta.

Why assess social and occupational history?

To identify support systems and occupational risks (e.g., chemical exposure, DVT risk from sedentary work).

Most common pregnancy complication?

Perinatal depression.

When to screen for depression and anxiety?

At least once during pregnancy.

How common is intimate partner violence (IPV) in pregnancy?

Occurs in ~20% of pregnancies.

Risk factors for IPV during pregnancy?

Young age, unintended pregnancy, low income/education, history of abuse.

Complications linked to IPV during pregnancy?

Miscarriage, hemorrhage, placental abruption, preterm birth, low birth weight.

Purpose of the physical exam in prenatal care?

To establish baseline health and detect early complications.

Initial lab tests recommended by the CDC?

Syphilis, chlamydia, hepatitis B (see Table 8.1 for full list).

Recommended schedule for prenatal visits?

Weeks 1–28: Monthly; 28–36: Every 2 weeks; 36–Birth: Weekly.

What’s included in the interview during prenatal follow-ups?

Assess health status, address concerns, educate patients.

What’s included in the physical assessment at follow-ups?

Monitor pain, edema, headaches, signs of complications.

How to estimate gestational age?

By uterine size and fundal height (pubic bone to fundus).

How should fundal height relate to gestational age?

It should approximately equal the number of weeks pregnant.

How to detect fetal heart rate early vs. later in pregnancy?

Ultrasound early on; Doppler later in the first trimester.

How long to count fetal heart rate and what to assess?

Count for one minute; assess rhythm and quality.

What does urinalysis check for at each visit?

Glucose, protein, nitrites, leukocytes.

When is glucose screening done, and how?

1-hour OGTT; if elevated → 3-hour OGTT.

When is Group B Streptococcus (GBS) testing done?

Between 35–37 weeks.

Why is GBS important?

It's normal flora but can cause neonatal respiratory distress.

What if GBS is positive?

Give IV antibiotics during labor.

How long is a GBS culture valid?

5 weeks—don't test too early.

Key patient education topics during prenatal visits?

Fetal/maternal changes, when to call provider, resources, nutrition, BMI, discomforts.

Example of important patient education about symptoms?

Epigastric pain may seem like heartburn but could signal preeclampsia—especially with high BP.