Nursing Care of the Childbearing Patient + Family Flashcards AI

What are the psychosocial changes experienced by a mother during the first trimester of pregnancy?

The mother accepts the reality of pregnancy, works through anxiety and feelings of ambivalence, and exhibits self-centeredness (narcissism).

What feelings might a partner experience during the first trimester of pregnancy?

The partner may accept the pregnancy and the reality of a child, accept the woman in her changed state, deal with feelings of jealousy and being overwhelmed, and may feel alone due to lack of support.

What psychosocial changes occur for the mother in the second trimester of pregnancy?

The mother accepts that she is having a baby, realizes the baby as a separate needing person, and fantasizes about the unborn child.

What challenges might a partner face during the second trimester of pregnancy?

The partner may feel increasingly alone, become overly absorbed in work, and struggle with biases or misinformation.

What are the key psychosocial changes for the mother in the third trimester of pregnancy?

The mother experiences nesting behavior as the due date approaches, has a strong desire to finish pregnancy, increases education related to labor, delivery, and caring for a child, and experiences anxiety over safe passage for herself and the baby.

What is 'couvade syndrome' in relation to pregnancy?

Couvade syndrome refers to the phenomenon where the reactions of the father may parallel those of the mother both mentally and physically.

What is the pre-embryonic stage of fetal development?

The pre-embryonic stage lasts for the first two weeks beginning with fertilization.

What is the embryonic stage of fetal development?

The embryonic stage lasts from weeks 3 to 8 of pregnancy.

What is the fetal stage of development?

The fetal stage lasts from week 8 until birth.

What are the two types of fetal membranes and their functions?

The inner membrane is the Amnion, and the outer membrane is the Chorion. They hold the developing fetus and the amniotic fluid.

What are the functions of amniotic fluid?

Amniotic fluid protects the fetus, allows for free movement, maintains temperature, provides oral hydration, and has an alkaline pH.

What is the average volume of amniotic fluid during pregnancy?

The average volume of amniotic fluid is about 1000 mls.

What is the purpose of the umbilical cord?

The umbilical cord is the connecting link between the fetus and placenta, containing two arteries and one vein (AVA) supported by Wharton's Jelly to prevent kinking and knotting.

What are the characteristics of the umbilical cord?

The umbilical cord contains two arteries and one vein, has no pain receptors, and is supported by Wharton's Jelly.

What is the role of the placenta in pregnancy?

The placenta allows for the passage of nutrients and waste material by osmosis, increases the mother's heart rate, total cardiac output, and blood volume to supply blood to the placenta, provides immunities to the fetus, and produces hormones.

How does the mother's body adapt to supply blood to the placenta?

The mother's heart rate, total cardiac output, and blood volume all increase to supply blood to the placenta.

What is the significance of the placenta in terms of immunities?

The placenta provides immunities to the fetus from the mother.

What hormones are produced by the placenta?

The placenta produces various hormones essential for maintaining pregnancy and supporting fetal development.

What is Nagele's Rule for calculating the estimated due date (EDD)?

Add 7 days to the first day of the last normal menstrual period, subtract 3 months, and add 1 year.

What are some presumptive signs and symptoms of pregnancy?

Amenorrhea, nausea and vomiting, urinary frequency, fatigue, breast changes, weight changes, skin changes, vaginal changes including leukorrhea, quickening, and Chadwick's Sign.

What are some probable signs and symptoms of pregnancy?

Uterine enlargement, changes in the uterus and cervix from increased vascularity, ballottement, Braxton Hicks contractions, laboratory tests for pregnancy, and changes in skin pigmentation.

What are positive signs and symptoms of pregnancy?

Fetal heartbeat, palpation of fetal movement, and demonstration of fetal outline by ultrasound or X-ray.

What does the term 'Gravida' refer to in pregnancy classification?

The number of times a woman has been pregnant, categorized as Primagravida (first pregnancy) or Multigravida (multiple pregnancies).

What does 'Para' indicate in pregnancy classification?

The number of pregnancies that have resulted in viable offspring, categorized as Nullipara (no births), Primipara (one birth), or Multipara (multiple births).

What does the TPAL classification stand for?

Term births, Premature births, Abortions, and Living children.

What is the recommended schedule for prenatal visits during pregnancy?

First visit after the first missed period, then once a month until the 7th month, every 2 weeks during the 8th month, and weekly during the 9th month.

What is included in the lab work during the first prenatal visit?

CBC, urinalysis, Pap smear, blood type and Rh, indirect Coombs, RPR (VDRL), rubella titer, STD testing, HIV testing, hepatitis viral studies, and other tests as indicated.

What are some components of subsequent prenatal visits?

Weight monitoring, blood pressure monitoring, urine screening for glucose and protein, evaluation of fetal development, and education on danger signs and healthy behaviors.

How is fetal development evaluated during prenatal care?

Auscultation of fetal heart rate (FHR), fundal height measurement, and palpation of fetal outline.

What additional prenatal tests are performed during pregnancy?

Hgb and Hct redrawn at 24-28 weeks, GTT at 24-28 weeks, antibody screen at 28 weeks, AFP testing at 15-20 weeks, and GBS testing at the beginning of the 9th month.

What is the significance of quickening in pregnancy?

Quickening refers to the first noticeable movements of the fetus felt by the mother, indicating fetal development.

What does ballottement indicate during a pregnancy examination?

Ballottement is when the fetus rebounds against the examiner's hand when pushed gently upwards, indicating the presence of the fetus.

What are Braxton Hicks contractions?

These are irregular, often painless contractions that can occur throughout pregnancy, often referred to as 'practice' contractions.

What is the purpose of prenatal education for the mother?

To promote optimal health of the mother and fetus, educate on nutrition, healthy weight gain, and what to expect during labor and delivery.

What is the importance of monitoring weight during prenatal visits?

To ensure appropriate weight gain for the health of both the mother and the developing fetus.

What tests are performed if a mother shows symptoms of infections in the 9th month?

Testing for GBS, STDs, and other infections as necessary.

What is the role of the initial prenatal visit?

To collect comprehensive data about the client's medical, obstetrical, and family history, and identify high-risk factors.

What is the significance of Chadwick's Sign in pregnancy?

Chadwick's Sign is a bluish discoloration of the cervix and vagina, indicating increased blood flow and a probable sign of pregnancy.

What does the term 'Nullipara' mean?

A woman who has never given birth.

What does the term 'Multipara' mean?

A woman who has given birth multiple times.

What is amniocentesis and when is it typically performed?

Amniocentesis is a procedure performed between 14-20 weeks of pregnancy to obtain amniotic fluid for testing.

What are the primary uses of prenatal ultrasound?

Prenatal ultrasound is used to confirm pregnancy, assess the placenta and amniotic fluid, establish fetal growth, check for gross anomalies, determine fetal sex, and predict maturity.

What are some gross anomalies that can be detected by prenatal ultrasound?

Gross anomalies include hydrocephalus, anencephaly, spinal cord defects, heart defects, kidney defects, and bladder defects.

What does the Biophysical Profile (BPP) measure?

The BPP measures the baby's heart rate, muscle tone, movement, practice breathing, and the amount of amniotic fluid, with each category scored from 0 to 2.

What are the warning signs during pregnancy that should prompt medical attention?

Warning signs include bleeding, severe nausea and vomiting, significant decline in baby's activity, early contractions, leaking or gushing of vaginal fluid, persistent severe headache, abdominal pain, visual disturbances, flu symptoms, and dysuria.

What is the recommended weight gain pattern during pregnancy?

Weight gain should be 2-3 lbs in the first trimester and 1 lb/week in the last two trimesters, with a total of 10 lbs gained in the first half being a concern if not achieved.

What dietary changes are recommended during pregnancy?

Increase caloric intake by 300 kcal/day, consider iron supplementation with vitamin C, maintain calcium intake of 1000 mg/day, and prenatal multivitamins are recommended.

What are the self-care recommendations for bathing during pregnancy?

Daily showers or tub baths are recommended.

What are the recommendations for breast care during pregnancy?

Wear a firm supportive bra, wash with tap water (no soap), dry nipples well, and maintain dryness.

What dental care practices are encouraged during pregnancy?

Encourage brushing teeth upon arising, after meals, and before bed.

What is the recommended hygiene practice for perineal care during pregnancy?

Wipe from front to back and avoid douching.

What clothing recommendations are made for pregnant women?

Wear comfortable clothing that does not restrict blood flow and shoes with little to no heel.

What exercise recommendations are suggested for pregnant women?

Encourage 30 minutes of exercise three times a week.

What is the recommended sleep position for pregnant women?

The left sims position is recommended.

What travel precautions should pregnant women take?

Take stretch breaks every 2 hours, wear a seatbelt, and some airlines may require a doctor's permission after 7 months.

What are teratogens and when do they have the most significant effect?

Teratogens are non-genetic factors that can cause malformations in the fetus, with the highest risk occurring during weeks 3-8 of pregnancy.

What is the significance of sodium intake during pregnancy?

Sodium should not be restricted unless medically indicated.

What should be done if a woman has not gained the expected weight during pregnancy?

Concern arises if a woman has not gained 10 lbs in the first half of pregnancy.

What should be done to promote fetal well-being during pregnancy?

Monitor fetal heart rate, muscle tone, movement, practice breathing, and the amount of amniotic fluid.

What is the importance of calcium during pregnancy?

Calcium intake of 1000 mg/day is important for fetal development, with milk providing 300 mg per glass.

What are the rights of working women during pregnancy?

Federal law protects working women's rights around pregnancy and maternity leave.

What are some examples of chemical teratogens?

Heavy metals such as lead and mercury, chemicals containing PCBs, nitrates, and nitrites.

What types of drugs are considered teratogenic?

All drugs except insulin and heparin, live virus vaccines (HPV, Mumps, Rubella, Polio), and specific drugs like Dilantin.

What is fetal alcohol syndrome and what causes it?

Fetal alcohol syndrome is caused by alcohol consumption during pregnancy.

What are the effects of cocaine use during pregnancy?

Cocaine can cause extreme vasoconstriction, compromising placental perfusion, leading to miscarriage, preterm labor, fetal intracranial hemorrhage, and learning/social disabilities.

What are the potential effects of amphetamines on fetal development?

Amphetamines can cause growth restriction, neonatal abstinence syndrome (NAS), and learning/social disabilities.

How does marijuana use during pregnancy affect fetal development?

Marijuana's effects are not well documented due to frequent polypharmacy abuse.

What are the risks associated with narcotic use during pregnancy?

Narcotics can lead to NAS, small for gestational age (SGA), fetal distress, and meconium aspiration.

What are the risks of inhalant use during pregnancy?

Inhalants can limit oxygen supply to the fetus and have effects similar to alcohol.

What are the effects of syphilis on pregnancy?

Syphilis can cause late abortions, stillbirths, and congenital syphilis if not treated before the 16th-18th week.

What is ophthalmia neonatorum and how is it caused?

Ophthalmia neonatorum is caused by gonorrhea during the birth process.

What is toxoplasmosis and how is it contracted?

Toxoplasmosis is a protozoan infection contracted by ingesting raw meat or kitten feces.

What are the effects of rubella during the first trimester of pregnancy?

Rubella can cause congenital heart defects (CHD), cataracts, blindness, deafness, and mental retardation.

What are the risks associated with cytomegalovirus during pregnancy?

Cytomegalovirus can cause congenital and acquired infections affecting the liver, brain, and blood.

What are the risks of herpes virus Type II during delivery?

Herpes virus Type II can be transmitted during vaginal delivery if active lesions are present, affecting blood, brain, liver, lungs, CNS, eyes, and skin.

What are some cultural considerations regarding pregnancy?

Cultural views may see pregnancy as a healthy time, with behaviors during pregnancy differing and superstitions playing a role.

What factors contribute to high-risk pregnancies?

Multiple pregnancies, unwanted pregnancies, abuse and violence, preconceptual health status, nutritional status, socioeconomic status, age, education, multiparity, lifestyle, and pre-existing medical problems.

What are some implications of adolescent pregnancy on socioeconomic status?

Adolescent pregnancy can lead to reliance on welfare and perpetuate a cycle of poverty.

What are the maternal health risks associated with adolescent pregnancy?

Risks include cephalopelvic disproportion (CPD), pregnancy-induced hypertension (PIH), anemia, and increased mortality.

What fetal health issues can arise from adolescent pregnancy?

Fetal health issues include low birth weight (LBW), prematurity, respiratory complications, cerebral palsy (CP), cognitive deficits, and death.

What should be assessed in adolescent pregnancy?

Assessment should include personal and family health history, menstrual history, family support system, financial status, and the potential role of the father.

What are the key aspects of infant care and needs?

Knowledge of infant care/needs, attitude toward pregnancy, identifying risks, developmental level, and baseline vital signs/weight.

What are the planning and implementation strategies for adolescent pregnancy?

Gain trust, refer to appropriate agencies & resources, promote problem-solving abilities, involve the father if desired, and provide prenatal education to encourage consistent prenatal care.

What are the higher risks associated with older pregnant women?

Chromosomal abnormalities, pre-existing medical conditions, multiple gestation from fertility drug use, spontaneous abortions, preterm labor, and emotional concerns related to changes in role, job, income, and childcare.

What assessments are important for older pregnant women?

Counseling, testing, genetic history, nutrition, use of medications, planning, referral to genetic counseling, and prenatal care focusing on preexisting conditions and immunizations.

What are the types of bleeding disorders in pregnancy?

Early pregnancy bleeding (miscarriage, premature dilation of cervix, ectopic pregnancy) and late pregnancy bleeding (placenta previa, abruptio placentae).

What are the maternal risks associated with hemorrhage in pregnancy?

Blood loss, hypovolemia, anemia, infection, preterm labor, and preterm birth.

What fetal risks are associated with maternal hemorrhage?

Hypoxia, preterm birth, and death.

What nursing interventions are related to bleeding disorders in pregnancy?

Alert the health team, position the patient on side, administer IV therapy and oxygen, assess maternal vital signs and oxygen saturation, monitor uterine contractions and fetal heart rate, assess fetal heart tones if pregnancy is over 12 weeks, assess bleeding, count and weigh pads, save any tissue passed, measure abdominal girth or fundal height, observe for signs of shock, collect and organize all data, and assess coping mechanisms.

What defines a spontaneous abortion (miscarriage)?

Pregnancy ends before 20 weeks, often due to abnormal fetal development, with clinical manifestations including uterine bleeding, contractions, cramping, and abdominal pain.

Match the type of miscarriage with its definition: A. All products of conception are expelled.

Complete miscarriage.

Match the type of miscarriage with its definition: B. Loss of fetus is imminent.

Inevitable miscarriage.

Match the type of miscarriage with its definition: C. Fetus dies during the first 20 weeks of gestation but is retained for 4 weeks or more.

Missed miscarriage.

Match the type of miscarriage with its definition: D. Some products of conception are expelled and some are retained in the uterus.

Incomplete miscarriage.

Match the type of miscarriage with its definition: E. May or may not lose fetus.

Threatened miscarriage.

What management strategies are recommended for a threatened spontaneous abortion?

Limit activity, abstain from intercourse, and provide emotional support without giving false encouragement.

What is the recommended treatment for a missed spontaneous abortion if products of conception are not expelled?

D&C (Dilation and Curettage) if under 14 weeks; induce labor (using prostaglandin, Cytotec, or Pitocin) if over 14 weeks.

What are the psychosocial care considerations post-abortion?

Grief response, future implications for childbearing, disposition of fetal remains, monitor for bleeding and cramping for 1-2 weeks, pelvic rest for 1 week, and follow up with care provider.

What characterizes premature cervical dilation?

Painless dilation and cervical effacement occurring in the second or early third trimester.

What is the most common site for ectopic pregnancy implantation?

The fallopian tube.