Module A_Student Notes

  • : 38-42 weeks

    • LMP: Last Menstrual Period

    • LNMP: Last Normal Menstrual Period

  • Implantation:

    • Important site: where the embryo develops

    • Normal implantation occurs in upper uterus

    • May confuse implantation bleeding with menstrual period

    • Complete by end of second week post-fertilization

  • Fetal Development:

    • Embryonic Period: Environmental agents (teratogens) can cause defects

    • Fetal Period: Divided into weeks 9-38, several developmental milestones.

Page 2: Auxiliary Structures

  • Placenta:

    • Thick organ: Maternal and Fetal components

    • Functions: Provides nutrients, removes wastes, secretes hormones

  • Fetal Membrane and Amniotic Fluid:

    • Inner membrane: Amnion, Outer membrane: Chorion

    • Functions of amniotic fluid: cushions fetus, maintains temperature, promotes development

  • Fetal Circulation:

    • Umbilical cord: 2 arteries (deoxygenated blood), 1 vein (oxygenated blood)

    • Key structures: Ductus venosus, Ductus arteriosus, Foramen ovale

Page 3: Genetic Influences

  • Genetic Review:

    • Disease inheritance depends on chromosome type (autosomal or sex)

    • Dominant inheritance: Abnormal gene from one parent can cause disease

    • Recessive inheritance: Both genes must be defective

  • Genetic Counseling: Educates about risks and options without directives

  • Maternal Conditions: Influential factors such as alcoholism, diabetes, smoking, and nutrition

    • Folic acid: vital before conception

  • Infectious Agents: e.g., rubella, toxoplasmosis affecting fetal development

  • Nursing Care: Educate on lifestyle modifications for optimal outcomes.

Page 4: Gravida and Para Classification

  • Gravida Types: Nulligravida (never been pregnant), Primigravida (first pregnancy), Multigravida (multiple pregnancies)

  • Para Classifications: Nullipara, Primipara, Multipara

  • Viability and Term: Definitions of birth stages and pregnancy timeline

  • Physiologic Changes:

    • Reproductive System: Increase in uterine size, changes in breasts and cervix directly tied to pregnancy confirmation

Page 5: Cardiovascular and Respiratory Changes

  • Cardiovascular System:

    • Heart enlarges, rates increase

    • BP affected by position; positional hypotension may occur

  • Physiologic anemia: Due to changes in plasma volume, not actual RBC decrease

  • Respiratory System:

    • Increased oxygen needs, may lead to hyperventilation

    • Lightening may relieve diaphragm pressure

Page 6: Urinary, Integumentary, and Musculoskeletal Systems

  • Urinary System: Urinary urgency due to pressure of the uterus

  • Integumentary Changes: Increased skin pigmentation, "mask of pregnancy"

  • Musculoskeletal: Softening cartilage may lead to waddling gait

Page 7: Signs of Pregnancy

  • Presumptive Signs: Least reliable indicators experienced by the woman

  • Probable Signs: Documented by an examiner, but not definitive

  • Positive Signs: Confirmation through fetal heart sounds, movements, or imaging

  • Initial Prenatal Visit:

    • Gather comprehensive history for care plan

    • Calculate Estimated Date of Delivery (EDD)

Page 8: Ongoing Care

  • Ongoing Visits: Monitor weight, assess fetal development and readiness for delivery

  • Assess fetal heart rate: Normal range is 120-160 bpm

Page 9: Health Behavior Education

  • Bathing: Importance of hygiene and heat management

  • Exercise: Essential for physical health unless contraindicated

  • Nutrition: Essential for adequate weight gain and fetal development; limit caffeine and alcohol

Page 10: Substance Use and Discomforts

  • Tobacco and Alcohol: Encourage cessation and provide support

  • Common Discomforts: Nausea, backache, edema, etc.

Page 11: Psychological Responses

  • Trimester Responses: Emotional reactions evolve through pregnancy stages from uncertainty to preparation for parenting

  • Father and Sibling Responses: Varies by age and family dynamics

Page 12: Factors Influencing Adaptation

  • Consider personal circumstances, social support, and socio-economic factors

  • Childbirth Education: Various classes available to support preparation

Page 13: Nutrition as a Consideration

  • Increase in caloric and protein needs during pregnancy

  • Folate and Iron: Crucial supplements with dietary sources emphasized; recommend hydration and calorie awareness.