Health Promotion Maintenance Ante MK (1) (1)

Health Promotion & Maintenance for the Antenatal Client

  • Presented by: Melissa King, MSN, RN

Learning Objectives

  • By the end of this presentation, the learner will be able to:

    • Analyze the meaning and importance of family-centered care when implementing care to diverse childbearing clients and families during the antenatal period.

    • Analyze how an obstetric nurse collaborates with members of the interprofessional healthcare team to achieve health outcomes of a childbearing person during the antenatal period.

    • Utilize the nursing process as a systematic approach to a person with childbearing health needs during the antenatal period.

    • Integrate components of clinical judgment when providing care for the childbearing person with antenatal needs.

    • Analyze the use of evidence-based practice when providing care to the childbearing person with antenatal needs.

Resources

  • Client Support System:

    • Understand the client's family support and their resources.

  • Barriers to Care:

    • Identify underlying health problems or habits that could complicate the pregnancy.

    • Assess barriers that may impede the client's access to routine appointments.

Risk Factors for Antenatal Clients

  • Categories of Risk Factors:

    • Obstetric History

    • Past Illness

    • Current Obstetrical Status

    • Psychosocial Factors

    • Lifestyle Choices

    • Demographic Factors

  • Risk Factors Examples:

    • Existing uterine or cervical anomalies

    • History of subfertility, recurrent miscarriages, or grand multiparity

    • Significant chronic diseases such as diabetes or heart disease

    • Emotional disorders or cognitive challenges

    • Lifestyle issues such as alcohol or drug use during pregnancy

Initial Prenatal Visit Activities

  • Activities to include during the visit at 9 weeks gestation:

    • A. Provide nutrition education

    • B. Obtain a midstream urinalysis

    • C. Send a blood sample for a complete blood count

    • D. Send a blood sample for alpha-fetoprotein (AFP) testing

    • E. Advise on DNA testing

    • F. Assist in collecting specimens for vaginal culture

    • G. Complete an obstetric ultrasound

    • H. Enter a prescription for blood typing.

Screening Assessments for Antenatal Care

  • Goals of Screening:

    1. Establish baseline of present health

    2. Monitor fetal development and maternal well-being

    3. Provide education and resources

    4. Identify and minimize risks

    5. Determine gestational age of fetus

Individualizing Prenatal Care Suggestions

  • Schedule promptly after the first contact, >1 week for accessibility.

  • Opt for convenient appointment times considering client’s personal obligations.

  • Minimize waiting times and provide educational materials while waiting.

  • Allow privacy for assessments and empower clients to manage health records.

Key Components of Prenatal Assessment

  • Initial Visit Components:

    • Obstetric, menstrual, contraceptive histories

    • Family and partner health histories

    • Baseline lab studies and psychosocial assessment

    • Vital signs, urinalysis, and physical exams

  • Subsequent Visits Include:

    • Monitoring weight, fetal heart rate, and uterine size

    • Education on warning signs and conditions for further testing.

Signs of Pregnancy

  • Presumptive Signs:

    • Fatigue, amenorrhea, breast changes, nausea

  • Probable Signs:

    • Chadwick's sign, positive pregnancy test, Braxton Hicks contractions

  • Positive Signs:

    • Fetal heartbeat detected via doppler or sonography

    • Fetal skeleton visible on X-ray.

Fetal Development by Trimester

  • First Trimester (0-12 Weeks):

    • Critical development including organ formation.

    • Fetal heartbeat detectable by ultrasound.

  • Second Trimester (13-24 Weeks):

    • Growth and development continue, mother may feel fetal movement.

  • Third Trimester (25-40 Weeks):

    • Rapid fetal growth with increased fetal activity.

Supporting Structures of Pregnancy

  • Membranes:

    • Protective barrier holding amniotic fluid and fetus.

  • Placenta:

    • Nutrition/waste/gas exchange center, hormone production.

  • Umbilical Cord:

    • Circulatory pathway connecting embryo to placenta.

Fetal Development Stages and Growth

  • Critical Stages in Growth:

    • Organ systems develop, heart visible at 8 weeks, eyes open by 28 weeks.

Nutritional and Lifestyle Considerations for Healthy Pregnancy

  • Balanced diet emphasizing nutrient-dense foods.

  • Regular prenatal vitamins, particularly folic acid.

  • Recommendations for exercise and avoiding teratogens (smoking, alcohol).

Pain Management Education in Labor

  • Informed approach to understanding labor pain, breathing techniques, and relaxation methods.

  • Pain Management Methods:

    • Bradley, Lamaze techniques emphasizing relaxation and focused breathing.

Warning Signs During Pregnancy

  • Indicators to watch for include:

    • Vaginal bleeding, persistent vomiting, fever, and significant swelling.

References

  • Silbert-Flagg, JoAnne, Maternal & Child Health Nursing, 9th Edition.