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objective of prenatal care
Identify fetal development from conception through birth
Describe ways family history may put fetus at risk.
Calculate gestational age of fetus.
Describe ways to promote healthy lifestyle during pregnancy including exercise, nutrition, and rest
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preconception education and care consideration
Immunizations and disease status
Medications
Smoking, alcohol, and illicit drugs
Genetic risk factors
Male contributions
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when does fertilization/conception occur
when sperm and ovum unite.
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fertilized ovum is called
zygote
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Gender of zygote determined at
fertilization
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embedding of the fertilized egg into the uterine lining?
implantation
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one fertilized ovum divides into identical halves that develop into two individuals with same appearance and same gender
identical
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Two separate ova fertilized by two different sperm at the same time. They may or may not resemble each other, may or may not be of same gender
fraternal
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amniotic fluid traits/responsibility
Equalizes the pressure around fetus.
Cushions fetus from external compression.
Provides constant temperature and fluid for fetus to swallow.
Allows freedom of movement for fetus.
Lubricates membranes and fetus
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clear yellow fluid that protects fetus
amniotic fluid
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when is placenta fully functional
12th week
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what is the placentas role
Produces hormones to sustain pregnancy.
Supplies fetus with oxygen and food.
Transports waste products from fetus.
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Membranous vascular organ connecting fetus to mother.
placenta
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Structure connecting fetus to placenta.
Has two arteries that carry unoxygenated blood and one vein which carries oxygenated blood.
umbilical cord
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umbilical cord is surrounded and protected by
wharton's jelly
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ball of knots in an umbilical cord is called
a true knot
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fetal development:
Preembryonic or germinal stage–
Embryonic stage–
Fetal stage–
Preembryonic or germinal stage–first 14 daysafter fertilization
Embryonic stage–week 3 through week 8.
Fetal stage–week 9 until 38 to 40 weeksor full term.
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how is pregnancy calculated
first day of mothers LMP
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living organism that applies to the first form of life
embryo
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when does the embryoblast usually plant in the uterine wall
usually by the 6th day
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order of system development
Cardiovascular system
Gastrointestinal system
Genitourinary system
Integumentary system
Respiratory system
Immunologic system
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factors affecting fetal development
Quality of sperm, ovum, genetic code
Teratogens
Maternal malnutrition
Acute and chronic diseases
Alcohol and drugs
Smoking
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a teratogen drug originally designed to combat morning sickness in pregnant women.
causes: the long bones in the arms or legs of fetuses to not develop properly, resulting in babies with severely stunted arms or legs
thalidomide
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antibiotics that readily cross the placenta.
and are deposited in teeth & bones of fetus
tetracycline
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tetracyline side effect in fetus
Can cause permanent tooth enamel discoloration
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why do breasts usually become tender during pregnancy
because of increased levels of estrogen and progesterone
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physiological changes in the pregnant cardiovascular system:
Blood flow _________.
Heart rate _________.
Blood pressure ________.
increase
increase
decrease
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________ causes edema and vascular congestion in the nasal mucosa
estrogen
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nausea and vomiting is common before the ________ week
12th
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what type of urinary physiological changes may
develop if kidneys are unable to reabsorb glucose
glycosuria
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pigmented line on the abdomen from umbilicus to pubis
linea nigra
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“mask of pregnancy" =
chloasma
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stretch marks =
striae gravidarum
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responsible for initial milk production
prolactin
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causes uterine contractions and ejection of milk from the breasts
oxytocin
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presumptive signs of pregnancy
Amenorrhea
Breast changes
Urinary frequency
Nausea and vomiting
Excessive fatigue
Quickening
Abdominal enlargement
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probable signs of pregnancy
- (G CHUBI B)
- Goodell’s sign
Chadwick’s sign
Hegar’s sign
Uterine enlargement
Braxton-Hicks contractions
Increased pigmentation
Ballottement
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Softening of cervix
goodells sign
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softening of the lower uterine segment just above the cervix. When the uterine is compressed between examining fingers, the wall feels tissue paper thin
*noted by the sixth to eighth week of pregnancy
hegar's sign
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Bluish discolaration of the cervix, vagina, vulva
caused by increased vascularization of reproductive organs
chadwicks sign
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Observed when fetus rises (or bounces) in amniotic fluid, then returns to its normal position after a gentle
push or tapping of the lower portion of the uterus by the examiner.
Usually observed during the 4th or 5th month of pregnancy
ballotment
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Mother’s first feelings of fetal movement
a ‘fluttering’ sensation
quickening
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quickening in Primigradiva: usually occurs _____ trimester
_____ weeks
2nd trimester
18- 20 weeks
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quickening in Multigravida: usually occurs _____, _____
weeks
earlier
14 - 18 weeks
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what do pregancy tests measure
hCG in either urine or blood
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Blood is positive ______days after
conception.
Urine is positive _____ days after
conception.
blood : 8 days
urine: 10 - 14
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positive signs of pregnancy
Hearing the fetal heartbeat.
Visualization of the fetus through ultrasound.
Examiner feeling fetal movement.
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pregnancy test is a _____ sign of pregnancy
probable
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Transvaginal ultrasound: detect pregnancy as early
As _______ weeks
2 1/2 - 3 weeks
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Abdominal ultrasound: detects preg. as
early as ______ weeks
5 - 6 weeks
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Fetal Heart rate should be between _______ beats/min
120 - 160
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factors affecting psychological response
Body image
Financial situation
Cultural expectations
Emotional security
Support from significant others
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developmental task of pregnancy
Pregnancy validation
Fetal embodiment
Fetal distinction
Role transition
Partners’ tasks
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goals of prenatal care
Healthy, prepared mother, minimal discomforts
Potential problems or complicationsIdentified as early as possible
Safe delivery of a healthy infant
Prepared father, partner
Prepared siblings and grandparents
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Woman who has delivered her first viable infant
primipara
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woman who has delivered more than one viable infant
multipara
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woman pregnant for first time
primigravida
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Woman who has been pregnant more than once
multigravida
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gravida
number of pregnancies
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Primary concern for initial visit =
clients health status, and estimate date of delivery
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nagele's rule
- Add 7 days to the first day of the
- last menstrual period
Then count back 3 months
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Measurement of fundal height correlates with?
Gestational age (on average)
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nursing Dx
- Activity intolerance
- Anxiety
- Breathing pattern, ineffective
- Body image disturbance
- Constipation
- Fatigue
- Family coping
- Fear
- Fluid volume deficit
- Excess fluid volume
- Ineffective health maintenance
- Health seeking behaviors
- Ineffective coping
- Risk for injury
- Deficient knowledge
- Noncompliance
- Imbalanced nutrition
- Impaired physical mobility
- Sexual dysfunction
- Disturbed sleep pattern
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nursing intervention for pregnant women
Must be individualized and specific for client.
Focused on teaching the client and providing anticipatory guidance.
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