Antepartum Care Overview

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is a key characteristic of placental abruption?

Painless bright red bleeding

Low-lying placenta

Painful dark red bleeding (correct)

Board-like abdomen

Which maneuver is indicated for shoulder dystocia?

Fowler's position

McRoberts maneuver (correct)

Breech extraction

Vaginal pressure exertion

During which stage of labor does cervical dilation occur from 0 to 6 cm?

2nd stage

1st stage latent phase (correct)

3rd stage

4th stage

What is NOT an intervention for a prolapsed cord?

Apply fundal pressure Signup and view all the answers

What is indicated by late decelerations during labor?

Placental insufficiency Signup and view all the answers

What is a common sign of uterine rupture?

Sudden severe abdominal pain Signup and view all the answers

What stage of lochia is characterized by a yellow/white color?

Alba Signup and view all the answers

Which of the following is a sign of cold stress in newborns?

Hypoglycemia Signup and view all the answers

What maternal change during pregnancy involves an increase in both cardiovascular volume and risk for thromboembolism?

Increased cardiac output Signup and view all the answers

What is a common complication associated with gestational diabetes?

Neonatal hypoglycemia Signup and view all the answers

Which of the following signs is NOT included in the danger signs of pregnancy mnemonic 'BURNT HOT'?

Bloating or abdominal discomfort Signup and view all the answers

What is the recommended weight gain target for a woman with a normal BMI during pregnancy?

25-35 lbs Signup and view all the answers

What dietary recommendation is given regarding calcium intake during pregnancy?

Increase to 1,000 mg/day for bone and tooth formation Signup and view all the answers

Which approach is used to manage severe preeclampsia?

Immediate delivery of the baby if severe Signup and view all the answers

Which of the following nutritional requirements should be increased by 10g/day during pregnancy?

Protein Signup and view all the answers

What action should be taken to prevent supine hypotensive syndrome during pregnancy?

Turn to the left side Signup and view all the answers

Study Notes

Antepartum Care

Breast Changes: Size increases; pigmentation changes.
Cardiac Output: Increases by 50%. Monitor for DVT and PE.
Hematologic Changes: Hemodilution (increased plasma volume), increased fibrinogen (hypercoagulable state), slight decrease in hemoglobin and hematocrit.
Supine Hypotensive Syndrome: Avoid lying flat to prevent vena cava compression. Turn to the left side.
Gastrointestinal (GI) System: Slows down, increased risk of constipation.
Endocrine System: Increased progesterone and relaxin cause muscle relaxation (watch for UTIs).
Psychosocial: Normal ambivalence in early pregnancy.
Danger Signs of Pregnancy ("BURNT HOT"):
- Blurry vision (B)
- Urinary pain or urgency (U)
- Red vaginal bleeding (R)
- Severe nausea/vomiting (N)
- Temperature > 101°F (T)
- Severe headaches (H)
- Low urine output (O)
- Trauma (T)
Weight Gain Targets:
- Normal BMI: 25-35 lbs
- Overweight BMI: 15-25 lbs
- Underweight BMI: 28-40 lbs
Nutritional Requirements:
- Increase protein by 10g/day
- Folic acid: 400-800 mcg/day for neural tube development
- Iron: 27 mg/day, best absorbed with Vitamin C
- Calcium: 1000 mg/day for bone and tooth formation
- Hydration: 2-3 L/day; avoid excessive caffeine (limit to 200-300 mg/day).
Preeclampsia: High blood pressure with proteinuria after 20 weeks.

Intrapartum Care

VEAL CHOP:
- V: Variable decelerations - Cord compression - Reposition
- E: Early decelerations - Head compression - OK
- A: Accelerations - Oxygenated - OK
- L: Late decelerations - Placental insufficiency - Stop pitocin, reposition, give oxygen
Stages of Labor:
- 1st Stage: Onset to 10 cm dilation (latent phase 0-6 cm, active phase 6-10 cm)
- 2nd Stage: 10 cm to delivery
- 3rd Stage: Delivery of placenta
- 4th Stage: Recovery and stabilization
Severe Signs- include vision changes, headaches, epigastric pain, hyperreflexia. Magnesium sulfate for seizure prevention if these are severe.
HELLP Mnemonic: H: Hemolysis, EL: Elevated Liver Enzymes, LP: Low Platelets
Gestational Diabetes:
- Diagnosis: 1-hour glucose challenge test (>140 mg/dL); confirm with 3-hour test
- Complications: Macrosomia, shoulder dystocia, neonatal hypoglycemia
- Management: Diet, exercise, insulin if needed.
- Monitoring: Blood glucose target 70-110 mg/dL
Placenta Previa (P-CLUB) vs. Abruption (P-BAD):
- Placenta Previa (P-CLUB): Painless bright red bleeding, c-section possible, low lying placenta.
- Abruption (P-BAD): Painful dark red bleeding, board-like abdomen, sudden onset, decelerations (fetal distress).

Postpartum Care

BUBBLEHE Assessment:
- Breasts (engorgement, latch)
- Uterus (firm, midline, fundal height)
- Bladder (voiding issues, distension)
- Bowel (constipation, hemorrhoids)
- Lochia (rubra, serosa, alba)
- Episiotomy (healing)
- Homan's Sign (DVT check)
- Emotions (bonding, baby blues)
4 T's of Postpartum Hemorrhage: Tone, Tissue, Trauma, Thrombin
Lochia Stages:
- Rubra: Days 1-3 (dark red)
- Serosa: Days 4-10 (pink/brown)
- Alba: Days 11-6 weeks (yellow/white)

Newborn Care

Thermoregulation: Keep baby warm and dry to prevent cold stress.
Signs of Cold Stress: Hypoglycemia, increased oxygen demand, decreased surfactant production.
Interventions: Skin-to-skin contact, warm blankets/room.
Newborn Reflexes: Moro, rooting, Babinski, palmar grasp

Breastfeeding Tips

Feed often (8-12 times/day).
Ensure proper latch.
Relief for engorgement: warm or cold compresses.
Signs of healthy feeding: 6-8 wet diapers/day, yellow stools.

Key Medications

Magnesium Sulfate: Preeclampsia seizure prevention. Toxicity signs: blood pressure drop, urine output < 30 mL/hr, respirations < 12/min, absent patellar reflexes.
Betamethasone: Promotes fetal lung maturity in preterm labor. Dosage: 12mg IM every 24 hrs for 2 doses.
Oxytocin (Pitocin): Labor induction, postpartum hemorrhage control.

Practice Questions

Client with painless, bloody discharge (34 weeks): Likely diagnosis is Placenta Previa
Postpartum boggy, displaced uterus: Encourage the client to urinate
Prolapsed umbilical cord: Reposition the client to relieve pressure.
Fetal monitor showing late decelerations: Turn the client to the left side.
Magnesium sulfate-low respiratory rate: Stop the infusion and administer oxygen.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers key concepts related to antepartum care, including breast and cardiac changes, hematologic alterations, and potential danger signs during pregnancy. It also addresses psychosocial factors and weight gain recommendations for expectant mothers. Test your knowledge on these critical aspects of prenatal health.