Antepartum Period and Obstetric Assessment
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Questions and Answers

What does the term 'gravida' refer to?

  • A woman who is currently pregnant (correct)
  • A woman who has never been pregnant
  • The number of pregnancies a woman has had
  • A woman who has had one or more pregnancies

    • What does Nägele’s rule help estimate?

  • The number of pregnancies
  • The baby's weight at birth
  • The estimated date of confinement or delivery (correct)
  • The duration of labor

    • Which condition qualifies a woman as a 'nullipara'?

  • A woman who has not had a birth at more than 20 weeks of gestation (correct)
  • A woman who has been pregnant once
  • A woman who has delivered twins
  • A woman who has had multiple pregnancies

    • How long is the typical gestation period from fertilization to delivery?

    <p>280 days</p> Signup and view all the answers

    What is the primary focus of nursing care during the antepartum period?

    <p>Health maintenance and prevention of complications</p> Signup and view all the answers

    What is a key component of an obstetrical history assessment?

    <p>Performing a complete physical examination</p> Signup and view all the answers

    What can be defined as a primigravida?

    <p>A woman who is pregnant for the first time</p> Signup and view all the answers

    What does the McDonald's rule utilize to determine the duration of pregnancy?

    <p>Fundal height measurements</p> Signup and view all the answers

    Which of these stages occurs during the antepartum period?

    <p>Conception to the onset of labor</p> Signup and view all the answers

    What is one common minor discomfort during pregnancy?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What contributes most significantly to weight gain during pregnancy?

    <p>Products of conception and water retention</p> Signup and view all the answers

    What physiological change occurs in the uterus during pregnancy?

    <p>Enlargement from approximately 60 to 1000 g</p> Signup and view all the answers

    What condition is associated with increased pigmentation during pregnancy?

    <p>Chloasma</p> Signup and view all the answers

    Which statement accurately describes the changes occurring in the cervix during pregnancy?

    <p>The endocervical glands secrete a thick mucous plug</p> Signup and view all the answers

    What role do the ovaries play in the early stages of pregnancy?

    <p>They secrete progesterone for the first few weeks</p> Signup and view all the answers

    What is a common psychological change experienced by mothers during pregnancy?

    <p>Frequent changes in emotional states</p> Signup and view all the answers

    How does pregnancy affect a woman's posture?

    <p>By increasing lordosis and resulting in a waddling gait</p> Signup and view all the answers

    What is a potential dietary concern indicated by the practice of pica during pregnancy?

    <p>Iron deficiency anemia</p> Signup and view all the answers

    What signifies Chadwick’s sign during pregnancy?

    <p>Softening and discoloration of the cervix</p> Signup and view all the answers

    What common discomfort is associated with the first trimester of pregnancy?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What common intervention can help manage urinary urgency during pregnancy?

    <p>Voiding at regular intervals</p> Signup and view all the answers

    Which dietary recommendation is essential for preventing neural tube defects during pregnancy?

    <p>High intake of folic acid</p> Signup and view all the answers

    What is a recommended position for sleeping to reduce shortness of breath during pregnancy?

    <p>With the head elevated or on the side</p> Signup and view all the answers

    What intervention is NOT typically recommended for managing heartburn during the second and third trimesters?

    <p>Consuming large, heavy meals before bedtime</p> Signup and view all the answers

    What causes leg cramps commonly experienced during the second and third trimesters?

    <p>Altered calcium-phosphorus balance</p> Signup and view all the answers

    Which of the following strategies is NOT effective in managing constipation during pregnancy?

    <p>Avoiding any form of physical activity</p> Signup and view all the answers

    What does the letter 'T' represent in the GTPALM system?

    <p>The number of term infants born after 37 weeks’ gestation.</p> Signup and view all the answers

    During which trimesters is backache most likely to occur due to changes in body mechanics?

    <p>Second and third trimesters</p> Signup and view all the answers

    Which of the following best describes presumptive signs of pregnancy?

    <p>Symptoms reported by the woman that suggest pregnancy but are not conclusive.</p> Signup and view all the answers

    What is a suitable non-pharmacological intervention for managing ankle edema during pregnancy?

    <p>Elevating the legs at least twice a day</p> Signup and view all the answers

    What physiological change occurs in the cardiovascular system during pregnancy?

    <p>Circulating blood volume increases.</p> Signup and view all the answers

    What describes a risk associated with ineffective health maintenance during the antepartum period?

    <p>Risk for deficient fluid volume</p> Signup and view all the answers

    Which sign indicates a probable sign of pregnancy?

    <p>Chadwick's sign.</p> Signup and view all the answers

    What level of caloric increase is generally recommended for women during pregnancy?

    <p>300 calories per day</p> Signup and view all the answers

    What is a common urinary change experienced in the first trimester of pregnancy?

    <p>Increased risk of bladder infections.</p> Signup and view all the answers

    What happens to a woman's oxygen consumption during pregnancy?

    <p>It increases by approximately 15% to 20%.</p> Signup and view all the answers

    What is the expected change in a pregnant woman's gastrointestinal system?

    <p>Increased risk of constipation.</p> Signup and view all the answers

    In the antepartum diagnostic evaluation, which test is performed to check for syphilis?

    <p>Rapid plasma regain.</p> Signup and view all the answers

    What is the impact of supine hypotension in a pregnant woman?

    <p>Compression of the vena cava.</p> Signup and view all the answers

    What role does the anterior lobe of the pituitary gland play during pregnancy?

    <p>Undergoes hypertrophy.</p> Signup and view all the answers

    Study Notes

    Antepartum Period

    • The antepartum period spans from conception to labor onset.
    • Focus during this period is on maintaining maternal and fetal health, preventing complications.
    • Nursing care includes detailed maternal history, physical exam, and education on antepartum health.

    Obstetric History/Assessment

    • Gestation: Time from fertilization to estimated delivery date (approx. 280 days).
    • Nägele's Rule: Calculates estimated delivery date based on last menstrual period (subtract 3 months, add 7 days, add 1 year).
    • McDonald's Rule: Uses fundal height (measured from symphysis pubis) to estimate pregnancy duration (lunar months/weeks).
    • Gravidity: Number of pregnancies (gravida).
      • Nulligravida: Never pregnant
      • Primigravida: First pregnancy
      • Multigravida: Second (or more) pregnancy
    • Parity: Number of pregnancies past 20 weeks, regardless of outcome (live births, stillbirths, abortions).
      • Nullipara: No births past 20 weeks
      • Primipara: One birth past 20 weeks
      • Multipara: Two or more births past 20 weeks
    • GTPAL/GTPALM: System used to document pregnancy history.
      • G: Gravida (number of pregnancies)
      • T: Term births (37+ weeks)
      • P: Preterm births (before 37 weeks)
      • A: Abortions (before 20 weeks)
      • L: Living children
      • M: Multiple pregnancies

    Signs and Symptoms of Pregnancy

    • Presumptive Signs (Possible): Amenorrhea, breast changes, fatigue, skin changes, nausea/vomiting, quickening, urinary frequency.
    • Probable Signs (Likely): Uterine enlargement, Hegar's sign (softening/compressibility of lower uterine segment), Goodell's sign (softening cervix), Chadwick's sign (violet coloration of cervix/vagina), ballottement (rebounding of fetus), Braxton Hicks contractions, positive pregnancy test.
    • Positive Signs (Definite): Fetal heart rate detected (Doppler/fetoscope), fetal movement felt by a provider, ultrasound showing fetal outline.

    Antepartum Diagnostic Testing

    • Various tests confirm pregnancy and rule out maternal/fetal complications.
      • Blood type, Rh factor (erythroblastosis fetalis risk)
      • Immunologic tests (rubella, syphilis, hepatitis B)
      • Pap smear (cervical neoplasia screening)

    Maternal Physiological Changes

    • Cardiovascular: Increased blood volume (plasma > RBC), physiological anemia, increased iron needs, heart size/position changes. -Supine hypotension: Uterus pressing vena cava; side-lying position is crucial.
    • Respiratory: Increased oxygen consumption, elevated diaphragm, shortness of breath.
    • Gastrointestinal: Increased progesterone (constipation, hemorrhoids, heartburn), increased appetite, morning sickness (4-12 weeks).
    • Urinary: Growing uterus pressure on bladder (frequent urination). Increased kidney/bladder infection risk.
    • Endocrine: Increased basal metabolic rate. Enlarged pituitary, thyroid, and parathyroid. Increased aldosterone, water retention, weight gain.
    • Reproductive: Uterus enlargement (hyperplasia/hypertrophy). Increased blood vessels & lymphatics; uterine contractions.
      • Cervix: Softening, increased elasticity. Thick mucus plug
      • Ovaries: progesterone production (first 6-7 weeks), cessation of ovum production.
      • Vagina: muscle hypertrophy, thickening, increased secretions (thick, white, acidic).
      • Breasts: duct/gland development, visible veins, darkening areola, colostrum secretion.

    Body Changes During Pregnancy

    • Dermatological: Skin pigmentation changes (areola, nipples, vulva, perianal; linea nigra, chloasma, striae gravidarum, spider nevi).
    • Musculoskeletal: Lordosis (waddling gait), low backache.
    • Metabolic: Elevated metabolic rate, increased carbohydrate, protein, mineral needs and water intake.
    • Immunological: Decreased resistance to infection, decreased maternal IgG levels.

    Maternal Psychological Changes

    • Ambivalence: Mixed feelings about pregnancy (early stages).
    • Acceptance: Factors influencing acceptance (readiness, identification with motherhood role).
    • Emotional Lability: Frequent, extreme emotional changes.
    • Body Image Changes: Gradually changing perception, positive or negative.
    • Relationship with Fetus: Daydreaming, accepting distinctness of fetus, realistic preparation for birth/parenthood.

    Common Minor Discomforts

    • Nausea/Vomiting: Increased HCG, metabolic changes, fatigue. Interventions: Avoid odors, dry crackers, small meals.

    • Pica: Eating non-food substances; unknown cause. Potential for iron deficiency anemia.

    • Urinary Urgency/Frequency: Uterine pressure on bladder. Interventions: Limit evening fluids, regular voiding, side-lying sleep, perineal pads.

    • Heartburn: Increased progesterone, decreased motility, esophageal reflux, uterine displacement. Interventions: Small meals, upright posture, avoid fatty/spicy foods, consider antacids.

    • Backache: Exaggerated lumbosacral curve. Interventions: Rest, proper posture, supportive shoes, firm mattress.

    • Shortness of Breath: Uterine pressure on diaphragm. Interventions: Rest, elevated head/side-lying position, avoid exertion.

    • Leg Cramps: Altered calcium/phosphorus balance, uterine pressure/fatigue. Interventions: Exercise (walking), dorsiflex foot.

    • Constipation: Increased progesterone, decreased motility, uterine pressure, iron supplements. Interventions: High-fiber diet, fluids, exercise.

    • Ankle Edema: Vasodilation, venous pressure. Interventions: Elevate legs, side-lying, support hosiery Avoid prolonged standing/sitting.

    Nursing Diagnoses, Planning, and Evaluation

    • Nursing Diagnoses: Ineffective health maintenance, risk for deficient fluid volume
    • Nursing Planning: Client's health history, physical, and diagnostic findings within normal limits; warn signs of complications described; body changes acceptable; concerns prioritized; follow-up appointments scheduled.
    • Nursing Evaluation: Healthy findings; understanding of complications; identification of support sources; scheduled appointments.

    Nutrition

    • Increased calorie needs (300/day during pregnancy, 500/day lactation, greater during last two trimesters).
    • High folic acid intake & supplements (prevent fetal defects).
    • Adequate fluid intake (8-10 glasses of water per day).
    • Sodium not restricted unless medically necessary.

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    Description

    This quiz covers the antepartum period, focusing on maternal and fetal health from conception to labor. Key concepts also include gestation, Nägele's Rule, McDonald's Rule, gravidity, and parity. Understanding these elements is essential for effective nursing care during pregnancy.

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