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Questions and Answers
What is the primary purpose of measuring fundal height during prenatal visits?
What is the primary purpose of measuring fundal height during prenatal visits?
Which of the following tests is commonly used to screen for neural tube defects?
Which of the following tests is commonly used to screen for neural tube defects?
What is the significance of conducting a pelvic examination during prenatal visits?
What is the significance of conducting a pelvic examination during prenatal visits?
Which aspect is NOT typically monitored during subsequent prenatal visits?
Which aspect is NOT typically monitored during subsequent prenatal visits?
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When is the earliest gestational age that ultrasonography can typically detect a gestational sac?
When is the earliest gestational age that ultrasonography can typically detect a gestational sac?
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What is the frequency of prenatal visits from weeks 29 to 36 of pregnancy?
What is the frequency of prenatal visits from weeks 29 to 36 of pregnancy?
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At what point in pregnancy is the fundal height expected to match the number of weeks of gestation?
At what point in pregnancy is the fundal height expected to match the number of weeks of gestation?
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What is one of the psychological signs of intimate partner violence?
What is one of the psychological signs of intimate partner violence?
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What prenatal screening is performed at 28 weeks for a woman who is Rho(D)-negative?
What prenatal screening is performed at 28 weeks for a woman who is Rho(D)-negative?
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During which weeks of pregnancy should a woman expect to receive prenatal visits weekly until delivery?
During which weeks of pregnancy should a woman expect to receive prenatal visits weekly until delivery?
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What type of behavior does controlling a partner's access to financial resources fall under?
What type of behavior does controlling a partner's access to financial resources fall under?
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What is not a part of the screening done throughout pregnancy?
What is not a part of the screening done throughout pregnancy?
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Which statement is true regarding the behaviors recognized as intimate partner violence?
Which statement is true regarding the behaviors recognized as intimate partner violence?
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What is the primary purpose of measuring fundal height during a prenatal visit?
What is the primary purpose of measuring fundal height during a prenatal visit?
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Which of the following prenatal screening tests is designed to identify potential infections in the mother?
Which of the following prenatal screening tests is designed to identify potential infections in the mother?
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What type of examination is conducted during the first prenatal visit to assess pelvic size?
What type of examination is conducted during the first prenatal visit to assess pelvic size?
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What behavioral factor is considered a risk during pregnancy, as it may impact the health of both the mother and fetus?
What behavioral factor is considered a risk during pregnancy, as it may impact the health of both the mother and fetus?
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At what point in pregnancy should the first prenatal visit ideally occur?
At what point in pregnancy should the first prenatal visit ideally occur?
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Which sign is considered a probable sign of pregnancy and can be verified by a healthcare provider?
Which sign is considered a probable sign of pregnancy and can be verified by a healthcare provider?
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What does the 'A' in the obstetric history recording GT/PALS stand for?
What does the 'A' in the obstetric history recording GT/PALS stand for?
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Which of the following would be classified as a positive sign of pregnancy?
Which of the following would be classified as a positive sign of pregnancy?
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Which symptom is classified as a presumptive sign of pregnancy?
Which symptom is classified as a presumptive sign of pregnancy?
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When assessing risk factors during pregnancy, which of the following factors would be considered a socioeconomic consideration?
When assessing risk factors during pregnancy, which of the following factors would be considered a socioeconomic consideration?
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Study Notes
Nursing Care & Complications of Pregnancy
- The presentation covers nursing care and complications during pregnancy, specifically focusing on management strategies.
Class Objectives
- Describe health promotion activities and prenatal monitoring in routine pregnancies.
- Discuss the antenatal record and documentation of pertinent information.
- Discuss domestic abuse and approaches to care.
- Review common warning signs and complications during pregnancy, including treatments.
Preconception Care
- Preconception assessment includes an in-depth health history of the individual and family.
- Early interventions, such as nutritional adjustments and smoking/drinking cessation, are crucial.
Preconception Care (Continued)
- Healthy babies result from healthy mothers.
- The most vulnerable time for pregnancy is between days 17 to 56 after fertilization (approximately 4 to 10 weeks).
- Folic acid is important for preventing neural tube defects.
Goals of Prenatal Care
- Ensure a safe birth for the pregnant person and child by promoting good health habits and reducing risks.
- Teach health habits that can continue after pregnancy.
- Educate the pregnant person about self-care during pregnancy.
- Provide physical care and promote health for the pregnant person, fetus, newborn, and family.
- Prepare clients for the responsibilities of parenthood.
The Initial Prenatal Visit
- The initial visit is the longest, and involves obtaining baseline data.
- This visit aims to confirm or rule out a pregnancy diagnosis and ascertain risk factors.
- Determining the due date and providing education for maintaining a healthy pregnancy are also key objectives.
Presumptive Signs of Pregnancy (Subjective)
- Amenorrhea (no menstruation)
- Nausea
- Breast changes (tenderness/increased pigmentation)
- Urinary frequency
- Fatigue and drowsiness
- Quickening (feeling the baby move)
Probable Signs of Pregnancy (Objective)
- Goodell's sign (softening of the cervix)
- Chadwick's sign (bluish/purplish vaginal color)
- Uterine enlargement
- Braxton Hicks contractions (mild tightening)
- Pregnancy tests (relatively accurate, but can have false negatives)
Positive Signs of Pregnancy (Not explained by anything else)
- Fetal heart sounds
- Fetal movement noted by the examiner
- Visualization of fetus by ultrasound
Reproductive History Terminology
- Gravida: The total number of pregnancies.
- Primigravida: First pregnancy.
- Multigravida: More than one pregnancy.
- Parity: Communicates the outcomes of previous pregnancies.
Recording Obstetric History (GT/PALS)
- Gravida (# pregnancies), Para (deliveries after 20 weeks).
- Term: Pregnancies that ended at term (37+ weeks).
- Preterm: Pregnancies that ended before 36 weeks.
- Abortions: Pregnancies that ended before 20 weeks.
- Living: Number of currently living children.
- Stillbirths: Number of babies born dead after 20 weeks.
First Prenatal Visit (Continued)
- Physical examination, including a head-to-toe assessment and pelvic exam for size.
- Laboratory work, such as a complete blood count, blood type and antibody screen, tests for infections, and pap smears.
Risk Assessment
- Factors considered include:
- Prenatal care sought late.
- Patient's attitude towards the pregnancy.
- Unwanted pregnancy.
- Risks during pregnancy (substance use, history of complications with previous pregnancies, preexisting diseases, socioeconomic factors, living conditions, and domestic violence).
Intimate Partner Violence
- Recognize the signs and behaviors of violence.
- Conduct private assessments, maintaining confidentiality to avoid escalation.
- Build rapport with the person to help them determine the best approach.
- Refer to appropriate shelters or support services.
- Report abuse of children to the proper authorities.
- Violence within an intimate relationship results in physical, emotional, or psychological harm.
Subsequent Prenatal Visits
- Usually seen monthly (weeks 1–28), biweekly between (weeks 29–36) and weekly until delivery.
- Visits include specific assessments like weight, blood pressure, urine protein/glucose, fetal heart rate, and edema.
Subsequent Prenatal Visits (Continued)
- Fundal height should match the number of weeks progressed.
- Practitioner measures fundal height in centimeters.
Subsequent Prenatal Visits (Continued)
- Screening for pregnancy, such as prenatal screening, is done throughout pregnancy.
- At 28 weeks, women who are Rh(D)-negative are screened for antibodies and administered anti-D immune globulin (RhoGam).
- Group B Streptococcus (GBS) is screened after 35 weeks.
Subsequent Prenatal Visits (Continued)
- MSAFP (Maternal Serum Alpha Fetoprotein) screens for neural tube defects and other chromosomal or genetic defects.
- Amniocentesis may be performed between 15–20 weeks to determine genetic makeup.
- Chorionic villus sampling for pregnancy elective abortions can be performed previously in a pregnancy, with the sampling of the placenta tissue taken through the vagina.
The Physical Examination
- Includes laboratory tests (Page 61/67).
- Ultrasonography
- Pelvic examinations.
- Assessment of the bony pelvis relative to existing conditions (e.g. size and position of fetus at term and quality of contractions in labor.)
Lab Tests
- Blood work: CBC, RH status, sickle cell, STD, rubella titre, HIV, Hep.
- Urinalysis: Glucose, protein, erythrocytes leukocytes, and bacteria.
- Pelvic lab tests: Pap, gonorrhea, chlamydia, and strep.
- Ultrasonography: Gestational sac detection, fetal heart beat (FHB).
Monitoring and Evaluating the Pregnant Woman in Subsequent Visits
- Blood pressure.
- Weight
- Fundal height.
- Fetal heart tones
- Urine
- Edema
- Sharing questions and concerns.
Pregnant Abdominal Assessment
- YouTube video link: https://www.youtube.com/watch?v=bwHx-RC-Pj4
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Description
This quiz covers essential nursing care practices and management strategies related to pregnancy complications. It highlights prenatal monitoring, antenatal records, warning signs, and the importance of preconception care. Gain insights into providing effective care for expectant mothers and ensuring the health of both mother and baby.
