HABSN Mod 1 ALG_6.2024 PDF

Module 1 Active Learning Guide ============================== Reproduction and Evidence-Based Care of the Childbearing Family =============================================================== Module Objectives 1. Contrast the structure and function of the major external and internal female gen...

Module 1 Active Learning Guide ============================== Reproduction and Evidence-Based Care of the Childbearing Family =============================================================== Module Objectives 1. Contrast the structure and function of the major external and internal female genital organs. 2. Outline the phases of the menstrual cycle including the hormones involved and their impact on the normal cycle 3. Examine fetal development, the function of the placenta, umbilical cord, and amniotic fluid 4. Differentiate between subjective (presumptive), objective (probable), and diagnostic (positive) signs of pregnancy. 5. Identify maternal physiologic changes that occur during pregnancy and the pathophysiology behind these changes. 6. Characterize the emotional and psychological changes that occur during pregnancy from a family-centered approach respecting diversity. 7. Outline appropriate nursing management to promote maternal self-care and minimize the common discomforts of pregnancy. 8. Recognize signs of violence against women **Instructions:** Answer the following questions as you work through the module content. Please note you are responsible for all content and assignments in each module. The questions below are not all-inclusive of exam content and meant solely to assist you as you work through the module content. This is not a graded assignment, but a complete guide will be a helpful study aid for exams. Factors affecting maternal and child health ------------------------------------------- 1. List different types of family structures. - **Nuclear Family** -- Two parents and their children living together. - **Extended Family** -- Includes additional relatives such as grandparents, aunts, uncles. - **Single-Parent Family** -- One parent raising children due to separation, divorce, or other circumstances. - **Blended Family** -- Two families coming together due to remarriage. - **Same-Sex Parent Family** -- Two parents of the same gender raising children. - **Adoptive/Foster Family** -- Parents caring for children who are adopted or in foster care. - **Multigenerational Family** -- Multiple generations living in the same household. - **Communal Family** -- Several families or individuals living together and sharing responsibilities. 2. Explain the relationship between violence and pregnancy. What are potential effects? - **Violence can escalate during pregnancy due to stress, financial strain, or power dynamics.** - **Potential Effects on the Mother:** Increased risk of miscarriage, preterm labor, hypertensive disorders, inadequate prenatal care, depression, and PTSD. - **Potential Effects on the Fetus:** Low birth weight, preterm birth, developmental delays, and stillbirth. Health status and lifestyle --------------------------- 1. Define teratogens. **Teratogens are substances or environmental factors that can cause congenital abnormalities or developmental issues in a fetus.** **Examples:** Alcohol, tobacco, certain medications (e.g., isotretinoin), infections (e.g., rubella, syphilis), and environmental toxins (e.g., lead, radiation). Family Centered Community- Based Care ------------------------------------- 1. What is family centered care? An approach to healthcare that recognizes the importance of family involvement in a patient's care, ensuring respect, collaboration, and support for both the patient and their family members. 2. What is evidence-based nursing practice? The integration of the best available research, clinical expertise, and patient preferences to guide nursing care and improve patient outcomes. 3. List 3 general guidelines for appropriate verbal communication. Use clear, simple, and respectful language appropriate for the patient's understanding. Maintain an empathetic and nonjudgmental tone when speaking. Encourage open-ended questions to facilitate dialogue and ensure understanding. 4. List 3 general guidelines for appropriate nonverbal communication. Maintain **eye contact** to show attentiveness (when culturally appropriate). Use **open body language** (e.g., avoid crossing arms) to appear approachable. Use **gentle touch** when appropriate to convey empathy and reassurance. 5. Define health literacy. The ability of individuals to understand, process, and apply health information to make informed healthcare decisions. 6. List at least two community-based nursing interventions. **Prenatal education programs** to improve maternal and fetal health outcomes. **Home visits for postpartum mothers** to monitor newborn health, provide breastfeeding support, and assess maternal well-being. Anatomy and Physiology of the Reproductive System ------------------------------------------------- ### External Female Reproductive Organs - List the location and function of each. 1. Mons pubis **Location:** Fatty tissue over the pubic bone. **Function:** Provides cushioning and protection for the pubic bone. 2. Labia **Location:** Folds of skin surrounding the vaginal opening. **Function:** Protects the vaginal and urethral openings from infection and injury. 3. Clitoris and prepuce **Clitoris Location:** Small erectile organ at the front of the vulva. **Prepuce Location:** Fold of skin covering the clitoris. **Function:** The clitoris is highly sensitive and involved in sexual stimulation. The prepuce protects the clitoris. 4. Vestibule  Location: Area inside the labia minora, surrounding the urethral and vaginal openings. Function: Contains the openings of the urethra and vagina, as well as Bartholin's glands for lubrication. 5. Perineum Location: Area between the vaginal opening and anus. Function: Supports pelvic structures and is often involved in childbirth. ### Internal Female Reproductive Organs- List location and function of each. 1. Vagina **Location:** Muscular canal extending from the external genitalia to the cervix. **Function:** Serves as the birth canal, allows menstrual flow, and facilitates sexual intercourse. 2. Uterus **Location:** Hollow, muscular organ between the bladder and rectum. **Function:** Supports fetal development during pregnancy and sheds its lining during menstruation. 3. Cervix **Location:** Lower portion of the uterus connecting to the vagina. **Function:** Produces cervical mucus, facilitates sperm movement, and dilates during childbirth. 4. Corpus **Location:** Upper portion of the uterus. **Function:** Houses the developing fetus and contracts during labor. 5. Fallopian tubes **Location:** Tubes extending from the ovaries to the uterus. **Function:** Site of fertilization; transports the egg from the ovary to the uterus. 6. Ovaries **Location:** Paired organs on either side of the uterus. **Function:** Produce eggs (ova) and secrete hormones (estrogen and progesterone). ### The Female Reproductive Cycle 1. Explain ovarian cycle including [f]ollicular phase, [o]vulation, and [l]uteal phase (tip: remember by FOL). **Follicular Phase (Days 1--13) (preparing a follide to release mature egg)** - **What Happens:** FSH stimulates follicle development; the dominant follicle produces estrogen. - **Key Hormones:** FSH (follicle growth), Estrogen (endometrial thickening). Extra Notes: - Hypothalamus will release Gonadotropin releasing hormone which will cause anterior pit. Gland to release follide stimulating hormone (FSH) and luteinizing hormone (LH) - FSH causes several follicles to grow but only one releases and is turned into Graafian follicle (found in ovary fluid filled sac w/ immature eggs) - As it gets bigger and more mature, the estrogen will increase - When estrogen is released, there is negative feedback which causes dip in FSH and LH because the egg is maturing and doesn't need allat. - Estrogen causes LH surge (positive feedback) which plays a role to get egg out of Graafian follicle so that it may be fertilized - LH role: cause egg to be released and mature - Graafian follicle turns into corpus luteum which releases progesterone and estrogen so that it is receptive to pregnancy - 24-36 after surge, egg will be released. Most fertile days for women are the last 5 days of the follicular and 24 hours after ovulation (around 9-16 days of cycle) **Ovulation (Day 14)** - **What Happens:** Surge in LH causes the mature follicle to release an egg. - **Key Hormones:** LH surge triggers ovulation. Extra Notes: - Ovum (mature egg cell) released in peritoneal cavity then swept into fallopian tube w/ help of fimbria (cilia) and journey towards uterus - Ovum only last 24 hours unless met with sperm - Egg will only live for 24 hours (women will have a dip in basal body temp and increase 0.4-1 F around 0 - If sperm present to fertilize, most likely to occur at **ampulla** of fallopian tube. - When ovulation occurs, there's a drop in estrogen **Luteal Phase (Days 15--28)** - **What Happens:** The ruptured follicle becomes the corpus luteum, secreting progesterone to prepare for implantation. - **Key Hormones:** Progesterone maintains the uterine lining. If no pregnancy, corpus luteum degenerates, and menstruation begins. Extra Notes: - Preparing for possible pregnancy...if not cycle restarts - Corpus luteum forms from follicle: temporary endocrine structure that releases progesterone (prepared egg for implantation) and estrogen - Corpus luteum stays in place for 14 days, if not pregnant it will disintegrate and turn into corpus albicans - Corpus albican decreases progestogen and estrogen which will start cycle over again because need FSH AND LH - If fertilization did occur, corpus luteum stays because it needs those hormones. Embryo will release HCG and prevents corpus lutuem from dying - Corpus lutem stays in place until placenta takes over (about 8 weeks) BOX 3.1 Summary of Menstrual Cycle Hormones LH rises and stimulates the follicle to produce estrogen. As estrogen is produced by the follicle, estrogen levels rise, inhibiting the output of LH. Ovulation occurs after an LH surge damages the estrogen-producing cells, resulting in a decline in estrogen. The LH surge results in establishment of the corpus luteum, which produces estrogen and progesterone. Estrogen and progesterone levels rise, suppressing LH output. Lack of LH promotes degeneration of the corpus luteum. Cessation of the corpus luteum means a decline in estrogen and progesterone output. The decline of the ovarian hormones ends their negative effect on the secretion of LH. LH is secreted, and the menstrual cycle begins again. 2. Explain the endometrial/uterine cycle including proliferative phase, secretory phase, ischemic phase, menstrual phase (tip: remember by PSIM).  **Proliferative Phase (Days 5--14)** - **What Happens:** Endometrial lining thickens in response to estrogen. - **Key Hormone:** Estrogen. - **Stratum functionalis rebuilds due to estrogen being secreted**  **Secretory Phase (Days 14--26)** - **What Happens:** Endometrium secretes nutrients for potential embryo implantation and helps thicken walls - **Key Hormone:** Progesterone.  **Ischemic Phase (Days 26--28 if no fertilization)** - **What Happens:** Corpus luteum degenerates, progesterone and estrogen drop, leading to endometrial breakdown.  **Menstrual Phase (Days 1--6)** - **What Happens:** Shedding of the endometrial lining (menstruation). - **Shredding stratum functionalis, prostergone and estrogen levels drop** ### Menstrual cycle hormones **Summarize the predominant hormones of the menstrual cycle including the function and where it is secreted.** 1. Gonadotropin-releasing hormone (GnRH) **Function:** Stimulates the release of FSH and LH. **Secreted by:** Hypothalamus. 2. FSH **Function:** Stimulates ovarian follicle growth. **Secreted by:** Anterior pituitary gland. 3. LH **Function:** Triggers ovulation and corpus luteum formation. - Function of LH: forming corpus luteum and breaking down the wall of the graffian follicle to allow for release of the ovum **Secreted by:** Anterior pituitary gland. 4. Estrogen **Secreted by:** Ovaries. 5. Progesterone **Secreted by:** Corpus luteum (ovaries). 6. Prostaglandin **Function:** Helps with uterine contractions and cervical ripening for labor. **Secreted by:** Endometrial cells. ### External male reproductive organs - List location and function of. 1. Penis **Location:** External organ. **Function:** Facilitates sperm delivery into the female reproductive tract. 2. Scrotum **Location:** Sac that holds the testes. **Function:** Regulates testicular temperature for sperm production. ### Internal male reproductive organs - List location and function of. 1. Testes **Location:** Within the scrotum. **Function:** Produce sperm and testosterone. 2. The ductal system **Includes:** Epididymis, vas deferens, urethra. **Function:** Stores and transports sperm. 3. Accessory glands **Includes:** Seminal vesicles, prostate gland, bulbourethral glands. **Function:** Produce seminal fluid to nourish and transport sperm. **Fetal Development and Genetics** 1. Define conception. 2. Explain fertilization (including where does it take place), implantation, and cell differentiation. #### Fertilization - **Definition:** Fertilization is the process where a sperm cell fuses with an egg (ovum) to form a **zygote**. - **Location:** It typically occurs in the **ampulla of the fallopian tube**, the widest and most common site for fertilization. - **Process:** 1. **Sperm Transport** -- Millions of sperm travel through the cervix, uterus, and into the fallopian tube. 2. **Capacitation** -- The sperm undergo biochemical changes that enhance their ability to penetrate the egg. 3. **Acrosomal Reaction** -- The sperm releases enzymes that help break through the **zona pellucida** (outer layer of the egg). 4. **Fusion of Sperm and Egg** -- One sperm successfully penetrates the egg, triggering a reaction that prevents other sperm from entering. 5. **Zygote Formation** -- The sperm and egg nuclei merge, restoring the diploid chromosome number (46 chromosomes). #### 2. Implantation - **Definition:** Implantation is the process where the fertilized egg (now called a **blastocyst**) embeds itself into the uterine lining. - **Timing:** Occurs **6--10 days after fertilization**. - **Location:** The blastocyst implants in the **endometrium of the uterus**, typically in the **upper posterior wall**. - **Process:** 1. **Blastocyst Formation** -- After fertilization, the zygote undergoes rapid cell division (cleavage), forming a **morula** and then a hollow **blastocyst**. 2. **Attachment to Endometrium** -- The blastocyst secretes enzymes that allow it to burrow into the uterine lining. 3. **hCG Secretion** -- The **trophoblast** (outer layer of the blastocyst) starts producing **human chorionic gonadotropin (hCG)**, which signals the corpus luteum to continue producing **progesterone** to maintain the pregnancy. #### 3. Cell Differentiation - **Definition:** Cell differentiation is the process where embryonic cells specialize into different cell types, tissues, and organs. - **Key Stages:** 1. **Germ Layer Formation (Gastrulation)** -- The blastocyst develops into three primary germ layers: - **Ectoderm** → Becomes the nervous system, skin, and sensory organs. - **Mesoderm** → Forms muscles, bones, cardiovascular system, and reproductive organs. - **Endoderm** → Develops into the digestive and respiratory systems. 2. **Organogenesis** -- The germ layers further differentiate to form specific organs and body structures. 3. **Placenta Formation** -- The placenta develops to supply oxygen and nutrients to the embryo while removing waste. **Cell Differentiation:** Cells begin specialization into tissues and organs. leading to different developmental stages: #### Pre-Embryonic Stage (First 2 Weeks Post-Fertilization) 1. **Zygote:** - **Single fertilized cell** immediately after sperm and egg fusion. 2. **Morula (\~3-4 days post-fertilization):** - A solid ball of **16+ cells** due to rapid mitotic division (cleavage). 3. **Blastocyst (\~5-6 days post-fertilization):** - A **fluid-filled** structure containing: - **Trophoblast** (outer layer → placenta formation). - **Inner cell mass** (develops into the embryo). - **Implants into the uterine lining** around **day 6-10**. #### b. Embryonic Stage (Week 3-8): - **Major organogenesis** occurs (heart, brain, spinal cord, limbs). - By week **4**, the fetal heartbeat begins. - By week **8**, all major organs have begun developing. #### c. Fetal Stage (Week 9 - Birth): - **Growth and refinement of organs** and body systems. - **Quickening** (first fetal movements) occurs around **16-20 weeks**. - **Viability** (\~24 weeks): Lungs begin surfactant production. - **Full term (\~37-40 weeks):** Organs fully mature, preparing for birth. Fetal Development 1. What does the umbilical cord do? 2. What does the placenta do? 3. What does the amniotic fluid do? 4. How do the following hormones affect pregnancy? a. Estrogen b. Progesterone Preconception Care ------------------ 1. Explain the importance of pre-conception folic acid and how much would you recommend?  **Importance:** - Reduces the risk of **neural tube defects (NTDs)** such as spina bifida and anencephaly. - Supports **DNA synthesis, cell division, and fetal brain development.**  **Recommended Dosage:** - **400--800 mcg (0.4--0.8 mg) daily** for all women of childbearing age. - **4 mg daily** for women with a history of NTDs in previous pregnancies. 2. Identify maternal preconception risk factors that impact pregnancy outcomes. **Maternal Preconception Risk Factors Impacting Pregnancy Outcomes** - **Medical Conditions:** Diabetes, hypertension, obesity, thyroid disorders, epilepsy. - **Infections:** STIs, TORCH infections (toxoplasmosis, rubella, CMV, herpes). - **Nutritional Deficiencies:** Low folic acid, iron, vitamin D. - **Lifestyle Factors:** Smoking, alcohol, drug use, high caffeine intake. - **Genetic Factors:** Family history of genetic disorders or chromosomal abnormalities. - **Psychosocial Factors:** Stress, domestic violence, inadequate prenatal care. Maternal Adaptation during Pregnancy ------------------------------------ 1. Differentiate between subjective (presumptive), objective (probable), and diagnostic (positive) signs of pregnancy. **Signs of Pregnancy** - **Subjective (Presumptive) Signs:** - Reported by the woman, but not conclusive. - **Examples:** Amenorrhea, nausea/vomiting, breast tenderness, fatigue, frequent urination, quickening (fetal movement). - **Objective (Probable) Signs:** - Detected by a healthcare provider but not definitive. - **Examples:** Positive pregnancy test, Chadwick's sign (bluish cervix), Goodell's sign (softened cervix), Hegar's sign (softened uterus), Braxton Hicks contractions, ballottement (rebound of fetus). - **Diagnostic (Positive) Signs:** - Directly confirm pregnancy. - **Examples:** Fetal heartbeat (via Doppler or fetoscope), ultrasound visualization of the fetus, fetal movement felt by provider. Physiologic Adaptations during Pregnancy ---------------------------------------- 1. Summarize physiologic adaptations during pregnancy of the following. a. reproductive system - **Uterus:** Expands to accommodate fetal growth. - **Cervix:** Softens (Goodell's sign), becomes bluish (Chadwick's sign), and produces mucus plug. - **Ovaries:** Ovulation stops, corpus luteum produces progesterone. - **Breasts:** Increase in size, areola darkens, colostrum production begins. b. GI system - Slowed gastric emptying → **constipation, bloating, reflux** (due to progesterone). - Increased salivation (**ptyalism**). - Nausea and vomiting (**morning sickness**). c. cardiovascular system - Blood volume increases by **30--50%** → **hemodilution (physiologic anemia).** - Heart rate increases by **10--15 bpm.** - Blood pressure slightly decreases in the **second trimester** but returns to normal by the third. - Increased clotting factors → **higher risk of DVTs.** d. respiratory system - Increased oxygen demand → **hyperventilation and mild respiratory alkalosis.** - **Diaphragm is pushed upward** by the growing uterus, leading to **dyspnea.** e. renal/urinary system  Increased blood flow → **increased glomerular filtration rate (GFR).**  **Frequent urination** due to bladder compression.  Risk of **UTIs** due to urinary stasis. f. musculoskeletal system  **Lordosis (inward spine curvature)** due to weight shift.  **Relaxin hormone loosens joints** → pelvic instability, increased risk of falls. g. integumentary system  **Linea nigra:** Darkened midline of abdomen.  **Chloasma (melasma):** \"Pregnancy mask\" (dark patches on the face).  **Striae gravidarum (stretch marks):** On abdomen, breasts, thighs. h. endocrine system  **hCG:** Maintains corpus luteum early in pregnancy.  **Progesterone:** Relaxes smooth muscles, maintains pregnancy.  **Estrogen:** Increases blood flow to reproductive organs.  **Prolactin:** Prepares breasts for lactation.  **Oxytocin:** Stimulates labor contractions and milk ejection. i. immune system  **Mild immunosuppression** to prevent fetal rejection.  **Increased risk of infections** but also improved immune tolerance. Psychosocial Adaptations during Pregnancy 1. What are five different emotional responses to pregnancy that a woman can have? **Five Emotional Responses to Pregnancy** - **Acceptance:** Excitement, joy, and bonding with the baby. - **Ambivalence:** Mixed emotions, feeling both happy and anxious. - **Mood Swings:** Hormonal fluctuations cause irritability, tearfulness. - **Anxiety:** Worry about finances, labor, or parenting. - **Fear:** Concerns about health, complications, or body changes. First Prenatal Visit 1. What is group prenatal care called? CenteringPregnancy 2. What are the risk factors for gestational diabetes as identified by ACOG, ADA, and WHO that would prompt screening for diabetes in the first trimester?  **Obesity (BMI ≥ 30)**  **Previous gestational diabetes**  **History of macrosomic baby (\>9 lbs)**  **Family history of diabetes (first-degree relative)**  **Polycystic ovarian syndrome (PCOS)**  **Hypertension or cardiovascular disease**  **Unexplained stillbirth/miscarriage**  **High-risk ethnic groups (e.g., Hispanic, African American, Native American, Asian, Pacific Islander)** 3. Health history is important to perform thoroughly during pregnancy to identify conditions that can complicate the pregnancy. For instance, what if a woman has a history of urinary tract infections---why do you want to know this for her pregnancy?  **Increased risk of pyelonephritis (kidney infection)**  **Potential preterm labor or low birth weight**  **UTIs can trigger uterine contractions, increasing miscarriage risk** 4. What is Nagele rule and how is it calculated? **Formula:** - **First day of last menstrual period (LMP) + 7 days -- 3 months + 1 year (best for LPM from April-Dec)** - **Another: add 7 days plus 9 months (best for Jan-March)** **Example:** - LMP = April 10, 2024 - Add 7 days → April 17, 2024 - Subtract 3 months → January 17, 2024 - Add 1 year → **Estimated Due Date: January 17, 2025** **Months with 30 days are: April, June, Sept, Nov. 29 days for Feb.** 5. What does gravid and para mean? **Para (P):** Number of pregnancies that reached viability (≥ 20 weeks) 6. What does GTPAL stand for? Used to assess pregnancy outcomes  **G:** Gravida (total pregnancies)  **T:** Term births (≥ 37 weeks)  **P:** Preterm births (20--37 weeks)  **A:** Abortions (spontaneous or elective before 20 weeks)  **L:** Living children Follow-up Visits Fundal Height - Assess if baby is growing properly and helps determine gestational age - Measure symphysis pubis to fundus measured in cm - Want to make sure measurement is similar to age - Around 12 weeks, above symphysis pubis - At 36 weeks, xiphoid process - Around 37-40 weeks, fundus moves down 4cm - 1 hour after birth, fundal should be at belly button - Decrease 1 cm per day - 7 days after: symphysis pubis - 10 days after: cant palpate (pelvic cavity) - 6 weeks after: pre pregnancy size 1. If a woman is 16 weeks gestation where should her fundus be located? 2. What if she is 20 weeks gestation? 3. While performing a physical assessment on a pregnant woman you notice only her left calf is swollen; it is also warm, and she reports pain with activity in that calf only. What would you be concerned for? 4. What are common laboratory tests performed at the initial obstetric visit?  **CBC (anemia, infection, platelets)**  **Blood type & Rh factor**  **Rubella immunity**  **Hepatitis B & C, HIV, Syphilis (RPR/VDRL)**  **Urinalysis & culture (UTI, protein, glucose)**  **Pap smear (cervical cancer screening if due)**  **Chlamydia & gonorrhea screening**  **Genetic screening (e.g., CF, sickle cell)** 5. Who is a candidate for RhoGam and why? **Rh-negative pregnant women** **Prevents maternal immune response against Rh-positive fetal blood cells, preventing hemolytic disease in the newborn** 6. Name five assessments to be completed at subsequent prenatal visits.  **Fundal height measurement**  **Fetal heart rate (FHR) assessment**  **Blood pressure monitoring**  **Weight gain tracking**  **Urinalysis (protein, glucose, ketones, infection screening)** Nursing Management for Common Discomforts of Pregnancy ------------------------------------------------------ 1. Teaching is a significant part of nursing. As pregnancy occurs, changes will occur in the body which can be uncomfortable. Which trimester would you expect to see these issues and what are some teaching tips you would give patients? Symptom Trimester Teaching Tips -------------------------------- ----------- -------------------------------------------------- Urinary Frequency/Incontinence 1st & 3rd Kegel exercises, limit fluids before bedtime Fatigue 1st & 3rd Rest frequently, light exercise Nausea & Vomiting 1st Small, frequent meals; avoid triggers Backache 2nd & 3rd Proper posture, supportive shoes, heat therapy Leg Cramps 2nd & 3rd Hydration, calf stretching, magnesium-rich foods Varicosities 2nd & 3rd Compression stockings, avoid prolonged standing Hemorrhoids 2nd & 3rd Fiber-rich diet, sitz baths Constipation 2nd & 3rd Fluids, fiber, mild exercise Heartburn 2nd & 3rd Small meals, avoid spicy foods Braxton Hicks 3rd Rest, hydration, differentiate from labor Nasal Congestion/Gums Bleeding All Humidifier, saline spray, soft toothbrush Leukorrhea All Cotton underwear, proper hygiene Shortness of Breath 3rd Upright posture, slow breathing Dependent Edema 3rd Elevate legs, avoid standing long periods Nursing Management to Promote Self-Care --------------------------------------- 1. Are pregnant women advised to use hot tubs, saunas, or tanning beds, why? - **Risk of hyperthermia → neural tube defects, miscarriage** 2. If a pregnant woman has periodontitis, an oral infection that spreads beyond the gum tissues to invade the supporting structures of the teeth, what may she be at risk for? Preterm birth, low birth weight, preeclampsia 3. List three teaching guidelines regarding exercise during pregnancy to a woman who is not high risk.  **30 minutes of moderate exercise most days**  **Avoid high-impact sports, overheating**  **Hydration, proper footwear** 4. Name five conditions/situations when women should not be having sex when pregnant.  **Placenta previa**  **Preterm labor risk**  **Ruptured membranes**  **Active vaginal bleeding**  **STI risk** 5. What is recommend for a pregnant woman who if is traveling long distance by car or plane?  **Frequent walking/stretching (prevent DVTs)**  **Hydration, compression socks**  **Avoid long car trips after 36 weeks** 6. Should a pregnant woman wear a seatbelt? Yes! Lap belt below belly, shoulder belt above 7. Briefly describe FDA pregnancy classification of drugs: a. Category A: No risk (e.g., prenatal vitamins) b. Category B: No human risk (e.g., acetaminophen) c. Category C: Risk unclear (e.g., SSRIs) d. Category D: Risk present, but benefits may outweigh (e.g., lithium) e. Category X: Contraindicated (e.g., isotretinoin) Nursing Management to Prepare the Woman and Her Partner for Labor, Birth, and Parenthood ---------------------------------------------------------------------------------------- 1. What is the purpose of preparation classes like Bradley, Lamaze, Dick Read **Childbirth Classes:** - **Lamaze:** Breathing techniques, pain control - **Bradley:** Partner-assisted, natural birth - **Dick-Read:** Fear-reduction techniques 2. What delivery options for setting and personnel are available to pregnant women? **Birth Settings:** - **Hospital, birth center, home birth** - **Providers: OB-GYN, midwife, doula** 3. Compare and contrast pros and cons of breast vs bottle feeding. Factor Breastfeeding Bottle Feeding ---------------- --------------------------------- ----------------------- Immunity Antibodies, reduced infections No immune benefits Bonding Skin-to-skin, hormonal benefits Less oxytocin release Convenience No prep needed Pre-measured formula Cost Free Expensive Public Feeding May be challenging No stigma Violence and Abuse ------------------ 1. List some characteristics of intimate partner violence. - Control, jealousy, threats, isolation 2. What are the 3 phases of the cycle of violence? - Tension-building → Acute battering → Honeymoon phase 3. List the various types of abuse. - Physical, emotional, sexual, financial, neglect 4. True or false: Violence against pregnant women seems to be more prevalent than diseases routinely investigated during prenatal care, such as preeclampsia and diabetes. - True. Violence against pregnant women is more prevalent than preeclampsia and diabetes. 5. What are some nursing interventions in response to caring for the battered women? - Screening, safety planning, social services, emergency support