Prenatal Care Presentation

Prenatal care: care for the mother & care for the fetus NCM 107 - Midterm Clinical Instructor: Leanne Ashley D. Bonifacio, RN, MN The Diagnosis of Pregnancy PHYSIOLOGIC CHANGES OF PREGNANCY  Reproductive System Changes Length: from approxima...

Prenatal care: care for the mother & care for the fetus NCM 107 - Midterm Clinical Instructor: Leanne Ashley D. Bonifacio, RN, MN The Diagnosis of Pregnancy PHYSIOLOGIC CHANGES OF PREGNANCY  Reproductive System Changes Length: from approximately 6.5 to 32 cm. Depth: from 2.5 to 22 cm. Weight: from 50 to 1000 g. Volume from about 2 mL to more than 1000 mL Uterine wall thickness from about 1cm to 2cm at the beginning of pregnancy Width: expands from 4 to 24 cm. Amenorrhea - brought about by suppression of FSH by rising estrogen levels o Vascularity o Fluid between cells o Endocervix glands Operculum  Vaginal walls: pH : (7 to 4 or 5) oOvulation oCorpus Luteum Corpus Albicans  Size Diameter of Areola Vascularity Estrogen Montgomery Tubercles Colostrum INTEGUMENTARY RESPIRATORY SYSTEM TEMPERATURE CARDIOVASCULAR SYSTEM GASTROINTESTINAL SYSTEM URINARY SYSTEM SKELETAL SYSTEM 01 Largely subjective in nature 02 Largely objective in nature 03 Findings that definitely indicate a pregnancy is present  Presumptive Signs Amenorrhea Frequent urination Melasma Breast Changes Fatigue Striae gravidarum Nausea & vomiting Linea nigra Quickening Ballottement  Probable Signs Laboratory Tests: Serum Ballottement Urine Evidence of gestational sac on ultrasound Chadwick’s Sign Hegar’s Sign Palpation of Fetal Outline Goodell’s Sign Braxton Hicks Contractions  Positive Signs Fetal outline Demonstration of Fetal on a fetal heart separate from movement ultrasound the mother’s felt by examiner  Common Discomforts in Pregnancy Discomfort Usual Causes Nursing Intervention Increased stimulation of breast Ø Encourage to wear a bra with a wide tissue brought about by high shoulder strap for support and to dress estrogen level warmly to avoid cold drafts. Slower peristalsis; weight of a Ø Increase the amount of fiber in diet Ø Drink at least 8 glasses of water per day growing uterus presses Ø Evacuate bowels regularly against the bowel Ø Eat dry crackers, toast, or a sourball Sensitivity to high level of before getting out of bed Ø Small frequent meals HCG; Lowered maternal Ø Avoid greasy & highly seasoned foods blood sugar caused by the Ø Delay meal until nausea passes & make needs of the developing up missed meals at other time of the day Ø Try sipping a carbonated beverage, water, embryo ; Lack of pyridoxine or an herbal noncaffeinated or ginger tea. (vitamin B6) Discomfort Usual Causes Nursing Intervention Increased metabolic Ø Advise to increase the amount requirements of rest and sleep. Decreased serum calcium levels, Ø Advise to lie on back momentarily and increased serum phosphorus levels, extend involved leg, keeping the knee and possible interference with straight and dorsiflexing the foot until the pain disappears. circulation Weight of the distended uterus Ø Encourage to lie on the back with the puts pressure on the veins legs raised against the wall or elevated on a footstool for 15 to 20 minutes returning blood from the lower twice a day extremities. This causes pooling Ø Encourage the use of elastic support of blood and distention of the stockings. vessels. Ø Encourage exercise. Pressure on the rectal veins Ø Encourage to assume a knee-chest position for 10-15mins daily. from the growing uterus Ø Apply cold compress to external hemorrhoids. Discomfort Usual Causes Nursing Intervention Ø Advise NOT to restrict fluid intake. Due to the pressure of the Ø Educate that it is normal during pregnancy, provided there are no growing uterus on the anterior other signs/symptoms indicative of bladder. UTI. Lung compression and shortness Ø Advise to sleep with head and chest of breath result as the expanding elevated (to relieve nighttime dyspnea) uterus places pressure on the Ø Caution to limit activities during the diaphragm day (to prevent exertional dyspnea) Ø Advise to squat rather than bend over As pregnancy advances, a to pick up objects. Ø Encourage to wear shoes with low to lumbar lordosis develops and moderate heels to reduce the amount postural changes necessary to of spinal curvature necessary to maintain balance lead to maintain an upright posture. Ø Encourage pelvic rocking or tilting backache exercises. Discomfort Usual Causes Nursing Intervention Ø Advise to rest in a left side-lying Caused by general fluid retention and position. reduced blood circulation in the Ø Elevate legs at least 30mins twice lower extremities because of uterine a day. pressure. Ø Avoid constrictive clothing that can impede lower extremity circulation. Ø Encourage to reduce any possible Pressure on cerebral arteries due to causative situations, such as eye the expanding blood volume. strain or tension. Ø Application of cold towels on forehead. Ø Prescribed analgesics. Uterus periodically contracts and Ø Advise to change position. then relaxes again as early as the 8th Ø Encourage to drink more water. to 12th week of pregnancy Ø Encourage warm baths.