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Antepartum:
Normal changes, nutrition, cultural issues, childbirth education
| Question | Answer |
|---|---|
| What is recommended weight gain during pregnancy? | usually 25-35 lb |
| How much increase in daily calorie is recommended for pregnancy? | 300 caloric increase (during pregnancy postpartum: 200-500 caloric increase) |
| What foods are high in folic acid? | leafy veggies, dried peas and beans, seeds, and orange juice |
| What increases iron absorption? | Vit C (milk and caffeine interfere with iron absorption) |
| Caffeine intake should be limited to how much? | 300g daily |
| Large amount of caffeine increases the risk for what? | risk for spontaneous abortion or IUGR |
| What are H/H range for pregnant women? | Hgb: 10.5-16 g/dL Hct: 32 to 47% |
| What is hyperemesis gravidarum? | persistent n/v during early pregnancy resulting in dehydration, wt loss, electrolyte imbalances |
| What is pregnancy anemia? | Hgb <10.5 Hct <32% |
| What are common side effects of iron supplementation? | constipation and darkened stools |
| What are folic acid supplements recommended for pregnancy? | to prevent neural tube defects in fetus |
| What is Naegele's rule? | to estimate date of delivery = Last menstrual period - 3 mo. + 7 days |
| Around what wk is fundus at level of umbilicus? | 20 wk |
| What are changes in reproductive system during pregnancy? | increase cervical mucous plug, larger bluish vagina with more acidic pH, ovulation ceases |
| What are changes in breasts during pregnancy? | increase in size and vascularity, darker areola, more erect nipple, colostrum |
| What are changes in CV system during pregnancy? | RBc increase 20%, Fe supplementation needed, WBC 2x and during labor from exertion, increase plasma fibrinogen |
| What are changes in respiratory system during pregnancy? | increase 15-20% O2 consumption, RR deeper, renal excretion of HCO3 to compensate for resp alkalosis |
| What are effects of progesterone on body systems? | decrease airway resistance, decrease gastric motility, loosens joints, heartburn, N/V, |
| What are effects of estrogen on body systems? | increase vascularity of mucous membranes in upper resp tract, edema in nose, fullness in ears and earaches, bleeding gums |
| What is true? | Breathing becomes thoracic rather than abdominal during pregnancy. |
| What are changes in GI system during pregnancy? | gingivitis, bleeding gums, excess salivation, heartburn, N/V, increase gastric emptying time, |
| What are changes in urinary system during pregnancy? | increase frequency and urgency, increase UTI, decrease creatinine and urea |
| What are changes in integumentry system during pregnancy? | increase circulation, hyper-pigmentation, linea negra, striae gravidarum, hair grows more rapidly |
| What are changes in mucsculoskeletal system during pregnancy? | wide stance, waddling gait, abd rectus, leaning backward to maintain balance, muscles stretch |
| What are changes in endocrine system during pregnancy? | prolactin produces milk, progesterone inhibits contraction, increase thyroid & parathyroid hormones, increase BG, increase cortisol and aldosterone |
| What are presumptive indications of pregnancy? | amenorrhea, N/V, urinary frequency, breast and skin changes, excessive salivation |
| What are probable indications of pregnancy? | abd enlargement, positive pregnancy test, cervical changes, changes in uterus |
| What are cervical changes during pregnancy? | - Chadwick's sign: blue cervix, vulva - Hegar's sign: softening of cervix - Goodwell's sign: softening of cervix at 6-8 wk |
| What are positive indications of pregnancy? | FHT ascultation, fetal movement by examiner, fetal visible on ultrasound or x-ray |
| What does GPTPAL stand for? | G: pregnancy, P: birth T: term, P: preterm, A: abortion, L: live births |
| What are common discomforts of pregnancy? | N/V, heartburn, backache, urinary frequency, variscosities, hemorrhoids, constipation, leg cramps |
| What is drug category pregnancy A? | well-controlled studies have failed to show a risk in fetus. |
| What is drug category pregnancy D? | Evidence of fetal risk, but benefits may warrant drug use in pregnant women. |
| What are some danger signs during pregnancy? | swelling of fingers, continuous HA, visual disturbances, epigastric pain, painful urination, persistent vomiting, change in strength of fetal movement |
| What are maternal psychological responses during first trimester? | uncertainty, ambivalence, self as primary focus |
| How often should mother count fetal movement? | recommended to count fetal activity 2-3 times /day for 60 min each time |
| What should pt do for N/V? | eat crackers or dry toast 1 hr b/4 rising in AM; avoid an empty stomach,spicy greasy or gas-forming food; drink fluids b/2 meals |
| What should pt do for breast tenderness? | wear a bra that gives adequate support |
| What should pt do for urinary frequency? | empty bladder frequently, limit fluid before bedtime, wear pads, perform Kegel exercises |
| What should pt do for UTI? | wear cotton underpants, drink plenty of fluid, yogurt and cranberry juice intake, wipe from front to back, urinate b/4 and after sex, urinate as soon as urge occurs, report malodorous blood or pus containing urine |
| What should pt do for heartburn? | eat small frequent meals, sit up 30 min after meals, check with MD before using any OTC meds |
| What should pt do for hemorrhoids? | warm sitz bath, witch hazel pads |
| What should pt do for backaches? | exercise regularly, perform pelvic tilt exercises, good posture |
| What should pt do for SOB and dyspnea? | maintain good posture, sleep with extra pillows, avoid overloading stomach, contact MD if worsen |
| What should pt do for leg cramps? | if negative Homan's sign, extend legs and dorsiflexing feet, massage and apply heat over affected muscle, notify MD if frequent cramping occurs |
| What should pt do for varicose veins and lower extremity edema? | rest with legs elevated, avoid constricting clothes, avoid sitting or standing in one position for a long time, do not cross legs, frequent walking to stimulate venous return, drink fluid for natural diuretic effect |
| What should pt do for gingivitis, nasal stuffiness, and epistaxis? | gently brush teeth, observe good dental hygiene, use humidifier, normal saline nose drops/spray |
| What should pt do for Braxton-Hicks contractions? | change position or walking should subside contractions |
| What should pt do for supine hypotension? | lie in a side-lying or semi-sitting position with knees slightly flexed |
Created by:
odbal24
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