Nursing Care During Pregnancy
Nursing Care During Pregnancy NURB 331
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This 5 page Class Notes was uploaded by Kelsey Forbeck on Thursday September 8, 2016. The Class Notes belongs to NURB 331 at University of Indianapolis taught by Professor Rairdon in Fall 2016. Since its upload, it has received 10 views. For similar materials see Lifespan 1 in NURSING at University of Indianapolis.
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Date Created: 09/08/16
NURB 331: Lifespan 1 Unit 3 Nursing Care During Pregnancy Due Date: o Also called: Estimated date of birth (EDB) Estimated date of delivery (EDD) Expected date of confinement (EDC) o Nagele’s rule: Determine first day of LMP, subtract 3 months, add 7 days plus a year Another way you can determine the date is adding 7 days to LMP then count forward another 9 months o Adapting to pregnancy: Adapting to Pregnancy: o Sibling: It may be hard for a sibling of the child because they have to share the spotlight with another They may have a feeling of being replaced o Grandparent: The family circle may be strengthened due to the widening of the support circle. Care Management: o Purpose: To identify existing risk factors and other problems during prenatal care period Care is important during the pregnancy o Frequency of visits: Every 4 weeks for first 28 weeks’ gestation Every 2 weeks until 36 weeks’ gestation After week 36, every week until childbirth Initial Visit: Very first doctor visit after officially being pregnant o Reason: Obstetric and gynecologic history Medical history History of drug use Family history Ethical/cultural backgrounds History of abuse The first examination forms baseline data to reflect back to during the pregnancy o Lab tests during initial visits Urinary analysis Hemoglobin, hematocrit, WBC Blood type Rubella titer Pap test HIV Hepatitis B Vaginal or rectal smear to check for STI’s Follow Up Visits: o The patient gets interviewed and educated on what will be rd coming during the 3 trimester, but the visit isn’t as intense as the initial visit o Physical exam is given o Warning Signs and symptoms: Preeclampsia. Hypertensive conditions Hyperemesis, gravidarum, hypertension, preeclampsia Vaginal bleeding Chills and fever Discharge from vagina o During each follow up visit: Measurement of fundal height Fetal assessment Gestational age Health status Lab tests Clean catch urine Blood tests Glucose tolerance tests GBS testing Ultrasound Education for self-care: o Nutrition o Personal hygiene o Prevention of UTI’s o Kegel exercises o Dental Health o Preparing to breast feed Pinch test: Normal nipple everts with gentle pressure Inverted nipple inverts with pressure o If nipples are inverted, then women are encouraged to purchase nipple plastic shells that fit over nipple. o Practice good posture and body mechanics o Rest and relax o Employment: Working doesn’t have much of an effect on pregnancy Jobs that have the patient standing for a long time are jobs to avoid while pregnant o Travel: While traveling try to include periods of rest Allowed to air travel up to 36 weeks Use the seatbelt that goes across the chest to decrease risk of traumatic flexion which reduces placental separation o Immunizations: Those that have live or attenuated viruses should not be taken during pregnancy due to the teratogenic effects Avoid: rubella, chickenpox, or mumps Variations in Prenatal Care: o Cultural influences: Emotional response Clothing Physical activity and rest Sexual activity Diet o Age: Adolescents May not be emotionally ready May be scared to receive prenatal care May not have realized they were pregnant so could have taken drugs while pregnant Women older than 35 Increased risk of miscarriage or stillborn Multifetal pregnancy: o Twin pregnancies tend to be born premature o Membranes may rupture before pregnancies (common)\ o Congenital malformations are twice as common in monozygotic twins as in singletons o Multifetal pregnancies can be increased by: History of dizygous twins User of fertility drugs Rapid uterine growth for weeks of gestation hydramnios
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