1 / 36

Nursing Care During the Antenatal Period

Nursing Care During the Antenatal Period. Maria Rubolino, MSN, FNPc September 6 th , 2005. A & P of Pregnancy. Terms to know Gravida Parity Nulliparous Multiparous Term TPAL. Signs of Pregnancy. Presumptive Signs/Symptoms Probable Positive. Uterine Growth.

daniel_millan
Télécharger la présentation

Nursing Care During the Antenatal Period

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Nursing Care During the Antenatal Period Maria Rubolino, MSN, FNPc September 6th, 2005

  2. A & P of Pregnancy • Terms to know • Gravida • Parity • Nulliparous • Multiparous • Term • TPAL

  3. Signs of Pregnancy • Presumptive Signs/Symptoms • Probable • Positive

  4. Uterine Growth • Stimulated by hormones in the 1st trimester • Larger as it rises out of the pelvis • Hegar’s • Chadwick’s

  5. Contractility • Braxton Hicks

  6. Cervical Changes • Goodell’s Sign • Friability

  7. Fundal Height Changes • Changes from week to week

  8. Vaginal Changes • Vaginal mucosa thickens • Chadwick’s sign • Vaginal discharge • Mucous plug • Varicosities

  9. Breast Changes • Fullness • Areolar pigmentation • Colostrum

  10. Circulatory Changes • CV- blood volume, cardiac hypertrophy • Cardiac output increases • Blood pressure changes

  11. Circulatory changes • Supine hypotension syndrome

  12. Renal Changes • Renal pelvis and ureters dilate • Urine rate is slowed • Bladder frequency

  13. GI Changes • Appetite • Gastric emptying • Absorption • Bowel sounds • Blood flow to the pelvis • Morning sickness • Pyrosis • Constipation

  14. Gallbladder and Liver • Gallbladder with decreased tone • PUPPS

  15. Skin Changes • Increased subdermal fat • Hyperpigmentation • Striae • Linea nigra • Chloasma • Angiomas • Pruritis • Palmar erythema • Increased perspiration

  16. Endocrine Changes • Amenorrhea • Progesterone • Estrogen • Ant pituitary suppresses the FSH and LH causing to rise • Post pituitary produces oxytocin

  17. Neurological Changes • Carpal Tunnel Syndrome • Numbness/Tingling • HA’s • Lightheadedness • Muscle Cramps

  18. Musculoskeletal Changes • Change in posture • Waddling • Back Pain

  19. Nutrition Needs • Folic Acid • Calories increased to 300/day • Increased protein • Iron requirements increased • Increased fluid intake • Limit caffeine

  20. Exercise • Will produce benefits • Must consume fluid • Watching heart rate • No new activities

  21. Weight Gain in Pregnancy • 25-35 pounds total weight gain With singleton pregnancy 35-45 pound total weight gain with multiples

  22. Nagele’s Rule • LMP minus 3 calendar days • Add 7 days and 1 year

  23. Tests in 1st Trimester • 1 hour post glucola if indicated • Blood type • Antibody screen • CBC • UA C/S • Hepatitis • HIV • RPR • TSH • Toxoplasmosis if indicated • CVS if desired

  24. Hyperemesis • N/V • Small frequent meals • Avoid spicy foods • Antiemetics

  25. 1st Trimester • Hyperemesis • No menses • N/V • Fatigue • Breast Tenderness

  26. 20 Weeks • Quickening • Pelvic Pressure • Constipation • Round ligament pain

  27. CVS • Screening to detect fetal genetic abnormalities • Risks of miscarriage 1 in 100

  28. Nuchal Fold Thickness • Ultrasound and 9-13 weeks • Increased with down syndrome • Screening only!!

  29. AFP • Triple marker test/screening • 16-20 weeks gestation • If abnormal refer to specialist

  30. Amniocentesis • Performed between 16-20 weeks • Done with AMA, FH, +AFP • Risks of miscarriage 1 in 200-300

  31. Testing in 3rd Trimester • 1 hour post glucola • CBC • UA • Antibody screen • Rhogam • TSH

  32. 32-36 Weeks • Fetal position • Descending into pelvis • Placental location • GBS • FKC’s

  33. 36-42 Weeks • Vaginal Exams • Labor precautions • PIH precautions

  34. Childbirth Education • Natural • Lamaze • Bradley

  35. Hospital Birthing Center Home Bath Pain Meds Epidural Natural Lighting Ambulating Doulas Hypnosis Birth Plan

More Related