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What are some Family Medical questions you would ask upon their Health and Risk assessment? (AnsCurrent Health Status Genetics Medical Conditions / Disease Zika Virus - 2-12 days of intubation: rash/fever, muscle joint pain; will get ultrasounds every 3-4 weeks What are some Reproductive questions you would ask upon their Health and Risk assessment? (AnsMenstrual Obstetric Gynecological Contraceptive Sexual - how many partnersWhat are some Self-Care/ Lifestyle / Safety behavior questions you would ask upon their Health and Risk assessment? (AnsFrequency of health maintenance visits Bowel patterns Stress management Nutrition Alcohol, tobacco, substance abuse/use Spiritual or religious practices
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What are some Family Medical questions you would ask upon their Health and Risk assessment? (Ans- Current Health Status Genetics Medical Conditions / Disease Zika Virus - 2 - 12 days of intubation: rash/fever, muscle joint pain; will get ultrasounds every 3-4 weeks What are some Reproductive questions you would ask upon their Health and Risk assessment? (Ans- Menstrual Obstetric Gynecological Contraceptive Sexual - how many partners
What are some Self-Care/ Lifestyle / Safety behavior questions you would ask upon their Health and Risk assessment? (Ans- Frequency of health maintenance visits Bowel patterns Stress management Nutrition Alcohol, tobacco, substance abuse/use Spiritual or religious practices Define Pelvic Inlet (Ans- superior space between the brim of each coxal bone Define Pelvic Outlet (Ans- inferior space between the ischial spine of each coxal bone Define diagonal conjugate (Ans- is 12.5 cm or greater distance from anterior surface of the sacral province to the anterior surface of the inferior margin of the synthesis pubic measured upon vaginal exam
What is chorionic villi sampling? (Ans- a test made in early pregnancy to detect congenital abnormalities in the fetus. A tiny tissue sample is taken from the villi of the chorion, which forms the fetal part of the placenta. Define a Non-Stress Test (Ans- If baby is too small or big from the McDonald test then they get an ultrasound and this test Press the button every time she feels the baby move It is a reactive ST 2 excels (15 beats above lasting 15 sec) within a 20 min period ; meaning that this kid is ok in the uterus If they are not good with this they will get a Biophysical Profile define biophysical profile (Ans- Will last 30 mins and results are based on a scoring system Normal is btwn 8-10. equivocal = 6, abnormal < If below the the HCP will have take out baby at 4 or below
How frequent are Prenatal Visits? (Ans- Every 4 weeks up to 28 weeks ( 7 months) Every 2 weeks from 29 - 36 weeks Every week from 37 weeks to birth What are done during the various follow-up Prenatal visits? (Ans- No vaginal exam every visit only : Check Urine - glucose and protein (preeclamsia) Glucose screening done at 24-28 weeks Check Weight Check VS - esp BP b/c of preeclampsia Fetal heart Tone - listent to child's heart beat Measureing Fundal Height ( McDonalds method) Asking her about discomforts of pregnancy
Avoid alcohol, tobacco, and recreational drugs Always seek advice from care provider before using medications of any kind Reinforce safety behaviors Maintain good oral hygiene -- Allow for more rest periods Continue to do kegel exercises Nutritional information **What are the danger signs for the first trimester? (Ans- Abdominal cramping or pain Vaginal spotting or bleeding Absence of fetal heart tone Dysuria Fever or chills Prolonged nausea and vomiting What are education points that should be given during the 2nd Trimester (15-28 weeks)? (Ans-
All previous education Signs and Symptoms of preterm labor (PTL) Signs and Symptoms of hypertensive disorders Choosing a health care provider for newborn Childbirth education classes **What are the danger signs of the 2nd trimester? (Ans- Abdominal or pelvic pain Absence of fetal movement Prolonged nausea and vomiting Fever and chills Dysuria Vaginal bleeding What are some education points that should be covered during the 3rd trimester? (29-40 weeks) (Ans- All previous education Promoting benefits of breastfeeding Education on pain control during labor Signs and symptoms of true versus false labor
Mucous plug (operculum) Increased discharge Increased vascularization What happens to the breasts during the pregnancy? (Ans- Increase in size Striae and red stretch marks Colostrum at the 12th week Darkening of the areola Montgomery glands more prominent What happens to the skin and hair during the pregnancy? (Ans- Linea Nigra - a pregnancy line that runs down the midline of the belly Chloasma- development of large brown patches develop esp on face Abdominal Striae - stretch marks
Vascular Spider Nevi - bad spider veins Hair growth decreases Sebaceous and sweat gland production increases Define Chloasma (Ans- development of large brown patches develop esp on face Mask of pregnancy Due to increase in estrogen and progesterone levels Increases melanin deposits Creating light brown to dark brown pigmentation on cheeks and nose What happens to the cardiovascular system during the pregnancy? (Ans- Supine hypotension - b/c baby is laying on inferior vena cava Plasma volume increases RBC increase Anemia Hypercoagulation What happens to the Gastrointestinal system during the pregnancy? (Ans- Nausea, Bloating, Gas
What are some Subjective or Presumptive signs of Pregnancy? (Ans- Amenorrhea Nausea and Vomiting Excessive Fatigue Urinary Frequency Changes in Breasts Quickening What are some Objective or Probable signs of Pregnancy? (Ans- Changes in the pelvic organs(Hegar's, Goodell's, & Chadwick's) Enlargement of the abdomen Braxton Hicks Uterine Souffle Changes in pigmentation Fetal outline Pregnancy What are some positive changes that we would see when conducting diagnostic tests when monitoring a baby? (Ans- Fetal heartbeat Fetal movement Visualization of the Fetus
what are some conditions that are considered high risk to have during Antepartum part of pregnancy? (Ans- Hypertensive disorders Multiple Gestation Hyperemesis Gravidarum - causes severe dehydration: will be on TPN, Zofran and have small meals Gestational Diabetes Placenta Previa Abruptio Placentae Substance Abuse Infections What are the different Hypertensive Disorders that relate to pregnancy? (Ans- Preeclampsia - Eclampsia Chronic Hypertension Chronic Hypertension with Superimposed Preeclampsia Gestational Hypertension Postpartum Hypertension Define HTN (Ans- Systolic BP of 140 or greater and a diastolic BP of 90 or greater, or both
Thrombocytopenia Liver enzymes elevated 2x the normal value RUQ pain not relieved by medication Creatinine> 1.1 mg/dL or doubling of serum Creatinine Pulmonary edema New Onset cerebral or visual disturbances Name the risk Factors for Preeclampsia (Ans- Primiparity Previous preeclamptic pregnancy Chronic hypertension or chronic renal disease In vitro fertilization Obesity Type I or II diabetes Advanced maternal age Multifetal pregnancy Family history of preeclampsia How can you prevent Preeclampsia? (Ans- Low - dose aspirin (60-80mg) beginning in the late first trimester For women with medical history of early-onset preeclampsia and preterm delivery at less than 34 0/7 weeks of gestation or preeclampsia in more than one prior pregnancy
How do you manage Preeclampsia that doesn't have severe features when less Than 37 weeks gestation? (Ans- If the mom is < 37 0/7 weeks gestation
What is Magnesium Sulfate used for? (Ans- used to block the neuro muscular transmission to dilate blood vessels; prevent the mom from developing Eeclampsia (Seizuring). Helping the mom relax and dealing with any spasms Given IV loading dose 4 - 6g w/in 100 ml of NSS given over 20 mins, and a following dose of 2g/hr continous IV infusion Side effects: red/flushed , sweating, feeling warm, lowering her RR, Slower LOC, can cause pulmonary edeam Need to evaluate her Resp Rate, Mg Serum levels closely, assess her DTR b/c they may go down (Deep tendon reflexes) +2 is the goal and Clonus What is the Therapeutic Level for a mother who is receiving Magnesium Sulfate? And what is the Antidote to it? (Ans- Thereputic Mg Level is 4- 8 mg/dL Antidote is Calcium Gluconate if she has too much What actions will the nurse take to manage Preeclampsia? (Ans- Every 2 - 4 hrs: BP measured with woman seated and her arm at heart level Administer antihypertensives and magnesium sulfate as ordered
Assess for CNS changes including headache, visual changes, deep tendon reflexes (DTRs), and clonus Assess for epigastric pain or right upper quadrant pain Assess weight daily. /. Complete 24 hour urine test Evaluate lab values (creatinine, cbcp, liver enzymes) Prepare for NST and BPP (Biophysical Profile) Maintain accurate intake and output Provide education concerning disease process Encourage left lateral recumbent position when resting Report deterioration in maternal or fetal status to provider Define Clonus? (Ans- evaluates the nervous system lay mom on back in supine , dorsal flex her foot to her head quickly and let go and feeling the bottom of the foot feeling for rebound if positive she is too hyper sensitive Define Eclampsia (Ans- New - onset grand mal seizures in a woman with preeclampsia Most severe development of the disease Severe headaches and hyperreflexia usually are premonitory events Define HELLP Syndrome (Ans- Hemolysis
