week 3-4

Cards (121)

  • Preconception planning
    • Limit smoking an etoh use
    • Some medications are teratogens
    • Cessation of birth control in order to conceive
  • Education
    • Healthy diet: prenatal vitamins
    Folic acid- prevents neural tube defects
    • Only a 25-40 pound weight gain
    • Exercise: walking, weight bearing, swimming
    • Safe food handling
    • Do not pick up cat feces
  • ABC’s of conception
    1. Ovum released into fallopian tube- viable for 24 hours
    2. Sperm deposited into vagina- viable for 48-72 hours
    • Chromosome pairs split up to produce diploid zygote
    • 23+23=46
    • Zygote contains new combination of genetic material
    • Sex of zygote determined at moment of fertilization
  • Nageles rule
    • 1st day of LMP subtract 3 months and add seven days
    • Can be difficult as periods are irregular and can affect ovulation
  • Prenatal considerations
    Adaptations- weight gain, additional hormones, changes in personal relationship
    Prenatal classes and education resources
    Creation of birth plan- communication between healthcare providers. Keep in mind labor does not always go according to plan
  • Follow up visits- every 4 weeks for first 28 weeks gestation, every 2 weeks from 28 weeks until 36 weeks gestation, after 36 week- every week until childbirth
    • Gestational hypertension+diabetes= extra screening/care
  • 1st Trimester ultrasound- important for:
    • Premature babies and knowing exact dates
    • Adjust dates(miscarage then get pregnant right away
  • Prenatal assessments- vitals and weight, uterine size and fetal heartbeat, Tests: urinalysis, blood tests, group b strep test, re-evaluation/prenatal history-questions will change
  • Gravida + TPAL
    G- any pregnancy, regardless of duration, including present pregnancy
    T- number of term infants born(37/0 and after)
    P- number of preterm infant born(20/0, 36/6)
    A-number of pregnancies ending in either spontaneous or therapeutic abortion
    L- number of living children
  • Abortion- a birth that occurs before the end of 20 weeks gestation
    • Spontaneous: naturally occurring from a multitude of causes, cause not always known
    • Therapeutic: medically induced
    • Stillbirth: a birth of an infant whom is dead< occurring after 20 weeks gestation
  • Umbilical cord: develops from amnion
  • Contains two arteries and one vein; surrounded by Wharton's jelly to protect vessels
    • Wharton's jelly: specialized connective tissue that protect blood vessels, less wharton's jelly puts baby at risk
  • Placenta: developed at site where embryo attaches to uterine wall at 3rd week after conception
  • Metabolic and nutrient exchange between embryonic and maternal circulation
  • Maternal portion- surface appears red and flesh-like
    Fetal portion- appears shiny and gray
  • 4 weeks: the fetal heart begins to beat
  • 8 weeks: all body organs are formed(if something happens to mom during this stage, it can effect babies organ development)
  • 8-12 weeks: fetal heart rate can be detected
  • 16 weeks: the sex of the baby can be detected, looks like a baby on an ultrasound image
  • 20 weeks: heart beat can be detected, mother experiences quickening, baby develops a regular schedule, vernix and lanugo is present, head hair, eyebrows, and eyelashes present
  • 24 weeks: weighs 780g, increasingly active, respiratory movements begin, sucking movements
  • 28 weeks: eyes open/close, baby can breath, surfactant is developed
  • 32 weeks: fingernails and toenails from, subcutaneous fat is developing less red and wrinkled
  • 38+ weeks: baby fills entire uterus, reciving antibiotics from mother
  • Multiple gestation
    Therapeutic management: serial ultrasounds, close monitoring during labor, operative delivery
    Nurse assess- uterus larger than expected for EDB
  • Monochorionic-monoamniotic is most dangerous- cords can wrap around each other and twins can fuse together
    A)
  • Dichorionic-Diamniotic
    A)
  • Monochromic-monoamniotic
  • Monochorinic-diamniotic
    A)
  • Dichorionic-diamniotic
    A)
  • Presumptive
    • Subjective changes experienced by a women
    • Cannot be used to diagnose pregnancy
    • Amenorrhea, nausea and vomiting, excessive fatigue, urinary frequency, breast changes, quickening, weight changes
  • Probable
    • Objective changes can be observed by the women or an examiner
    • These changes alone cannot confirm pregnancies
    • Pelvic organ changes, enlargement of the abdomen with amenorrhea, braxton hicks contractions, changes in skin pigmentation, fetal outline, pregnancy tests
  • Positive
    • Objective changes that cannot be confused with a pathologic state and can be measured conclusively
    • Fetal heartbeat, fetal movement, visualization of the fetus via ultrasound
  • First
    Week 1-12
    Extreme fatigue, tender swollen breasts, nausea and vomiting, taste changes, mood swings, constipation, urinary frequency, headache, heartburn, weight changes
  • Second
    Week 13-28
    Body aches, stretch marks, darkening of the skin around the nipples, linea nigra, darker patches on the face, carpal tunnel syndrome, insomnia, itchiness, swelling of ankles, fingers and face
  • Linea nigra-darkening of line of stomach
    Itching- palms of feet can indicate colestitus
  • Third
    Week 29-40+
    Shortness of breath, heartburn, swelling, hemorrhoids, tender breasts with/out colostrum, leakage, umbilical protrusion, difficulty sleeping, lightening, braxton hicks
  • Exercise
    • Recommended throughout pregnancy 5x per week for 30 minutes a day
    • Avoid contact sports
    • Pelvic physiotherapy and kegel exercises are recommended
    • For first 4-6 weeks postpartum women should avoid exercise until their follow-up appointment
    • Women having c-section should avoid lifting more than 10 pounds
  • Nutritional needs
    • Caffeine should be limited to 1-2 cups a day
    • Avoid- unpasteurized dairy products, raw fish and eggs, deli meats
    • 2nd trimester +340 kcal, 3rd +452
    • Women who are breast feeding require +330kcal per day in first six months; +400kcal per day in next six months