Before birth (prenatal)
Antepartum
During birth
Intrapartum
After birth
Postpartum
Obstetricians
Family practice physicians
certified nurse midwives
Nurse practitioners
Prenatal Care Providers
Ensure adequate intake of folic acid to prevent neural tube defects in developing fetus
Preconception care
Obstetric
Menstrual
contraceptive
medical and surgical
womans family
partners family
both womans and partners history to identify risk factors
psychosocial
Components of prenatal health history
evaluate the womans general health
determine baseline weight and vital signs
evaluate nutritional status
identify current physical/social problems
determines the estimated date of delivery (EDD)
Physical Examination
Evaluate the size adequacy, and condition of the pelvis and reproductive organs.
assess for signs of pregnancy.
Pelvic examination objectives
Conception to 28 weeks - every 4 weeks
29 to 36 weeks - every 2-3 weeks
37 weeks to birth - weekly
certain laboratory and/or diagnostic tests are performed at various times throughout the pregnancy
Recommended schedule of prenatal visits. Uncomplicated pregnancy
Risk factors: review known and assess for new
Vital signs and weight: determine if gain is normal
Urinalysis: protein, glucose, and ketone levels
Blood glucose screening
Fundal height: fetal growth/amniotic fluid volume
Leopolds maneuvers: assess presentation/ position
fetal heart rate
nutrition intake
any discomforts or problems since last visit
Routine assessments at each prenatal visit
Bacterial vaginosis is most common caused by decrease in lactobacilli.
increase in bacteroid and other anaerobic microorganisms.
may be milk-white discharge.
Vaginal discharge during pregnancy
collecting data from the pregnant woman
identifying and reevaluating risk factors
educating in self-care
providing nutrition counseling
promoting family adaptation to pregnancy
Role of the nurse during prenatal care
Average pregnancy is 40 weeks (280 days) after first day of LNMP, plus or minus 2 weeks.
Nageles Rule
-identify first day of LNMP
-Count backward 3 months
-add 7 days
-update year, if applicable
Determining the estimated date of delivery
Pregnancy divided into 3 13 week parts
important to know what occurs during each trimester to both woman and fetus
helps provide anticipatory guidance
identify deviations from the expected pattern of development
Trimesters
Amenorrhea
nausea
breast tenderness
deepening pigmentation
urinary frequency
fatigue and drowsiness
quickening
Presumptive signs of pregnancy