Essentials of Maternity and Pediatric NursingChapter 12N.pptVIP

Chapter X Essentials of Maternity and Pediatric NursingChapter 12Nursing Care During Pregnancy insert Box 12-1 Preconception Care Immunization status Underlying medical conditions Reproductive health care practices Sexuality and sexual practices Nutrition Lifestyle practices Psychosocial issues Medication and drug use Support system 1st Prenatal Visit Establishment of trusting relationship Focus on education for overall wellness Detection and prevention of potential problems Comprehensive health history, physical examination, and laboratory tests Comprehensive Health History Reason for seeking care Suspicion of pregnancy Date of last menstrual period Signs and symptoms of pregnancy Urine or blood test for hCG Past medical, surgical, and personal history Woman’s reproductive history: menstrual, obstetric and gynecologic history Menstrual History Menstrual cycle Age at menarche Days in cycle Flow characteristics Discomforts Use of contraception Menstrual History (cont’d) Date of last menstrual period (LMP) Calculation of estimated or expected date of birth (EDB) or delivery (EDD) Nagele’s rule Use first day of LNMP 11/21/07 Subtract 3 months 8/21/07 Add 7 days 8/28/07 Add 1 year 8/28/08 = EDB Gestational or birth calculator or wheel (see Fig. 12-3) Ultrasound Obstetric History Gravida: a pregnant woman Gravida I (primigravida): first pregnancy Gravida II (secundigravida): second pregnancy, etc. Para: a woman who has produced one or more viable offspring carrying a pregnancy 20 weeks or more Primapara: one birth after a pregnancy of at least 20 weeks (“primip”) Multipara: two or more pregnancies resulting in viable offspring (“multip”) Nullipara: no viable offspring; para 0 Obstetric History (cont’d) Terminology G (gravida): the current pregnancy T (term births): the number of pregnancies ending 37 weeks’ gestation, at term P (preterm births): the number of preterm pregnancies ending 20 weeks or viab