Prenatal Care
Anatomical changes
o Uterus
enlarges, stretches due to estrogen & progesterone
Blood flow increases
o Weight gain
o Pubic b
... [Show More] one to top of fundus is how many weeks along
o Cervix
Chadwick’s sign (blue or purple) of vulva
Goodell sign (softening) of cervix
Mucus plug will form
Call if discharge indicates infection
Leukaria- NORMAL white discharge
o Vagina/Vulva
Thickening of vaginal mucosa
Vagina swells
More susceptible to yeast infections-due to increased glycogen
pH will decrease-more acidic
o Ovaries
o Breasts
Stretch marks
Bumps (Montgomery tubercles)
Increase pigmentation
Colostrum
o Cardiovascular
Blood vol. inc. 40%
Potential physiological anemia
Supine hypotension syndrome (compression on inferior vena cava)
Left side laying best
o Respiratory
Inc. title vol.
Inc. O2 consumption
Diaphragm elevates
Inc. chest circumference/dyspnea
Less room for lung expansion-inc. in RR
o GI
Lower: Dec. motility- could lead to hemorrhoids
Necessary for inc. nutrient absorption
Upper: heartburn
General nausea/vomiting
o Urinary
Frequency & urgency (1st & 3rd trimester)
Glomerular filtration rate inc.
o Integumentary
Hyperpigmentation
Cholasma: patches on face
Linea nigra: dark line on tummy
Cutaneous vascular changes
Striae gravidarum: stretch marks
Angiomas: small red papule
Palmar erytheman: red hands-inc. blood flow to area
o Musculoskeletal
Postural changes
Lumbar lordosis- sway back
“waddle” gait: due to change in gravity & softening of ligaments
calcium storage
lower extremity cramps
o EENT
Blurred vision: due to dec. intraocular pressure in corneal thickening
Temporary
Nasal congestion: due to inc. mucus production
Epistaxis-nose bleeds
Increase fluids
o Psychosocial
1
st Tri.
Mixed emotions
2
nd Tri.
Body image, getting “real”
3
rd Tri.
Preparing for baby
Maternal Role Transitions
o Rubin (steps in maternal role taking)
Mimicry
Role play
Fantasy
Search for role fit
Grieving
Partner Adaptations/Sibling
o Couvade: sympathetic pregnancy by partner
o Whole family effected
Nurses Role in Prenatal Care
o Being rapport
o Assessment & teaching
o Anticipatory guidance
o Focus on current trimester
o S&S of pregnancy
Presumptive: signs that think would presume pregnancy (not definitive)
Amenorrhea
Nausea/vomiting
Urinary frequency
Breast tenderness
Chadwick’s sign(blue/purple vulva)
Probable
Hagar sign: softening of cervix
Piskacek sign: asymmetry of uterus
Abdominal enlargement
Braxton Hicks
Pos. preg. Test
Positive
FHB
Fetal movements
Visualization of fetus [Show Less]