Antepartum Nursing Care
What vitamin is recommended for clients of childbearing age to take for neurological development (brain and spinal chord)?
Extra 100 pts- how much is required dose?
Folic acid - 400 mcg once a day
600 mcg once you become preganant
What pregnancy is abnormal implantation of fertilized ovum outside the uterine cavity?
Ectopic pregnancy
How would you explain uterine involution to your patient?
The uterus is returning to its pre-pregnant state and will decrease by one finger width per day in relation to the belly button.
What is the range for a healthy newborn temp in Celsius?
36.5-37.5
Calculate the due dates using Nagele’s Rule:
Last menstrual period (LMP) of August 2, 2019
8/2/19: 8-3=5, 2+7=9, so 5/9/20 is the EDD
either add 9 or subtract 3 from month, add 7 to days.
What are the 3 signs of pregnancy? (3 P's)
Presumptive, probable and positive
Which trimester is patients screen for GBS?
Third
What exercise is recommended for regain of pelvic floor muscles?
Kegal exercises
Class- Try it!
What antibiotic is given to the newborn to prevent Gonorrhea and Chlamydia infection?
Erythromycin eye ointment.
A 39 year old is 18 weeks pregnant. She has 2 sets of twin daughters that born at 38 and 39 weeks gestation and a 11 year old son who was born at 32 week gestation. She has no history of miscarriage or abortion. What is GTPAL?
G 4 T 2 P 1 A 0 L 5
What 2 tests check for amount of hCG (human chorionic gonadotropin)
Serum and Urine tests
What are expected findings of hyperemesis gravidarum?
Weight loss
Excessive vomiting for prolonged periods
Dehydration with prolonged electrolyte imbalance
Increased HR
Decrease BP
Poor skin turgor and dry mucous membranes
What are the 3 stages of lochia and explain them?
Lochia rubra- dark red to brown "period like discharge" flow lasts 1-3 days from delivery
Lochia serosa- pinkish brown watery discharge- old blood, WBC and debris from uterine lining. Discharge is from day 4- day 10 after delivery
Lochia Alba- yellowish or white discharge consists of serum WBC, epithelial cells and debris from them mucous lining of uterus, day 11-8 weeks after delivery.
Double Jeopardy!!!
Explain the difference from caput succedaneum and cephalohematoma?
Caput- soft edemous mass that does not cross sutue line- resolves on it own 3-4 days
Hematoma- collection of blood between the peristeum and skull bone, does not cross suture line. Resolves in 2-3 weeks.
Calculate the GTPAL
Ms. Jones is speaking with her nurse about her pregnancy history. She is currently 14 weeks pregnant and lost a pregnancy at 14 weeks last year. She has twins at home that were born by cesarean section at 34 weeks gestation.
G: 3 T: 0 P: 1 A: 1 L: 2
What is GTPAL stand for?
Gravidity- number of pregnancies
Term Births (38 weeks or more)
Preterm Births (viability up to 37 weeks)
Abortions/miscarriages before viability
Living Children
What is placenta previa?
It occurs when the placenta abnormally implants in the lower segment of the uterus near or over the cervical os instead of attaching to the fundus
How many mLs of blood loss is considered for postpartum hemorrhage? Vaginal and c section- 2 answers
500 mL after vaginal birth
1000 mL after c section
What is a positive babinski sign in newborn?
Stroke the sole of foot from heel to toes. Toes will fan outward- expected birth to 1 year.
Note: children over 2 and adults - a positive sign may mean neurological defect.
Calculate the due dates using Nagele’s Rule:
LMP December 20, 2019
12/20/19: 12-3=9, 20+7=27, so 9/27/20
either add 9 or subtract 3 from month, add 7 to days.
What are the 3 positive signs of pregnancy?
Fetal heart sounds
Visualization of fetus by ultrasound
Fetal movement
Double Jeopardy!!!!
A nurse is assisting care of a client with abruptio placentae- what are the expected findings?
sudden intense localized uterine pain with dark red vaginal bleeding
uterus tender and boardlike abdomen
fetal distress
manifestation of hypovolemic shock ( low urine output, increase HR, low BP, clammy skin, confusion, weak/tired, quick shallow breathing)
What will you teach your formula feeding patient regarding breast care?
Wear a tight fitting bra, apply cool compresses to breast, no heat, do not express milk
What is Vitamin K used for and where is Vitamin K administered? Name the location/site in newborn
It is used to prevent hemorrhagic disorders. Im injection at the vastus lateralis.
Calculate the GTPAL
The nurse is obtaining a prenatal history on Josie who is currently pregnant. Josie has had one daughter at 35 weeks, one son at 32 weeks, two spontaneous miscarriages at 12 weeks, and one stillborn baby at 40 weeks.
G: 6 T: 1 P: 2 A: 2 L: 2