1. Nursing Care During the Antenatal Period

2. A & P of Pregnancy Terms to know Gravida Parity Nulliparous Multiparous Term TPAL

3. Signs of Pregnancy Presumptive Signs/Symptoms Probable Positive

4. Uterine Growth Stimulated by hormones in the 1 st trimester Larger as it rises out of the pelvis Hegar’s Chadwick’s

5. Contractility Braxton Hicks

6. Cervical Changes Goodell’s Sign Friability

7. Fundal Height Changes Changes from week to week

8. Vaginal Changes Vaginal mucosa thickens Chadwick’s sign Vaginal discharge Mucous plug Varicosities

9. Breast Changes Fullness Areolar pigmentation Colostrum

10. Circulatory Changes CV- blood volume, cardiac hypertrophy Cardiac output increases Blood pressure changes

11. Circulatory changes Supine hypotension syndrome

12. Renal Changes Renal pelvis and ureters dilate Urine rate is slowed Bladder frequency

13. GI Changes Appetite Gastric emptying Absorption Bowel sounds Blood flow to the pelvis Morning sickness Pyrosis Constipation

14. Gallbladder and Liver Gallbladder with decreased tone PUPPS

15. Skin Changes Increased subdermal fat Hyperpigmentation Striae Linea nigra Chloasma Angiomas Pruritis Palmar erythema Increased perspiration

16. Endocrine Changes Amenorrhea Progesterone Estrogen Ant pituitary suppresses the FSH and LH causing to rise Post pituitary produces oxytocin

17. Neurological Changes Carpal Tunnel Syndrome Numbness/Tingling HA’s Lightheadedness Muscle Cramps

18. Musculoskeletal Changes Change in posture Waddling Back Pain

19. Nutrition Needs Folic Acid Calories increased to 300/day Increased protein Iron requirements increased Increased fluid intake Limit caffeine

20. Exercise Will produce benefits Must consume fluid Watching heart rate No new activities

21. Weight Gain in Pregnancy 25-35 pounds total weight gain With singleton pregnancy 35-45 pound total weight gain with multiples

22. Nagele’s Rule LMP minus 3 calendar days Add 7 days and 1 year

23. Tests in 1 st Trimester 1 hour post glucola if indicated Blood type Antibody screen CBC UA C/S Hepatitis HIV RPR TSH Toxoplasmosis if indicated CVS if desired

24. Hyperemesis N/V Small frequent meals Avoid spicy foods Antiemetics

25. 1 st Trimester Hyperemesis No menses N/V Fatigue Breast Tenderness

26. 20 Weeks Quickening Pelvic Pressure Constipation Round ligament pain

27. CVS Screening to detect fetal genetic abnormalities Risks of miscarriage 1 in 100

28. Nuchal Fold Thickness Ultrasound and 9-13 weeks Increased with down syndrome Screening only!!

29. AFP Triple marker test/screening 16-20 weeks gestation If abnormal refer to specialist

30. Amniocentesis Performed between 16-20 weeks Done with AMA, FH, +AFP Risks of miscarriage 1 in 200-300

31. Testing in 3 rd Trimester 1 hour post glucola CBC UA Antibody screen Rhogam TSH

32. 32-36 Weeks Fetal position Descending into pelvis Placental location GBS FKC’s

33. 36-42 Weeks Vaginal Exams Labor precautions PIH precautions

34. Childbirth Education Natural Lamaze Bradley

35. Birth Plan Hospital Birthing Center Home Bath Pain Meds Epidural Natural Lighting Ambulating Doulas Hypnosis