XIV. MATERNITY NURSING
A. First trimester (Week 1 through Week 13):
1. Assessment:
a. Presumptive Signs of Pregnancy:
Amenorrhea – what is the name of the hormone that causes this?
_______________
N/V
Frequency – can be one of the first signs.
Breast Tenderness – excess hormones
b. Probable Signs of Pregnancy:
A positive pregnancy test – since it is based on the presence of hCG levels.
Maternity
There are other conditions that can ↑ hCG levels: hydatidiform mole; drugs.
Goodell’s sign (softening of _________________; second month)
Chadwick’s sign (bluish color of vaginal mucosa and cervix; week ______)
Hegar’s sign (softening of the lower uterine segment; 2nd/3rd month)
Uterine enlargement
Braxton Hicks contractions (throughout pregnancy; move blood through the
placenta).
Pigmentation/changes of skin
Linea nigra
Abdominal striae
Facial chloasma (mask of pregnancy)
Darkening of the areola (around the nipple)
c. Positive Signs of Pregnancy:
Fetal heartbeat: Doppler→ _________ - __________ weeks
Fetoscope→ ___________ - ___________ weeks
Fetal movement
Ultrasound
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, d. Miscellaneous Information:
1) Gravidity: # of times someone has been pregnant
2) Parity: # of pregnancies in which the fetus reaches _________________.
3) Viability ___________ weeks = Infant has the ability to live outside the
uterus.
A 20 week baby is NOT considered __________________.
4) TPAL: acronym that gives you further information on parity
T= term
P= preterm
A= abortion – this includes spontaneous and elective abortions
L= living children
5) Naegele’s Rule:
Maternity
Find the first day of the LMP
Add ______ days
Subtract ______ months
Add _______ year
2. Client Education/Teaching:
a. Nutrition:
4 food groups
Increase calories by _______ per day after the first trimester
Adolescent: ↑ calories by ______ after first trimester
Increase protein to ________ grams per day
b. Weight Gain:
Expect to gain _________ pounds in the first trimester
c. Prenatal vitamin supplements:
Why don’t women like to take iron? It causes _____________________.
Take iron with vitamin _________ to enhance absorption.
Folic acid prevents? ________________ defects
Daily dose? _________mcg/day
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, d. Exercise Rules:
No high impact; ______________and swimming are best.
No heavy or unaccustomed exercise program.
No overheating (no hot tubs or electric blanket either)
Why? __________________________________ = birth defects
Exercise Rule: Don’t let your heart rate get above 140.
If the heart rate goes over 140bpm = _______________________ and uterine
perfusion will drop.
e. Danger Signs:
Sudden gush of vaginal fluid
Bleeding
Maternity
Persistent vomiting
Severe headache
Abdominal pain
Increased temps
Edema
No fetal movement
f. Common Discomforts:
N/V Nasal stuffiness
Breast Tenderness Varicose veins
Frequency Ankle edema
Tender gums Hemorrhoids
Fatigue Constipation
Heartburn Backache
Increased vaginal secretions Leg cramps
g. Medications:
What are you going to tell the pregnant person about taking medications?
________________________
h. Smoking:
What are you going to tell them? _____________________
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A. First trimester (Week 1 through Week 13):
1. Assessment:
a. Presumptive Signs of Pregnancy:
Amenorrhea – what is the name of the hormone that causes this?
_______________
N/V
Frequency – can be one of the first signs.
Breast Tenderness – excess hormones
b. Probable Signs of Pregnancy:
A positive pregnancy test – since it is based on the presence of hCG levels.
Maternity
There are other conditions that can ↑ hCG levels: hydatidiform mole; drugs.
Goodell’s sign (softening of _________________; second month)
Chadwick’s sign (bluish color of vaginal mucosa and cervix; week ______)
Hegar’s sign (softening of the lower uterine segment; 2nd/3rd month)
Uterine enlargement
Braxton Hicks contractions (throughout pregnancy; move blood through the
placenta).
Pigmentation/changes of skin
Linea nigra
Abdominal striae
Facial chloasma (mask of pregnancy)
Darkening of the areola (around the nipple)
c. Positive Signs of Pregnancy:
Fetal heartbeat: Doppler→ _________ - __________ weeks
Fetoscope→ ___________ - ___________ weeks
Fetal movement
Ultrasound
Copyright protected. Reproduction prohibited without authorization and release by Hurst Review Services. 179
, d. Miscellaneous Information:
1) Gravidity: # of times someone has been pregnant
2) Parity: # of pregnancies in which the fetus reaches _________________.
3) Viability ___________ weeks = Infant has the ability to live outside the
uterus.
A 20 week baby is NOT considered __________________.
4) TPAL: acronym that gives you further information on parity
T= term
P= preterm
A= abortion – this includes spontaneous and elective abortions
L= living children
5) Naegele’s Rule:
Maternity
Find the first day of the LMP
Add ______ days
Subtract ______ months
Add _______ year
2. Client Education/Teaching:
a. Nutrition:
4 food groups
Increase calories by _______ per day after the first trimester
Adolescent: ↑ calories by ______ after first trimester
Increase protein to ________ grams per day
b. Weight Gain:
Expect to gain _________ pounds in the first trimester
c. Prenatal vitamin supplements:
Why don’t women like to take iron? It causes _____________________.
Take iron with vitamin _________ to enhance absorption.
Folic acid prevents? ________________ defects
Daily dose? _________mcg/day
180 Copyright protected. Reproduction prohibited without authorization and release by Hurst Review Services.
, d. Exercise Rules:
No high impact; ______________and swimming are best.
No heavy or unaccustomed exercise program.
No overheating (no hot tubs or electric blanket either)
Why? __________________________________ = birth defects
Exercise Rule: Don’t let your heart rate get above 140.
If the heart rate goes over 140bpm = _______________________ and uterine
perfusion will drop.
e. Danger Signs:
Sudden gush of vaginal fluid
Bleeding
Maternity
Persistent vomiting
Severe headache
Abdominal pain
Increased temps
Edema
No fetal movement
f. Common Discomforts:
N/V Nasal stuffiness
Breast Tenderness Varicose veins
Frequency Ankle edema
Tender gums Hemorrhoids
Fatigue Constipation
Heartburn Backache
Increased vaginal secretions Leg cramps
g. Medications:
What are you going to tell the pregnant person about taking medications?
________________________
h. Smoking:
What are you going to tell them? _____________________
Copyright protected. Reproduction prohibited without authorization and release by Hurst Review Services. 181
