1
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- Maternal Newborn Nursing
- Sandra Gallagher MSN, CNM
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2
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- Review of AP terms
- Assessment of the antepartum patient
- Common Discomforts
- The Expectant Family
- A few Antepartum Medications
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3
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4
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- History
- © Age
- © Gravidity
- © Parity ( TPAL)
- © LMP – Nagele’s Rule
- © HPI - ? FM, FH, Bleeding
- © PMH/PSH/GYN/OB etc.
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5
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- Physical Exam
- Ht , Wt and vital signs
- HEENT
- Heart/Lungs/Back/Breasts
- Abdomen
- Pelvis
- Extremities
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6
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- Laboratory Collection
- ¥CBC/ T&Rh/Ab screen
- ¥TB, Rubella, Hepatitis
- ¥PAP, STI’s, Syphylis
- ¥Urine UA/Dip
- þ OFFER EVERY PATIENT HIV
TESTING
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7
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- Psychosocial Assessment
- Emotional status
- Support systems
- Economic viability
- Cultural influences on affect
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8
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- Follow-up and anticipatory
guidance
- RTC q 4 wks → 28 wks
- RTC q 2 wks → 36 wks
- RTC weekly until birth of baby
- $ Trimester appropriate
guidance and warning
signs!!!
- $ Encourage adequate
water intake: 6-8 glasses daily
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9
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- Wt
- Urine dip
- Vital signs
- Fetal Movement
- Uterine size
- Fetal heart tones
- Extremities
- Lab reviews
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10
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- Important Milestones
- @ 16-18 wks IUP-MSAFP, ? Amnio
- 24-28 wks IUP – GCT (? GTT), CBC
- 28 wks IUP - ? Rhogam
- GBS @ 35-36 wk IUP
- 36 weeks’ gestation ~ birth prep
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11
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- * 1st ∆ : N&V, freq’cy, fatigue, Breast
tenderness, ↑ vag d/c,
nasal stuffiness, ptyalism
- * Second and Third ∆ : Heartburn, ankle edema, varicosities,
hemorrhoids, ↑ constipation, backache, faintness, dyspnea, carpal
tunnel
- *** See Table 9.1 pg. 184-185
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12
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- ♀ Language barriers
- ♀ Home remedies
- ♀ Nutrition
- ♀ Health care providers
- ♀ Spirituality
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13
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- Sexual Activity
- Kegel Exercises
- Dental Care
- Immunizations
- Teratogens
- Medications
- Drugs, Alcohol, tobacco et al.
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14
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- PNV
- FeSo
- Colace
- Betamethasone
- RhoGam
- MgSo
- Ritodrine
- Terbutaline
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15
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- 1. What is the normal range of the fetal heart?
- a) 90-110 bpm
- b) 100-115 bpm
- c) 120-160 bpm
- d) 170-180 bpm
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16
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- What teaching do we provide for
the AP pt with heartburn?
- How do we counsel the pt who loves eating rare steaks?
- T/F? Ultrasound is the only way to
determine adequate fetal growth
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17
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18
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