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- Paternal responses to pregnancy
- Partner identifies with woman’s pregnancy
- May experience discomforts such as N & V, fatigue, weight gain, difficulty sleeping, backaches or depression
First task for mother in pregnancy
Accept the biologic fact of pregnancy. The woman needs to be able to state, “I am pregnant”.
Second task for mother in pregnancy
Accept the growing fetus as distinct from herself. The woman can now state, “I am going to have a baby”.
Third and last stage for pregnant mother to complete
Prepare realistically for the coming of the child and prepare to relinquish it. The woman expresses the thought that, “ I am going to be a parent”.
Aunt Julie’s rule for calculating age of fetus
- at synthesis pubis = 12 weeks
- at umbilicus= 20 weeks
- lvl of xiphoid process = 36 weeks
- drop below xiphoid process after 36 weeks (drops
Nagele’s Rule -
- -How to calculate due date
- First day of LMP, subtract 3 months, add 7 days, add 1 yr,
- i.e.: July 4th, 2011, (LMP) EDC 4/11/2012
- (top of pubic bone to top of fundus); fundal height corresponds with fetal growth from 16 wks until 38
- wks then subsides
- i.e. If the fundal
- measurement is at the umbilicus which is 20 cm = 20 wks
Presumptive sign of pregnancy –
s/s that lead client to believe she is pregnant; all considered subjective/not conclusive. Think signs the MOTHER would know or recognize. (breast changes, skin changes, N/V, menstrual suppression)
Probable indications of pregnancy
- (objective) MD/NP Think signs that a NURSE
- would assume meant pregnancy but would need additional testing for verification. (+ preg test,
Positive sign of pregnancy –
- Only four which give direct evidence of live
- fetus: all are objective; Think this is positively pregnancy; there is nothing else this could be.
– brown colored facial blotches, hormonally induced
striae gravidarum –
“stretch marks” caused by rupture and atrophy of connective tissue, appear pink to reddish purple during pregnancy/birth and will change to silver white/cream/pink within one year following birth
– tiny capillary branches – “spiders”. Related to estrogen
– pigmented line running from umbilicus to symphysis pubic; lightensafter pregnancy
-change in color of cervix, becomes more bluish
– cervical softening
– softening of the uterine ishmus; it is easy flexion of the lower uterine segment during bimanual exam. It occurs about the 2nd or 3rd month
Danger signs of pregnancy and need to be reported
- -Any leakage or gush of anything from the vagina
- -Vaginal bleeding – with or without discomfort; of any kind; ask amounts
- -Abdominal pain –persistent or severe; could be abruption, premature labor, gallbladder disease
- -Temp > 101 – and chills; indication of infection
- -Blurred vision, dimness, spots (scotoma), any form of visual disturbance – could be viral;
- -Persistent vomiting
- -Severe backache – could be way baby is laying or indicate hypertension (big vessels back there are distended/stretched), could be her posture, could be UTI
- -Headaches – if consistent could be PIH, pounding headache is characteristic of PIH
- -Edema or swelling in hands or face is NOT NORMAL and should be reported immediately.
- * *Edema of legs and feet which is worse
- after having been up and about for a period of time is normal.
- -Muscle rigidity/irritability or convulsions- may be preceded by epigastric pain (cardinal sign w/ PIH)
- -Oliguria – not drinking enough water, impaired intake, kidney stone – need lots of water!
- -Painful urination – bladder or kidney infection could cause preterm labor
- -Changes in frequency or strength of fetal movement
At what point must mom take iron suppliment to be effective in creating RBC?
Normal weight gain during pregnancy…
About 2 to 4 pounds during your first three months of pregnancy and 1 pound a week for the remainder of your pregnancy
Calorie intake above normal for breast feeding mother (when sole-nutrient for baby)
100 calories per pound of baby
- Variable-Cord compression
- Early-Head Compression
- Acceleration-Other – food, movement, activity, fever
- Late-Placental Insufficiency
Measuring fetus locations compared to ischial spine
- -2- above ischial spine
- 0- at Ischial Spine (tops of pelvis)
- 2-below ischial spine
PURR of labor
=Position- have mom change positions =Urinate- have mom urinate often =Respiration- have mom breath through contractions not to starve uterus of O2. =Relaxation- relax
Stages of labor
- 0cm -------3-------4-------7---------------10cm
- Early active transition
-transition- very intense
2) Expulsion- starts when fully dilated and ends with birth of baby
3) Placental- Starts with birth of baby and ends with birth of placenta
4) Recovery- Starts with birth of placenta and ends with fully recovered mom.
VEAL CHOP (infant response to contractions)
- Variable Cord compression
- Early Head compression
- Acceleration Other- (eats, sugar, pitocin, pain, hemorrhage)Late Placental insufficiency