Chapter_014 _care of Family During Pregnancy

7/17/2019 Chapter_014 _care of Family During Pregnancy

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Chapter 14

NURSING CARE OF THEFAMILY

DURING PREGNANCY

Copyright 2016 by Elsevier Inc. All rights reserved.


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2Copyright 2016 by Elsevier Inc. All rights reserved.

Learning Obe!ti"e#

De#!ribe #trategie# $%r !%n&r'ing pregnan!( an)e#ti'ating the )ate %$ birth*

S+''ari,e the ph(#i!a-. p#(!h%#%!ia-. an) beha"i%ra-!hange# that +#+a--( %!!+r a# the e/pe!tant '%ther an)

%ther $a'i-( 'e'ber# a)apt t% pregnan!(* E"a-+ate the bene&t# %$ prenata- !are an) pr%b-e'# %$

a!!e##ibi-it( $%r #%'e 0%'en*

O+t-ine the pattern# %$ hea-th !are +#e) t% a##e##'aterna- an) $eta- hea-th #tat+# at initia- an) $%--%0+p

"i#it# )+ring pregnan!(*


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Learning Obe!ti"e#

2C%nt*3 Se-e!t the t(pi!a- n+r#ing a##e##'ent#. )iagn%#e#.inter"enti%n#. an) 'eth%)# %$ e"a-+ati%n inpr%"i)ing !are $%r the pregnant 0%'an*

P-an e)+!ati%n nee)e) b( pregnant 0%'en t%

+n)er#tan) an) 'anage ph(#i!a- )i#!%'$%rt#re-ate) t% pregnan!( an) t% re!%gni,e #ign# an)#('pt%'# %$ p%tentia- !%'p-i!ati%n#*

E"a-+ate the ee!t %$ !+-t+re. age. parit(. an)

n+'ber %$ $et+#e# %n the re#p%n#e %$ the $a'i-( t%the pregnan!( an) %n the prenata- !are pr%"i)e)*

C%'pare the %pti%n# $%r hea-th !are pr%"i)er# an)birth #etting !h%i!e# that are a"ai-ab-e*


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De&niti%n#55

Prenatal period: A ti'e %$ ph(#i!a- an)p#(!h%-%gi! preparati%n $%r birth an)parenth%%)

D+rati%n %$ pregnan!(6 Gestation

Span# 7 !a-en)ar '%nth#. 18 -+nar '%nth#

48 0ee9# %r :;8 )a(#

Tri'e#ter#

Fir#t6 0ee9# 1148 2pg*


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Diagn%#i# %$ Pregnan!( 5

Sign# an) #('pt%'#

Pre#+'pti"e in)i!at%r#

Rep%rte) b( 0%'an

A'en%rrhea. na+#ea an) "%'iting. brea#tten)erne##. +rinar( $re?+en!(. $atig+e

@+i!9ening


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Diagn%#i# %$ Pregnan!(

2C%nt*3 Sign# an) #('pt%'# 2C%nt*3

Pr%bab-e in)i!at%r#

Dete!te) b( e/a'iner

Uterine en-arge'ent

ra/t%n Hi!9# !%ntra!ti%n#

P-a!enta- #%+Be

a--%tte'ent

P%#iti"e pregnan!( te#t


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Diagn%#i# %$ Pregnan!(

2C%nt*3 Sign# an) #('pt%'# 2C%nt*3

P%#iti"e in)i!at%r#

Attrib+te) t% the $et+#

Feta- heartbeat )i#tin!t $r%' '%ther#

Feta- '%"e'ent $e-t b( #%'e%ne %ther than '%ther

i#+a-i,ati%n %$ the $et+#


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E#ti'ating Date %$ irth

E#ti'ate) )ate %$ birth 2ED3

O-)er ter'#

E#ti'ate) )ate %$ )e-i"er( 2EDD3

E#ti'ate) )ate %$ !%n&ne'ent 2EDC3

U-tra#%+n)

Stan)ar) pr%!e)+re $%r )eter'ining thege#tati%na- age %$ the $et+#

Naege-e# r+-e t% !a-!+-ate ED

A##+'e# that the 0%'an ha# a :;)a( !(!-ean) that $erti-i,ati%n %!!+r# %n the 14th )a(

A$ter )eter'ining the &r#t )a( %$ the LMP.#+btra!t < !a-en)ar '%nth# an) a)) > )a(#


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A)aptati%n t% Pregnan!(

Materna- a)aptati%n

A!!epting the pregnan!(

I)enti$(ing 0ith the '%ther r%-e

Re%r)ering per#%na- re-ati%n#hip#

E#tab-i#hing re-ati%n#hip 0ith $et+#6 atta!h'entpr%!e## %$ the '%ther

Pha#e 16 She a!!ept# the bi%-%gi! $a!t %$ pregnan!(

Pha#e :6 She a!!ept# the gr%0ing $et+# a# )i#tin!t$r%' her#e-$

Pha#e


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A)aptati%n t% Pregnan!(

2C%nt*3 Paterna- a)aptati%n

A!!epting the pregnan!(

C%+"a)e #(n)r%'e

De"e-%p'enta- ta#9# e/perien!e) b( thee/pe!tant $ather

Ann%+n!e'ent pha#e

M%rat%ri+' pha#e

F%!+#ing pha#e

I)enti$(ing 0ith the $ather r%-e Re%r)ering per#%na- re-ati%n#hip#

E#tab-i#hing re-ati%n#hip 0ith the $et+#

Preparing $%r birth


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A)aptati%n t% Pregnan!(2C%nt*3 A)aptati%n t% parenth%%)

$%r the n%npregnantpartner

Sib-ing a)aptati%n

Depen)# %n age an))epen)en!( nee)#

Gran)parent a)aptati%n


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Care Manage'ent

Initia- "i#it Prenata- inter"ie0

Rea#%n $%r #ee9ing!are

C+rrent pregnan!(

Chi-)bearing an)$e'a-e repr%)+!ti"ehi#t%r(

Hea-th hi#t%r(

N+triti%na- hi#t%r(

Hi#t%r( %$ )r+g an)

herba- preparati%n +#e Fa'i-( hi#t%r(

S%!ia-. e/perientia-.%!!+pati%na- hi#t%r(

Pg*


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Care Manage'ent

2C%nt*3 Initia- "i#it 2C%nt*3

Prenata- inter"ie0 2C%nt*3

Hi#t%r( %r ri#9 %$ inti'ate partner "i%-en!e

Re"ie0 %$ #(#te'#

Ph(#i!a- e/a'inati%n

S+pine h(p%ten#i%n5

Lab%rat%r( te#t#

Urine. !er"i!a-. an) b-%%) #a'p-e#

S!reening an) )iagn%#ti! te#t# $%r in$e!ti%+#)i#ea#e# an) 'etab%-i! !%n)iti%n#


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Care Manage'ent 2C%nt*3

F%--%0+p "i#it#

Inter"ie0

Ph(#i!a- e/a'inati%n

Feta- a##e##'ent

Ge#tati%na- age

Feta- heart t%ne#

Hea-th #tat+#

F+n)a- height

Lab%rat%r(%ther te#t#


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Dete!ting Feta- Heartbeat


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N+r#ing Inter"enti%n#6E)+!ati%n $%r Se-$Manage'ent

E/pe!te) 'aterna- an) $eta- !hange#

N+triti%n

Per#%na- h(giene

Pre"enti%n %$ +rinar( tra!t in$e!ti%n#

ege- e/er!i#e#

Preparati%n $%r brea#t$ee)ingPin!h te#t an) brea#t#he-- pg*


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2C%nt*3 P%#t+re an) b%)('e!hani!#

Re#t an) re-a/ati%n

E'p-%('ent

C-%thing

Tra"e-

Me)i!ati%n# an)

herba- preparati%n# I''+ni,ati%n#

Pg*


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2C%nt*3 A-!%h%-. !igarette #'%9ing. !aeine. )r+g#

N%r'a- )i#!%'$%rt#

Re!%gni,ing p%tentia- !%'p-i!ati%n#

Re!%gni,ing preter' -ab%r5

Se/+a- !%+n#e-ing

U#ing the hi#t%r(

C%+ntering 'i#in$%r'ati%n

Sa$et( an) !%'$%rt )+ring #e/+a- a!ti"it(

P#(!h%#%!ia- #+pp%rt


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ariati%n# in Prenata-

Care C+-t+ra- in+en!e#

Man( !+-t+ra- "ariati%n# are $%+n) in prenata- !are

C+-t+ra- barrier# t% prenata- !are6 -a!9 %$ '%ne(.

-a!9 %$ tran#p%rtati%n. -ang+age barrier#. '%)e#t( C+-t+ra- pre#!ripti%n# "#* !+-t+ra- pr%#!ripti%n#

E'%ti%na- re#p%n#e

Ph(#i!a- a!ti"it( an) re#t

C-%thing

Se/+a- a!ti"it(

Diet

Pg*


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Care 2C%nt*35 Age )ieren!e#

A)%-e#!ent#

Le## -i9e-( than %-)er 0%'en t% re!ei"e a)e?+ate

prenata- !are

%'en %-)er than


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Care 2C%nt*3 M+-ti$eta- pregnan!(

P+t# the '%ther an) $et+#e# at in!rea#e) ri#9 $%ra)"er#e %+t!%'e#

M+-ti$eta- pregnan!ie# are '%re -i9e-( t% en) inpre'at+rit(*

Sp%ntane%+# r+pt+re %$ 'e'brane# be$%re ter'i# '%re !%''%n*

C%ngenita- 'a-$%r'ati%n# t0i!e a# !%''%n in'%n%,(g%ti! t0in# a# in #ing-et%n#

Pg*


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Care 2C%nt*3 M+-ti$eta- pregnan!( 2C%nt*3

C%+n#e-ing nee)# t% be pr%"i)e) $%r

Ri#9 %$ preter' -ab%r

M%)i&!ati%n %$ 0eight gain an) n+triti%na- inta9e

Se-e!ti"e repr%)+!ti%n

Li$e#t(-e !hange#

Can p-a!e a #train %n &nan!e#. #pa!e. 0%r9-%a). an) the 0%'an#an) $a'i-(# !%ping !apabi-itie#


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Perinata- E)+!ati%n

G%a- i# t% he-p in)i"i)+a-# an) $a'i-( 'e'ber#t% 'a9e in$%r'e) an) #a$e )e!i#i%n# ab%+tpregnan!(. birth. in$ant !are. an) ear-(

parenth%%) C-a##e# $%r e/pe!tant parent#

E)+!ati%n pr%gra'# !%n#i#t %$ a 'en+ %$ !-a###erie# an) a!ti"itie# $r%' pre!%n!epti%n thr%+ghthe ear-( '%nth# %$ parenting*


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Perinata- Care Ch%i!e#5

Ph(#i!ian#

Mi)0i"e#

Certi&e) n+r#e'i)0i"e# 2CNM#3

Dire!t entr( 'i)0i"e# %r !erti&e) 'i)0i"e# 2CM#3

Tra)iti%na- %r -a( 'i)0i"e#

D%+-a#

irth p-an#


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irth Setting Ch%i!e#

H%#pita-

Lab%r. )e-i"er(. re!%"er( r%%'# 2LDR#3

Lab%r. )e-i"er(. re!%"er(. p%#tpart+' r%%'#2LDRP#3

irth !enter#

H%'e birth

Re'ain# a !%ntr%"er#ia- t%pi! in A'eri!an hea-th

!are


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e( P%int#

The prenata- peri%) i# a preparat%r( %ne b%thph(#i!a--(. in ter'# %$ $eta- gr%0th an) parenta-a)aptati%n#. an) p#(!h%-%gi!a--(. in ter'# %$anti!ipati%n %$ parenth%%)*

Pregnan!( ae!t# parent!hi-). #ib-ing!hi-).an) gran)parent!hi-) re-ati%n#hip#*

Di#!%'$%rt# an) !hange# %$ pregnan!( !an!a+#e an/iet( $%r the 0%'an an) her $a'i-(an) re?+ire #en#iti"e attenti%n an) a p-an $%rtea!hing #e-$'anage'ent 'ea#+re#*


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e( P%int# 2C%nt*3

E)+!ati%n ab%+t #a$et( )+ring a!ti"it( an)e/er!i#e i# e##entia-. gi"en 'aterna-anat%'i! an) ph(#i%-%gi! re#p%n#e# t%

pregnan!(* I'p%rtant !%'p%nent# %$ the initia- prenata-

"i#it in!-+)e )etai-e) an) !are$+--()%!+'ente) &n)ing# $r%' the inter"ie0. a!%'prehen#i"e ph(#i!a- e/a'inati%n. an)

#e-e!te) -ab%rat%r( te#t#* F%--%0+p "i#it# are #h%rter than the initia-

"i#it an) are i'p%rtant $%r '%nit%ring thehea-th %$ the '%ther an) $et+# an) pr%"i)inganti!ipat%r( g+i)an!e a# nee)e)*


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e( P%int# 2C%nt*3

E"en in n%r'a- pregnan!( the n+r#e '+#tre'ain a-ert t% ha,ar)# #+!h a# #+pineh(p%ten#i%n. #ign# an) #('pt%'# %$ p%tentia-!%'p-i!ati%n#. an) #ign# %$ $a'i-('a-a)aptati%n#*

-%%) pre##+re i# e"a-+ate) %n the ba#i# %$ab#%-+te "a-+e# an) -ength %$ ge#tati%n an) i#interprete) in -ight %$ '%)i$(ing $a!t%r#*

Ea!h pregnant 0%'an nee)# t% 9n%0 h%0 t%re!%gni,e an) rep%rt #ign# %$ p%tentia-!%'p-i!ati%n# #+!h a# preter' -ab%r*


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e( P%int# 2C%nt*3

There i# an in!rea#e) in!i)en!e %$ ph(#i!a-.'enta-. an) "erba- ab+#e )+ring pregnan!(*

C+-t+re. age. parit(. an) '+-ti$eta- pregnan!(

!an ha"e a #igni&!ant ee!t %n the !%+r#e an)%+t!%'e %$ the pregnan!(*

N+r#e# '+#t a#9 pregnant 0%'en an) their$a'i-ie# ab%+t pre$eren!e#. pra!ti!e#. an)!+#t%'# re-ate) t% !hi-)bearing t% pr%"i)e

!+-t+ra--( #en#iti"e !are*


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e( P%int# 2C%nt*3

Chi-)birth e)+!ati%n tea!he# t+ning in t% theb%)(# inner 0i#)%' an) !%ping #trategie# thatenhan!e 0%'en# abi-it( t% !%pe ee!ti"e-(0ith -ab%r an) birth*

Perinata- e)+!ati%n #tri"e# t% pr%'%te hea-thierpregnan!ie# an) $a'i-( -i$e#t(-e#*

N+r#e# !an he-p pregnant 0%'en an) their$a'i-ie# t% 'a9e in$%r'e) )e!i#i%n# ab%+t !arepr%"i)er#. birth #etting#. an) -ab%r #+pp%rt*


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34C i ht 2016 b El i I All i ht d

@+e#ti%n

1* hat #h%+-) the RN be a0are )+ring $%--%0+p "i#it# an) theph(#i!a- e/a'inati%n $%r 0%'en re!ei"ing prenata- !areK

a* The inter"ie0 p%rti%n# be!%'e '%re inten#i"ea# the "i#it# be!%'e '%re $re?+ent %"er the

!%+r#e %$ the pregnan!(*b* M%nth-( "i#it# are #!he)+-e) $%r the &r#t

tri'e#ter. e"er( : 0ee9# $%r the #e!%n)tri'e#ter. an) 0ee9-( $%r the thir) tri'e#ter*

!* D+ring the ab)%'ina- e/a'inati%n. the n+r#e#h%+-) be a-ert $%r #+pine h(p%ten#i%n*

)* F%r pregnant 0%'en. a #(#t%-i! b-%%) pre##+re2P3 %$ 1

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Chapter_014 _care of Family During Pregnancy