Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children,

Maternal-Child Nursing CareOptimizing Outcomes for Mothers, Children, & FamiliesMaternal-Child Nursing CareOptimizing Outcomes for Mothers, Children, & Families

Susan WardShelton HisleySusan WardShelton Hisley



Chapter 10

Promoting a Healthy Pregnancy

Edited by Catherine Marin, MSN/Ed(c), WHCNP, RN



Planning for Pregnancy

Preconception Periconception Interconception Preconception counseling

Identify conditions that could adversely affect pregnancy



The Healthy Body Menstrual and medical history

Exposure to childhood illnesses Exposure to STIs (for example, chlymydia,gonorrhea,

herpes) Exposures related to lifestyle choices (for e.g.,

monagamous relationship or multiple partners) Physical examination

Laboratory evaluation (for e.g., CBC, UA, Blood Type, Rubella, VDRL/RPR, Hepatitis, HIV

Genetic testing



The Healthy Mind

Readiness for motherhood Psychological changes during pregnancy

(Ambivalence, Acceptance, Preparation for motherhood)

The healthy relationship Readiness for fatherhood Support for life changes



Nutrition and Weight Gain

Nutritional elements Calories Protein Water Minerals and vitamins

Iron Folic acid



Weight Gain Affected by:

Physiological factors Social influences Inadequate diet Inadequate physical activity

Management Daily food and fluid intake



Factors That Affect Nutrition

Eating disorders PICA- associated with anemia Anorexia nervosa, bulimia nervosa

Cultural factors Vegetarian diets Food cravings and food aversions



Exercise, Work, and Rest

Exercise Muscle strengthening No rigorous aerobic activity

Work Impact on pregnancy Maternity leave

Rest



Medications Safe versus teratogenic Always consult physician regarding ANY medication Over-the-counter Herbal and homeopathic preparations Prescription

FDA pregnancy categories



Common Discomforts

Nausea and vomiting Ptyalism Fatigue Nasal congestion Backache Leukorrhea



Common Discomforts (cont.)

Urinary frequency Dyspepsia Flatulence Constipation/hemorrhoids Dental problems Leg cramps




Dependent edema Varicosities Dyspareunia Nocturia Insomnia Round ligament pain




Hyperventilation, shortness of breath Numbness/tingling in fingers Supine Hypotensive Syndrome



Signs and Symptoms of Danger



First Trimester

Severe, persistent vomiting Abdominal pain and vaginal bleeding Indicators of infection



Second Trimester Maternal complications

Preeclampsia Premature rupture of the membranes Preterm labor

Fetal complications Decreased fundal height Absence of fetal movement after quickening



Third Trimester

Maternal complications Gestational diabetes Placenta previa Abruptio placentae

Fetal complications Hypoxia



Pregnancy Map

Prenatal care map Timetable



Childbirth Education Primary goal

To promote a positive childbearing experience Topics

Anatomy and physiology Comfort measures Labor and birth process Relaxation and pain management



Childbirth Education—Methods

Lamaze Empowerment Dispelling myths Controlled breathing, position, massage, relaxation

Bradley Inward relaxation Normal breathing



Other Methods

Dick-Read HypnoBirthing LeBoyer method Odent method Birthing from within



Finding Information on Childbirth Education Primary source—health care provider Online and at-home programs Parents need to ask questions about the

class to determine if it fits their needs Factors related to personal values and

beliefs



The Birth Plan

Written information that identifies labor and birth preferences

The choices Choosing a provider Choosing a location

Documents

Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children,