UNFAMILIAR WORDS AND BACKUP ANSWERS:

1. WHY IS PRENATAL CARE NEEDED? WHAT ARE THE REASONS WHY YOU
NEED MONTHLY CHECK-UPS?

The fetus is most vulnerable during the first 12 weeks. During this period of
time, all of the major organs and body systems are forming and can be
damaged if the fetus is exposed to drugs, infectious agents, radiation,
certain medications, tobacco, and toxic substances.

2. WHY IS FAMILY IMPORTANT DURING THESE TIMES?

Women who receive strong social support from their families during
pregnancy appear to be protected from sharp increases in a particular
stress hormone, making them less likely to experience depression after
giving birth, a new study by UCLA life scientists indicates.

During pregnancy, there is evidence that family support has beneficial

effects on pregnancy and birth outcomes, like postpartum depression,
adequate infant birth size, breastfeeding, and infant adiposity. When
pregnancy occurs during adolescence, family support becomes more
important, because adolescents have a higher risk of inadequate
gestational weight gain and low birth weight, in addition to their own needs
as adolescents.

It is known that family support has a positive impact on pregnancy in

adolescence, especially when this support is provided by a female relative,
such as the mom or older sister, but there are other family members that
offer support to the adolescent.

3. IF THE PATIENT DOES NOT WANT THE CHILD, BUT THE PARENTS WANT
HER TO CONTINUE THE PREGNANCY, WHO WILL BE THE ONE TO
DECIDE?

If the patient is a minor, the parents will be responsible for the choice,
unless there is a risk to the patient or the unborn child; in that case, they
will need to discuss the situation and then decide whether or not to
terminate the pregnancy.
 4. What happens at your first prenatal visit?

During the first prenatal visit, you can expect your doctor to:

 Ask about your health history including diseases, operations, or prior

pregnancies
 Ask about your family's health history
 Do a complete physical exam, including a pelvic exam and Pap test
 Take your blood and urine for lab work
 Check your blood pressure, height, and weight
 Calculate your due date
 Answer your questions

At the first visit, you should ask questions and discuss any issues related to your
pregnancy. Find out all you can about how to stay healthy.

Later prenatal visits will probably be shorter. Your doctor will check on your health and
make sure the baby is growing as expected. Most prenatal visits will include:

 Checking your blood pressure

 Measuring your weight gain
 Measuring your abdomen to check your baby's growth (once you begin to show)
 Checking the baby's heart rate

While you're pregnant, you also will have some routine tests. Some tests are suggested
for all women, such as blood work to check for anemia, blood type, HIV, and other
factors. Other tests might be offered based on your age, personal or family health
history, your ethnic background, or the results of routine tests you have had. Visit the
pregnancy section of our website for more details on prenatal care and tests.

What causes elevated blood pressure?

What causes high blood pressure during pregnancy?

 being overweight or obese.
 not getting enough physical activity.
 smoking.
 drinking alcohol.
 first-time pregnancy.
 a family history of pregnancy-related hypertension.
 carrying more than one child.
 age (over 35)
 If blood pressure goes up during pregnancy, it can place extra stress on your
heart and kidneys. This can lead to heart disease, kidney disease, and stroke.
High blood pressure during pregnancy also increases the risk of preeclampsia,
preterm birth, placental abruption, and cesarean birth.

What should I do if my blood pressure is elevated?

As blood pressure increases, so does the risk of heart disease. That's why it's so
important to control elevated blood pressure.
...
Try these tips:
1. Eat healthy foods. Eat a healthy diet. ...
2. Use less salt (sodium). ...
3. Manage weight. ...
4. Increase physical activity. ...
5. Limit alcohol. ...
6. Don't smoke. ...
7. Manage stress.

The fetus appears small on the sonogram ( explain)

Some babies are small because their parents are small. But most babies who are small
for gestational age have growth problems that happen during pregnancy. Many of these
babies have a condition called intrauterine growth restriction (IUGR). This happens
when the unborn baby doesn’t get the nutrients and oxygen needed to grow and
develop organs and tissues. This can begin at any time in pregnancy.

Growth restriction early in pregnancy (early onset) happens because of chromosome

problems in the baby. It also happens because of disease in the mother, or severe
problems with the placenta. Growth restriction is called late onset if it happens after
week 32 of the pregnancy. It is often linked to other problems.

Why did you come up with ncp?

A nursing care plan (NCP) is a formal process that correctly identifies existing
needs and recognizes potential needs or risks. Care plans provide
communication among nurses, their patients, and other healthcare providers to
achieve health care outcomes. Without the nursing care planning process, the
quality and consistency of patient care would be lost.
 What are care plans important?

Care plans are essential for the patient's recovery. They assist them in
developing and enacting a sound action plan by clearly defining the rules and the
nurse's role in patient care. This enables nurses to deliver targets without
skipping crucial stages.

What is the purpose of nursing care plan?

A nursing care plan's objective is to record the patient's needs, preferences, and
planned nursing interventions (or implementations) for addressing those needs. The
care plan is used to ensure continuity of care and is a part of the patient's health record.

Sonogram (SAH-noh-gram) - Diagnostic ultrasound, also called sonography or

diagnostic medical sonography, is an imaging method that uses sound waves to
produce images of structures within your body. The images can provide valuable
information for diagnosing and directing treatment for a variety of diseases and
conditions.

Prenatal Care - is the health care you get while you are pregnant. Take care of yourself
and your baby by:

 Getting early prenatal care. If you know you're pregnant, or think you might be,
call your doctor to schedule a visit.
 Getting regular prenatal care. Your doctor will schedule you for many checkups
over the course of your pregnancy. Don't miss any — they are all important.
 Following your doctor's advice.

Why do I need prenatal care?

Prenatal care can help keep you and your baby healthy. Babies of mothers who do not
get prenatal care are three times more likely to have a low birth weight and five times
more likely to die than those born to mothers who do get care.
Doctors can spot health problems early when they see mothers regularly. This allows
doctors to treat them early. Early treatment can cure many problems and prevent
others. Doctors also can talk to pregnant women about things they can do to give their
unborn babies a healthy start to life.

 Get early and regular prenatal care. Whether this is your first pregnancy or third,
health care is extremely important. Your doctor will check to make sure you and
the baby are healthy at each visit. If there are any problems, early action will help
you and the baby.
Maternal Mortality – deaths due to complications from pregnancy or childbirth.
Perinatal Mortality – the sum of the number of perinatal deaths (stillbirths and early
neonatal deaths) divided by the number of pregnancies of seven or more months'
duration (all live births plus stillbirths).
Cultural Literacy – being able to understand the traditions, regular activities, and history
of a group of people from a given culture.
Puerperium – the time from the delivery of the placenta through the first few
weeks after the delivery. This period is usually considered to be 6 weeks in duration.

What are the types of puerperium?

Puerperium can be divided into immediate – within 24 hours. Early – up to 7
days. Remote – up to 6 weeks.

Placenta – The oval or discoid spongy structure in the uterus from which the fetus
derives its nourishment and oxygen. It consists of a fetal portion, the chorion frondosum,
bearing many chorionic villi that interlock with the decidua basalis of the uterus, which
constitutes the maternal portion.

Termination of Pregnancy – Abortion is the removal of pregnancy tissue, products of

conception or the fetus and placenta (afterbirth) from the uterus. In general, the terms
fetus and placenta are used after eight weeks of pregnancy.

Systemic vascular resistance (SVR) – also known as total peripheral resistance

(TPR), is the amount of force exerted on circulating blood by the vasculature of the
body.

Decreased cardiac output – occurs when the cardiac output reaches a level of fewer
than 4 liters per minute. The patient demonstrates adequate cardiac output; the
patient will also be able to tolerate activity without symptoms of dyspnea, syncope, or
chest pain.
 Generalized body swelling
Also known as: anasarca, edema
A general accumulation of serous fluid in various tissues and body cavities is
characterized by swelling of the whole body.

Common Causes – Generalized body swelling is not always related to an underlying

condition. It may be caused by:

 Excess intravenous fluids administration

 Use of some anticancer drugs eg. docetaxel
 Excessive consumption of salt
 Side effects of certain medications
 Pregnancy

PHYSICAL EXAMINATION FOR PATIENT WHO HAS EDEMA

To check for swelling, a doctor or nurse can press on the skin and then remove their
finger. If the indent stays there, the person has swelling. Doctors call this "pitting
edema."

Physical Examination - In physical examination, pitting, tenderness, skin changes, and

temperature are evaluated. Pitting: There are two types of edema, pitting and non-
pitting edema. Pitting edema is described as an indentation that remains in the
edematous area after pressure is applied.

Intrauterine growth restriction, or IUGR, is when a baby in the womb (a fetus) does
not grow as expected. The baby is not as big as would be expected for the stage of
the mother's pregnancy. This timing is known as an unborn baby's "gestational age."

Can babies with IUGR be normal?

In accurately dated pregnancies, approximately 80-85% of fetuses identified as
being IUGR are constitutionally small but healthy, 10-15% are 'true' IUGR cases,
and the remaining 5-10% of fetuses are affected by chromosomal/structural anomalies
or chronic intrauterine infections.

What is the leading cause of IUGR during pregnancy?

Placental insufficiency is the leading cause of IUGR: Placental Insufficiency: placental
insufficiency (also called placental dysfunction) is a serious pregnancy complication
where the placenta develops abnormally or becomes damaged.
Is IUGR considered high risk?
Babies with IUGR are at greater-than-normal risk for a variety of health problems
before, during, and after their birth. These problems include low oxygen levels while
in the womb, a high level of distress during labor and delivery, and an increased risk of
infectious disease after birth.

What is optimal mobility?

Optimal mobility, defined simply as being able to safely and reliably go where you
want to go, when you want to go, and how you want to get there, is a key
component of healthy aging.

Furosemide belongs to a group of medicines called loop diuretics (also known as water
pills). Furosemide is given to help treat fluid retention (edema) and swelling that is
caused by congestive heart failure, liver disease, kidney disease, or other medical
conditions.

NCP

● Edema is swelling caused by excess fluid trapped in your body's tissues. Although
edema can affect any part of your body, you may notice it more in your hands, arms,
feet, ankles, and legs.

● If a person is hemodynamically stable, it means that he/she has a stable pumping

heart and good circulation of blood

● Elevated blood pressure is a measurement of 120 to 129 mm Hg and a bottom

number below (not above) 80 mm Hg. A diagnosis of elevated blood pressure is based
on the average of two or more blood pressure readings. The measurements should be
taken on separate occasions in the same way.
Pregnancy-induced hypertension (preeclampsia) OB/CH
Also, refer to Eclampsia
(Preeclampsia or eclampsia, amniotic fluid embolism)

Deficient Fluid Volume may be related to a plasma protein decreasing plasma colloid
osmotic pressure allowing fluid shifts out of the vascular compartment, possibly
evidenced by edema formation, sudden weight gain, hemoconcentration, nausea,
vomiting, epigastric pain, headaches, visual changes, decreased urine output.

Decreased Cardiac Output may be related to hypovolemia/decreased venous return,

increased SVR, possibly evidenced by variations in BP and hemodynamic readings,
edema, shortness of breath, and change in mental status.

Risk for disturbed Maternal-Fetal Dyad possibly evidenced by risk factors of

vasospasm of spiral arteries and relative hypovolemia.

Deficient Knowledge regarding the pathophysiology of the condition, therapy,

self-care, and nutritional needs, and potential complications may be related to lack
of information or recall, misinterpretation, possibly evidenced by statements of concern,
questions, misconceptions, inaccurate follow-through of instructions, or development of
preventable complications.