chapter 5: physical/psychological changes of pregnancy ppt

Question 1

patient centered teaching

Answer 1

• assess educational needs
• plan personalized approach to teaching

Question 2

presumptive signs of pregnancy

Answer 2

• subjective signs
• least reliable
• due to rapid rise of hormone levels at implantation of trophoblast
• amenorrhea
• nausea and vomiting
• fatigue
• urinary frequency
• breast enlargement and tenderness
• quickening: fetal movement typically felt by the mother by 20 weeks

Question 3

probable signs of pregnancy (objective signs)

Answer 3

• Goodll’s sign: softening of the cervix
• chadwick’s sign: a bluish purple coloration of the vaginal mucosa and cervix
• Hegar’s sign: softening of the lower uterine segmen
• Ballottement: fetus floats away from the cervix when the cervix is pushed
• positive pregnancy test: hcG is typically detectable by day 11 of gestation

Question 4

positive signs of pregnancy

Answer 4

• attributed to the presence of the fetus
• experienced healthcare provider confirms the presence of a fetus

Question 5

signs of fetus

Answer 5

• fetal heart auscultation by Doppler
• fetal movement felt by an experienced practitioner
• ultrasound: used to verify an embryo or fetus
• after pregnancy is confirmed, the hcp arranges visits for prenatal care and to prepare the mother for birth

Question 6

normal physiological changes in pregnancy

Answer 6

• changes occur because of effects of progesterone, estrogen, and the growing fetus

Question 7

patient teaching of normal physiological changes in pregnancy

Answer 7

• kegel exercises: help strengthen perineal muscles
• preventing vena cava syndrome: supine hypotension

Question 8

cardiovascular system changes

Answer 8

hemodilution occurs causing anemia reduction in RBCs

varicose veins - swollen veins raised above surface of skin

Question 9

patient teaching for GI system changes

Answer 9

• high fiber foods to reduce/avoid constipation and hemorrhoids
• method to take iron supplements
• hemorrhoids are common: swollen, bulging veins in the rectum

Question 10

integumentary system changes

Answer 10

• melasma: mask of pregnancy, brownish patches on forehead, cheeks, and nose
• linea nigra: hyperpigmented line extending from symphysis pubis to fundus
• health promotion: skin care during pregnancy
• striae gravidarum: aka stretch marks
• pruritic urticarial papules and plaques of pregnancy (PUPPP): pregnancy specific dermatosis, itchy plaques and papules with erythematous patches of papules and vesicles, appears on abdomen and occasionally involves extremities

Question 11

pregnancy and childbirth are considered a life…

Answer 11

transition or a maturational crisis

Question 12

factors that influence how pregnancy is received

Answer 12

• access to health care
• financial issues
• family support
• availability of day care
• transportation
• previous experiences with childbirth and childrearing

Question 13

the maternal role: per Reva Rubin, 4 maternal tasks to be accomplished during pregnancy lead to maternal identity…

Answer 13

1. seeking safe passage for herself and her fetus
2. securing acceptance of herself as a mother and for her fetus
3. learning to give of self and to accept herself as mother to the infant
4. committing herself to the child as she progresses through pregnancy

Question 14

seeking safe passage for herself and the fetus

Answer 14

• concern for own health and pregnancy symptoms
• rapidly changing emotions
• observes mothers and other pregnant women for info
• obtains info on the internet or by reading books
• may be ambivalent about the pregnancy
• seeks competent prenatal care
• engages in healthy self care
• reality of pregnancy causes introspection

Question 15

seeking acceptance of the child by others

Answer 15

• support and acceptance of the pregnancy by partner and family are important
• adjustments of psychological, social, and physical space within the family to make a place for the coming child
• pregnant woman’s relationship with her own mother is significant
• mother’s reaction indicates acceptance of the grandchild
• pregnant woman’s mother reminiscing helps the patient anticipate and prepare for pregnancy, labor, and mother hood

Question 16

bonding with the infant

Answer 16

• develop bonds of attachment and feelings of love for the infant
• feels fetal movement
• feels an intimate connection with the unborn fetus
• emotional “binding in” motivates the pt to be a good mother
• pts own mother is the strongest model
• mothering style either patterned after own mother or adjusted

Question 17

committing to the child through pregnancy

Answer 17

• develop the ability for self denial
• learn to meet the needs of another being before self

Question 18

prepare for the baby

Answer 18

• prepare a nursery
• accumulate clothing and baby care items
• read books on newborn care, parenting
• attend childbirth classes

Question 19

unsuccessful resolution of psychological changes are associated with…

Answer 19

difficulties in pregnancy, delivery, child abuse, and neglect

Question 20

pregnancy adolescents

Answer 20

• many psychosocial issues to manage
• completing developmental tasks of adolescence and those of becoming a mother
• priorities typical for this age: appearance, peer group, focus on own needs
• may keep the pregnancy a secret
• denial until late in gestation is common
• experience anxiety informing her parents, baby’s father, friends
• behaviors: ambivalence, resistance, inconsistency

Question 21

the father

Answer 21

• most important person to the pregnant pt is usually spouse or partner
• the mother needs partner to accept the child
• some spouses or partners experience physical changes: couvade syndrome
• undergo psychological changes: ambivalence, strong protective feelings, concerned about ability to be a good father, examine own father child relationship

Question 22

fathers and unplanned/unwanted pregnancies

Answer 22

• may not accept changes in lifestyles or life plans
• may feel left out
• unsure of relationship after baby born
• may engage in affairs
• express disappointment and frustration w/ violence
• ACOG suggests screening for violence at each prenatal visit
• concerned about ability to provide emotional support during childbirth: cope by doing concrete tasks

Question 23

siblings

Answer 23

• new baby is a major crisis
• response influenced by: child’s age, parents’ attitudes, how prepared for the upcoming birth
• toddlers: becoming clingy and irritable; baby is only a story
• preschool child: sense of loss; being replaced; jealous
• older children: interested and ask questions about conception, pregnancy and childbirth; think of ways to be helpful
• older children and teenagers: embarrassed by parents’ sexuality