Chapter 12, Nursing Care During Pregnancy

Guided Lecture Notes

Learning Objective 1. Define the key terms used in this chapter.

 Review the list of key terms at the beginning of the chapter.

 Correlate the key terms to what is discussed in the chapter.

Learning Objective 2. Identify the information typically collected at the initial prenatal visit.

 Explain the importance of preconception care.

 Identify risk factors associated with adverse pregnancy outcomes. (See Box 12-1;

refer to PowerPoint slide 02.)

 Describe the nursing management associated with preconception care. (See Fig. 12-1;

refer to PowerPoint slide 03.)

 Discuss the benefits of the initial prenatal visit. (Refer to PowerPoint slide 04.)

 Explain the various types of information obtained with the comprehensive health

history. (See Fig. 12-2; refer to PowerPoint slide 04.)

 Identify key components to be covered when obtaining the woman’s past history.

 Describe the key areas involved with the woman’s reproductive history, including:

o Menstrual history (Refer to PowerPoint slides 05 and 06)

o Obstetric history

o Gynecologic history

 Review how to determine the estimated date of birth using Nagele’s rule. (Refer to

PowerPoint slide 07.)  Explain the terminology used for an obstetric history, and give examples. (See Box

12-2; refer to PowerPoint slides 08 and 09.)

 Describe the physical examination. (Refer to PowerPoint slides 12 and 13.)

 Identify the typical assessment findings of the pelvic examination. (Refer to

PowerPoint slide 13.)

 Discuss the impact of pelvic shape and size on pregnancy and birth.

 List the typical laboratory tests performed at the initial prenatal visit. (Refer to

PowerPoint slide 14.)

Learning Objective 3. Explain the assessments completed at follow-up prenatal visits.

 Review the usual schedule for follow-up visits, including the assessments completed

with each visit. (Refer to PowerPoint slides 15 and 16.)

 Describe fundal height measurement and its significance.

 Explain the methods for determining fetal movement. (See Box 12-3.)

 Demonstrate fetal heart rate auscultation. (See Nursing Procedure 12-1.)

 Identify key danger signs that pregnant women need to report.

Learning Objective 4. Discuss the tests used to assess maternal and fetal well-being, including nursing management for each.

 Review the common laboratory tests performed during the prenatal period.

 Discuss the following tests used to determine fetal well-being, including when they

are performed, the information obtained, the risks to mother or fetus, and nursing

management. (Refer to PowerPoint slide 19.) o Ultrasound

o Doppler flow studies

o Alpha-fetoprotein analysis

o Marker screening tests

o Nuchal translucency screening

o Amniocentesis

o Chorionic villi sampling

o Percutaneous umbilical blood sampling

o Nonstress test

o Contraction stress test

o Biophysical profile

Learning Objective 5. Outline appropriate nursing management to promote maternal self-care and minimize the common discomforts of pregnancy.

 Identify the common discomforts of pregnancy according to trimester. (Refer to

PowerPoint slides 20, 21, and 22.)

 Explain the physiological basis for each discomfort.

 Describe nursing management, including client teaching, for managing each of the

discomforts. (See Teaching Guidelines 12-1.)

 Emphasize that pregnancy is a time of health, not illness.

 Outline the following common measures for health promotion and maintenance that

should be addressed with pregnant women. (Refer to PowerPoint slides 23 and 24.) o Personal hygiene

o Perineal care

o Dental care

o Breast care

o Exercise (see Teaching Guidelines 12-2)

o Sleep and rest

o Sexual activity

o Employment (see Teaching Guidelines 12-3)

o Travel (see Teaching Guidelines 12-4)

o Immunizations and medications

Learning Objective 6. Discuss the key components of perinatal education.

 Define the term “perinatal education.”

 Describe the usual components of childbirth education classes.

 Compare and contrast the Lamaze, Bradley, and Dick-Read methods of childbirth.

(Refer to PowerPoint slide 27.)

 Identify the options for birth settings and care providers. (Refer to PowerPoint slide

 List the advantages and disadvantages of breastfeeding. (Refer to PowerPoint slide

 Explain the measures needed, including client education, to prepare a woman for

breastfeeding.  Discuss the teaching needed for parents who choose bottle feeding.

 Explain the information to be addressed as final preparation for labor and birth.