<p>Guided Lecture Notes</p><p>Chapter 12, Nursing Care During Pregnancy</p><p>Learning Objective 1. Define the key terms used in this chapter.</p><p> Review the list of key terms at the beginning of the chapter.</p><p> Correlate the key terms to what is discussed in the chapter.</p><p>Learning Objective 2. Identify the information typically collected at the initial prenatal visit.</p><p> Explain the importance of preconception care.</p><p> Identify risk factors associated with adverse pregnancy outcomes. (See Box 12-1; </p><p> refer to PowerPoint slide 02.) </p><p> Describe the nursing management associated with preconception care. (See Fig. 12-1;</p><p> refer to PowerPoint slide 03.) </p><p> Discuss the benefits of the initial prenatal visit. (Refer to PowerPoint slide 04.) </p><p> Explain the various types of information obtained with the comprehensive health </p><p> history. (See Fig. 12-2; refer to PowerPoint slide 04.) </p><p> Identify key components to be covered when obtaining the woman’s past history.</p><p> Describe the key areas involved with the woman’s reproductive history, including: </p><p> o Menstrual history (Refer to PowerPoint slides 05 and 06) </p><p> o Obstetric history</p><p> o Gynecologic history</p><p> Review how to determine the estimated date of birth using Nagele’s rule. (Refer to </p><p>PowerPoint slide 07.)  Explain the terminology used for an obstetric history, and give examples. (See Box </p><p>12-2; refer to PowerPoint slides 08 and 09.)</p><p> Describe the physical examination. (Refer to PowerPoint slides 12 and 13.)</p><p> Identify the typical assessment findings of the pelvic examination. (Refer to </p><p>PowerPoint slide 13.)</p><p> Discuss the impact of pelvic shape and size on pregnancy and birth.</p><p> List the typical laboratory tests performed at the initial prenatal visit. (Refer to </p><p>PowerPoint slide 14.)</p><p>Learning Objective 3. Explain the assessments completed at follow-up prenatal visits.</p><p> Review the usual schedule for follow-up visits, including the assessments completed </p><p> with each visit. (Refer to PowerPoint slides 15 and 16.)</p><p> Describe fundal height measurement and its significance.</p><p> Explain the methods for determining fetal movement. (See Box 12-3.)</p><p> Demonstrate fetal heart rate auscultation. (See Nursing Procedure 12-1.) </p><p> Identify key danger signs that pregnant women need to report.</p><p>Learning Objective 4. Discuss the tests used to assess maternal and fetal well-being, including nursing management for each.</p><p> Review the common laboratory tests performed during the prenatal period.</p><p> Discuss the following tests used to determine fetal well-being, including when they </p><p> are performed, the information obtained, the risks to mother or fetus, and nursing </p><p> management. (Refer to PowerPoint slide 19.) o Ultrasound</p><p> o Doppler flow studies</p><p> o Alpha-fetoprotein analysis</p><p> o Marker screening tests</p><p> o Nuchal translucency screening</p><p> o Amniocentesis</p><p> o Chorionic villi sampling</p><p> o Percutaneous umbilical blood sampling</p><p> o Nonstress test</p><p> o Contraction stress test</p><p> o Biophysical profile </p><p>Learning Objective 5. Outline appropriate nursing management to promote maternal self-care and minimize the common discomforts of pregnancy.</p><p> Identify the common discomforts of pregnancy according to trimester. (Refer to </p><p>PowerPoint slides 20, 21, and 22.)</p><p> Explain the physiological basis for each discomfort.</p><p> Describe nursing management, including client teaching, for managing each of the </p><p> discomforts. (See Teaching Guidelines 12-1.) </p><p> Emphasize that pregnancy is a time of health, not illness.</p><p> Outline the following common measures for health promotion and maintenance that </p><p> should be addressed with pregnant women. (Refer to PowerPoint slides 23 and 24.) o Personal hygiene</p><p> o Perineal care</p><p> o Dental care</p><p> o Breast care</p><p> o Exercise (see Teaching Guidelines 12-2) </p><p> o Sleep and rest</p><p> o Sexual activity</p><p> o Employment (see Teaching Guidelines 12-3)</p><p> o Travel (see Teaching Guidelines 12-4) </p><p> o Immunizations and medications</p><p>Learning Objective 6. Discuss the key components of perinatal education.</p><p> Define the term “perinatal education.”</p><p> Describe the usual components of childbirth education classes.</p><p> Compare and contrast the Lamaze, Bradley, and Dick-Read methods of childbirth. </p><p>(Refer to PowerPoint slide 27.)</p><p> Identify the options for birth settings and care providers. (Refer to PowerPoint slide </p><p>28.)</p><p> List the advantages and disadvantages of breastfeeding. (Refer to PowerPoint slide </p><p>29.)</p><p> Explain the measures needed, including client education, to prepare a woman for </p><p> breastfeeding.  Discuss the teaching needed for parents who choose bottle feeding.</p><p> Explain the information to be addressed as final preparation for labor and birth. </p>