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ROUTINE PRENATAL CARE - Rachelle Nurse PhD, MSHA, RN, WHNP-BC EXAM
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ROUTINE PRENATAL CARE - Rachelle Nurse PhD,MSHA, RN, WHNP-BC EXAM
Definition of Terms - ANSWER • Antepartum (Prenatal) -from conception to onset of
labor• Intrapartum - onset of labor until birth of placenta• Postpartum - from birth of
placenta to the return of mother's body to pre-pregnant state (6 weeks)
Prenatal Care Goal - ANSWER • To assess risk factors in hopes of predicting
complications• To assess the well-being of the mother and fetus• To prevent adverse
fetal and maternal outcomes• To assess the growth of the fetus• To educate the patient•
To establish an EDC• Complete 80% of expected prenatal visits
PROVIDER ROLE. - ANSWER • Assessment routine care, risk assessment, change in
perinatal status • Diagnosis deviations from routine • Education common discomforts,
safety, warning signs, prevention of injuries, nutrition, exercise, etc • Screening
domestic violence, depression, substance abuse • Treating common discomforts,
deviations from norm • Referral if appropriate • Advocate
Prenatal Care Barriers - ANSWER • Unrecognized pregnancy• Denied pregnancy•
Finances/insurance• Inaccessibility of health care• Lack of support (#1 reason women
do not seek early PNC)• Language barrier
Definition of Terms 2 - ANSWER • Gestation - number of weeks since LMP• Abortion
(miscarriage) - birth prior to 20weeks gestation &/or < 350 gms.- Elective vs.
Therapeutic- Threatened vs. Imminent- Incomplete vs. Complete- Missed• Term - normal
duration of pregnancy, 37to 42 weeks (average 40 weeks)• Pre-Term (Premature) - after
20 weeks, before 37 weeks• Post-Term - greater than 42 weeks
Initial Visit - ANSWER • Timing of initial visit before 10wks gestation• Establishment of
rapport/trust• Emphasis on education for wellness• Identification and prevention of
complications• Thorough health history, physical examination, and laboratory tests
, Health History Comprehensive- ANSWER • Pregnancy History currently- Suspicion of
pregnancy- Date of last menstrual period• Dating with the gestational wheel or Nagel's
Rule First day of LMP - 3 months +7 days- Signs and symptoms of pregnancy- Urine or
blood test for hCG
Comprehensive Health History 2 - ANSWER • Menstrual History-Age at menarche-Days
in cycle-Flow characteristics-Discomforts-Use of contraception-Date of last menstrual
period (LMP) and previous period
Obstetric History - ANSWER Gravida: a pregnant woman- Gravida I (primigravida): first
pregnancy- Gravida II (secundigravida):second pregnancy, etc.- Nulligravida - never
been pregnant• Para: a woman who has producedone or more viable offspring carryinga
pregnancy 20 weeks or more- Primipara: one birth after apregnancy of at least 20
weeks("primip")- Multipara: two or morepregnancies resulting in viableoffspring
("multip")- Nullipara: no viable offspring;para 0• Terminology- G (gravida): the
currentpregnancy- T (term births): the numberof pregnancies ending >37weeks'
gestation, at term- P (preterm births): thenumber of pretermpregnancies ending
>20weeks or viability but beforecompletion of 37 weeks- A (abortions): the number
ofpregnancies ending before 20weeks or viability- L (living children): number ofchildren
currently living
Comprehensive Health History 3 - ANSWER Past Pregnancies• Neonatal status of
previous pregnancies• Loss of a child• Blood type and Rh Factor• Prenatal Classes,
resources• Father of baby and family involvement
Comprehensive Health History 4 - ANSWER Gynecologic History• Last PAP Smear•
History of Abnormal Paps• Previous Infections• Previous gyn surgery• History of
infertility• Sexual history• Contraceptive history
Comprehensive Health History 5 - ANSWER Sexually Transmitted Infections• HSV
(Herpes virus type 2)• HIV• Syphilis• GBS infection• Gonorrhea• Chlamydia
INFECTIONS TORCH - ANSWER t - toxoplasmosis, treponema pallidum (syphilis)
o - gonorrhea, group beta step GBs
r - rubella
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