PRELIM 01 III.

Maternal Medical History

✓ Peptic ulcer disease
TOPIC 1 - Nursing Care of the Pregnant Client ✓ Maternal hypertension
a) Health Assessment as part of the Nursing ✓ Diabetes mellitus
Process ✓ Severe anemia
b) The nursing role and nursing care during ✓ Thyroid disease
pregnancy complications
TOPIC 3 – Care of couple with infertility IV. MATERNAL LIFESTYLE AND HABITS
a) Causes of infertility in males and females ✓ Inadequate nutrition leading to Iron, folic acid,
b) Diagnostics Test and protein deficiency.
c) Nursing Interventions ✓ Cigarette smoking and alcohol
✓ Exposure to toxic substances such as lead,
TOPIC 1 Nursing Care of Pregnant Client organic solvent, certain gases, and radiation
Nurses play a vital role in supporting pregnant clients by ✓ Ingestion of OTC (over the counter) and
ensuring their physical and emotional well-being prescription drugs
throughout the pregnancy journey.
V. MATERNAL OBSTETRIC AND GYNECOLOGICAL
Assessment of RISK FACTORS HISTORY
Involves evaluating various factors that could potentially Obstetric history - asking relevant question to patient’s
affect the health of the mother and the baby, this current and previous pregnancy.
includes assessing preexisting health conditions, ✓ 2 or more premature deliveries or spontaneous
previous pregnancy complications, maternal age, lifestyle abortion, multiple pregnancy, H-mole
factors, genetic history, and current health status to ✓ Lack of previous prenatal or preparation for labor
identify potential risks and take necessary precautions or or birth.
interventions to ensure a safe pregnancy and delivery. ✓ History of stillbirth or fetal demise
High Risk pregnancy jeopardize the mother, fetus, or ✓ Ectopic pregnancies
both.
A condition due to pregnancy or result of condition Gynecologic history - an assessment the of the female
present before pregnancy. reproductive system
In doing our assessment we will do our clinical judgement ✓ Last menstrual period LMP
after we have done our assessment using IPPA ✓ Pelvic inadequacy or abnormal shaping
Inspection, palpation percussion, and auscultation. ✓ Cycle length and frequency
✓ Vaginal discharges, pain, or discomfort
RISK FACTORS: ✓ Infertility problem
✓ Uterine or fibroids or myoma
I. AGE
✓ Adolescents younger than age 15 years old
✓ Primipara at 35 and older
✓ Multiparas at 40 and older

II. MATERNAL PARITY

Refers to the number of times a woman has given birth
to a live neonate at any gestation.
✓ 5 or more pregnancies of at least 20 weeks
duration
✓ gap of 8yrs or more since the last pregnancy
TYPES OF PELVIS and what they mean for giving birth. when women’s uterus develops differently, or uterine
Pelvis is a group of bone located in lower part of torso, incompetency, position, or structure.
between your lower back and your thighs.
Types of congenital uterine anomalies:
1. Gynecoid
Is the most common types of pelvis in females The most 1.Didelphys
favorable pelvis type for a vaginal birth. because of wide a rare condition where a woman develops two uterus.
and open shape that give the baby a plenty space during a congenital abnormality that you are born with it, can be
delivery. pregnant but needs to monitor pregnancy closely.

2. Platypelloid 2.Arcuate
known as flattened pelvis, the least common type of a minor irregularity in the shape of uterus, a mild
pelvis, its wide but shallow and it resembles an egg or indentation of the endometrium
oval lying on its side. The shape of platypelloid pelvis can
make a vaginal birth difficult because the baby may have 3. Unicornuate
trouble passing through pelvic inlet. Women with the a rare condition that causes a woman to have only half of
platypelloid pelvis need to have a caesarian section. the uterus has developed.

3. Android 4. Bicornuate
This type of pelvis bears more resemblance to the male A uterus that is shape irregularly, it describes as heart
pelvis, its narrower than gynecoid pelvis and is shape shaped appearing to have two sides, it can be treated
more like a heart or wedge. The narrower shape of with surgery.
android can make a labor difficult because the baby
might more slowly through the birth canal, some 5. Septate
pregnant women with this shape may require C-section. A normal shaped uterus with a wall of tissue creating two
cavities, may discover even during pregnancy.

4. Anthropoid
A narrow and deep pelvis, its shape is similar to an
upright egg or oval. The elongated shape of anthropoid
pelvis makes it roomier from front to back. Its narrow
than gynecoid pelvis. Pregnant women with this type of
pelvis able to have a vaginal birth but labor might last
longer.

Uterine Position:
1. Anteverted/normal position – uterus tilted forward
2. Retroverted – tilted backward towards the spine

Bending Uterus:
3. Retroflexion – bending backward
4. Anteflexion – bending forward

Gynecologic: Uterine Anomalies VI. FAMILY CULTURE AND ETHNICITY

 ✓ Sickle cell anemia
an abnormal form of hemoglobin that red blood
cells become rigid are shaped like sickle or
crescent moons.

✓ Thalassemia
is inherited from parents through genes, blood
disorder caused when the body doesn’t make
enough or inadequate amount of hemoglobin or
defects of synthesis of hemoglobin.

VI. FAMILY CULTURE AND ETHNICITY

✓ Religious Practice
refers to traditional beliefs and practices of
pregnant women.

VII. FAMILY HISTORY

A conditions or disorders which are considered familial.

✓ Father’s family medical history

✓ Family environment
TOPIC 2- Nursing care of the client during labor and Treatment/Management
delivery ✓ Medication
a) Nursing care of the family experiencing a Beta blockers (carvedilol, metoprolol, bisoprolol)
sudden pregnancy complication ACE inhibitors (lisinopril, captopril)
b) Nursing care of the family experiencing a Angiotensin receptor blockers (losartan)
complication of labor or birth Digoxin (Lanoxin)
c) Nursing care of the family experiencing Aldosterone Antagonist
postpartum complications
✓ Lifestyle change
The Nursing Role and Nursing Care During Pregnancy Surgery – Left Ventricular Assist Device (LVAD)
Complications
During pregnancy complications, nurses play a crucial Nursing Interventions
role in providing comprehensive care to both the ✓ Assessment and Monitoring
mother and the unborn child. ✓ Medication Management
✓ Fluid Management
Gestational Problems: ✓ Positioning
✓ Diet Counselling
I.CARDIOVASCULAR DISORDER AND PREGNANCY ✓ Rest and Activity Balance
HEART Function, pumps blood throughout the body ✓ Education and Support
✓ delivers oxygen and nutrient-rich blood to ✓ Collaboration and Coordination (Cardiologist and
tissues and organs. OB)
✓ removes the carbon dioxide and waste products
of metabolism. Diagnostics Test
✓ Electrocardiogram
The danger of pregnancy in a woman with cardiac ✓ Chest X-ray
disease occurs primarily due to the increase in ✓ Coronary Angiography
circulatory volume. ✓ Echocardiogram
✓ Blood Test (electrolytes)
The most dangerous time for a woman is 28 to 32 weeks
after the blood volume peaks.
2. Pulmonary Edema
1. Woman with Left Sided Heart Failure ✓ interferes with oxygen-carbon dioxide exchange
✓ occurs in condition such as a mitral stenosis, because fluid coats the alveolar exchange space.
mitral insufficiency and aortic coarctation. ✓ If pulmonary capillaries rupture under pressure,
✓ The left ventricle cannot move the volume of small amounts of blood leak into the alveoli
blood forward that is received by the left atrium
from pulmonary circulation Occurs. Risk of Pregnant Women
✓ Spontaneous Miscarriage due to limited
Signs and Symptoms oxygenation - Preterm Labor
✓ Fatigue ✓ Maternal Death
✓ Palpitation As oxygen saturation of the blood decreases from
✓ Paroxysmal nocturnal dyspnea dysfunction of the alveoli chemoreceptors stimulate
✓ Pulmonary edema respiratory center to increase respiratory rate.
✓ Cough or hemoptysis
Signs and Symptoms Signs and Symptoms
✓ Shortness of Breath ✓ Liver and Spleen enlargement
✓ Coughing leading to dyspnea and pain in pregnant women
✓ Wheezing because the enlarged liver, as it pressed upward
✓ Difficulty of Breathing when lying down by the enlarged uterus, puts extreme pressure on
✓ Rapid or Irregular Heartbeat diaphragm.
✓ Pink or frothy sputum ✓ Ascites
✓ Bluish lips or nails due to lack of oxygen distention of abdominal vessels can lead to
exudates of fluid from the vessels into the
Treatment/Management peritoneal cavity.
✓ Medications ✓ Peripheral Edema
Diuretics to reduce fluid retention. fluid moves from the systemic circulation into
✓ Oxygen Therapy lower extremity interstitial spaces.
✓ Positioning ✓ Eisenmenger Syndrome
✓ Monitoring of patient the congenital anomaly most apt to cause the
✓ treating underlying cause right sides heart failure in women reproductive
age.
Nursing Interventions ✓ Swelling of legs and ankles
✓ Assessment and monitoring ✓ Nocturnal shortness of breath
✓ Oxygen Therapy ✓ shortness of breath during exercise or lying flat
✓ Positioning ✓ coughing Treatment/Manage
✓ Assistance with medication
✓ Emotional Support Treatment/Management
✓ Education ✓ Medications
diuretics and aldosterone antagonist
Diagnostic Test ✓ Oxygen administration
✓ Electrocardiogram ✓ Frequent arterial blood assessment to ensure
✓ Chest X-ray fetal growth.
✓ Coronary Angiography ✓ During Labor
✓ Echocardiogram ✓ Pulmonary artery catheter to monitor.
✓ Blood Test measure oxygen level, electrolyte
imbalance and assess for potential causes of Surgical Management
heart failure. ✓ Ventricular Assist Device implant (VAD)
✓ CT (Computed Tomography) scan or Magnetic the device can be implanted to help a weak heart
Resonance Imaging (MRI) provide detailed pump more effectively.
images to assess the lungs and heart condition.
Nursing Interventions
3. Woman with Right Sided Heart Failure ✓ Assessment and monitoring
✓ occurs when output of the ventricle is less than Management of fluid retention and improving
the blood volume received by the right atrium cardiac function
from the vena cava. ✓ Monitoring of Fluid intake
✓ Medications- prescribe diuretics.
Causes: Congenital heart defects, pulmonary valve ✓ Diet – low sodium
stenosis and atrial and ventricular septal defects can ✓ Ensuring proper rest
result in right sided heart failure ✓ Collaboration and Coordination (Cardio and OB)
Diagnostic Test
✓ Electrocardiogram
✓ Chest X-ray
✓ Coronary Angiography