Chapter 22 - Nursing care of pregnant client >inelasticity of uterus

with special needs >perineal anal tears

-assess strengths >perineal bleeding
-capacity to adapt to pregnancy *if oxytocin doesn’t work, massage uterus
- pre-natal check up is important (hypogastrium), cold compress for
constriction to lessen blood loss
* assess lochial flow
1. PREGNANT ADOLESCENT – risk for PIH,
anemia and preterm labor, CPD, low birth
weight 3. PREGNANT WOMEN WHO IS
Assess for: PHYSICALLY/COGNITIVELY
CHALLENGED
- health history -childbirth preparation
-rights of physically/ cognitively challenged
-family profile -birth decisions person
-medication history -plans for baby -modifications for pregnancy
-PE(BP,FH, weight, etc) -safety measures to explore
-activity at rest > emergency contacts
-monitor physiologic changes of pregnancy >transportation
>mobility
2. PREGNANT 40< WOMEN – w/ previously -prenatal care modifications
diagnosed condition
>physically challenged
Developmental tasks:
>cognitively challenged
-develop generativity
>hearing impaired
-ambivalent feelings
*What to do:
-issues of caring older patients
-Allow to verbalize feelings
-additional responsibilities and obligations
-bring aids
-“sandwhich generation”
-don’t use hands as demo if blind
Assess for:
-if hearing is impaired stand by
-health history head of table, repeat what you’re
-family profile saying
-physical exam -pregnancy education
-chromosomal assessment -modifications for labor and birth
-genetic screening >palpate abdomen for contractions
>Nuchal transluscency of women w spinal injury

>Maternal serum levels of alpha fetoprotein >CS is advised

> Pregnancy associated plasma protein -modifications for postpartum care

>Chronic Villi sampling -modifications for planning child care

>Amniocentesis
Complications: 4. A WOMAN WHO IS SUBSTANCE
DEPENDENT
-failure to progress
Considered substance dependent if:
-difficulty accepting events
-has withdrawal symptoms, abandon
-postpartum hemorrhage (>500 ml of important activities
blood)

KristelOndong
-usually late adolescent
-delay prenatal period
-ilicit substance has small molecular weight, so they
readily cross placenta
a.) cocaine (Erythroxylum coca)
b.) Amphetamines ( mothamphetamine)
c.) Marijuana/Hashish (Hemp Plant/cannabis)
d.)Phencyclidine
e.) Narcotic Agonist ( Morphine, meperidine,
codeine, opiates)
f.) inhalants *contains Freon which leads to severe
g.) alcohol resp depression and cardiac
irregularities

KristelOndong