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Antenatal care

الكلية كلية التمريض     القسم قسم التمريض العام     المرحلة 7
أستاذ المادة سلمى كاظم جهاد الابراهيمي       06/10/2018 18:22:42

Antenatal care:


The focus of nursing care during the preconception and antepartum period is
Prior to pregnancy:
- Assessment of the health of the woman and potential risk factors
- Education on health promotion and disease prevention
During pregnancy:
- Regular assessment of the health of the pregnancy
- Regular assessment and screening of risk factors for potential complications
- Education on health promotion and disease prevention
- Inclusion of significant others/family in care and education to promote pregnancy adaptation
- Implementation of appropriate interventions based on risk status or actual complications


Screening includes an extensive health history, a complete physical examination, including a pelvic examination, and blood and urine specimens for laboratory work. Manual pelvic measurements can be taken to determine pelvic adequacy.

Components of the Health History
An initial interview serves several purposes:
• Establishing rapport
• Gaining information about a woman’s physical and psychosocial health
• Obtaining a basis for anticipatory guidance for the pregnancy

If on subsequent visits a symptom is mentioned, establishing a baseline health picture at the initial pregnancy allows you to be able to verify that it is truly a new symptom and a woman is not just becoming more aware of it.

The elements pertinent to a pregnancy history.
Demographic Data
Demographic data usually obtained include name, age, address, telephone number, e-mail address, religion, and health insurance information.

Chief Concern
The chief concern is the reason a woman has come to the health care setting—in this instance, the fact that she is or thinks she is pregnant.

To help confirm pregnancy, inquire about the date of her last menstrual period and whether she has had a pregnancy test or used a home test kit. Elicit information about the signs of early pregnancy, such as nausea, vomiting, breast changes, or fatigue. Ask if she has any discomforts of pregnancy, such as constipation, backache, or frequent urination.
Also, ask about any danger signs of pregnancy, such as bleeding, continuous headache, visual disturbances, or swelling of the hands and face.



Family Profile
The social history or family setting history (family profile)

identify important support persons, shape the nature and kind of questions to be asked, and evaluate the possible impact of a woman’s culture on care.

It also lays a foundation for health teaching as before you can begin to offer a woman any more than
stereotyped health care instructions,
1. you need to know her age (additional testing such as genetic screening may be necessary if she is over 35),
2. Educational levels (offers an estimation of the level of teaching you will plan),
3. And occupation (does a woman’s work involve heavy lifting, long hours of standing in one position, handling of a toxic substance, actions that may need to be modified during pregnancy?).

Be certain to ask about marital status and support people available as part of the information obtained.

Ask enough questions about the size of the apartment or house in which a woman lives so you can talk with her in the coming months about a bedroom or space for a baby’s bed.

It also is important to know whether the essential rooms are:
- On the ground floor or upstairs in case she is restricted from climbing stairs more than once or twice a day during the last part of pregnancy or after birth.
- A change in status from independence to dependence because of stopping work, chronic illness at home, the death or loss of a significant person during pregnancy, geographic moves, financial hardship, and lack of support people are examples of situations that can hinder a woman’s ability to accept her pregnancy and child.

History of Past Illnesses
Questions about a woman’s past medical history are an important part of an interview because a past condition can become active during or immediately following pregnancy.

1. kidney disease,
2. heart disease (coarctation of the aorta and heart valve problems from rheumatic fever cause problems most often),
3. hypertension,
4. sexually transmitted infections (including hepatitis B and human immunodeficiency
virus [HIV]),
5. diabetes,
6. thyroid disease,
7. recurrent seizures,
8. gallbladder disease,
9. urinary tract infections, varicosities, phenylketonuria, tuberculosis, and asthma. It is important to find out whether a woman had childhood diseases such as
10. chickenpox (varicella), mumps (epidemic parotitis), measles (rubeola), German measles (rubella), or poliomyelitis and whether she has had immunizations against these.

History of Family Illnesses
A family history documents illnesses that occur frequently in the family and so can help identify potential problems in a woman during pregnancy or in her infant at birth.
Ask specifically about

1. cardiovascular and renal disease,
2. cognitive impairment,
3. blood disorders, or any known genetically inherited diseases or congenital anomalies

Day History/Social Profile
Information about a woman’s current:
1. nutrition,
2. elimination,
3. sleep,
4. recreation,
5. and interpersonal interactions can be elicited best by asking a woman to describe a typical day of her life.
6. obtain information about a woman and her family’s smoking habits
7. Many women use herbal supplements to relieve the nausea of early pregnancy

Gynecologic History
A woman’s past experience with her reproductive system
may have some influence on how well she accepts a pregnancy
so obtain information about her

1. age of menarche (first menstrual period) and how well she was prepared for it as a
normal part of life.
2. Ask about her usual cycle, including the interval, duration, amount of menstrual flow, and any discomfort
3. discomfort with periods, including when the discomfort occurs, how long it lasts, and what she does to relieve it.
4. past surgery on the reproductive tract. For example, if a woman has had tubal surgery following an ectopic pregnancy
5. uterine surgery, a cesarean birth may be necessary because her uterus may not be able to expand and contract as efficiently as usual because of the surgical scar

Obstetric History
For each previous pregnancy, document the child’s sex and the place and date of birth. Review the pregnancy briefly for:
• Was it planned?
• Did she have any complications, such as vaginal spotting, swelling of her hands or feet, falls, or surgery?
• Did she take any medication? If so, what and why?
• Did she receive prenatal care? If so, when did she start?
• What was the duration of the pregnancy?
• What was the duration of labor?
• Was labor what she expected? Worse? Better?
• What was the type of birth? Vaginal or cesarean? Vertex or breech? In a hospital or at home?
• What type of anesthesia, if any, was used?
• Did she have perineal stitches following birth?
Did she have any complications, such as excessive bleeding
or infection following the birth?
• What was the infant’s birth weight and sex?
• What was the condition of the infant at birth? Did the infant
cry right away?
• What was the infant’s Apgar score? (Most mothers know
this.)
• Was any special care needed for the baby, such as suctioning,
oxygen, or an incubator?

Physical Examination:

# providing a urine specimen for laboratory testing. The urine specimen is sent to the laboratory for evaluation of
1. bacteria,
2. protein,
3. glucose, and ketones.


المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .