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Hesi-Hints-Maternity-For-Nursing-Students-.pdf
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Hesi-Hints-Maternity-For-Nursing-Students-.pdf
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Hesi Hints Maternity The menstrual phase varies in length for most women, usually lasting 2 to 8 days
From ovulation to the beginning of the next menstrual cycle is usually 14 days. In
other words, ovulation occurs 14 days before the next menstrual period
Sperm live approximately 3 days but some sperm may remain viable for as long as 5
days, and eggs live about 24 hrs. A couple must avoid unprotected sex for several days
before the anticipated ovulation and for 3 days after ovulation to prevent pregnancy.
Because some women experience implantation bleeding or spotting, they do not
know they are pregnant.
Look for signs of maternal-fetal bonding DURING pregnancy. For example: talking to
fetus in utero, massaging abdomen, nicknaming fetus are all healthy psychosocial
activities.
For many women BATTERING (emotional or physical abuse) BEGINS during pregnancy.
Women should be assessed for abuse in private AWAY from the partner, by a nurse
who knows local resources and how to determine the safety of the client.
Nagle’s Rule : Count back 3 months and add 7 days
At approximately 28 to 32 weeks gestation, the maximum plasma volume increase of
25% to 40% occurs, resulting in normal hemodilution of pregnancy and HCT values of
32% to 42%. High Hct values may look “good”, but in reality represent pregnancy
induced hypertension and a depleted vascular space.
As pregnancy advances, the uterus presses on abdominal vessels (vena cava and
aorta). Reinforce teaching that a side- lying position increases perfusion to uterus,
placenta and fetus. Recent research indicates that the knee-chest position is best for
increasing perfusion and that the side- lying position (either left or right side-lying) is
the second most desirable position to increase perfusion. Before this research, the left
side-lying position was usually encouraged.
Fetal well-being is well is determined by assessing fundal height, fetal heart
tones/rate, fetal movement, and uterine activity (contractions). Changes in fetal heart
rate are the first and most important indicator of compromised blood flow to the
fetus, and these changes require action! Remember, the normal fetal heart rate (FHR)
is 110 to 160 bpm.
DANGER SIGNS DURING PREGNANCY…reinforce teaching about immediately reporting
any of the following danger signs. Early intervention can optimize maternal and fetal
outcome. POSSIBLE INDICATIONS OF PREECLAMPSIA/ECLAMPSIA: Visual disturbances,
swelling of face, fingers, or sacrum, severe continuous headache, and persistant
o vomiting.
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