Prenatal And Antepartum Support - NCLEX-PN

Goodell sign (softened cervix). Probable signs are objective findings detected by an examiner that strongly indicate pregnancy but are not definitive, as they may mimic other conditions.

Fetal heart tones heard by Doppler. Positive signs provide definitive confirmation of pregnancy through direct evidence of fetal presence or activity detected by reliable methods.

110 to 160 beats/min. The normal fetal heart rate reflects adequate oxygenation and cardiac function, typically ranging between these values throughout pregnancy.

Unpasteurized dairy products (soft cheeses). Unpasteurized products may contain Listeria monocytogenes, which can cross the placenta and cause severe fetal infection or miscarriage.

MMR (measles, mumps, rubella). Live virus vaccines pose a theoretical risk of fetal infection, making them contraindicated during pregnancy to ensure maternal and fetal safety.

Tdap during $27$ to $36$ weeks gestation. Administering Tdap in this window provides passive immunity to the newborn via maternal antibodies, protecting against pertussis until infant vaccination.

Report decreased movements or no movement within expected time. Monitoring fetal movements helps assess well-being, with reduced activity potentially indicating distress and warranting immediate medical attention.

Gush or continuous leakage of fluid from vagina. Such leakage suggests amniotic fluid escape, which can increase infection risk and requires assessment to confirm rupture and plan management.

Regular contractions with low backache or pelvic pressure. This combination may signal uterine activity leading to cervical changes before 37 weeks, necessitating evaluation to prevent preterm birth.

Severe headache with visual changes. These symptoms indicate possible severe preeclampsia, a hypertensive disorder requiring urgent assessment to prevent eclampsia or other complications.

Left lateral side-lying position. This position reduces compression of the inferior vena cava by the gravid uterus, improving venous return and preventing hypotension.

$25$ to $35\ \text{lb}$ (about $11.5$ to $16\ \text{kg}$). This range supports optimal fetal growth and maternal health without excessive risks, based on pre-pregnancy BMI guidelines from health organizations.

Increase fluids and dietary fiber. Iron supplementation can cause constipation by altering gut motility, which is mitigated by increased hydration and fiber to promote bowel regularity.

$30\ \text{mg/day}$ elemental iron. Pregnancy increases iron demands for fetal growth and maternal blood volume expansion, making this supplementation essential to prevent anemia.

$0.4\ \text{mg/day}$. This dosage supports neural tube development in the fetus, as adequate folic acid intake is crucial during early pregnancy to prevent birth defects.

Any bleeding or fetomaternal mixing (e.g., amniocentesis, trauma). These events may cause fetal-maternal blood mixing, prompting prophylaxis in Rh-negative mothers to avoid sensitization and future complications.

At 28 weeks and within 72 hours after birth if infant is Rh-positive. Administration at these times prevents maternal antibody formation against Rh-positive fetal cells, reducing risk of hemolytic disease in the newborn.

Identify need for Rh immune globulin prophylaxis. Rh typing determines if the mother is Rh-negative, necessitating prophylaxis to prevent alloimmunization and hemolytic disease in future pregnancies.

Maternal serum alpha-fetoprotein (MSAFP). Elevated or low levels of this protein in maternal serum between 15-20 weeks can indicate fetal neural tube defects or other anomalies.

Oral glucose challenge test (screening). This non-fasting test measures blood glucose after a glucose load to identify women at risk for gestational diabetes requiring further diagnostic evaluation.

As soon as pregnancy is suspected (first trimester). Early prenatal care initiation allows for timely risk assessment, health promotion, and intervention to optimize maternal and fetal outcomes.

Avoid vaginal exam and notify provider immediately. Painless bleeding may indicate placenta previa, where vaginal exams could provoke massive hemorrhage, requiring immediate provider notification for safe management.

Take with vitamin C or orange juice. Vitamin C enhances non-heme iron absorption in the gastrointestinal tract by reducing ferric iron to the more absorbable ferrous form.

Eat small frequent meals; dry crackers before rising. These strategies help manage symptoms by preventing an empty stomach, which exacerbates nausea due to hormonal changes in early pregnancy.