Maternal and Child Health Nursing (NCM 65):

NURSING CARE r/t ASSESSMENT OF

A PREGNANT FAMILY
Ms. Grace Bautista | Sept. 15, 2021

OUTLINE
I. Prenatal Health Assessment
A. Review of Systems
II. Assessing Health Status During Pregnancy
III. Nursing Diagnoses: Prenatal Health Assessment
IV. Implementing Care During Pregnancy
V. Common Gynecologic Disorders Seen in Pregnancy

I. PRENATAL HEALTH ASSESSMENT

• Reasons for assessment
1. Establish baseline for present health
2. Determine gestational age of fetus
3. Monitor fetal development and maternal well-being
4. Identify women at risk for complications
5. Minimize risk of possible complications by anticipating
and preventing problems before they occur
6. Provide education about pregnancy, lactation, and
newborn care
• Preconceptual visit
o Accurate reproductive life planning information
o Assurance about fertility based on health history and
PE
o Identification of any problems needing correction
o Hemoglobin level and blood type determined
o Pap smear taken
• Choosing a healthcare provider who will:
1. Provide care throughout pregnancy and birth
2. Initiate prenatal care early
o Nurse’s role:
1. Educate
2. Listen
3. Counsel
o Include support people
• Typical day and social history for a pregnant:
o Nutrition
o Exercise
o Hobbies
o Tobacco, alcohol, drug consumption
o Medication and herbal therapy
o Intimate partner violence

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 A. REVIEW OF SYSTEMS II. ASSESSING HEALTH STATUS DURING PREGNANCY
• Baseline height/weight • Types of pelvises:
• Vital sign measurement
• Body systems
o General appearance and mental status
o Head and scalp
o Eyes
o Nose and sinuses
o Ears
o Mouth, teeth, throat
o Neck
o Lymph nodes
o Breasts
o Heart
o Lungs
o Back
o Rectum
o Extremities and skin
• Physical examination
o Appearance of cervix:

• Estimating pelvic size by

o Diagonal conjugate
o Ischial tuberosity diameter
• Laboratory assessments
o Blood serum studies
 CBC; genetic screen
 Serologic test for syphilis
 Blood typing and Rh factor
 Maternal serum for AFP and PAPP-A
 Cultures for chlamydia and gonorrhea
 Indirect Coombs test
 Serum antibody titers
 HIV screening
 Glucose challenge test
o Pelvis (establishing adequacy for childbirth): o Urinalysis
o Tuberculosis screening
o Ultrasonography

III. NURSING DIAGNOSES: PRENATAL HEALTH ASSESSMENT

• Health-seeking behaviors r/t guidelines for nutrition and
activity during pregnancy
• Deficient knowledge regarding exposure to teratogens during
pregnancy
• Health-seeking behaviors r/t strong cultural desire to have a
healthy child
• Risk for injury to fetus r/t lifestyle choices

IV. IMPLEMENTING CARE DURING PREGNANCY

• Danger signs to report during pregnancy
1. Vaginal bleeding
2. Persistent vomiting
3. Chills and fever
4. Escape of fluid from vagina
5. Abdominal or chest pain
6. Swelling of face and fingers
7. Vision changes or continuous headache
8. Rhythmic cramping
9. Burning with urination
10. Pronounced decrease in fetal movement
11. Uterine contraction before 37 wks of pregnancy

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V. COMMON GYNECOLOGIC DISORDERS SEEN IN
PREGNANCY

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 Q&A
A woman’s diagonal conjugate measurement is 10.5 cm. You would
interpret that her pelvis is which of the following?
A. Adequate for childbearing
B. Narrow anterior-posterior
C. Narrow transversely
D. Larger than normal

Which of the following suggestion would be the best technique to help

a patient relax during a pelvic examination?
A. “Bear down as if you have to move your bowels.”
B. “Take a deep breath and hold it.”
C. “Count backward from 20 at a steady pace.”
D. “Tense your abdominal muscles so the uterus contracts less.”

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