Pangasinan State University

Bayambang Campus
Institute of Nursing
Bayambang, Pangasinan

Handouts in NCM 107

Assessment of a Pregnant Woman

A. How to compute for AOG if Fundic Height is not given

IMPORTANT: Ask for the LMP
The date of clinic visit
Number of days of each month
Examples:
1. Given: LMP: March 18, 2020
Date of clinic visit: Nov. 18, 2020
Problem: AOG
Solution:
1. Subtract the LMP from the number of days of the month.
March 31 – 18 = 13
2. List the months and the number of days of the month. For the month of the LMP, the
number of days is the answer in number 1. For the month of the last clinic visit, the
number of days is the date of the clinic visit.
March 13
April 30
May 31
June 30
July 31
Aug 31
Sept 30
Oct 31
Nov. 18 - Date of clinic visit
245 - Sum of all the days of the month

245/7 = 35 Answer = 35 wks

2. Given: LMP: June 24, 2020

Date of Clinic Visit: Nov. 12, 2020
Problem: AOG
Solution:
1. June 30 – 24 = 6
2. June 6
July 31
Aug 31
Sept 30
Oct 31
Nov 12
141
3. 141/7 = 20 remainder 1 Answer: 20 wks and 1 day
20
7 141
14
1
B. Fetal Heart Rate (FHR) Assessment
 Can be done thru
a) Doppler ultrasound – detects FHR by 10-12 wks of pregnancy
b) Fetoscope – detects FHR by 18-20 wks of pregnancy
 Expected Rate: 120-160 breaths per minute (bpm) with regular rhythm

C. Leopold’s Maneuver
 Systemic palpation of the abdomen to determine fetal presentation, position, degree of fetal
descent, uterine contour
 Instruct the client to void so that the full bladder will not be palpated and not be mistakenly
identified as the head of the fetus.

D. Weight
 The best index of maternal health in pregnancy and is checked every visit
 Total weight gain during pregnancy is 20-25 pounds (lbs)
 Patterns of weight gain: 1 lb/month in the first trimester (3-4 lbs weight gain for 1st trimester)
0.9 lb – 1 lb/wk in the 2nd trimester (10-12 lbs for 2nd tri)
0.5 lb – 1 lb/wk in the 3rd trimester (8-11 lbs for 3rd tri)
 Note: The pattern of weight gain is more important that the amount of weight gain.

E. Length of Pregnancy
Days > 267 – 280 Calendar months > 9
Weeks > 40 Trimester > 3
Lunar months > 10

First trimester > period of organogenesis or development of the different parts of the fetus
 During this period, the pregnant woman should avoid drinking alcoholic beverages, taking any
drugs or medications, contracting virus, and exposure to radiation as these are highly damaging
to the fetus.
Second Trimester > this is the most comfortable period for the pregnant woman with continued
fetal growth. Also, this is the most comfortable period because the body of the pregnant
woman has already adjusted to the changes brought about by the pregnancy, especially the
changes brought about by the increase in hormones
Third Trimester > period of most rapid growth because of rapid fat deposition, iron, and calcium
deposition (with implication on maternal diet)
 Iron supplements can start at 4 months of pregnancy. Inform the client that constipation and
dark stool are common side effects of iron supplementation. Therefore, advise the client to
increase water intake to prevent constipation and not to worry about the dark stool.
 There may also be discoloration of teeth (gray color) which is also a side effect of iron
supplement.
 Also, inform client that milk interferes with the ability of the body to absorb iron while Vitamin C
enhances iron absorption.
 There may be no need for calcium supplement as intake of food rich in calcium can supply the
body with enough calcium needed by the woman during pregnancy.

F. Schedule of Clinic Visits

For the first 32 weeks, the clinic visit is once a month.
32-36 weeks, clinic visit is twice a month
36-40 weeks, clinic visit is 4x a month
Note: It is important that on the initial visit, the nurse must conduct history taking. This means that
the pregnant woman would be asked about pregnancy history (how many pregnancies experienced,
abortion experienced, miscarriage, premature delivery, etc) and presence of disease such as heart
disease, diabetes, hypertension, asthma, etc. which can affect the outcome of pregnancy.