Guided Lecture Notes
Chapter 12, Nursing Care During Pregnancy
Learning Objective 1. Define the key terms used in this chapter.
 Review the list of key terms at the beginning of the chapter.
 Correlate the key terms to what is discussed in the chapter.
Learning Objective 2. Identify the information typically collected at the initial prenatal
visit.
 Explain the importance of preconception care.
 Identify risk factors associated with adverse pregnancy outcomes. (See Box 12-1;
refer to PowerPoint slide 02.)
 Describe the nursing management associated with preconception care. (See Fig. 12-1;
refer to PowerPoint slide 03.)
 Discuss the benefits of the initial prenatal visit. (Refer to PowerPoint slide 04.)
 Explain the various types of information obtained with the comprehensive health
history. (See Fig. 12-2; refer to PowerPoint slide 04.)
 Identify key components to be covered when obtaining the woman’s past history.
 Describe the key areas involved with the woman’s reproductive history, including:
o Menstrual history (Refer to PowerPoint slides 05 and 06)
o Obstetric history
o Gynecologic history
 Review how to determine the estimated date of birth using Nagele’s rule. (Refer to
PowerPoint slide 07.)
 Explain the terminology used for an obstetric history, and give examples. (See Box
12-2; refer to PowerPoint slides 08 and 09.)
 Describe the physical examination. (Refer to PowerPoint slides 12 and 13.)
 Identify the typical assessment findings of the pelvic examination. (Refer to
PowerPoint slide 13.)
 Discuss the impact of pelvic shape and size on pregnancy and birth.
 List the typical laboratory tests performed at the initial prenatal visit. (Refer to
PowerPoint slide 14.)
Learning Objective 3. Explain the assessments completed at follow-up prenatal visits.
 Review the usual schedule for follow-up visits, including the assessments completed
with each visit. (Refer to PowerPoint slides 15 and 16.)
 Describe fundal height measurement and its significance.
 Explain the methods for determining fetal movement. (See Box 12-3.)
 Demonstrate fetal heart rate auscultation. (See Nursing Procedure 12-1.)
 Identify key danger signs that pregnant women need to report.
Learning Objective 4. Discuss the tests used to assess maternal and fetal well-being,
including nursing management for each.
 Review the common laboratory tests performed during the prenatal period.
 Discuss the following tests used to determine fetal well-being, including when they
are performed, the information obtained, the risks to mother or fetus, and nursing
management. (Refer to PowerPoint slide 19.)
o Ultrasound
o Doppler flow studies
o Alpha-fetoprotein analysis
o Marker screening tests
o Nuchal translucency screening
o Amniocentesis
o Chorionic villi sampling
o Percutaneous umbilical blood sampling
o Nonstress test
o Contraction stress test
o Biophysical profile
Learning Objective 5. Outline appropriate nursing management to promote maternal
self-care and minimize the common discomforts of pregnancy.
 Identify the common discomforts of pregnancy according to trimester. (Refer to
PowerPoint slides 20, 21, and 22.)
 Explain the physiological basis for each discomfort.
 Describe nursing management, including client teaching, for managing each of the
discomforts. (See Teaching Guidelines 12-1.)
 Emphasize that pregnancy is a time of health, not illness.
 Outline the following common measures for health promotion and maintenance that
should be addressed with pregnant women. (Refer to PowerPoint slides 23 and 24.)
o Personal hygiene
o Perineal care
o Dental care
o Breast care
o Exercise (see Teaching Guidelines 12-2)
o Sleep and rest
o Sexual activity
o Employment (see Teaching Guidelines 12-3)
o Travel (see Teaching Guidelines 12-4)
o Immunizations and medications
Learning Objective 6. Discuss the key components of perinatal education.
 Define the term “perinatal education.”
 Describe the usual components of childbirth education classes.
 Compare and contrast the Lamaze, Bradley, and Dick-Read methods of childbirth.
(Refer to PowerPoint slide 27.)
 Identify the options for birth settings and care providers. (Refer to PowerPoint slide
28.)
 List the advantages and disadvantages of breastfeeding. (Refer to PowerPoint slide
29.)
 Explain the measures needed, including client education, to prepare a woman for
breastfeeding.
 Discuss the teaching needed for parents who choose bottle feeding.
 Explain the information to be addressed as final preparation for labor and birth.