chapter 12
Multigravida
A woman pregnant for at least the third time
Hepatitis B
Determines if the mother has hepatitis B by detecting presence of hepatitis antibody surface antigen (HbsAg) in her blood
A pregnant client is undergoing a fetal biophysical profile. Which parameter of the profile helps measure long-term adequacy of the placental function? -amniotic fluid volume -fetal heart rate -fetal breathing record -fetal reactivity
amniotic fluid volume A biophysical profile combines five parameters (fetal reactivity, fetal breathing movements, fetal body movement, fetal tone, and amniotic fluid volume) into one assessment. The fetal heart and breathing record measures short-term central nervous system function; the amniotic fluid volume helps measure long-term adequacy of placental function.
Cervical smears
Detects abnormalities such as cervical cancer (Pap test) or infections such as gonorrhea, chlamydia, or group B streptococcus so that treatment can be initiated if positive
Rubella titer
Detects antibodies for the virus that causes German measles; if titer is 1:8 or less, the woman is not immune; requires immunization after birth, and the woman is advised to avoid people with undiagnosed rashes.
After teaching the pregnant woman about ways to minimize flatulence and bloating during pregnancy, the nurse understands that which client statement indicates the need for additional teaching? -"I'll try to drink more fluids to help move things along." -"I'll switch to chewing gum instead of using mints." -"I'll stay away from foods like cabbage and brussels sprouts." -"I'll increase my time spent on walking each day."
"I'll switch to chewing gum instead of using mints." Eating mints can help reduce flatulence; chewing gum increases the amount of air that is swallowed, increasing gas build-up. Increasing fluid intake helps to reduce flatus. Gas-forming foods such as beans, cabbage, and onions should be avoided. Increasing physical exercise, such as walking, aids in reducing flatus.
A primigravida at her 12-week prenatal visit expresses concern that she hasn't felt her baby move yet. What is the best response from the nurse? -"Fetal movements can be felt at 13 weeks." -"You should start to feel fetal movements within the next few weeks." -"You usually cannot feel them until approximately 16 to 20 weeks." -"You won't be able to feel movements until you lie down and concentrate on them."
"You usually cannot feel them until approximately 16 to 20 weeks." The first fetal movements felt by the pregnant woman are usually felt between 16 and 20 weeks gestation. Thirteen weeks is too early (fetus is too small), and movements cannot be felt even if the woman lies down and concentrates on them, although the woman should start feeling movements within the next few weeks.
When is screening for gestational diabetes done?
24 and 28 weeks' gestation
A pregnant client wishes to know if sexual intercourse would be safe during her pregnancy. Which should the nurse confirm before educating the client regarding sexual behavior during pregnancy? -Client does not have cervical insufficiency. -Client does not have anxieties and worries. -Client does not have anemia. -Client does not experience facial and hand edema.
Client does not have cervical insufficiency. The nurse should inform the client that sexual activity is permissible during pregnancy unless there is a history of cervical insufficiency, vaginal bleeding, placenta previa, risk of preterm labor, multiple gestation, premature rupture of membranes, or presence of any infection. Anemia and facial and hand edema would be contraindications to exercising but not intercourse. Freedom from anxieties and worries contributes to adequate sleep promotion.
STI screening: venereal disease research laboratory (VDRL) or rapid plasma reagin (RPR) serologic tests or by cervical smears, cultures, or visual identification of suspicious lesions
Detects STIs (such as syphilis, herpes, HPV, gonorrhea) so that treatment can be initiated early to prevent transmission to fetus
HIV testing
Detects HIV antibodies and if positive, requires more specific testing, counseling, and treatment during pregnancy with antiretroviral medications to prevent transmission to fetus
Complete blood cell count (CBC)
Evaluates hemoglobin (12-14 g) and hematocrit (42% ± 5%) levels and red blood cell count (4.2-5.4 million/mm3) to detect the presence of anemia; identifies white blood cell level (5,000-10,000 mm−3), which if elevated, may indicate an infection; determines platelet count (150,000-450,000 mL3) to assess clotting ability
FOLLOW-UP VISITS
Every 4 weeks up to 28 weeks (7 months) Every 2 weeks from 29 to 36 weeks Every week from 37 weeks to birth
amniocentesis
Involves a transabdominal puncture of the amniotic sac to obtain a sample of amniotic fluid for analysis. The fluid contains fetal cells that are examined to detect chromosomal abnormalities and several hereditary metabolic defects in the fetus before birth. In addition, amniocentesis is used to confirm a fetal abnormality when other screening tests detect a possible problem.
A client who is uncertain when her LMP occurred is given an EDD of April 23 after the first ultrasound. Based on this information, the nurse determines the client's LMP was probably which day? -July 13 -July 16 -July 19 -July 21
July 16 According to Naegele rule, the last menstrual period was July 16th. Take the LMP and add 7 days and subtract 3 months; if finding the LMP from the EDD, subtract 7 days and add 3 months.
A client in her second trimester of pregnancy visits a health care facility. The client frequently engages in aerobic exercise and asks the nurse about doing so during her pregnancy. Which precaution should the nurse instruct the pregnant client to take when practicing aerobic exercises? -Begin a new exercise regimen. -Wear support hose when exercising. -Maintain tolerable intensity of exercise. -Reduce the amount of exercise.
Maintain tolerable intensity of exercise. Women accustomed to exercise before pregnancy are instructed to maintain a tolerable intensity of exercise. They are instructed not to begin a new exercise regimen. A nurse does not tell the client to wear a support hose when exercising or to reduce the amount of exercises.
A woman reports that her LMP occurred on January 10, 2017. Using Naegele rule, what is her due date? -October 17, 2017 -October 10, 2017 -October 7, 2017 -October 11, 2017
October 17, 2017 To determine the due date using Naegele rule, add seven days to the date of the first day of the LMP, then subtract three months.
Blood typing
Determines woman's blood type and Rh status to rule out any blood incompatibility issues early; Rh-negative mother would likely receive RhoGAM (at 28 weeks' gestation) and again within 72 hours after childbirth if she is Rh-sensitive
The nurse is completing the teaching for a newly pregnant client with a BMI of 23. Which statement by the client indicates an understanding of weight gain during this pregnancy? -"I need to gain 25 to 35 pounds (11 to 16 kg) during this pregnancy." -"I need to gain 0.5 pounds (0.23 kg) per week during this pregnancy." -"I need to gain less than 25 pounds (11 kg) during this pregnancy." -"I need to gain 1 pound (0.45 kg) per week throughout this pregnancy."
"I need to gain 25 to 35 pounds (11 to 16 kg) during this pregnancy." A prepregnant BMI of 23 is in the normal category, and this client needs to gain 25 to 35 lbs (11 to 16 kg) during this pregnancy. Lower weight gain would be recommended for women with a BMI of over 25.
A nurse is teaching a client who is 30 weeks' pregnant about ways to deal with pyrosis (heartburn). The nurse determines a need for additional teaching based on which client statement? -"I need to cut out caffeine." -"I should chew my food slowly." -"I should lie down for 1/2 hour after eating." -"I need to raise the head of my bed about 15 to 30 degrees."
"I should lie down for 1/2 hour after eating." The client should remain sitting for 1 to 3 hours after eating and avoid lying down within 3 hours of eating. Cutting out caffeine, chewing food slowly, and raising the head of the bed are helpful in reducing pyrosis (heartburn) of pregnancy.
A pregnant woman at her first prenatal visit asks the nurse if it is safe to have sex during her pregnancy. Which client statement alerts the nurse to the need for further teaching? -"I should substitute intercourse with nonsexual touch to avoid harming the fetus." -"I will experience a heightened need for touch throughout my pregnancy." -"If I experience bleeding, I will abstain from vaginal intercourse." -"I will avoid having intercourse following the rupture of the membranes."
"I should substitute intercourse with nonsexual touch to avoid harming the fetus." Sexual needs may be met through sexual intercourse with a partner as long as the pregnancy is healthy and there are no other risk factors, such as bleeding or rupture of membranes. Pregnancy is a time of a heightened need for touch, which may be met partially by sexual expression, but which can also be met through nonsexual touch, such as massage, caressing, or holding.
The nurse is reviewing client data following a regular monthly appointment at 6 months' gestation. Which fundal height requires no further intervention? -18 cm -24 cm -30 cm -32 cm
24 cm An anticipated fundal height for 24 weeks' gestation (6 months) is 24 cm. Between 18 and 32 weeks' gestation, the fundal height in centimeters should match the gestational age. All of the other measurements would require further intervention.
Utilize the GTPAL system to classify a woman who is currently 18 weeks pregnant. This is her 4th pregnancy. She gave birth to one baby vaginally at 26 weeks who died, experienced a miscarriage, and has one living child who was delivered at 38 weeks gestation. -3, 2, 1, 2, 1 -4, 2, 2, 1, 1 -3, 2, 1, 1, 1 -4, 1, 1, 1, 1
4, 1, 1, 1, 1 The GTPAL system is used to classifying pregnancy status. G = gravida, T= term, P = preterm, A = number of abortions, L= number of living children.
Secundigravida
A woman pregnant for the second time
Primipara
A woman who has given birth once after a pregnancy of at least 20 weeks, commonly referred to as a "primip" in clinical practice
Multipara
A woman who has had two or more pregnancies of at least 20 weeks' gestation resulting in viable offspring, commonly referred to as a "multip"
Nulligravida
A woman who has never experienced pregnancy
What is the most effective way for a nurse to assess a woman's usual food intake during her pregnancy? -Assess a list she makes describing a good diet. -Ask her to describe her total intake for a week. -Assess her skin for hydration and color. -Ask her to describe her intake for the last 24 hours.
Ask her to describe her intake for the last 24 hours. A 24-hour food intake history is the best method to assess food intake in all individuals.
The nurse is educating a woman about the importance of folic acid before conception and during pregnancy, to prevent neural tube defects in the fetus. The client plans to take prenatal vitamins and minerals. What food source would the nurse recommend to add to the woman's diet? -Yogurt and low-fat milk -Green leafy vegetables -Oily fish such as salmon -Green and iced tea
Green leafy vegetables Green leafy vegetables are a good source of folic acid. In the past, green tea was thought to interfere with the absorption of folic acid; however, studies do not support this. The women would be advised to avoid green and iced tea due to the caffeine content. Yogurt, low-fat milk and oily fish are not known to be high in folic acid.
A woman who is 4 months pregnant notices frequent heart palpitations and leg cramps. She is anxious to learn how to alleviate these. Which nursing diagnosis would best apply to her? -Impaired urinary elimination related to inability to excrete creatine from her muscles -Risk for ineffective breathing pattern related to pressure of the growing uterus -Pain related to severe complications of pregnancy -Health-seeking behaviors related to ways to relieve discomforts of pregnancy
Health-seeking behaviors related to ways to relieve discomforts of pregnancy Health-seeking behaviors is a diagnosis used to describe clients who are actively interested in learning ways to improve their health.
A pregnant client is planning a vacation to a different state and questions the nurse concerning precautions. Which suggestion should the nurse prioritize for this client who will be traveling by automobile? -Travel no more than 120 miles daily. -Sit in the back seat with feet elevated. -Stop and walk every 2 hours. -Limit trips away from home, greater than 200 miles.
Stop and walk every 2 hours. Walking increases venous return and reduces the possibility of thrombophlebitis, a risk for pregnant women who sit for extended periods of time. Limiting mileage, sitting in the back with the feet elevated, and limiting trips may help, but they are not enough to prevent phlebitis.
The health care provider has prescribed an over-the-counter antacid for a pregnant client in her first trimester who is having ongoing nausea, vomiting, and heartburn. Which instruction concerning the antacid should the nurse prioritize after noting the client is also prescribed a multivitamin supplement? -Avoid caffeinated beverages. -Take only at bedtime. -Take antacid 1 hour after the multivitamin. -Take with dairy products.
Take antacid 1 hour after the multivitamin. Antacids interfere with the uptake of the vitamin contents so the client should take the antacid 1 hour after taking the multivitamin. Caffeine should be avoided due to increases in blood pressure and diuretic effects. Antacids can be taken more often than solely at bedtime, and some clients need them after each meal. Antacids do not have to be taken with dairy products. The priority is to avoid allowing the antacid to cancel out the multivitamin.
Para
The number of times a woman has given birth to a fetus of at least 20 gestational weeks (viable or not), counting multiple births as one birth event
gravida
The total number of times a woman has been pregnant, regardless of whether the pregnancy resulted in a termination or if multiple infants were born from a pregnancy
The nurse teaches a sedentary pregnant client with a BMI of 35 about the importance of healthy lifestyle during pregnancy. Which goal would be appropriate for this client? -Walk for 30 minutes 5 days a week. -Adhere to a weight reduction diet. -Participate in a daily aerobic dance program. -Begin lifting weights for 30 minutes per day.
Walk for 30 minutes 5 days a week. For a sedentary client a walking program is an appropriate goal. Dieting/weight reduction is never recommended during pregnancy. A daily aerobic or weight lifting program are not appropriate goals for a sedentary client with a high BMI.
Alpha-fetoprotein (AFP)
a glycoprotein produced initially by the yolk sac and fetal gut, and later predominantly by the fetal liver. In a fetus, the serum AFP level increases until approximately 14 to 15 weeks and then falls progressively. In normal pregnancies, AFP from fetal serum enters the amniotic fluid (in microgram quantities) through fetal urination, fetal gastrointestinal secretions, and transudation across fetal membranes (amnion and placenta). About 30 years ago, elevated levels of maternal serum AFP or amniotic fluid AFP were first linked to the occurrence of fetal neural tube defects. This biomarker screening test is now recommended for all pregnant women along with other prenatal screening tests depending on risk profile
Before beginning the initial prenatal examination, a nurse should instruct a client to complete what procedure before undressing? -clean-catch urine -initial blood tests -measurement of fundal height -ultrasound for fetal measurements
clean-catch urine The first procedure a nurse should ask the client to do is obtain a clean-catch, midstream urine before undressing. Lab tests can be done after the examination is complete. At the first visit, the fetus is too small to be measured or have an ultrasound performed.
A woman calls the prenatal clinic and says that she thinks she might be in labor. She shares her symptoms over the phone with the nurse and asks what to do. The nurse determines that she is likely in true labor and that she should head to the hospital. Which symptom is an indicator of true labor? -contractions beginning in the back and sweeping forward across the abdomen -lightening (descent of the fetus into the pelvis) -intermittent backache stronger than usual -increase in fetal kick count
contractions beginning in the back and sweeping forward across the abdomen True labor contractions usually begin in the back and sweep forward across the abdomen similar to tightening of a rubber band. They gradually increase in frequency and intensity over a period of hours. Lightening and intermittent backache are preliminary signs of labor but do not indicate true labor. Increase in fetal kick count does not indicate true labor.
Some pregnant women hire a trained professional to provide support during pregnancy and birth, to provide emotional support during labor and birth, and to aid in establishing breastfeeding. What is the name of the woman who takes this role? -partera -doula -midwife -pregnancy aide
doula The pregnant woman may hire a doula to provide support for labor and birth and help with establishing breastfeeding. A doula can also provide support for the postpartum period.
Which finding from a woman's initial prenatal assessment would be considered a possible complication of pregnancy that requires reporting to a primary care provider for management? -episodes of double vision -increased lumbar curvature -nasal congestion and swollen nasal membranes -palpitations when lying on her back
episodes of double vision Difficulty with vision can occur from cerebral edema or is a symptom of hypertension of pregnancy.
The nurse is preparing to administer a prescribed medication to the pregnant client. Which order should the nurse question? -penicillin -rubella -acetaminophen -folic acid
rubella Most vaccines are contraindicated during pregnancy and are considered teratogenic, such as rubella. Penicillin and acetaminophen may be taken under provider supervision. Folic acid supplementation should be encouraged.
biophysical profile (BPP)
uses a real-time ultrasound and NST to allow assessment of various parameters of fetal well-being that are sensitive to hypoxia. A BPP includes ultrasound monitoring of fetal movements, fetal tone, and fetal breathing as well as ultrasound assessment of amniotic fluid volume with or without assessment of the fetal heart rate. A BPP is performed in an effort to identify infants who may be at risk of poor pregnancy outcome, so that additional assessments of well-being may be performed or labor may be induced or a cesarean section performed to expedite birth. The primary objectives of the BPP are to reduce stillbirth and to detect hypoxia early enough to allow delivery in time to avoid permanent fetal damage resulting from fetal asphyxia.
The nurse is assessing a client's risk for sexually transmitted infections. Which statement by the client would be cause for concern? -"I am not sure if I want to keep the baby. It is a hard decision." -"I am unsure who the father of the baby is. I will be raising it alone." -"I needed Rho(D) immune globulin after my last pregnancy. Will I need it again?" -"I only want my family to see the baby after it is born."
"I am unsure who the father of the baby is. I will be raising it alone." While many individuals have complex social issues, if a client states that she is unsure of the father of the baby, it is understood that she has had recent, multiple sex partners. Sex with multiple partners places the client and fetus at risk for a sexually transmitted infection. Not wanting to keep the baby, needing Rho(D) immune globulin, and having social issues does not place the client at risk for sexually transmitted infections.
At the first prenatal visit of all clients who come to the clinic appropriate blood screenings are obtained. The nurse realizes that an HgbA1C above which level is concerning for diabetes and warrants further testing? -6.5% -6.0% -5.5% -5.0%
6.5% A hemoglobin A1C level of at least 6.5% is concerning for overt diabetes, and further testing should be conducted to ensure the client is not diabetic. If glucose testing is not diagnostic of overt diabetes, the woman should be tested for gestational diabetes from 24 to 28 weeks' gestation with a 75-gm oral glucose tolerance test.
Primigravida
A woman pregnant for the first time
The nurse is assigned to clients who are having the following procedures: amniocentesis, fetal nonstress test, chorionic villus sampling, percutaneous umbilical blood sampling, and Doppler assessment of fetal heart rate. For which clients will the nurse ensure that signed informed consent has been given and is in the client's record? -Amniocentesis, chorionic villus sampling, fetal nonstress test -Amniocentesis, chorionic villus sampling, percutaneous umbilical blood sampling -Fetal nonstress test, Doppler assessment of fetal heart rate -Amniocentesis, percutaneous umbilical blood sampling, Doppler assessment of fetal heart rate
Amniocentesis, chorionic villus sampling, percutaneous umbilical blood sampling While the client ultimately consents to all procedures, some require signed documentation of consent within the client's record. An informed consent is needed for an amniocentesis, chorionic villus sampling and a percutaneous umbilical blood sampling due to the invasive nature of the procedures. Both the fetal nonstress test and the Doppler assessment of the fetal heart rate are non-invasive procedures.
The nurse is assessing a client at 12 weeks' gestation who reports enjoying her usual slow, long daily walk. The nurse should point out which recommendation to this client? -Reduce walking to half a block daily. -Continue this as long as she enjoys it. -Stop and rest every block. -Engage in aerobics for greater benefits.
Continue this as long as she enjoys it. Walking is an excellent exercise during pregnancy because it is low impact and increases venous circulation. Exercise should be maintained as long as it is comfortable, but intensity should not increase over what is normally performed.
At 32 weeks' gestation a client with a BMI of 23 has gained 24 lb (11 kg). What is the nurse's recommendation for weight gain for the remainder of this pregnancy? -Continue to gain approximately 1 lb (.45 kg) per week during this pregnancy. -Watch the diet so no additional weight is gained during this pregnancy. -Limit weight gain to less than 5 lb (2 kg) for the remainder of this pregnancy. -Increase weight gain to 1.5 lb (0.68 kg) per week during this pregnancy.
Continue to gain approximately 1 lb (.45 kg) per week during this pregnancy Expected weight gain is 1.5 lb (0.68 kg) per month in the first trimester and 1 lb (.45 kg) per week for the second and third trimester. This client needs to continue to gain 1 lb (.45 kg) per week. Restricting weight gain near the end of pregnancy can negatively impact fetal growth.
A pregnant woman states that she would like to take a tub bath but has heard from her aunt that this could be dangerous to the baby. Which instruction should the nurse give to the client? -Tub baths are fine unless you are unstable on your feet or are experiencing vaginal bleeding. -Avoid tub baths at all times during pregnancy, as they may be dangerous for the fetus. -Long soaks in very hot water are encouraged during pregnancy to promote relaxation. -Tub baths are fine, but avoid using soap, as this may prove a teratogen to the fetus.
Tub baths are fine unless you are unstable on your feet or are experiencing vaginal bleeding Daily tub baths or showers are recommended. Women should not soak for long periods in extremely hot water or hot tubs, however, as heat exposure for a lengthy time could lead to hyperthermia in the fetus and birth defects, specifically esophageal atresia, omphalocele, and gastroschisis. As pregnancy advances, a woman may have difficulty maintaining her balance when getting in and out of a bathtub. If so, she should change to showering or sponge bathing for her own safety. If membranes rupture or vaginal bleeding is present, tub baths become contraindicated because there might be a danger of contamination of uterine contents. Soap is not a teratogen to the fetus.
At each subsequent prenatal visit, the following assessments are completed:
Weight and blood pressure, which are compared with baseline values Urine testing for protein, glucose, ketones, and nitrites Fundal height measurement to assess fetal growth Assessment for quickening/fetal movement to determine fetal well-being Assessment of fetal heart rate (should be 110 to 160 bpm)
The nurse discovers a new prescription for Rho(D) immune globulin for a client who is about to undergo a diagnostic procedure. The nurse will administer the Rho(D) immune globulin after which procedure? -contraction stress test -amniocentesis -nonstress test -biophysical profile
amniocentesis Amniocentesis is an invasive procedure whereby a needle is inserted into the amniotic sac to obtain a small amount of fluid. This places the pregnancy at risk for a woman with Rh(D)-negative blood, since the puncture can allow the seepage of blood and amniotic fluid into the woman's system. She should receive Rho(D) immune globulin after the procedure to protect her and future babies. The CST, NST, and a biophysical profile are noninvasive tests.
Chorionic villus sampling (CVS
an invasive procedure involving an 18-gauge needlestick through the abdomen or passage of a suction catheter through the cervix under ultrasound guidance. This test is used to obtain a sample of the chorionic villi from the placenta for prenatal evaluation of chromosomal disorders such as Down syndrome or cystic fibrosis, enzyme deficiencies, and fetal gender determination and to identify sex-linked disorders such as hemophilia, sickle cell anemia, and Tay-Sachs disease (Levy, 2019). Chorionic villi are fingerlike projections that cover the embryo and anchor it to the uterine lining before the placenta is developed. Because they are of embryonic origin, sampling provides information about the developing fetus. CVS can be used to detect numerous genetic disorders with the exception of neural tube defects
A nurse is providing education to a client who is 8 weeks' pregnant. The client stated she does not like milk. What is a source of calcium that the nurse can recommend to the client? -dark, leafy green vegetables -deep red or orange vegetables -white bread and rice -meat, poultry, and fish
dark, leafy green vegetables Dark leafy green vegetables are a source of calcium. Red and orange vegetables contain a variety of vitamins, bread and rice contain carbohydrates, and meat and fish contain protein, but none of these foods are a good source of calcium.
A pregnant woman experiences frequent leg cramps. Which measure would the nurse include in her teaching plan to provide her with relief? -elevating her leg on two pillows -bending her knee and dorsiflexing her foot -plantarflexing her foot and wiggling her toes -extending her knee and dorsiflexing her foot
extending her knee and dorsiflexing her foot Dorsiflexing the foot with the knee extended is an effective method for relieving cramps in the calf muscle, the most frequently affected muscle.
A pregnant client tells the nurse that she has a 2-year-old child at home who was born at 38 weeks; she had a miscarriage at 9 weeks; and she gave birth to a set of twins at 34 weeks. Which documentation would be appropriate for the nurse? -gravida 2, para -1 gravida 4, para 2 -gravida 3, para -4 gravida 2, para 4
gravida 4, para 2 Gravida (G) indicates the number of pregnancies. When a nurse calculates the GP of a pregnant client, the current pregnancy counts as one, the twin pregnancy counts as one, and the previous pregnancies count as two for a gravida of 4. Para (P) indicates the number of pregnancies that result in birth at a viable gestational age. The birth of multiples count as one. Thus, this client has a 2-year-old and one set of twins, for a para of 2.
A client in her third trimester of pregnancy visits the health care center and asks why she is constipated. The nurse would include which most likely cause when responding to the client? -engorgement of veins by the weight of the uterus -pressure on intestine by the growing fetus -pressure of fetal head on the bladder -relaxation of cardioesophageal sphincter
pressure on intestine by the growing fetus The nurse should explain that constipation often occurs during the third trimester because the growing fetus exerts pressure on the intestine. Engorgement of veins by the weight of the uterus causes varicosities. Pressure of the fetal head on the bladder increases the frequency of urination. Relaxation of the cardioesophageal sphincter causes heartburn.
A nursing student correctly identifies which action to be the best way to prevent complications of pregnancy? -limiting work hours -receiving prenatal care -getting adequate rest each night -eating a diet high in protein
receiving prenatal care Prenatal care is essential for ensuing the overall health of newborns and their mothers. Prenatal care is a major strategy for helping to reduce complications of pregnancy. Limiting work hours is not necessary. Eating a diet high in protein and getting adequate rest (although helpful) will not prevent complications during pregnancy.
