MCN: Module 3

Johnson’s rule

distance beween the top of the uterus and pubic bone

Johnson’s rule

to measure the fundic height

Mcdonald’s rule

to measure AOG or fundic height

Naegele’s rule

measure EDD or length of pregnancy

n = 12

below the ischial spine

n= 11

above the level of ischial spine

add plus 1

over 200lbs patient

haase’s rule

fetal length

Bartholomew’s rule

fundic height

12 wks

level of symphysis pubis

16 wks

halfway bet the symphysis pubis and umbilicus

20 wks

level of the umbilicus

24 wks

2 fingers above the umbilicus

28-30 wks

midway between umbilicus and xiphoid process

36 weeks

level of xiphoid process

40 wks

2 fingers below xiphid process

8 months or 32 weeks up

time to do leopold’s maneuver

dorsal recumbent

position for leopold’s maneuver

Maneuver 1 or fundal grip

results: buttocks/breech is somewhat hard, globularm non-ballotable

head: hard, round, ballotable (/moves independently of the body)

Maneuver 2 or lateral grip

to check for the fetal back and extremities

Maneuver 2 or lateral grip

results of this maneuver is

Back: hard, smooth, resistant plane (fetal back is also the best way to assess the FHR)

Small parts: irregular, nodular with bony preferences

Maneuver 3 or pawlik’s grip

determines where the fetus is at the lower uterine segment

Maneuver 3 or pawlik’s grip

results are:

fetal head: shift more easily back and forth; firm

fetal breech: move the whole body ; soft

Maneuver 4 or first pelvic grip

to assess the fetal attitude

poor atttitude of the fetus

obstruction on the side of the fetal back

posterior position

brow is very easily palpated

uterine souffle

heart rate from the mother that rush through the large vessels of the uterus

120-160

normal fetal heart rate

funic souffle

a soft murmur caused by blood rushing through the umbilical cord

Hypermesis Gravidarum

nausea and vomiting of pregnancy that extends past 16 weeks of pregnancy

UTI

associated with preterm birth

Nitrazine paper test

can help in distinguishing urine from amniotic fluid

abnormal sign for PIH

tightness of the ring (swelling of hands)

Prophylactic

treatment for HPV 2 infection of the mother

light pink

color of the cervix for non-pregnant women

almost purple

color of the cervix for pregnant women

round and small

cervical os/opening of the cervix for nulligravida women

slitlike

cervical os/opening for previous vaginal birth

8 to 12 days from the star of the LMP

do not do pap smear on the time of menstural cycle for?

Class 1 pap smear

atypical cells are not cancerous

often caused by inflammatory conditions such as infections

Class 2 of pap smear

Suggestive of malignancy with possible maligant cells

Class 3

probably malignant with signs of malignancy present

class 4

Definitely malignant cells are present

ASC (Atypical Squamous cells)

Some cells appear different byt cannot be classified as precancerous

Lowgrade squamous intraepithelial lesion (LSIL)

mild precancerous

High grade squamous intraepithelial lesion (HSIL)

Moderate to severe precancerous

Squamous cell carcinoma

cancerous cells are present

ilium

forms the upper and lateral portion

ischial tuberosities

serves as markers for lower pelvic width

ischial spines

mark the midpoint of the pelvis and assess the fetus has descended into the birth canal

false pelvis

aids in directing the fetus into the true pelvis for birth

inlet

where the fetal presenting part will pass through during delivery

inlet

wider transversely

outlet

inferior portion of the pelvis

outlet

greater diameter is anteroposterior diameter

pelvic cavity

space between the inlet and outlet

10.5- 11 cm

normal size for the true conjugate/conjugate vera

diagonal conjugate

minus 1.5 or 2 cm

platypellloid pelvis

inlet is oval and AP is shallow

anthropoid

TD is narrow and apelike

more than 12.5 cm

ideal vaginal delivery if the diameter is

anus

ischial tuberosity is measured at the level of the

11 cm

is considered as an adequate diameter that will allo w the widest diameter of the fetal head

mild anemia

hgb is less than 11 mg/dl

severe anemia

hgb is less than 9 mg/dl

mild anemia

hct is 27-33%

severe anemia

hct is less than 27%

12-16 mg/dl

normal hgb level

37-47%

normla hct level

VDRL (Venereal disease research laboratory)

serologic test for syphilis

FDAABS

confirmatory test for syphilis

VDRL /RPR (rapid plasma reagin test)

also culture for chlamydia and gonorrhea

Maternal Serum Alpha Fetoprotein (MSAFP)

detects the presence of neural tube or abdominal effect

elevated MSFPMSAFP

result for the presence of neural tube or abdominal effect

decreased MSAFP

result of trisomy 21

amniocentesis or sonogram

confirmatory diagnostic for MSAFP

Indirect coombs test

determine whether Rh positive or Rh negative are present in a woman

offer RhoGAM

if titer is not elevated for coombs test, offer what?

Zidovudine

used to help prevent pregnant women who have HIV from passing the virus to their babies

rubella and hepa b

these vaccines are offered in the postpartum period

2500 cal/day

RDA for pregnant women

iron

the most important mineral that must be taken in supplementary amounts

800-1000mg

recommended daily allowance for iron intake

organ liver

best source of iron

constipation, dark stools, and nausea/gastric irritation

common side effects of takin iron

1200-1500 mg/day

rda for calcium and phosphorus

iodine

helpful for the formation of thyroxine

seafood

best source for iodine combined with iodized salt

vitamin c

promote iron absorption, antioxidant, collagen formation

vit c

excessive intake of this vitamin can result in a functional deficiency in vitamin b12

zinc

for nucleic acid and protein metabolism

sodium

major electrolyte that acts to maintain fluid in the body

fluoride

aids in the formation of teeth

fluoride

large amount of these can cause brown-stained teeth

vitamin k

antihemorrhagic, formation of clotting factors

source for vit k

liver, green leafy veggies, egg yolk, soy beans, tomatoes

vit a

normal vision with main influence on the retina

vit d

aka calciferol

vit d

promotes calcium absorption

bone and teeth development

vit d

source is exposure to UV light