Reproduction

Case study’

Presumptive: N/V, aversion to smells, urinary frequency, amenorrhea, breast tenderness, fatigue, quickening

Probable: Positive pregnancy test, weight gain, cervical changes, ballottement (pressive fetal movement is elicited when provider pushed on the cervix), colostrum present, Chadwick sign (blue tint to cervix), Linea nigra, Hegar sign (softening of the istrums of the uterus). Braxton hicks, fundus palpation height, blood pregnancy test, mask of pregnancy, darkining and elarging of nipples.

Positive: Fetal heartrate on an ultrasound

G2P0A1L0

Pregnant 2, none born alive, abortion one, living none

AMA: advance materinal age 35 and above

Dilation and evacuation prodcudure

Had postpartum depression after loss of first pregancy

Iron deficiey anemia which is common

Basal body temp to see when the pt is ovulating

Folic acid preven neuro two defects which occurs during the first two weeks of pregancy

25=30j lbs wieght gain

Prenatal vitamin: its for baby nutriontal need can make n/v worse

Iron

Flu, Covid, RSV good for baby bc crossess placenta to baby to rpvie aqcuired imunity

TDAP 9tentnus, diphetheria, pertusisi (whopping cough) mom gets its week 27-36 week of pregancy, and caregicers should get it as well to protect baby

Do not give live vaccines such as MMR, Vaccerlia, nasal flu, HPV

MMR (measules, murps, rubella) live want to know if they are immune, would give it to them after delivery, get a boaster if they aint immune

A immunocomprimsed/high risk would get pneumonia,

If non-immune and does not have active hep B infection - consider hep B vaccine

20 week morphology scan - looks at baby and amnitic fluid and placenta placement

Rh postive baby give rohgan after 72 hrs of birth

Coffe less than 200 mg a day, alchol, unpastruazed cheese,engergy drink, raw fish (high in mercury) /sushi listera & samollia, tuna, salmon (big fish/old fishe, deep sea fish)
Quadrplic marker screening, mood screening/postrum depression, non invasim prenatal testing, group data, blood typing,GBS for baby, non-fetal stress test, measures baby fetal Hr and movement’=, Auad screen has many false postives.
Ultrasound, fetal heart, fundal heiggt, vs,balloment, fetal monitoring, weight checks, pica, support system, cervical checks, Dropplor

Timester expectations 9baby weight,

poly

WIC- woman and children food and formula, does not cover diappers

SNAP - food stamps for low income

food drive/bank

Medicaid

walking, yoga, water arobic, kegals low impact, 150 mins per week. lay on left side

Indirect coombs test:

Expect during trimester

1: wieght gain 1-5 lbs, N/V, fatiguie, increse urination, amnehorrhea, implantation bleeding (spotting), cravings, breat tenderness/nipple changes, changes in mood

2:lessened discomfty sympoms, weight gain 1lb a week, quickining, gender reveal 20 week, vaginal discharge, glucose tolerance test, dental changes, skin changes, limia nigra, avoid sleeping on back

3:lordosis (curving of spine in the back), swelling in legs, hemrrhoids, baxtons hicks, birth plan, feeding plan, postpartum depression vs baby blues, parenting classess, nesting. Signs of impending labourl lossing mucus plug, braxton hicks(sit down and water should relive it), increase of kicking of baby

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Aminocentesis is inbasive testing to look for fetal abnormalities or lung maturity during 3 trimester

FNST is non-invasive and uses an external monitor to assess babys HR and o2. CNS system and HR.

Danger warning signs

No fetal movement

Abd pain excessive or intense cramping

DVT( heat, pain, leg swelling)

no compression stocking on DVT leg

Signs of infection0 fever, hypereminsis,

Oluguira

Bleeding

Thoughts of harming self or other, fall on body, chest pian, stroke sympoms

Gush of fluid or contrasn leaking of fluid - color, amount

ph is alkaline for the amonic fluid

Ferning test to test if its amonic fluid vs urine

sever headache that wont go away (preecplamisa) blurry vision, URQ pain, sweeling on hands,

Magnesium sulfate drip and RR 10 stop immdeitnly and give calicum glucanate. Magnesium sulfate is given for preeclampsia to prevent seizurez. Magnesium toxcitiy - resp suppersion, halos of light. '

36 weeks

Position is baby spine to moms spine,

Leopold maneuver to feel for the baby position if baby is breached under med in hospital externally turn baby.

Effaced is how thin the cervix is.

latent phase

Cervix begins to dilate 0-6 cm, contractions begin mild and irregular, lasting 30-40 secs, Q 10:30 minutes.

Talks through contractions, excited/anxious, birthing ball, sitting backwards on the toilet, breathing excerzie.

Interventions: Ambulation, water, warm showers

pain control: Warm bath (if membranes are not ruptured)

If preterm and membranes are intact, to stop labor administer: Terbutaline

If baby gonna be born preterm adminster betamethasone to speed up development of baby lungs. Also magnesium seulfate for neuro protection for baby.

NPO/clear liquid

120-160 FHR norm

Early decela is a peack before the contraction bc baby head is trying to move

Late deceal is after the contraction, placenta

Variable decials is cord compression

For late decial and variable decels: 10-15 nonrebreather, stop oxy, L side, md

Reasurring is vairability, accelerations, early deceleration baby moving down

Mom is not dilating/thinning on own?

Cerivcal ripening agents (prostaglandins): Misoprostol a prostagladin E2

Cooks ballon

Mom contraction not progressing?

Uterine stiumaltion: Oxytocin (pitocin

IV nalbuphine (opiod) have naloxone reversal

Active phase labour

Lamaze breathing, distraction, counter pressure, involve support person,

Epidural: bupivacain/gentanyl non-system goes in epidural space

Give bolus of LR to prevent BP drop after, can they hold still, get baseline of vs, platelet level stable, foley cath, full maternal bladder increase risk of hemorrhage. D/c foley before pushing baby. Itching

Nalbuphine systempic opiod risk of low bp and suppressed RR for mom and baby

Transition phase feels like I need to push she finna push

+2 station in birth cannal +3 baby is coming out

Not push when doing cerival check when feeling imblace cord leave the hand stays there until mom goes to or for c-section, okacebta

foot,, butt, hand

Only thing ya should be feeing is the head

if stoping oxy due to late decelas then can cont oxytocin post delivery

Oil around do they wont tear

crowining you see the head

lightling: baby is moving down therefore the baby goes from diaphram to down bc preasure is off

quiz wednesday mood and afect and thruday postpartum