GU 3 Flashcards
pregnancy - take hx of
7
- LMP
- delivery date
- prior pregnancies
- new vaginal discharge
- bleeding
- prenatal care, vitamines
- fetal movement
pregnancy - if BP elevated consider
2
preeclampsia, eclampsia
pregnancy - PE might reveal
3
- enlarged uterus
- Chadwick sign - cervical changes of softening, bluish discoloration
- increased vaginal discharge (leukorrhea)
pregnancy - img/testing
3
- pregnancy test
- fetal heart tones - 2nd and 3rd trimester
- POC urine
pregnancy - refer to who for f/u care
gyno
pregnancy - recommend daily vitamin that contains what
2
folic acid and DHA
NV in pregnancy - non pharm info
4
- recommend frequent, small meals
- small sips of water
- changing positions slowly
- consider ginger products
NV in pregnancy - rx options
2
- pyridoxine (vitamin B6) 10-25 mg PO q8h plus doxylamine succinate 25 mg PO up to q8h
- persistent vomiting despite above tx - metoclopramide or ondansetron but discuss why gyno before
pregnancy - when to refer to ER
- all suspected obstetrical emergencies - pain, bleeding, or ruptured membarnes
suspect ectopic pregnancy
unilateral pelvic pain and positive urine hCG - send to ER
hyperemesis gravidarum
excessive vomiting, send to er - can check urine for ketones but send to ER
premature prelabor ruptue of membranes (PPROM)
< 37 weeks gestation - sterile speculum exam may confirm pooling of amniotic fluid; nitrazine paper will stain dark blue; send to L/D in ER
cord prolapse
umbilical cord slides through cervix and may be compressed w/ contractions, resulting in fetal hypoxia, anoxia or death
cord prolapse tx
3
- call 911
- place oxygen on mother, place in Trendelenburg position
- try to decompress cord w/ hand by elevating fetal presenting part
placenta previa
implantation of placenta over cervical os
placenta previa - pt may present with
painless vaginal bleeding in 2nd half of pregnancy
painless vaginal bleeding in 2nd half of pregnancy
placenta previa - major risk for PP hemorrhage
placenta previa tx
911
if suspected, do not attempt bimanual or speculum exam
placental abruption
premature separation of placenta from wall of uterus, resulting in bleeding and pain secondary to uterine contractions
premature separation of placenta from wall of uterus, resulting in bleeding and pain secondary to uterine contractions
placental abruption
placental abruption tx
911
if suspected, do not attempt bimanual or speculum exam
HTN in pregnancy
BP reading 140 or 90 lasting >15 min
HTN in pregnancy - urine neg for proteinuria and asymptomatic do what
consult OB
HTN in pregnancy - urine + proteinuria or symptomatic (HTN, HA, visual disturbances, HELLP syndrome, abd pain RUQ epigastric)
refer to ER, consider EMS transport
