Maternal Newborn Flashcards
How do you calculate a due date?
- Take the first day of the last period
- Add 7
- Subtract 3 mths
i.e June 10 + 7days - 3 mths = March 17th
What is the average weight gain for a pregnant women?
28 pds, plus or minus 3
1st trimester = 1 pd per mth.
2nd and 3rd trimester = 1 pd wk
How do you calculate weight gain?
Take the week of gestation and minus 9
Question:
A women in her 28th week has gained 22 pds. what is your inpression?
28-9=19pds
She gained 3pds more than she was suppose to therefore assess - if she’s within 1-2pds she’s ok. 3+ pds assess. 4 > trouble.
What is the formula for ideal weight gain?
Week of gestation minus 9
The fundus is the top part of the ______.
Uterus
Can you palpate the uterus in the first trimester?
NO! Cannot palpate till 12 weeks ( end of 1st trimester)
When is the fundus at the belly button (umbilicus)
Approx. 20-22 weeks gestation.
When is the date of viability
22-24 weeks ( end of the 2nd trimester)
Can you use uterine height to determine what trimester the women in?
YES!
1st trimester if you cannot palpate fundus who’s is the priority mom or baby?
Mother
2nd trimester where do you palpate the fundus?
Who is the priority mom or baby?
At or below the umbilicus.
Mother.
3rd trimester where do you palpate the fundus?
Who is the priority mom or baby?
Above the umbilicus
Baby
List the 4 positive signs of pregnancy.
- Fetal Skeleton on xray
- Fetal presence on ultrasound (8-12 weeks)
- Auscultation of fetal heart rate - 140
- Examinar palpates ( not mom)
Most OB questions give a range i.e. fetal heart rate 8-12 weeks, so read OB questions carefully. Pay particular attention to the wording.
- When would you FIRST auscultate a fetal heart rate?
- When would you MOST LIKELY auscultate a fetal heart rate?
- When SHOULD YOU BY?
- First = 8 weeks ( earliest part of range)
- Most likely = 10wks ( mid range)
- Should you by = 12 weeks ( end range)
For quickening:
- When would you FIRST feel quickening?
- When would you MOST LIKELY feel quickening
- When SHOULD YOU BY?
- FIRST-16 wks
- MOST LIKELY 18 wks
- SHOULD YOU BY 20 wks
List Maybe signs (probable and presumptive signs)
- All urine and blood tests
2. Chadwicks, Goodells Sign, Hegars
Is a positive pregnancy test a positive sign of pregnancy?
NO! it only means you have the hormones for pregnancy but not necessary fetus
Describe Chadwicks Sign, Goodells Sign and Hegars
Chadwicks - Cervical , color change to cyanosis ( All “C”)
Goodells - cervix softening
Hegars - Uterus softening
What is included in teaching the OB patient the pattern in office visits.
Good prenatal care decreases infant mortality.
Visits include:
1. Visit once a mth until 28 weeks.
2. From 28 wks - 36 wks visit every 2 weeks
3. 36 wks visit weekly until baby delivered or 42 wks.
What is the normal hemoglobin range?
12-16.
Is the hemoglobin level in a pregnant women expected to rise or fall? What are the expected levels in the 1st, 2nd, and 3rd trimester?
Fall.
1st - 11 normal
2nd - 10.5
3rd - 10
How should you tx. morning sickness?
1st trimester
Dry Carbs - before they get out of bed
How do you deal with urinary incontinence in the 1st and 3rd trimester?
Void every 2 hrs from day of pregnancy to 6 weeks after delivery.
What do you do in the 2nd and 3rd trimester when you pt. is having difficulty breathing?
Teach the tripod postion
How do tx. back pain in the 2nd and 3rd trimester?
Tx. pelvic tilt exercises tilt pelvis forward.
How do you know if a women in labour?
Onset of regular progressive contractions