module 12 prenatal care Flashcards
Barriers to care
physically accessible financially accessible culturally accessible temporally accessible practically accessible
nageles rule
LNMP - 3 months + 7 days
prenatal visit schedule
before 28 weeks: monthly
28-36 weeks: every 2 weeks
36 weeks - birth: weekly
initial prenatal visit labs
BHCG US Blood type, Rh Rubella titer CBC (Hgb/Hct) UA Pap if indicated RPR, VDRL HepBsAG HIV antibody screen CF screen Varicella titer TB GC/chlamydia
done at prenatal visit
BP Wt FHT UA fundal height GBS screen vaccines
prenatal vaccines: during preg
Flu
Tdap: between 27-36 weeks
vaccines contraindicated during preg
HPV
Live flu
MMR
Varicella
genetic testing in the 1st trimester
US for size and dates (8-12wks)
Non-invasive prenatal testing (10 wks)
Nuchal translucency US (11-13 wks)
CVS (11-13 wks)
Genetic testing in the 2nd trimester
Quad screen (15-18wks)
Amnio (15-19 wks)
Anatomy scan US (18-20 wks)
gestational DM screening
OGTT 24-26wks
- 50g check serum 60 minutes later
- > 130 mg/dl need to have 100g OGTT
Nutrition during preg
1800-2400kcal/day protein intake of 60-75g/day folic acid Vit B12 Iron Calcium Vit D
Wt gain during pregnancy by BMI
< 18.5: 28-40lb total (1lb/week 2/3 trimester)
18.5-24.9: 25-35 total 1lb/week 2/3 trimester)
25-29.9: 15-25 total 0.5lb/week 2/3trimester)
>30: 11-20 total (0.5lb per week 2/3trimester)
postpartum visit
4-6 weeks PP physical emotional contraception breastfeeding infant
physically accessible
located on bus routes
no parking fees
financially accessible
acceptance of a variety of payment options
low out-of-pocket costs
