Pre-natal and Well Child Visits Flashcards
What info do you need to get at first pre-natal visit?
(OB History)
G (gravida) - # of times pregnant
T (term) - # of full term deliveries
P (preterm) - # of preterm deliveries
A (abortions) - # of abortions prior to 20 wks
L (living) - # of living children
Calculate EDD
example: woman with first day of LMP Feb 14, 2015
Naegele’s Rule: 1st day of LMP + 7 days +9months
example:
Feb 14+ 7days = Feb 21,
Feb21 + 9mo= Nov 21, 2015 is estimated due date
which STD do you screen for at initial pre-natal visit?
chylamdia
What physiologic changes occur in pregnancy:
(Cardiovascular)
increased HR (by 10-20BPM)
May develop murmur (systolic ejection)
IVC syndrome – may get light-headed or faint
→Lie on left side for relief
Producing more RBCs (need more iron)
What physiological changes occur in pregnancy?
(Vascular)
Increased risk for VTE
Edema
Blurred vision – don’t need Rx for glasses
What physiologic changes occur in pregnancy?
(pulmonary)
Congestion
SOB
What physiologic changes occur in pregnancy?
(Gastrointestinal)
N/V
Reflux
Constipation/bloating
Hemorrhoids
What physiologic changes occur in pregnancy?
(urinary)
Frequency
Incontinence
increased risk of UTI
What physiologic changes occur in pregnancy?
(endocrine)
TGs up by 300% - don’t check cholesterol
*may get: *gesational diabetes mellitus or hypothyroidism
What physiologic changes occur in pregnancy?
(Breasts)
Bigger/darker areola, tender breasts
What physiologic changes occur in pregnancy?
(Skin, hair, nails)
Mask of pregnancy (blotchy skin darkening)
Linea nigra
Acne
Varicosities
Stretch marks
Increased hair volume
What physiologic changes occur in pregnancy?
(MSK)
Back pain
Lax ligaments
What are some important education topics to cover pre-natally?
Pregnancy Education
Nutrition
Wt gain of 25-35 lbs (if healthy weight pre-pregnancy→ Underweight women should gain 28 to 40 pounds. Overweight women may need to gain only 15 to 25 pounds during pregnancy
Pre-natal vitamins
Exercise
Seat belt – below uterus, across hips
Avoid toxins
Medications – pay attention to class
Travel- safest mid pregnancy, restricted on commerical airlines in last month
Milestones at 1mo
Responds to parents’ faces/voices
Able to fix gaze and focus
Alerts to sounds/noises – startles, change in respiration, etc
Milestones at 2mo
Gaze follows past midline
Coos reciprocally
Smiles socially
Able to move head/lift chest briefly when lying prone
Improving head control when upright
Interest in visual stimuli
Milestones at 4-5 mo
In prone position, hold head upright and raises body on forearms
Holds head high and steady when seated/upright
Laughs and giggles
Holds own hands, brings hands to mouth
Begins reaching for items with purpose and intent
Rolls over front to back
Milestones at 6mo
Squealing, screeching and babbling reciprocally
Shows differential recognition of family and caregivers
Transfers objects from hand to hand
Rolls front to back and back to front
No head lag when pulled to sit
Sits with support
Bears weight on legs
Rakes objects to pick them up
Eating pureed foods
Milestones at 9mo
Babbles with single consonants, imitates vocalizations
understands simple words like, “hi” or “bye”
Crawling/scooting/creeping/cruising
Sits independently
Enjoys social games such as peek-a-boo and patty cake
Eating some table foods/starting to self feed
Stranger/separation anxiety
Responds to own name
milstones at 1yr
Precise pincer grasp (can pick up Cheerios)
Points with index finger
Pulls to stand, cruises, possibly takes steps alone
Looks for dropped/hidden objects
Says 1-3 words in addition to Mama/Dada
Imitates vocalizations
Bangs things together
Puts items into and takes items out of containers
Plays social games
Drinks from cup and eats table food/self feeding
milestones at 18mo
Identifies pictures in a book/turns pages
Follows simple commands
Vocabulary of 10-20 words, 2 word phrases
Imitates words
Walks quickly or runs stiffly
Shows affection – gives hugs and kisses
Uses spoon and cup
Uses toys/things correctly
Throws ball
Stacks 3 blocks
Milestones at 2yr
Walks up and down stairs one step at a time
showing defiance
Kicks ball
Vocabulary of 30-40 words, 2 word phrases
Speech 25-50% intelligible to strangers
Follows 2 step commands
Makes horizontal and circular strokes when coloring
Eats independently with utensils/fingers
Climbs on furniture, opens doors
Milestones at 3yr
Identifies some colors
Can copy a cross or circle
Speech mostly intelligible to strangers
Speech conversational – uses pronouns, plurals, sentences
Kicks and throws a ball
Knows name, age and sex
Pedals a tricycle
Can dress/undress with assistance
Takes turns and shows affection for friends/family
Can walk up and down stairs, one foot on each step
Milestones at 4yr
Can count objects to 5
Identifies most colors
Pedal tricycle/bicycle
Gets dressed without assistance
Draws person with 2-4 body parts
Uses scissors and pencil well
Hops and stands on one foot up to 2 seconds
Enjoys make-believe play
Developing friendships, shows empathy
Can identify/discuss likes and interests
Can retell a favorite story/sing a favorite song
