Pregnant Abdomen - vital signs, urinalysis, pregnancy dating, EDD, fundal height

Question 1

Introduction

Answer 1

Hello my name is An, I’m a 3rd year medical student attached to the obstetrics department. Can I confirm your name and DOB?
I’ve been asked by the team to measure your vital signs, test your urine, measure you tummy and date your pregnancy, would this be ok?
Do you have any questions?
Are you in any pain today?

Question 2

Vital signs

-possible problems

Answer 2

HR, RR, SaO2 on other finger, temp probe in mouth
BP
AVPU

High blood pressure

• more freq monitoring for signs of preeclampsia
• labetolol

Question 3

Urinalysis

Answer 3

Inspect - cloudy, blood, colour, foamy?
Open with gloves on, have tissue paper ready
Sniff - foul (infection?)
Dip completely
Place on tissue and wait

Gestational diabetes

• capillary glucose monitoring kit
• regular 150min moderate physical exercise
• regular meals with slow release carbs, 5aday, reduce sugary food/drink intake
• metformin or insulin if needed
• extra antenatal appointments

UTI

• Nitrofurantoin, plenty of fluids, simple analgesia for pain relief
• MSU for culture and sensitivities
• safety net - symptoms don’t improve, fever, N+V, back pain

Preeclampsia - proteinuria + HTN + blurry + abdo pain + swollen ankles
-hospital admission for monitoring, may need to deliver

Question 4

Pregnancy dating, EDD

Answer 4

Pregnancy dating

EDD
LMP => add 1 year, minus 3 months, add 7 days

Question 5

Fundal height

Answer 5

Pubic symphysis => top of uterus (feels like the top of a hard ball)
Matches no of weeks after 20wks