Screening for Obstetric, Geriatric, and Post-Op pts Flashcards
list examinations and treatment considerations for Obstetric pts
- avoid flat prone lying in mid-late pregnancy
- avoid supine positions for longer than a few minutes after 4th month of pregnancy → monitor for nausea, bradycardia, and syncope
- avoid activities that strain the pelvic floor/abdominal muscles
- avoids positions that involve rapid uncontrolled bouncing or swinging
- avoid aggressive stretching of hip adductors
- avoid overheating
- avoid deep heat modalities or electrical stimulation over the trunk
what is supine hypotension syndrome?
occurs due to weight of growing baby pressing onto and obstructing the inferior vena cava
examination and treatment considerations for supine hypotension syndrome
- Monitor for:
- nausea
- bradycardia
- syncope
- suggested positioning:
- rotate 30 degrees to L supported with pillow under R side to shift uterus to L and relive caval occlusion
list common medical conditions and symptoms of pregnancy
- Backache → consider possibility of kidney infection
- Carpal tunnel syndrome
- HA
- muscle cramps
list special questions for pregnant pts
- any complications with this pregnancy?
- any complications with a previous pregnancy or delivery that is placing you at high risk now? Were you considered high risk in a previous pregnancy?
- Did you have any of your current MSK symptoms during a previous pregnancy and, if so, what was done for them? Was the treatment successful?
- What meds are currently being taken and what meds did you stop b/c of your pregnancy?
- are you currently having any urinary or anal incontinence?
list special questions for postpartum pts
- were you on bed rest during pregnancy? If so, how long?
- did any of the following occur during delivery:
- regional anesthetic injection
- forceps or vacuum extraction
- episiotomy or tears of perineum
- cesarean
- do you now have symptoms of urinary or anal incontinence or organ prolapse?
- did you have current symptoms during your pregnancy or after a previous pregnancy and, if so, was there any treatment that was successful in alleviating these symptoms
list common referrals to pelvic health specialists
- anal or urinary incontinence; urinary urgency
- pubic symphyses pain
- SI pain
- Rib pain
- LBP in pregnancy or postpartum
- diastasis recti abdominis
- pelvic floor muscle tenderness or pain
- pelvic floor muscle weakness
- postpartum neuromuscular injury
list 7 conditions to screen for in pregnant or postpartum pts
- preeclampsia
- ectopic pregnancy
- fetal distress
- osteoporosis of pregnancy
- DVT
- postpartum depression
- postpartum psychosis
list S/S of Preeclampsia
- Symptoms
- HA
- blurred vision
- Signs
- edema (sudden onset, may be global)
- HTN
- proteinuria
List S/S of ectopic pregnancies
- severe lower abdominal pain
- dizziness
- lightheadedness
- nausea
list S/S of fetal distress
decreased fetal movement
list S/S of osteoporosis of pregnancy
- Symptoms
- pain in hip or lower back
- pain with WBing
- Signs
- empty or spasm end-feel in hip flexion
- lose of height
list S/S of DVTs
- localized calf, popliteal or anterior thigh or groin pain
- calf of LE swelling
- pitting edema
list S/S of postpartum depression
- severe mood swings
- loss of appetite
- irritability
- withdrawal from family
- difficulty bonding with baby
- thoughts of harming baby
list S/S of postpartum pyschosis
- mania and depression
- hallucinations/delusion especially concerning the child
what can be used to screen for postpartum depression?
Edinburgh Postnatal Depression Scale (EPDS)
a score of 10 or more warrants a referral
what is gestational diabetes?
women that have high blood glucose levels during pregnancy that did not previously have DM
usually goes away after pregnancy