Presumptive signs of pregnancy
Amenorrhea
Breast Tenderness
Nausea Vomitting
Breast enlargement
Urinary frequency
Uterine enlargement
Fatigue
Hyperpigmentation of skin
Fetal movement (Quickening)
What is a Nonstress test and results
NST is a external fetal monitor- in response to fetal movement
Reactive= good shows 2 accelerations in FHR lasting 15 seconds during 20 minute period
Non Reactive= not good- do a biophysical profile
What to do if prolapsed umbilical cord
Use fingers to hold presenting part of baby off umbilical cord to reduce compression
Call for help
Place mom knee to chest - trendeleburg
Apply o2
Prepare for c-section
Postpartum Assessment
Breast
Uterus
Bowels
Bladder
Lochia
Episiotomy/Laceration
Gestational HTN
BP higher than 140/90 without presence of protein in urine after 20 wks gestation
Probable Signs of pregnancy
Positive pregnancy test
Heger sign
Goodell sign
Chadwich Sign
Uterine enlargement (exam)
Braxton Hicks
How to do a Kick count at home and positive results
Eat and drink before
Left side lying down
Count kicks
Regular= 10 kicks in 2 hours
Placenta covering cervical os- partial or completly
S/S
Painless red bleeding
Uterine tone is soft
US done to diagnose previa
Mastitis S/S
Enlarged breast on one side
bread lump and pain
fever and flu like symptoms
itching and nipple discharge
redness, swelling, tender and warmth
Preeclampsia
BP higher than 140/90 and proteinuria over 300mg in urine
Positive Signs of pregnancy
Fetal heart beat per doppler
Fetal movement palpated by clinician
Ultrasound visual of fetus
Naegele Rule- How to calculate
LMP- June 15 2022
Subtract 3 months
Add 7 days
Answer= March 22, 2023
What is abruptio placentae and Signs of it
Placenta detaches from uterus wall can cause hemorrhage
RF- Cocaine use, HTN, Trauma to Abdomen
S/S severe abd pain
Fundus firm boardlike
Dark red vaginal bleeding
Late decelerations
Lochia - 3 different stages
Rubra- 1-3 days bright red small clots
Serosa 4-9 days pink to brown serous no clots
Alba 10 days-3 wks cream yellowish
Eclampsia
Tonic clonic seizures in relation to increased BP and proteinuria - C SECTION
What is the line in middle of abdomen called
Five digit system G T P A L
G= # of pregnancies including current
T= Term babies born after 37 weeks
P- Preterm births born b/w 20-36w6d
A- Abortions elective or spontaneous prior to 20wks
L-Living children
Pitocin (Oxytocin)
Used to induce labor and strengthen contractions and control bleeding after childbirth
6 contractions or more in 10 minutes turn it OFF
Evaluate- FHR Contraction Pattern and Materal VS
C section care
Incentive spirometer
Foley cath-24hours
Early ambulation
Splint when coughing
Fundus checks
HELLP syndrome
Hemolytic anemia
Elevated Liver enzymes -ALT AST LDH
Low Platelets - less than 100,000
Life threatening
3 components of fetal circulation
Amniotic fluid
Placenta
Umbilical Cord
When do give Rhogam
Pregnant woman with negative coombs test at 28 wks
After delivery - baby is Rh positive and mom was negative
give within 72 hours of birth
S/S of True Labor
Regular contractions
increasing in frequency and intensity
Pain in back to abdomen even with rest
cervical changes
sedation doesn't stop contractions
bloody show
Post partum infection
Fever
chills
tachycardia
lochia- foul order
UTI
Severe pain
Mag Sulfate
4-6gm bolus over 30 min
2-4/hr maintenance
SE: facial flushing, nose stuffy, vision disturbances, sweating , sleeping
Toxic-crackles, sob, low o2, no deep tendon reflex, loc, low urine output
give calcium gluconate