Galen NUR 230 Maternity exam 1
Abruptio Placentae (Abruption) - ANS -Premature separation of placenta from implantation site
after 20 weeks
Signs:
-vaginal bleeding (a lot)
-severe abd pain, rigid board-like abd
-uterine contractions, hypertonus
-port wine stained amniotic fluid
-in severe constant pain
will likely be a c section
complete: emergency! baby is not getting enough oxygen
\Anemia - ANS -Normal values during pregnancy:
-hgb 11 or greater
-hct 33 or greater
occurs in 20% of pregnant women
associated with increased incidence of miscarriage, preterm labor, preeclampsia, infection,
postpartum hemorrhage, and intrauterine growth restriction
\Cardiac changes in mom - ANS -Blood volume increases 40-50%
-results in anemia
-BP stays the same or decreases
Cardiac output increases 30-50%
-HR increases
Increased risk for clotting due to increased clotting time and factors
\Fetal Assessment - ANS -FHR: 110-160
Uterine height in cm should equal gestational age +/- 2
Fetal movement: once felt, they should keep feeling it and it should increase as pregnancy goes
\first trimester complications - ANS -heavy bleeding and severe abd pain- may indicate abortion
or ectopic pregnancy
\First trimester discomforts - ANS -Breast enlargement, paim, tingling, and/or tenderness
Urgency and frequency of urination
, Fatigue
N/V
Ptyalism
Gingivitis/Epulis
Nasal stiffness
Leukorrhea (clear/light vaginal discharge)
\First trimester labs - ANS -Hgb and Hct (CBC)
-should be at least 11 and 33
Blood type and Rh
Antibody screen
Rubella titer (may offer booster after pregnancy)
Urinalysis
Screening for HIV, Hep B, Gonorrhea/Chlamydia
VDRL and RPR (screen for syphilis)
Pap smear
Offer sickle cell and cystic fibrosis
\Gestational diabetes - ANS -risk factors:
-obesity
-family hx
-older than 35
-comorbidities
-having a previous infant greater than 9lb at birth
screening:
1 hour glucose test: done at 24-28 weeks, drink the drink in 5 minutes, wait 1 hour, then test.
140 or above, is abnormal
if abnormal, 3 hour OCTT. must be fasting. tested at 1, 2, and 3 hours. if two or more readings
are abnormal, dx is made
if they have it with the first pregnancy they are likely to have it with the next
Abruptio Placentae (Abruption) - ANS -Premature separation of placenta from implantation site
after 20 weeks
Signs:
-vaginal bleeding (a lot)
-severe abd pain, rigid board-like abd
-uterine contractions, hypertonus
-port wine stained amniotic fluid
-in severe constant pain
will likely be a c section
complete: emergency! baby is not getting enough oxygen
\Anemia - ANS -Normal values during pregnancy:
-hgb 11 or greater
-hct 33 or greater
occurs in 20% of pregnant women
associated with increased incidence of miscarriage, preterm labor, preeclampsia, infection,
postpartum hemorrhage, and intrauterine growth restriction
\Cardiac changes in mom - ANS -Blood volume increases 40-50%
-results in anemia
-BP stays the same or decreases
Cardiac output increases 30-50%
-HR increases
Increased risk for clotting due to increased clotting time and factors
\Fetal Assessment - ANS -FHR: 110-160
Uterine height in cm should equal gestational age +/- 2
Fetal movement: once felt, they should keep feeling it and it should increase as pregnancy goes
\first trimester complications - ANS -heavy bleeding and severe abd pain- may indicate abortion
or ectopic pregnancy
\First trimester discomforts - ANS -Breast enlargement, paim, tingling, and/or tenderness
Urgency and frequency of urination
, Fatigue
N/V
Ptyalism
Gingivitis/Epulis
Nasal stiffness
Leukorrhea (clear/light vaginal discharge)
\First trimester labs - ANS -Hgb and Hct (CBC)
-should be at least 11 and 33
Blood type and Rh
Antibody screen
Rubella titer (may offer booster after pregnancy)
Urinalysis
Screening for HIV, Hep B, Gonorrhea/Chlamydia
VDRL and RPR (screen for syphilis)
Pap smear
Offer sickle cell and cystic fibrosis
\Gestational diabetes - ANS -risk factors:
-obesity
-family hx
-older than 35
-comorbidities
-having a previous infant greater than 9lb at birth
screening:
1 hour glucose test: done at 24-28 weeks, drink the drink in 5 minutes, wait 1 hour, then test.
140 or above, is abnormal
if abnormal, 3 hour OCTT. must be fasting. tested at 1, 2, and 3 hours. if two or more readings
are abnormal, dx is made
if they have it with the first pregnancy they are likely to have it with the next
