Mark Klimek - Maternity/Newborn Lecture
Calculating expected date of delivery (Naegale's Rule) - ANSFIRST day if last menstrual period
+ 7 days - 3 months
Example: June 10-15 was last menstrual period
Expected date of delivery:
March 17
Total expected weight gain during pregnancy - ANS28 lb + or - 3
(25 - 31 lb)
1st trimester expetcted weight gain - ANS1 lb/MONTH (total of 3 lbs in 3 months)
2nd/3rd trimester expected weight gain - ANS1 lb/WEEK
Calculating patient's weight during pregnancy
Weeks: 12 13 14 15 16 17 18 19 20 30 40
Pounds: 3 4 5 6 7 8 9 10 11 21 31 - ANSRULE: Difference of 9
week - 9 = ideal weight gain
compare to actual weight gain
Example:
28 weeks gestation - 9 = 19 lb compared to 22 lb = off by 3lb
Within 1-2 lbs = okay
3 lbs off = ax
4 lbs off = trouble
First trimester (1 - 12 weeks) - ANSexpected weight gain: 1 lb/month (total: 3lbs/3 months)
Fundus not palpable
priority = mom
Fundus can be palpated at end of 1st trimester (12 weeks)
Second trimester (13 - 27 weeks) - ANSexpected weight gain: 1 lb/week
Fundus is at or below the umbilicus
priority = mom
, At 20-22 weeks the fundus is at the umbilicus
Third Trimester (28 - 40 weeks) - ANSexpected weight gain: 1 lb/week
Fundus is above the umbilicus.
priority = baby
Fundus (top part of uterus) - ANSnot palpable until week 12
When will the fundus be at the level of umbillicus? - ANSWeeks 20-22
Nurses use the fundal height to - ANSAx the age of gestation
(ex- mom comes in ER after MVC. She is unable to tell you how far along she is)
4 positive signs of pregnancy - ANS1. Fetal skeleton on xray
2. Fetal presence on ultrasound
3. Auscultation of fetal HR
4. Examiner palpates fetal movement (NOT mom)
how to answer 3 different types of OB questions - ANS1. When would you first...
(pick earliest)
2. When would you most likely...
(pick middle)
3. When should you by...
(pick last)
When would you FIRST auscultate a fetal heart? - ANS8 weeks
When would you MOST LIKELY auscultate a fetal heart? - ANS10 weeks
When should you auscultate a fetal heart BY? - ANS12 weeks
What are some probable/presumptive signs of pregnancy? "The Maybes" - ANS-All urine/blood
pregnancy tests (positive pregnancy test NOT a positive sign - false positives)
-Chadwick's sign- cervical color change to cyanosis (all C's)
-Goodell's sign - cervical softening
-Hegar's sign - uterine softening
Calculating expected date of delivery (Naegale's Rule) - ANSFIRST day if last menstrual period
+ 7 days - 3 months
Example: June 10-15 was last menstrual period
Expected date of delivery:
March 17
Total expected weight gain during pregnancy - ANS28 lb + or - 3
(25 - 31 lb)
1st trimester expetcted weight gain - ANS1 lb/MONTH (total of 3 lbs in 3 months)
2nd/3rd trimester expected weight gain - ANS1 lb/WEEK
Calculating patient's weight during pregnancy
Weeks: 12 13 14 15 16 17 18 19 20 30 40
Pounds: 3 4 5 6 7 8 9 10 11 21 31 - ANSRULE: Difference of 9
week - 9 = ideal weight gain
compare to actual weight gain
Example:
28 weeks gestation - 9 = 19 lb compared to 22 lb = off by 3lb
Within 1-2 lbs = okay
3 lbs off = ax
4 lbs off = trouble
First trimester (1 - 12 weeks) - ANSexpected weight gain: 1 lb/month (total: 3lbs/3 months)
Fundus not palpable
priority = mom
Fundus can be palpated at end of 1st trimester (12 weeks)
Second trimester (13 - 27 weeks) - ANSexpected weight gain: 1 lb/week
Fundus is at or below the umbilicus
priority = mom
, At 20-22 weeks the fundus is at the umbilicus
Third Trimester (28 - 40 weeks) - ANSexpected weight gain: 1 lb/week
Fundus is above the umbilicus.
priority = baby
Fundus (top part of uterus) - ANSnot palpable until week 12
When will the fundus be at the level of umbillicus? - ANSWeeks 20-22
Nurses use the fundal height to - ANSAx the age of gestation
(ex- mom comes in ER after MVC. She is unable to tell you how far along she is)
4 positive signs of pregnancy - ANS1. Fetal skeleton on xray
2. Fetal presence on ultrasound
3. Auscultation of fetal HR
4. Examiner palpates fetal movement (NOT mom)
how to answer 3 different types of OB questions - ANS1. When would you first...
(pick earliest)
2. When would you most likely...
(pick middle)
3. When should you by...
(pick last)
When would you FIRST auscultate a fetal heart? - ANS8 weeks
When would you MOST LIKELY auscultate a fetal heart? - ANS10 weeks
When should you auscultate a fetal heart BY? - ANS12 weeks
What are some probable/presumptive signs of pregnancy? "The Maybes" - ANS-All urine/blood
pregnancy tests (positive pregnancy test NOT a positive sign - false positives)
-Chadwick's sign- cervical color change to cyanosis (all C's)
-Goodell's sign - cervical softening
-Hegar's sign - uterine softening
