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71 Cards in this Set
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Nutrition
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Daily Requirements
Weight Gain Eating Disorders- PICA(food substitutes, not food) OTC Meds Smoking- Growth Retardation Folic Acid- Before Pregnancy need to take 400mg folic acid to prevent spinabifida. Iron Deficency Anemia |
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Inaddicuate Nutrition
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Fetal Deprevation
Preterm Birth Still Borns Congenital birth deficts Preg Moms- 300 calories per day, Vitamin B-12, Protein 3 servings a day, Carbs 6 servings a day, Dairy 4 servings a day for bone formation, Fruits 2 servings a da, Vegies 3 servings a day. |
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Weight Gain
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Avg preg weight gain is 25-35 lb with normal preg.
1st 20 wks- woman gain 10-15 lbs After 20wks gain 1 lb per week. |
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Where weight comes from.
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Fetus, Plecenta, and emlionic fluid give you 20 lbs.
Increase in BV about 4 lbs. Breast Tissue 3 lbs. Maternal Stores - 5-10 lbs. |
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Over the counter medication
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Affect fertilized ovum embriyo or fetus.
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Smoking
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Low birth weight infants, growth retardation. Snijubg vasicibstructuib ti yterube muscle limit supply to fetus.
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Caffine
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No caffine stimulates system. Low birth weight baby.
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Alcohol
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No alcohol, cognitive impairment, cognitive deformities.
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Folic Acid
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Formation of RBC. Take folic Acid decrease neurotube diffects. Prenatal vitamins have iron supplements.
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Estrogen
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stimulates uterine development to provide enviornment for fetal growth. Prepare breast for lactation.
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Human Choronic Gonadtropin (HCG)
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Stimulates progesterone/estrogen production to maintain the pregnancy. Urine Test 2 days after missed period.
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Human placental Lactogen (HPL)
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Promotes lipolysis. Insulin antagonist release of nsulin. Inhibits higher free fatty acids avaliable for maternal metabolic use. Lower maternal metabolism of glucose to allow fetal growth.
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Progesterone
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Maintains the endometrium and inhibits uterine contractions. Prevent abortions. Aids in prep for lactation.
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Prostaglandin
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Assosiated with the onset of labor. Lipids found throuout repoduction system. High concentration found in preg. Pregnancy Induced Hypertension.
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Relaxin
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Inhibits uterine contractions/softems cervix. Found in maternal serum from time of firse pissed period.
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Cardiovascular system
Physiologic anemia |
(plasma volume increase 50%=7% decrease in hematocrit)
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Vena Cava Syndrome
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Decreased blood flow to right atrium lower blood pressure. Dizzy, clamy skin, pale. Left side, pillow under right hip.
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Hypercoagulation
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Blood vessel higher 45%. Red blood cells 18-30%. Cardio Output 30-40%. 10-15 BPM
Heart rate increases Blood pressure changes. |
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Respiratory System
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Nasopharyngeal Edema- Nasal stuffiness.
Shortness of breath. |
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Renal System
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Glycosuria
Glomerular Filtration rate (GPR)- Kidneys not able to absorb all Gluose, GFR higher 50%. Urinary Frequency 1st Trimester: Uterus presses on bladder= urinary frequency 2nd Trimester: Relieved by uterus moving into abdominal area. GFR higher 50% 2nd trimester till delivery. 3rd Trimester: Urinary frequency as the presenting part presses on the bladder. |
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Gastrointestinal System
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Hyperptyalism- higher siliva formation.
Pyrosis/Heartburn Decreased gastric motility- Constipation. Nausea and Vomiting Displacement of stomach. Slowed intestinal parasaltisis. Increase in prenatal levels smooth muscle and parastalsis evidence of feeling better. |
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Integumentary System
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Increased pigmentation
Striae gravidarium Linea Negra Cholasma- Skin gets darkin on forehead around eyes. High levels of estrogen make skin darker. Strech Marks- High adrenal and steriod levels make connective tissue strech dark pigmented. |
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Musculoskeletal System
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Lordosis- Curvature in spin compensates weight of baby.
Carpal Tunnel Syndrome Diastasis recti |
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Endocrine System
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Thyroid Gland
Parathyroid Pancreas Pituitary Gland |
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Thyroid Gland
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Enlargement causes an increases in metabolic weight.
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Parathyroid
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slight enlargement bettr for calcium and vitamin D. Decrease in insulin production. Allows more glucose availability for fetal growth.
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Pituitary Gland
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Increase in secreation of prolactin, prepares breast for lactation.
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Uterus
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Increase in size palpable by end of 12th week.
Lightening Hegar's Sign Braxton Hicks Contractions |
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Lightening
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Baby drops on pelvis.
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Hegar's Sign
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Evident 6-8 weeks softening of the lower uterine segment.
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Braxton Hicks Contraction
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False Labor
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Cervix
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Goodell's Sign
Mucus Plug |
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Goodell's Sign
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8 weeks softening of cervix
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Mucus Plug
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Barrier, baby can not have a BM.
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Vagina
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Chadwick's Sign
Increase in vaginal discharge |
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Chadwick's Sign
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Cervix and vaginal wall (blue/purple). Acidic white and thick, breast changes estrogen and progesteron.
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Breast Changes
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Fullness/tingling/tenderness/darkened/areola/prominent blue veins/secretion of colostrum by 16th week.
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First Trimester (1-12 weeks)
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Acceptance
Announcement Ambivalence |
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Second Trimester (13-24 weeks)
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Differentiation
Fetal Embodiment Visulization Quickening- Visualisation by ultrasound 12 weeks, feel baby more 16-20th week. |
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Third Trimester (25-40 weeks)
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Separation of baby
Concerned with safe delivery Childbirth education Nesting Covade- get same thing mome does Preparing for parenthood. |
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Signs of Pregnancy
Presumptive (subjective) |
Finding reported by the mother that suggest presence of pregnancy. Amenoria, missing period. Brease changes, nausea vomiting, quickening.
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Signs of Pregnancy
Probable (obj) |
Finding noted by a healthcare provider that suggest a pregnancy is present. Hager, Chedricks, Enlarged abdomin. Pigmentation and pregnant test. Palpation of fetal outline.
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Signs of Pregnancy
Positive (diagnostic) |
Finding that confirm pregnancy. Fetal heart tones, 120-160 BPM. Doppler heart sound, baby 20-24 weeks and fetal movement 12 weeks. Visulization of fetus. Brain and heart beat visulaize by 8 weeks.
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First Trimester Discomforts
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Nausea/Vomiting
Fatigue Urinary Frequency Breast Tenderness Salvation |
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Second/third trimester discomforts
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Heartburn
Ankle edema Varicose Veins Hemorrhoids Constipation Backache Leg Cramps SOB Difficulty Sleeping |
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Warning Signs of Pregnancy
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Bleeding
Decreased Fetal Movements Headache Edema of hands of face Visual changes Pain Symptoms of infection |
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Prenatal Screening
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Gestational Age
-Nagele's Rule Obstertrical History -Gravida (# of times pregnant) -Parity (# infants delievered >20wks.) -FPAL Medical History/Past Medical History -Surgeries -Chromosomal abnormalities |
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Prenatal Screening cont.
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BP/weight, fundal height.
1cm=1week Symphatic pelvis to above uterus 10-12 weeks heart tones. Any signs of edema. Urine dipstick, glucose, protein, edema. Every 4 till 28 weeks. Every 2 weeks till 36 Every week till Delivery. |
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Nagele's Rule
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First day of last mentral period, go back 3 months and add 7 days.
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Laboratory Screening
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Initial Labs
H&H/WBC Blood Type and Cross/RH (RH-, recieve rogam at 28 weeks) Ryubella DRL (Syphalis) GC (Gonorea Chlamidia) HBsAg (antibody titer for Rub/hep B) MSAFP(16-18weeks) Diabetes Screen (24-28 weeks) HIV (AZT) Genetic Screening |
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Gravida Parity
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G/P- Gravida/Parity FPAL
F- Full Term Birth (37 weeks higher) P- Premies (Lower then 37 weeks, 20-36 weeks) A- Abortions (lower then 20 weeks) L- Living |
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Gonorea
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Neonatal sepsis
Preterm growth blindness. IUGR- Intra uterine growth retardation. |
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Diabetes Screen (24-28 weeks)
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50g oral
Draw Blood Higher 140 needed 3 hrs CTT |
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Chlamidia
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Phnemonia conguctivitis.
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MSAFP- Maternal Serum Alfa Fetal Protein
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Maternal Serum Alfa Fetal Protein.
Higher chance neural tube defict or abdominal defict. Lower suspect down syndrome. Will do eminio Centesis. |
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GYN History
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Last pap smear/ normal. Sexually transmitted disease periods regular how long last dismineria, contraseption.
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TOURCH Infections
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Cross placenta
Toxoplasmosis Other Infections -HIV/Hepatitis/GBS/Syphillis/Varicella Rubella Cytomegalovirus Herpes Simplex |
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Toxoplasmosis
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Protozol infection eating improperly cookd meats or fetal or contact to cat feces or liter.
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Other Infections
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HIV/Hepatitis/GBS/Syphillis/Varicella
Fetal Brain damage and abort in first trimester. GBS- Group B streptococcus cause preterm labor, UTI, (PROM) Premature rupture of the membrane. |
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Rubella
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Fetal infection abort. Hearing impairment psychomotor retardation. IUGR congenital Heart Disease.
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Cytomegalovirus
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Mental Retardation and audatory.
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Herpes Simplex
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IUGR- Intrauterine growth reduction.
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Diagnostic Tests
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Ultrasound
CVS(Chronic Villus Sampling) Amniocentesis MSAFP (Maternal Serum Alpha Fetal) PUBS (Percutaneous Umbilical Blood Sampling) BPP (Biophysical Profile) NST (Non Stress Test) CST (Contraction Stress Test) |
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Ultrasound
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As early as 5 weeks
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CVS Chronic Villus Sampling
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High risk determineee fetal caratype, sickle cell anemia
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Amniocentesis
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14-16 weeks gestation >30 weeks gestation. If suspect early pregnancy.
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MSAFP Maternal Serum Alpha Fetal protein
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16-18 weeks gestation.
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BPP Biophysical Profile
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3rd trimester. Fetal breathing movement, fetal movement, fetal tone extension and flex ion, Emnonic Fluid Volume.
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NST Non stress test
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Fetal heart rate with fetal movement done x2 in 20 min intravals. 2 or more of 15 beats per min for 15 sec intervals.
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CST Contraction Stress Test
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Provoke contractions in hospital. Fetal abiility to withstand uterine contractions
Watch fetal heartrate when contraction. Lower heart rate could not be getting O2 |
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PKU
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Down Syndrome, Peuchne muscular dystrophy.
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