Exam (elaborations)
MARK KLIMEK LECTURES MATERNITY AND OB 2021 COMPLETE LECTURES
- Course
- NURSING 4530
- Institution
- Stratford University
MARK KLIMEK LECTURES MATERNITY AND OB 2021 COMPLETE LECTURES
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MATERNAL HEALTH & THE NEWBORN1.Calculating a due date
a.Take the first day of the last menstrual period, add 7 days, and then subtract 3 months. i.First day of menstrual period + 7 days – 3 months = Due date ii.June 10th (first day) + 7 days – 3 months = March 17th
2.Weight gain during pregnancy a.Total weight gain during full term pregnancy is expected to be 28 lbs, plus or minus 3 lbs. i.1-2 lb. difference is okay
ii.3 lb. difference, need to have an assessment
iii.4 lb. difference is trouble. Proper Weight Gain During Pregnancy
Trimester Expected Weight Gain
First trimester (1-12 weeks) 1 lb. each month (total of 3 lbs. in first 12 weeks)
Second trimester (13-27 weeks) 1 lb. each week (total of 9 lbs. in 9 weeks)
Third trimester (week 27- delivery) 1 lb. each week
-How to calculate:
- take the week of gestation – 9 + ideal weight gain 3.Fundal Height
a.The fundus is the top part of the uterus
i.It is not palpable until week 12 (can’t be felt during first trimester)
ii.After the first trimester (week 13) the fundus should be palpable under the umbilicus
iii.The fundus is at the level of the umbilicus (belly button) at 20-22 weeks gestation, (second trimester) the date of viability is 22-24 weeks 4.Positive signs of pregnancy a.Fetal skeleton on x-ray
b.Fetal presence on ultrasound
c.Auscultation of fetal heart rate ( heard between 8-12 weeks) i.If a question says, “When would you first hear a heartbeat?” you would say 8 weeks. ii.If a question says, “when would you most likely hear a heartbeat?” you would say 10 weeks. This study source was downloaded by 100000829490088 from CourseHero.com on 08-02-2021 05:12:18 GMT -05:00
https://www.coursehero.com/file/32398561/MATERNAL-HEALTH-newborn-mark-klimek-docx/This study resource was
shared via CourseHero.com iii.“When should you auscultate a fetal heart rate by?” – you say 12 weeks. **WATCH HOW THEY WORD THE QUESTIONS
iv.same with quickening (kicking) 16-20 weeks .
1.When would you first? -16 weeks
2.When would you most likely? -18 weeks
3.When should you by? – 20 weeks d.When examiner palpates fetal movement, only positive if the examiner palpates. 5.Presumptive(maybe) signs of pregnancy
a.All urine and blood tests b.Chadwick’s, Goodell’s, and Hegar’s sign- THEY OCCUR IN ALPHABELTICAL ORDER
i.Chadwick’s sign- Cervical Color Change to Cyanosis. – all C’s
ii.Goodell’s sign- Cervical softening iii.Hegar’s sign- Uterine softening 6.Patient teaching in pregnancy a.Pattern of office visits- good prenatal care is a major factor in reducing infant mortality
Office visit patterns
Once a month Until week 28 (first & second trimester, some of third) Once every two weeks Until week 36
Once a week Until delivery or week 42 (either C section or induction at that point)
b.Hgb will drop- TOLERATE THESE DROPS IN PREGNANT WOMEN (12-16 normal)
i.In 1st trimester, a hemoglobin may drop to 11 and be normal ii.In 2nd trimester, a hemoglobin may drop to 10.5 and be normal
iii.In 3rd trimester, a hemoglobin may drop to 10 and be normal c.Teaching on the discomforts of pregnancy i.Morning sickness ( first trimester)- Tx w/ dry carbohydrates before you get
out of bed ii.Urinary incontinence ( first & third trimester problem )- Tx void every 2 hours iii.Difficulty breathing ( second & third trimester )- teach tripod positioning iv.Back pain (second & third trimester ) – pelvic tilt exercises (tilt forward) 7.Labor & Birth a.Onset of regular progressive contractions (most valid sign a woman is in labor)
i.Little review***
1.Dilation- opening of the cervix (0-10cm) 2.Effacement- thinning of the cervix (thick-100%) This study source was downloaded by 100000829490088 from CourseHero.com on 08-02-2021 05:12:18 GMT -05:00
https://www.coursehero.com/file/32398561/MATERNAL-HEALTH-newborn-mark-klimek-docx/This study resource was
shared via CourseHero.com
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