Pregnancy Wheel Review Notes

Determine due date: Pregnancy wheel Naegle’s rule By the first day of the last menstrual period Ultrasound Abbreviations for due date: EDD Major deciding factor for true labor Cervical change Constant contractions that do not go away Contractions 5 min apart and do not go away Bleeding No fetal movement Bag of water broke Practice contractions (not real labor) Baxtron hicks True labor Fetus moves lower into the pelvis There is bloody show Cervical change UC’s stronger than usual What is the most critical time for pregnancy ? First 8 weeks o All the organs are developing o Damage can be done if there are drug use or exposures Up to what gestation is considered an embryo? First 8 weeks Considered fetus ? 9 months to birth When reviewing GTPAL G- gravida T- term P- preterm A- abortion L- living Up to how many weeks of gestation is considered an abortion or miscarriage Under 20 weeks gestation What medication should they take during pregnancy Folic acid 400-800 Zinc 12 mg per day Spinach (green leafy veggies) What foods to avoid during pregnancy? Fish Unpasteurized cheese or foods If vegan add vitamin B12, calcium and D Stages and phases of labor Stage 1 o Phase 1  Late stage  Can be up to a week  0-3 cm o Phase 2  Active stage  Lamaze o Phase 3  Transition Stage 2 o Birth Stage 3 o Placenta o Oxytocin Pitocin ones it is delivered Stage 4 o Recovery o Focus hemorrhage o Massage fundus  Firm, down and midline if deviated to the right full bladder and needs to pee to release the pressure and avoid bleeding. o Sims to check the back for bleeding Fetal monitoring VEAL CHOP o Variable – cord compression o Early decelerations – head compression o Accelerations- Okay o SinusoidalPreeclampsia High blood pressure with protein 2 types o Mild and severe o Admit for severe Eclampsia Seize Super elevated BP Magnesium sulfate : increase seizure threshold What is HELLP Hemolysis Elevated liver enzymes Low platelet Can have high BP like in PIH Flu like symptoms Both of these can lead to DIC disseminated intervascular coagulation What is hyperemesis Super bad morning sickness Caused by o Psychosomatic o Allergy o Metabolic o High amounts of HCG Weight loss of 5% of pregnant weight Outpatient treatment IV and antiemetics Inpatient and home health will do TPN Drug use Cocaine o Increased risk of placental abruption MethHeroin o Increase PTL/PROM Marijuanao In newborn SIDS LATCH Score How the baby is latching Latch o Latch Audible swallowing Type of nipple Comfort Hold Early signs of hemorrhage Tachycardia Late signs of hemorrhage Tachycardia and high BP How many mL’s is considered a hemorrhage? Vaginal delivery o 500 C-section o 1000 Medications for hemorrhage Pitocin Methergine Hemabate Cytotec Tranexamic acid Bakri ballon/ Jada suction OR for hysterectomy worst case scenario APGAR Score Done at birth and then 5 min Normal is 8-10 At 1 min : 7-10 5 min : 8-10 10 min if under 7 at five min Appearance Pulse Normal vitals 110-160 HR o Increases with crying o Decrease down to 80 when sleeping 30-60 Breaths per min o Obligatory nose breathers o Have episodes of period apnea from 10-20 seconds Temp Six states of infant consciousness Quiet sleep o Feeding unsuccessful o Regular resp o Decreased pulse Active sleep Drowsy Quiet alert o Irregular respirations o Face bright and shinny o Best time to feed o Most attentive to stimuli Active alert Crying Labor Meds Pain Acronym Stop Feeling Discomfort Now o Stadol  Butorphanol Tartrate o Fentanyl o Diladud o Nubain Newborn Meds Vitamin K o Clotting factors Erythromycin o Ophthalmic to prevent infections Hepatitis B Tocolytic Nifedipine Medications Rhogram o First dose  Week 28 o Second dose  Up to 72 hours GBS Group Beta Strep Screened on all women by week 35-37 If positive treated with PCN in active labor to prevent sepsis in the newborn