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OB.t4PregnancyAssess
Pregnancy&BasicNeeds
| Question | Answer |
|---|---|
| wt gain | wt gain 25-35lbs 3.5-5lbs 1st trimester 1lb/wk or 4lbs/mo last 2trimester |
| FOOD&FLUID | add 300cal, up to 500cal for lactating 8-10glass/day= 4-8 should be water *avoid fish/shellfish (mercury), raw eggs-Ceasar dressing, eggnog, raw cookie dough (salmonella poisoning), hotdogs, feta/brie cheese, unpasteurized milk, raw milk (listeria) |
| OGGT screening | @24-28wks hormonal effects: hPL - release of growth hormone Insulin Antagonist = risk gestational diabetes |
| OXYGENATION.CARDIOVASCULAR | BP prepregnant 1st&3rd, < 2nd trimester due to progesterone/relaxin HR ^ 10-15bpm, blood vol ^40-50%/1500ml CO ^30-50% peaks @ 24-28wk, hgb&hct < WBC ^2nd&3rd trimester, platelet prepregnant |
| OXYGENATION.CARDIOVASCULAR: Assessment | identify changes, know pt baseline |
| OXYGENATION.RESPIRATORY | rr 12-22rpm, may look barrel chested ventilation: ^tidal vol (total amnt of air in) nasal stuffiness, congestion, epistaxis, ^sense of smell |
| ELIMINATION.URINARY | ^frequency, ^GFR (body compensates with ^renal tubular reabsorption Glycosuria not uncommon/pathogenic, kidney unable to reabsorb all glucose filtered |
| ELIMINATION.URINARY: Proteinuria | albuminuria. ALWAYS ABNORMAL +1, indication of PIH ALONG WITH HTN AND EDEMA (preeclampsia) |
| ELIMINATION.GASTROINTESTINAL | NV (^hCG), ptyalism (risk of dental carries), changes in smell/taste,bleeding gums (^estrogen), heartburn, constipation (^progesterone) |
| REST&ACTIVITY | fatigue (^BMR), pelvic immobility, lumbar lordosis (low back pain), round ligament pain (sharp pain in lower quadrant with movement), skin changes (^acne, night sweats), carpal tunnel syndrome (medial nerve edema-repetitive hand movement) |
| SEXUALITY | pelvic congestion (^estrogen, more orgasmic, ^libido) uterine enlargement libido (fatigue 3rd trimester, colostrum leak) *pregnant woman is safe to have sex unless instructed by MD pelvic rest-no sex |
| SAFETY | increased clotting factor fibrinogen 15%=hypercoagulation = DVT [ambulate, stay hydrated, avoid stockings, no crossing legs] infection (^WBC), injury (mucus plug to protect fetus), teratogens (most risky 1st 8wk)toxoplasmosis-cat litter |
| SAFETY: IVCS inferior vena cava syndrome | compression while supine, <oxygenation Sx <BP, dizziness, diaphoresis, pale skin *position sidelying, sleep with pillow, O2, IV/PO fluids |
| SELF-ESTEEM | planned vs unplanned (varies-happy/conflict of feelings) body changes, eating disorder, depression |
| FISH INTAKE | ok once/week if wild fish from ocean not from farm, may substitute with fish oil omega3 is good for brain development of fetus |
Created by:
sarahjqs
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