OB Exam.docx - OB Exam#1 GTPAL-Gravida the number of...

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OB Exam #1GTPAL-Gravida: the number of pregnancies total-Term: how many babies delivered at 38 weeks or more-Preterm: how many babies delivered 22-37 weeks-Abortion: how many babies were born prior to viability-Living: how many are currently living*para refers to the number of pregnancies that have been born 20 weeks or more, whether alive or stillbornPregnancy Symptoms-Nausea/Vomiting: 1sttrimester-occurs due to hormonal changes or inc. of pressure within the abdomen as stomach & intestinesare displaced-instruct to eat crackers & toast 30m-1hr before rising in morning-avoid empty stomach, spicy foods, greasy or gas-forming foods-drink fluids between meals & not with meals-Heartburn: 2nd& 3rdtrimester-caused by stomach being displaced by enlarging uterus & slowing of GI motility & digestioncaused by inc. progesterone levels-eat small, frequent meals-avoid empty or too full stomach-sit up for 30 mins after meals-check with provider prior to using OTC antacids-Constipation: 2nd& 3rd-occurs due to increased transit time of food through the GI tract & thus inc. water absorption-drink plenty of fluids, eat diet high in fiber-exercise regularlyFetal Heart Rate-Normal: 110-160bpm-Bradycardia: below 110bpm for 10mins or more-causes: uteroplacental insufficiency, umbillical cord prolapse, maternal hypotension,prolonged umbilical cord compression, fetal congenital heart block, anesthetic medications, viralinfection, maternal hypoglycemia, fetal heart failure, maternal hypothermia.-interventions: d/c oxytocin, side-lying position, admin. 02 @10L/min, insert IV & give fluids,admin. tocolytic, notify MD-Tachycardia: above 160bpm for 10mins or more-causes: infection, chorioamnonitis, fetal anemia, maternal use of cocaine/methamphetamines,maternal dehydration, maternal hyperthyroidism, admin. antipyretics, admin. o2 10L/min, IVfluid bolus.Folic Acid-crucial for neurological development & prevention of neurological tube defects-foods high in folic acid; leafy veggies, dried peas/beans, seeds, OJ, (breads, cereals, grains)-before pregnancy: 400mcg-during pregnancy: 600mcgImmunizations-Rubella: 28 days before pregnancy; not during pregnancy-MMR & Varicella: not during pregnancy (live vaccines)-Flu vaccine: can be given at any point during pregnancy (typically flu season)
Leopold’s ManeuverExternal palpations of maternal uterus through abdominal wall-determines: # of fetuses, presenting part, fetal lie, fetal attitude, degree of descent of presenting part into pelvis, location of fetuses back to assess fetal heart tones-If vertex…. Listen in lower abdomen

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