Reassure parents Check the babies abdomen and make sure they are eatingpeeing

Reassure parents check the babies abdomen and make

This preview shows page 25 - 27 out of 55 pages.

- frequent crying. Reassure parents. Check the babies abdomen and make sure they are eating/peeing enough. - increased gas? Make sure they are burping the baby Womens health Pregnancy Signs of pregnancy - presumptive- amenorrhea, brest tenderness, nausea/vomiting, fatigue, chadwicks sign - probable – things that the MD can detect – enlarged uterus , +HCG - positive - direct evidence of preg. Fetal heart tones, US - htn in pregnancy- treatment - no ace or arbs in pregnancy cat D. organ malformation and/or renal failure to baby -primary HTN is diagnosed before 20 weeks. Other wise >20 = pre eclampsia - dm in pregnancy - screen at 24-28 weeks – non fasting 2hr oral glucose tolerance test - Pregnancy Meds YES - PCN, macrolides- Zithromax, Tylenol, antacids, clindamycin, heparin, Colace NO - ACE/ARBs, Statins, Sulfa, valproic acid, Coumadin, phenytoin, tetracyclines
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- vacations and pregnancy and babies - no MMR, varicella or herpes - common heart sound changes in pregnancy – louder s1, split s1, displaced apical pulse, systolic ejection murmur, s3. - Will have an increase in blood volume, increase HR (minimal), increased CO (by 30%), and DECREASED SVR and PVR from hormones - fundal height should be equal to weeks gestation after 20 weeks. 34 weeks = 33-35cm -12 weeks – palpable just above the symphysis pubis -20 weeks at the level of the umbilicus Wt gain – 25-30lbs. obese 20lbs. if under wt. = ideal wt + 25-30lbs Pregnancy hormones -Alpha fetoprotein - produced in the fetal (mostly) and maternal liver. Can be elevated in neural tube defects, low in downs syndrome and fetal demise. Take folic acid - HCG- produced by the placenta - Abortions - threatened – bleeding cramping- closed cervix - inevitable – vaginal bleeding with pain and cervical dilation - incomplete – moderate to diffuse bleeding with the passage of tissue - complete- - flu -meds and inactivated flu vaccine okay in pregnancy – all trimesters. - Preg women have an increased morb. And mortality with the flu - if mom has flu like symptoms within 2 weeks postpartum she needs meds and to be separated from baby. - she can still pump and feed baby, even ill and on meds - STI infection treatments and for pregnant women - chlamydia- preg. 1gm azithromycin - postpartum endometritis = broad spectrum antibiotics- poly therapy. - test for cure in all STI pregnant women - those with renal disease who become pregnant - need to be followed closely with their nephrologist and OBGYN - can develop normochromic normocytic anemia - less than expected expansion of plasma volume - increased risk of clots - vit D deficiency - keep bp below 140/90 - ASA 75-81mg daily for protection - Preeclampsia - HTN after 20 weeks and 2 BP > 140/90 at least 6hrs apart - risk factors- age >40, age <16, first pregnancy, and multiple gestation - cure is delivery - symptoms – HA, blurred vision, edema of the face and upper extremities, wt gain, proteinuria.
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