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Which hormone stimulates the growth of the endometrium in preparation for implantation?A. EstrogenB.Follicle-stimulating hormoneC.Luteinizing hormoneD.Progesterone
MATERNAL – NEWBORN NURSINGWK1 CH 3, 4, & 5CH 4 – PHYSIOLOGICAL ASPECTS OF ANTEPARTUMDIAGNOSIS OF PREGNANCYBased on a combination of the followingoPresumptive signs: SubjectiveoProbable signs: Perceived by HCPoPositive signs: Objective signs attributed to the fetus (noted by the HCP) – ULTRASOUND = ONLY SIGN THAT WILL CONFIRM THAT WOMAN IS PREGNANT, also fetal toneCalculating Due Date (Naegele’s Rule Formula)oLMP – 3 months + 7 days = EDDPHYSIO CHANGES OF PREGNANCYGastrointestinal systemMusculoskeletal systemIntegumentaryEndocrine systemRespiratoryCardiovascularRenalReproductiveMATERNAL POSITION & BLOOD FLOWPRENATAL CAREEssential for ensuring overall health of newborns & moms↓Low birth weight babies↓ComplicationsShould be initiated earlyPurposeoEstablish baseline of present healthoDetermine gestational age of fetusoMonitor fetal developmentoID women at risk for complicationsoMinimize risk of possible complicationsoProvide time for education***Schedule of Prenatal Visits***oEvery 4 weeks for first 28 weeks of gestationoEvery 2 weeks until 36 weeks of gestationoEvery week from 36 weeks until birth
MATERNAL – NEWBORN NURSINGWK1 CH 3, 4, & 5oFirst Prenatal Visit – What Happens?Establish rapport & trustExtensive health history Screening tool that IDs factors that may adversely affect the pregnancyFamily/social profile/socioeconomicHistory of past illness, family illnesses, current medical historyGynecologic historyObstetric historyIdentify high risk factors Lab WorkCBCABO & Rh typeAntibody screenRubella titerVDRL or RPR (syphillis)Hepatitis B surface antigenGonorrhea cultureChlamydia cultureHIV screen Urine: glucose, protein & ketones by dipstick. Urinalysis: RBCs, leukocytes, bacteria^^^ ABOVE LABS ARE DONE DURING FIRST TRIMESTER ^^^Glucose tolerance test is done between 24-28 wks to test for presence of gestational diabetesAlpha-fetoprotein @ 14wks**Group Beta Strep (GBS)- 35-37 weeks; no s/s of infection, nontransferable, just commonly found in perineal area and it’s related to hormones and alters with vaginal flora! IMPORTANT TO ID BC ITS DETRIMENTAL TO HEALTH OF NEONATE(NOT FETUS) could develop meningitis and die within 6 months of lifeoTx: antibiotics during labor/ onset of laborIV ANTIBIOTICS drug of choice = ampicillin (2g IVPB x1 or STAT then change to 1g IVPB Q4 up until she delivers)oImportant to tx her even if result is still pending, but she’s in laborOr even if she hasn’t been tested at all! Better to be safe than sorryHereditary disease screening oSickle celloTay-sachsoCystic fibrosis ASSESSMENT OF GROWTH & DEVELOPMENT (CONFIRM DATING OF PREGNANCY)Estimating fetal growth:oFundal height: symphysis to top of fundusoMcDonald’s Rule: Between wks 22-34 fundal height in cms should match no. of weeks gestation (± 2 cm)