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first exam
Presumptive Signs of Pregnancy
Amenorrhea
Fatigue
Urinary Frequency
Nausea and Vomiting
Breast Changes
Quickening
1 min
Probable Signs of Pregnancy
Goodell Sign
Chadwick Sign
Hegar Sign
Positive Serum and Urine Sample
Braxton Hicks Contractions
Ballottement
2 mins
Positive Signs of Pregnancy
Fetus on Ultrasound
Fetal Heart Rate by Doppler or Fetoscope
Fetal X-ray
Fetal Movements
1 min
Discomforts of Pregnancy - First Trimester
Breast Tenderness
Supportive Bra
Nausea and Vomiting
Frequent Small Meals
Urinary Frequency and Urgency
Frequently Empty Bladder
Leukorrhea
Perineal Pad
Ptyalism
2 mins
Discomforts of Pregnancy - Second Trimester
Supine Hypotension
Side-lying Position
Food Cravings
Heartburn (Pyrosis)
Constipation
Moderate Exercise
Varicose Veins
Elevate Legs
Backache
Pelvic Tilt Exercise
Considerations
Nutrition
2 mins
Discomforts of Pregnancy - Third Trimester
Shortness of Breath (SOB)
Rest Periods
Return of Urinary Frequency and Urgency
Empty Bladder Regularly
Leg Cramps
Stretching Exercises
Ankle Edema
Elevate Legs
2 mins
Ovulatory Hormones I - Follicular Phase
Characteristics
0-14 Days
GnRH Stimulates FSH and LH
Follicle Secretes Estrogen
Negative Feedback from Estrogen
Increased Estrogen Leads to Positive Feedback
FSH and LH Surge
LH Spike Leads to Ovulation
2 mins
Ovulatory Hormones II - Luteal Phase
Days 15-28
Corpus Luteum
Secretes Progesterone
Negative Feedback inhibits FSH and LH
No pregnancy forms Corpus Albicans
Stops Estrogen Secretion
Endometrial Sloughing - Menses
GnRH secretion produces new follicular phase
2 mins
Fetal Circulation
Placenta
Umbilical Vein
Ductus Venosus
Right Atrium
Foramen Ovale
Left Atrium
Aorta
Right Ventricle
Ductus Arteriosus
Umbilical Arteries
2 mins
Postnatal Circulation
Infant Breathes
Decreased Pressure in Pulmonary Vasculature
Decreased Right Heart Pressure
Increased Left Atrial Pressure
Closes Foramen Ovale
Increased O2
Decreased Prostaglandins
Closed Ductus Arteriosus
Pharmacologic Intervention of Ductus Arteriosus
Open with Prostaglandins
Closed with Indomethacin
3 mins
Newborn Assessment
APGAR
Umbilical Cord
2 Arteries 1 Vein
Eye Prophylaxis
Fontanels
Vitamin K Injection (Phytonadione)
Gestational Age Assessment (GAA)
Measurements
Birth Weight
Head Circumference
Length
Considerations
Keep Warm
ID Bands
3 mins
APGAR Score
1 and 5 Minutes
Appearance
Pulse
Grimace
Activity and Muscle Tone
Respiration
Total Scores
Gentle Stimulation
Oxygen
2 mins
Hyperbilirubinemia
Cause/Mechanism
Increased Unconjugated Bilirubin
Assessment
Jaundice
Kernicterus
Interventions
Early Feedings
Heme Oxygenase Inhibitors
Phototherapy
Protect Eyes
Monitor for Dehydration
Considerations
Monitor Bilirubin Levels
3 mins
Age 2 Months - Developmental Milestones
Gross Motor
Holds Head Up, But Unsteady
Fine Motor
Tracks Objects to the Midline
Language
Coos
Social / Cognitive
Social Smile
Recognizes Parents
1 min
Age 4 Months - Developmental Milestones
Gross Motor
Sits With Support
Rooting Reflex Disappears
Moro Reflex Disappears
Fine Motor
Reaches Across Midline
Language
Turns to Voice
Laughs
Social / Cognitive
Enjoys Looking Around
2 mins
Age 6 Months - Developmental Milestones
Gross Motor
Palmar Reflex Disappears
Sits Propped Up On Hands
Rolls
Fine Motor
Transfers Objects Hands to Hands
Raking Grasp
Language
Babbles
Responds to Name
Social / Cognitive
Stranger Anxiety Develops
2 mins
Age 9 Months - Developmental Milestones
Gross Motor
Pulls to Stand
Starts Cruising
Fine Motor
Three-Finger Pincer Grasp
Holds Bottle or Cup
Language
Starts Sounding "Mama" or "Dada"
Social / Cognitive
Waves Bye
Separation Anxiety
Plays Pat-A-Cake
2 mins
Age 1 Year - Developmental Milestones
Gross Motor
Stands Well
First Steps
Throws Ball
Points to Objects
Babinski Reflex Disappears
Fine Motor
Two-Finger Pincer Grasp
Language
"Mama & Dada"
Social / Cognitive
One-Step Commands with Gesture
2 mins
Age 18 Months - Developmental Milestones
Gross Motor
Climbs Up Stairs
Runs
Fine Motor
Stacks Three Blocks
Eats with Spoon
Removes Clothing
Language
10-25 Word Vocabulary
Social / Cognitive
āMineā
Pretend Play
2 mins
Age 2 Years - Developmental Milestones
Gross Motor
Jumps
Fine Motor
Copies a Line
Stacks Six Blocks
Turns Pages
Language
Two-Word Phrases
Half of Speech is Understandable
200 Words by Age 2
Social / Cognitive
Parallel Play
Begins Toilet Training
Rapprochement
2 mins
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