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maternal newborn
Abruptio Placentae
Mechanism
Premature Separation of Placenta
Assessment
Tearing Pain
Bleeding (Often Concealed)
Rigid Uterus
Contractions
Interventions
Corticosteroids as Needed
Emergent Delivery
Considerations
Increased Risks for Neonate
Rh (Rhesus) Incompatibilities
Increased Risk for Shock
Monitor Fetal Heart Rate
3 mins
Placenta Previa
Mechanism
Placenta Covers Cervical Os
Assessment
Painless
Bright Red Vaginal Bleeding
Interventions
Stable Fetus
Bed Rest
Observation
Unstable Fetus
C-section Delivery
Considerations
Risk for Shock
Magnesium Sulfate
Tocolysis
3 mins
Syphilis TORCH
Signs and Symptoms
Nonspecific TORCH Symptoms
Often Results in Stillbirth
Hydrops Fetalis
Saber Shins
Notched Teeth
Saddle Nose
Blindness
Deafness
Hepatitis
3 mins
Hydatidiform Mole (Molar Pregnancy)
Cause/Mechanism
Abnormal Fertilization
Assessment
Symptoms of Pregnancy
Elevated hCG
Vaginal Bleeding
Inappropriate Uterine Growth
No Fetal Heart Rate (FHR)
Interventions
Dilation and Curettage (D&C)
Emotional Support
Considerations
No Pregnancy 1 Year
Hysterectomy
3 mins
Syphilis
Characteristics
Treponema pallidum
Spirochete with characteristic motility
Signs and Symptoms
Painless chancre
Condylomata lata
Generalized lymphadenopathy
Rash on palms and soles
Aortitis
Gummas
Neurosyphilis
Argyll Robertson pupils
Vasa vasorum
Tabes dorsalis
Treatment
Penicillin
Jarisch-Herxheimer reaction
2 mins
Lab and Diagnostic Tests During Pregnancy (Other Visits)
Diagnosis
10-13 Weeks
Offer Chorionic Villus Sampling (CVS)
15-18 Weeks
Quad Screen
18-20 Weeks
Ultrasound
Anatomic Screening
24-28 Weeks
One-Hour Glucose Challenge Test
35-37 Weeks
Streptococcus Agalactiae
3 mins
Prenatal Care
Prenatal Visits
Vital Signs, FHR
Fundal Height
Urine Dipstick
Weight
Prenatal Screening
Laboratory Testing
2 mins
Quad Screen Results Interpretation
Markers
AFP
Estriol
hCG
Inhibin A
Associations
Increased hCG + Inhibin A (HIgh)
Down Syndrome
Decreased hCG + Estriol + AFP (Low HEAp)
Edward Syndrome
Increased AFP
Neural Tube Defects
Abdominal Wall Defects
2 mins
Preeclampsia Interventions
Side Lying Position and Bedrest
Antihypertensives
Magnesium Sulfate
Labor Induction
1 min
Lab and Diagnostic Tests During Pregnancy (1st Visit)
Diagnosis
Complete Blood Count (CBC)
Blood Typing and Rh
Rubella
HIV
Hepatitis B
Tuberculosis Skin Mantoux Test (PPD)
Sexually Transmitted Infections
Chlamydia
Neisseria gonorrhoeae
Syphilis
Pap Smears
Urinalysis
Sickle Cell Screening (If Indicated)
2 mins
Spontaneous Abortion Overview
Assessment
Bleeding < 20 weeks Gestation
Interventions
Identify Type
Bed Rest
Monitor for Hemorrhage
Save Pads and Linens
RhoGAM
Dilation and Curettage (DandC)
Cerclage
Emotional Support
2 mins
Infertility
No Conception After 1 Year
Interventions
Artificial Insemination
In Vitro Fertilization (IVF)
Drug Therapy
Clomiphene Citrate (Clomid)
Menotropins
GnRH Agonists
Considerations
Treat Underlying Disorders
Emotional Support
Multiple Gestations
3 mins
Presumptive Signs of Pregnancy
Amenorrhea
Fatigue
Urinary Frequency
Nausea and Vomiting
Breast Changes
Quickening
1 min
Herpes Simplex Virus (HSV)
Characteristics
Enveloped
Double Stranded DNA
Linear
Signs and Symptoms
Type 1 HSV
Gingivostomatitis
Keratoconjunctivitis
Encephalitis of Temporal Lobes
Latent in Trigeminal Ganglia
Type 2 HSV
Genital Vesicles
Neonatal Herpes
TORCHES
Latent in Sacral Ganglia
Diagnosis
Tzanck Test
Multinucleated Giant Cells
Cowdry A Inclusions
Treatment
Acyclovir
2 mins
Pregnant Diabetic Patient Interventions
First Trimester
Increase Insulin then Decrease
Metformin
Nutrition
Exercise
Second Trimester
Increase Insulin
More Likely to Develop Hypoglycemia than Hyperglycemia
Third Trimester
Double or Quadruple Insulin
Early Delivery
Postpartum
Drastically Decrease Insulin
Monitor Neonate for Hypoglycemia
3 mins
Prolapsed Umbilical Cord
Mechanism
Cord Prolapses
Signs and Symptoms
Visualization of Cord
Prolonged or Variable Decelerations
Considerations
Hips Elevated
Insert 2 fingers in Vagina
Saline Towel on Cord
Oxygen
2 mins
Preeclampsia Assessment
After 20 Weeks of Pregnancy
Mild
Hypertension > 140/90
Proteinuria or End-Organ Dysfunction
Severe
Hypertension > 160/110
Progressive Renal Insufficiency
Vision Changes
HELLP Syndrome
Pulmonary Edema
2 mins
TORCHeS Screening
TORCHES
Toxoplasmosis
Other
Rubella
Cytomegalovirus (CMV)
Herpes Simplex Virus (HSV)
Syphilis
Considerations
Diagnostic Testing
3 mins
Probable Signs of Pregnancy
Goodell Sign
Chadwick Sign
Hegar Sign
Positive Serum and Urine Sample
Braxton Hicks Contractions
Ballottement
2 mins
Incompetent Cervix
Mechanism
Premature Cervical Dilation
Assessment
Recurring Miscarriage
Short Cervix
Considerations
Cervical Cerclage
Rest
Labor
1 min
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