Lynn Shared "Antepartum care" - 27 Picmonics

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Antepartum care

Prenatal Care
Prenatal Visits
Vital Signs, FHR
Fundal Height
Urine Dipstick
Weight
Prenatal Screening
Laboratory Testing
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2 mins
Prenatal Nutrition
Prenatal Vitamins
Iron Supplement 30 mg Daily
Folate/Folic acid 600 mcg daily
Appropriate Weight Gain Recommendations
340 Calorie Increase
25 gram Protein Increase
Foods and Substances to Avoid
Coffee, Alcohol, Tobacco
Fish Containing High Mercury Levels
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2 mins
Pregnant Cardiac Patient Assessment
Mechanism
Cardiac Decompensation
Signs and Symptoms
Frequent Cough
Dyspnea
Palpitations
Excessive Fatigue
Pulse > 100 bpm
Crackles
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2 mins
Toxoplasma gondii TORCH
Signs and Symptoms
Congenital TORCH Infection
Mom Usually Asymptomatic
Rarely Lymphadenopathy
Nonspecific TORCH Signs
Intrauterine Growth Retardation
Hepatosplenomegaly
Deafness
Chorioretinitis
Hydrocephalus
Diagnosis
Calcifications
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1 min
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
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2 mins
Preeclampsia Interventions
Side Lying Position and Bedrest
Antihypertensives
Magnesium Sulfate
Labor Induction
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1 min
Eclampsia
Mechanism of Action
Increased Central Nervous System Irritability
Signs and Symptoms
Hyperreflexia
Positive Ankle Clonus
Headaches
Visual Disturbances
Epigastric or RUQ Pain
Seizures
Coma
Considerations
Don't Leave Bedside
Magnesium Sulfate
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2 mins
Severe Preeclampsia
Mechanism of Action
Vasospasm and Decreased Organ Perfusion
Intravascular Coagulation
Increased Permeability and Capillary Leakage
Signs and Symptoms
Hypertension
Proteinuria or End-Organ Dysfunction
HELLP Syndrome
Hepatic Dysfunction and Hemolysis
Elevated Liver Enzymes
Low Platelet Counts
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3 mins
Incompetent Cervix
Mechanism
Premature Cervical Dilation
Assessment
Recurring Miscarriage
Short Cervix
Considerations
Cervical Cerclage
Rest
Labor
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1 min
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
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2 mins
Sheehan's Syndrome
Postpartum Pituitary Gland Necrosis
Agalactorrhea
Amenorrhea
Secondary Hypothyroidism with Cold Intolerance
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1 min
Chorioamnionitis
Fever
Maternal or fetal tachycardia
Leukocytosis
Foul Odor to Amniotic Fluid
Treatment: Antibiotics
Monitor uterine tenderness, contractions and fetal activity
Monitor maternal vital signs & FHR
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2 mins
RhoGam [Rho(D) Immune Globulin]
Indications
Antepartum Prevention at 28 weeks
Suppress Antibody Production
Mechanism of Action
Lysis of Fetal RBC in Maternal Bloodstream
Side Effects
Myalgia and Lethargy
Considerations
Negative Coombs Test
Standard Dose 300 mcg
Microdose 50 mcg
Blood Product
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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
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2 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
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3 mins
Pyelonephritis Assessment
Cause/Mechanism
Ascending Urethral Bacteria
Assessment
Dysuria
Fever
Fatigue
Flank Pain
Costovertebral Tenderness
Nausea and Vomiting
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1 min
Pyelonephritis Interventions
Urinalysis
NSAIDs
Antibiotics
Increase Fluid Intake
Avoid Catheterization
Consideration
Urosepsis
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1 min
Pregnant Cardiac Patient Interventions
Prenatal
Monitor for Cardiac Decompensation
Stool Softener
Calcium Channel Blockers
Labor
ECG Monitor
Open Glottis Pushing
Pulmonary Artery Catheter
No Beta-Adrenergic Medications
Penicillin Prophylaxis
Postpartum
Stress on Heart
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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
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3 mins
Placental Implantation Abnormalities
Mechanism
Placenta adheres directly to myometrium
Placenta Accreta
Placenta Increta
Placenta Percreta
Caused by scar tissue
Hemorrhage
Diagnosis
Ultrasound is First-line, then MRI
Treatment
C-section delivery
Artery ligation or embolization
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2 mins

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