Prenatal Nutrition
- Prenatal Vitamins
- Iron Supplement 30 mg Daily
- Folate/Folic Acid 400 mcg Daily
- Appropriate Weight Gain Recommendations
- 340 Calorie Increase
- 25 gram Protein Increase
- Coffee, Alcohol, Tobacco
- Fish Containing High Mercury Levels
Prenatal Care
- Prenatal Visits
- Vital Signs, FHR
- Fundal Height
- Urine Dipstick
- Weight
- Prenatal Screening
- Laboratory Testing
Lab and Diagnostic Tests During Pregnancy
- Complete Blood Cell Count
- Blood Typing
- Rubella Titer
- Hepatitis B
- HIV Testing
- Urinalysis
- Diabetes
- Pap Smears
Lab and Diagnostic Tests During Pregnancy (Other Visits)
- 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
Hyperemesis Gravidarum
- Excessive Vomiting
- Significant Weight Loss
- Dehydration
- Hypotension
- Electrolyte Imbalance
- Antiemetics
- Frequent Small Meals
- IV Therapy
Amniocentesis
- Transabdominal Puncture
- > 14 weeks gestation
- Genetic and Congenital Anomalies
- Fetal Hemolytic Disease
- Fetal Lung Maturity
- Miscarriage
- Hemorrhage
- Infection
- RhoGAM (Rh Immune Globulin)
Placental Implantation Abnormalities
- Placenta Adheres Directly to Myometrium
- Placenta Accreta
- Placenta Increta
- Placenta Percreta
- Caused by Scar Tissue
- Hemorrhage
- Ultrasound is First-line, then MRI
- C-section Delivery
- Artery Ligation or Embolization
Presumptive Signs of Pregnancy
- Amenorrhea
- Fatigue
- Urinary Frequency
- Nausea and Vomiting
- Breast Changes
- Quickening
Probable Signs of Pregnancy
- Goodell Sign
- Chadwick Sign
- Hegar Sign
- Positive Serum and Urine Sample
- Braxton Hicks Contractions
- Ballottement
Positive Signs of Pregnancy
- Fetus on Ultrasound
- Fetal Heart Rate by Doppler or Fetoscope
- Fetal X-ray
- Fetal Movements
Fetal Circulation
- Placenta
- Umbilical Vein
- Ductus Venosus
- Right Atrium
- Foramen Ovale
- Left Atrium
- Aorta
- Right Ventricle
- Ductus Arteriosus
- Umbilical Arteries
Patent Ductus Arteriosus
- Continuous
- Machine like murmur
- Often Due to Congenital Rubella
- Prematurity
Contraception
- Preventing Unplanned Pregnancy
- Spermicides
- Diaphragm
- Cervical Cap
- Contraceptive Sponge
- Male Condom
- Oral Contraceptive
- Intrauterine Device (IUD)
- Injectable Progestins
Infertility
- No Conception After 1 Year
- Artificial Insemination
- In Vitro Fertilization (IVF)
- Clomiphene Citrate (Clomid)
- Menotropins
- GnRH Agonists
- Treat Underlying Disorders
- Emotional Support
- Multiple Gestations
TORCHeS Screening
- Toxoplasmosis
- Other
- Rubella
- Cytomegalovirus (CMV)
- Herpes Simplex Virus (HSV)
- Syphilis
- Diagnostic Testing
Rubella TORCH
- Nonspecific TORCH Symptoms
- Patent Ductus Arteriosus
- Pulmonary Artery Hypoplasia
- Cataracts
- Deafness
- Blueberry Muffin Rash
- Glaucoma
Syphilis TORCH
- Nonspecific TORCH Symptoms
- Often Results in Stillbirth
- Hydrops Fetalis
- Saber Shins
- Notched Teeth
- Saddle Nose
- Blindness
- Deafness
- Hepatitis
Toxoplasma gondii TORCH
- Congenital TORCH Infection
- Mom Usually Asymptomatic
- Rarely Lymphadenopathy
- Nonspecific TORCH Signs
- Intrauterine Growth Retardation
- Hepatosplenomegaly
- Deafness
- Chorioretinitis
- Hydrocephalus
- Calcifications
Gonorrhea
- Neisseria gonorrhoeae
- Dysuria
- Yellowish-Green Discharge
- Increased Urinary Frequency
- Women Often Asymptomatic
- Ceftriaxone (IM)
- Doxycycline
- Azithromycin
- Treat Partners
Syphilis
- Treponema pallidum
- Spirochete with characteristic motility
- Painless chancre
- Condylomata lata
- Generalized lymphadenopathy
- Rash on palms and soles
- Aortitis
- Gummas
- Neurosyphilis
- Argyll Robertson pupils
- Vasa vasorum
- Tabes dorsalis
- Penicillin
- Jarisch-Herxheimer reaction
Chlamydia
- Chlamydia trachomatis
- May Be Asymptomatic
- Dysuria
- Epididymitis
- Discharge
- Dyspareunia
- Doxycycline
- Azithromycin
- No Intercourse for 1 Week
- Treat Partners
Human Papillomavirus (HPV)
- Non-enveloped
- Circular
- Double Stranded DNA
- Warts 1, 2, 6, 11
- Condyloma acuminata
- Type 16, 18
- Cervical Carcinoma
- Penile Carcinoma
- AIDS/Immunocompromised
- Worsened by Smoking
- Koilocytic change in squamous epithelium
- Pyknotic Nuclei Surrounded by Clear Halo
- Vaccine Available
Spontaneous Abortion Overview
- Bleeding < 20 weeks Gestation
- Identify Type
- Bed Rest
- Monitor for Hemorrhage
- Save Pads and Linens
- RhoGAM
- Dilation and Curettage (DandC)
- Cerclage
- Emotional Support
Ectopic Pregnancy
- Lower Abdominal Pain
- Delayed Menses
- Abnormal Vaginal Bleeding
- Shock
- Referred Shoulder Pain
- Cullen Sign
- Methotrexate
- Surgery
- RhoGAM
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
Abruptio Placentae
- Premature Separation of Placenta
- Tearing Pain
- Bleeding (Often Concealed)
- Rigid Uterus
- Contractions
- Corticosteroids as Needed
- Emergent Delivery
- Increased Risks for Neonate
- Rh (Rhesus) Incompatibilities
- Increased Risk for Shock
- Monitor Fetal Heart Rate
Placenta Previa
- Placenta Covers Cervical Os
- Painless
- Bright Red Vaginal Bleeding
- Stable Fetus
- Bed Rest
- Observation
- Unstable Fetus
- C-section Delivery
- Risk for Shock
- Magnesium Sulfate
- Tocolysis
Incompetent Cervix
- Premature Cervical Dilation
- Recurring Miscarriage
- Short Cervix
- Cervical Cerclage
- Rest
- Labor
Preeclampsia Assessment
- After 20 Weeks of Pregnancy
- Hypertension > 140/90
- Proteinuria or End-Organ Dysfunction
- Hypertension > 160/110
- Progressive Renal Insufficiency
- Vision Changes
- HELLP Syndrome
- Pulmonary Edema
Preeclampsia Interventions
- Side Lying Position and Bedrest
- Antihypertensives
- Magnesium Sulfate
- Labor Induction
Severe Preeclampsia
- Vasospasm and Decreased Organ Perfusion
- Intravascular Coagulation
- Increased Permeability and Capillary Leakage
- Hypertension
- Proteinuria or End-Organ Dysfunction
- Hepatic Dysfunction and Hemolysis
- Elevated Liver Enzymes
- Low Platelet Counts
Primary Hypertension Risk Factors
- Excessive Alcohol Consumption
- High Sodium Diet
- Dyslipidemia
- Obesity
- People of African Descent
- Advanced Age
- Vitamin D Deficiency
- Reduced Nephron Number
- Diabetes
- Lack of Physical Activity
Hypertension Assessment
- Essential Hypertension
- Secondary Hypertension
- Headache
- Vision Changes
- Nosebleed (Epistaxis)
- Chest Pain
- Syncope (Fainting)
- Average 2 Sets, 2 Minutes Apart
- After 2 or More Visits (within 1-4 weeks)
- Take BP Both Arms
- Common in African Americans
Hypertension Intervention
- Weight Reduction and Exercise
- Diet Changes
- Relaxation Techniques
- Smoking Cessation
- Medications
- Encourage Self Monitoring
Trichomonas vaginalis
- Protozoa
- Vaginitis
- Pruritus
- Foul-smelling Greenish Frothy Discharge
- Strawberry Cervix
- Corkscrew Motility on Wet Prep
- Metronidazole
Tuberculosis Assessment
- Airborne Droplet
- 3 Week Productive Cough
- Night Sweats
- Chest Pain
- Fever
- Weight Loss
- Fatigue
- Chest X-Ray
- Blood Tests
- Mantoux Skin Test
- 3 Positive Sputum Tests
Tuberculosis Intervention
- Airborne Isolation
- Combination Drug Therapy (RIPE)
- 6-12 Months
- DOT
- BCG Vaccination
- Medication Education
- 3 Negative Sputum Specimens
- Infection Control
Urinary Tract Infection Symptoms
- More Common in Elderly
- Most Common in Females and Babies
- Change in LOC
- Dehydration
- Fever
- Urgency
- Urethral Infection
- Burning
- Smelly Urine
- Dark Cloudy Urine
- Frequency of Urination
Urinary Tract Infection Prevention and Treatment
- Shower after Sex
- Urinate after Sex
- Wipe front to Back
- I and Os with Daily Weights
- Increase Water Intake
- Antibiotics
- Avoid Caffeine
- Dr Appointment in 2 Weeks
- Void every 2 - 4 hours
Pyelonephritis Assessment
- Ascending Urethral Bacteria
- Dysuria
- Fever
- Fatigue
- Flank Pain
- Costovertebral Tenderness
- Nausea and Vomiting
Pyelonephritis Interventions
- Urinalysis
- NSAIDs
- Antibiotics
- Increase Fluid Intake
- Avoid Catheterization
- Urosepsis
Postpartum Hemorrhage
- Uterine Atony
- Lacerations
- Retained Placenta
- Bleeding
- Hypotension
- Boggy Uterus
- Oxytocin
- Bimanual Compression of Uterus
- Surgery
- Blood Transfusion
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
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
- Nutrition
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