Lecture 10 | Maternity

• How do you determine the estimated date of delivery?

  Add 7 days, subtract 3 months
• How weight should be gained in the first trimester (12 weeks)?

  3 lbs (1 lb per month)
• How weight is gained in the 2nd & 3rd trimesters?

  1 lb every week
• What is the ideal weight gained during pregnancy?

  28 lbs plus or minus 3
• What is a quick way to determine ideal weight gained during pregnnacy?

  # of weeks gestation minus 9
• What to do for weight gained during pregnancy

  A) WNL

  B) assess

  C) trouble

  D) BPP

  
• When is the fundus palpable?

  week 12
• When is the fundus midway between the umbilicus and the pubic symphysis (belly button)?

  between 20 & 22 weeks
• Range of value: fetal HR can be heard first between 8 to 12 weeks
• Range of value: quickening may first be felt between 16 to 20 weeks
• When should you first?

  Fetal heart: 8 weeks

  Quickening: 16 weeks
• When would you most likely?

  Fetal heart: 10 weeks

  Quickening: 18 weeks
• When should you ⎼ by?

  Fetal heart: 12 weeks

  Quickening: 20 weeks
• Chadwick sign?


  cervical color change to cyanosis
• Goodell sign?


  good and soft - softening of the cervix
• Hegar sign?

  uterine softening - lower uterine segment
• Moves up from vulva, vagina, cervix to the uterus?

  Chadwick sign → Goodell sign → Hegar sign
• How often should pt be advised to go for prenatal visits?

  once a month until 28 weeks
• How often should pt be advised to go for prenatal visits between 28 & 36 weeks?

  every other week
• How often should pt be advised to go for prenatal visits after 36 until delivery or 42 week?

  once a week
• What is lowest level of Hgb for pregnancy?

  10
• How do you treat morning sickness?

  dry carbohydrates before pt gets out of bed
• How do you deal with urinary incontinence?

  void every 2 hours from the day she gets pregnant until 6 weeks PP
• How do you treat back pain?

  pelvic tilt exercises? tilt foward
• How do you treat difficulty breathing?

  tripod position (lean forward with hands on knee or surface of desk/table)
• What is the truest most valid sign that she is in labor?

  the onset of regular/progressive contractions
• Dilation is opening og cervix from 0 to 10 cm
• Effacement is the thinning of the cervix. It goes from thick to 100% efface (thin like paper)
• Station is the relation between fetal presenting part to mother's ischial spines
• what are the ischial spines?

  the narrowest part of the pelvis
• Engagement is station 0 - the presenting part is at the ischial spines
• Lie is the relationship between the spine of the mother and the spine of the baby
• A vertical lie is when the mother's spine and the baby's spine is parallel - compatible with vaginal birth
• If the lie is perpendicular (transverse) = trouble (csection)
• What are the most common presentation?

  ROA or LOA - pick ROA before LOA
• What is stage 1?

  onset of labor (it has 3 phases)
• What are the 3 phases of labor?

  Latent, active, & transition
• What is stage 2?

  Delivery of the baby
• What is stage 3?

  Delivery of the placenta
• What is stage 4?

  recovery (lasts only 2 hours)