Vitals in pregnancy / what changes and what remains the same – BP no change Ch 7-pg 157
HR increases around 5 wks gestation, peak increase of 15-20 beats/min, CO increases by 30%-50%
peaking at 25-30 wks, BP no changes- factors that affect maternal BP- age, activity level, presence of
health problems, cardiac rhythm, alcohol, smoking, pain, anxiety. Maternal positioning also affects BP
reading. Sitting- reads high, lying in lateral recumbent- lowest, supine- intermediate. Should be
measured same arm each visit. Respiratory- increased O2 consumption- nasal congestion/nosebleeds,
diaphragm elevates and some SOB
Abnormal-Fluid leakage from vagina (not leukorrhea), abnormal pelvic pain, epigastric pain, severe heart
burn, sudden/unusual continuous headache, edema of face and hands, dizziness, blurred vision, seeing
spots, persistent vomiting, dysuria, oliguria, temperature 100.4, no fetal movement for 12 hours, leg
edema with pain or redness, chest pain, dyspnea (not just SOB)
** Tylenol for headaches, Imitrex and opiods**
Iron deficiency anemia best diet- 208
Iron in pregnancy- 30mg (about the weight of a grain of rice), lactation-10/9mg (about the weight of
a grain of table salt). Maternal hemoglobin formation, fetal liver iron storage. Food- Liver, meats
whole grain/enriched breads and cereals, drk green leafy veggies, legumes, and dried fruit
Anemia-n Iron with vitamin C helps with absorption- NO CALCIUM OR TABBIC ACID, IT INHIBITS
ASORPTION OF IRON>
Folic Acid Anemia- Large immature RBC’s, anticonvulsants, contraceptives, sulfa, alcohol, decreased
absorption.
Sickle cell crisis- fluid minimize ischemia, and control pain
DIET: Protein
Rice/whole grains
Oranges, Vit C
Folic acid for neural tube protection
Iron
Tofu, dairy, leafy greens, rich in calcium
Manage morning sickness – crackers, ginger, 187
Breast soreness, enlargement. Urgency and frequency of urination, N/V, avoid
empty or overloaded stomach, fried odorous, spicy greasy or gas forming foods eat
crackers or dry carbs upon awakening, remain in bed until feeling better, good posture,
Accupressure band to decrease motion sickness, ginger
Educate on S/S report to provider –177
, Probable, Presumptive, Positive signs of Pregnancy- 152
Presumptive (subjective) - 3—4 weeks breast changes 4 weeks- amenorrhea, 4-14 weeks (about 3
months) N/V, 6-12 weeks (about 3 months) - urinary frequency 12 weeks (about 3 months)- fatigue, 16-
20 weeks (about 4 and a half months)- quickening (baby kicking), and possible constipation.
Probable (objective) - 5 weeks- Goodell sign (softneing of the cervix) 6-8 weeks- Chadwich sign (blue
uterus), 6-12 weeks- Hegar sign-(softening of the uterus), enlarging uterus, 4-12 weeks – positive serum
pregnancy test, 6-12 weeks postivie urine test, stria gravidum, 16 weeks (about 3 and a half months)-
Braxton hicks, 16-28 weeks (about 6 and a half months)-Ballotment
Positive signs (objective)- assess by provider- 6 weeks (about 1 and a half months)- hear fetal heart via
ultrasound, 5-6 weeks (about 1 and a half months)- visualizing fetus by ultrasound, 16 weeks (about 3
and a half months) visualization of fetus via radiography, 8-17 weeks (about 4 months) heart sound by
dopplerf, 17-19 weeks (about 4 and a half months) fetal heart tones via fetal stethoscope, 19-22 weeks
(about 5 months) fetal movement palpated by examiner, Late- fetal movement visible to examiner
Family and Kids react to new baby – 170
Nonpregnant partner-can be fearful, include them in the process of preparation- give them
resources, Siblings-loss, jealous, replaced, by sympathetic to older children's concerns about losing
place in the family, responses vary with age
Grandparents-historian, resource person, role model, and support person, can strengthen family
systems. Some may react negatively due to not being ready for the new role of grandparent.
Naegeles Rule (EDD) –167
Frist day of last menstrual cycle + 7 days + 9 months OR
First day of last menstrual cycle + 7 days – 3 months + 1 year
PICA affect to what lab values- anemic- 215
Consuming nonfood substances or excessive amounts of food low in nutritional value.
May have lower hemoglobin, craving ice may be a sign of anemia
Mexican- lead due to pottery
Coach patient normal symptoms of pregnancy- nauseated, urinary frequency
Rubella in pregnancy means – manage her (immune or not immune)
HR increases around 5 wks gestation, peak increase of 15-20 beats/min, CO increases by 30%-50%
peaking at 25-30 wks, BP no changes- factors that affect maternal BP- age, activity level, presence of
health problems, cardiac rhythm, alcohol, smoking, pain, anxiety. Maternal positioning also affects BP
reading. Sitting- reads high, lying in lateral recumbent- lowest, supine- intermediate. Should be
measured same arm each visit. Respiratory- increased O2 consumption- nasal congestion/nosebleeds,
diaphragm elevates and some SOB
Abnormal-Fluid leakage from vagina (not leukorrhea), abnormal pelvic pain, epigastric pain, severe heart
burn, sudden/unusual continuous headache, edema of face and hands, dizziness, blurred vision, seeing
spots, persistent vomiting, dysuria, oliguria, temperature 100.4, no fetal movement for 12 hours, leg
edema with pain or redness, chest pain, dyspnea (not just SOB)
** Tylenol for headaches, Imitrex and opiods**
Iron deficiency anemia best diet- 208
Iron in pregnancy- 30mg (about the weight of a grain of rice), lactation-10/9mg (about the weight of
a grain of table salt). Maternal hemoglobin formation, fetal liver iron storage. Food- Liver, meats
whole grain/enriched breads and cereals, drk green leafy veggies, legumes, and dried fruit
Anemia-n Iron with vitamin C helps with absorption- NO CALCIUM OR TABBIC ACID, IT INHIBITS
ASORPTION OF IRON>
Folic Acid Anemia- Large immature RBC’s, anticonvulsants, contraceptives, sulfa, alcohol, decreased
absorption.
Sickle cell crisis- fluid minimize ischemia, and control pain
DIET: Protein
Rice/whole grains
Oranges, Vit C
Folic acid for neural tube protection
Iron
Tofu, dairy, leafy greens, rich in calcium
Manage morning sickness – crackers, ginger, 187
Breast soreness, enlargement. Urgency and frequency of urination, N/V, avoid
empty or overloaded stomach, fried odorous, spicy greasy or gas forming foods eat
crackers or dry carbs upon awakening, remain in bed until feeling better, good posture,
Accupressure band to decrease motion sickness, ginger
Educate on S/S report to provider –177
, Probable, Presumptive, Positive signs of Pregnancy- 152
Presumptive (subjective) - 3—4 weeks breast changes 4 weeks- amenorrhea, 4-14 weeks (about 3
months) N/V, 6-12 weeks (about 3 months) - urinary frequency 12 weeks (about 3 months)- fatigue, 16-
20 weeks (about 4 and a half months)- quickening (baby kicking), and possible constipation.
Probable (objective) - 5 weeks- Goodell sign (softneing of the cervix) 6-8 weeks- Chadwich sign (blue
uterus), 6-12 weeks- Hegar sign-(softening of the uterus), enlarging uterus, 4-12 weeks – positive serum
pregnancy test, 6-12 weeks postivie urine test, stria gravidum, 16 weeks (about 3 and a half months)-
Braxton hicks, 16-28 weeks (about 6 and a half months)-Ballotment
Positive signs (objective)- assess by provider- 6 weeks (about 1 and a half months)- hear fetal heart via
ultrasound, 5-6 weeks (about 1 and a half months)- visualizing fetus by ultrasound, 16 weeks (about 3
and a half months) visualization of fetus via radiography, 8-17 weeks (about 4 months) heart sound by
dopplerf, 17-19 weeks (about 4 and a half months) fetal heart tones via fetal stethoscope, 19-22 weeks
(about 5 months) fetal movement palpated by examiner, Late- fetal movement visible to examiner
Family and Kids react to new baby – 170
Nonpregnant partner-can be fearful, include them in the process of preparation- give them
resources, Siblings-loss, jealous, replaced, by sympathetic to older children's concerns about losing
place in the family, responses vary with age
Grandparents-historian, resource person, role model, and support person, can strengthen family
systems. Some may react negatively due to not being ready for the new role of grandparent.
Naegeles Rule (EDD) –167
Frist day of last menstrual cycle + 7 days + 9 months OR
First day of last menstrual cycle + 7 days – 3 months + 1 year
PICA affect to what lab values- anemic- 215
Consuming nonfood substances or excessive amounts of food low in nutritional value.
May have lower hemoglobin, craving ice may be a sign of anemia
Mexican- lead due to pottery
Coach patient normal symptoms of pregnancy- nauseated, urinary frequency
Rubella in pregnancy means – manage her (immune or not immune)
