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couvades syndrome
- Paternal responses to pregnancy
- Partner identifies with woman’s pregnancy
- May experience discomforts such as N & V, fatigue, weight gain, difficulty sleeping, backaches or depression
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First task for mother in pregnancy
Accept the biologic fact of pregnancy. The woman needs to be able to state, “I am pregnant”.
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Second task for mother in pregnancy
Accept the growing fetus as distinct from herself. The woman can now state, “I am going to have a baby”.
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Third and last stage for pregnant mother to complete
Prepare realistically for the coming of the child and prepare to relinquish it. The woman expresses the thought that, “ I am going to be a parent”.
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Aunt Julie’s rule for calculating age of fetus
- at synthesis pubis = 12 weeks
- at umbilicus= 20 weeks
- lvl of xiphoid process = 36 weeks
- drop below xiphoid process after 36 weeks (drops
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Nagele’s Rule -
- -How to calculate due date
- First day of LMP, subtract 3 months, add 7 days, add 1 yr,
- i.e.: July 4th, 2011, (LMP) EDC 4/11/2012
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McDonald’s rule
- (top of pubic bone to top of fundus); fundal height corresponds with fetal growth from 16 wks until 38
- wks then subsides
- i.e. If the fundal
- measurement is at the umbilicus which is 20 cm = 20 wks
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Presumptive sign of pregnancy –
s/s that lead client to believe she is pregnant; all considered subjective/not conclusive. Think signs the MOTHER would know or recognize. (breast changes, skin changes, N/V, menstrual suppression)
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Probable indications of pregnancy
- (objective) MD/NP Think signs that a NURSE
- would assume meant pregnancy but would need additional testing for verification. (+ preg test,
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Positive sign of pregnancy –
- Only four which give direct evidence of live
- fetus: all are objective; Think this is positively pregnancy; there is nothing else this could be.
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chloasma gravidarum
– brown colored facial blotches, hormonally induced
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striae gravidarum –
“stretch marks” caused by rupture and atrophy of connective tissue, appear pink to reddish purple during pregnancy/birth and will change to silver white/cream/pink within one year following birth
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Angiomas
– tiny capillary branches – “spiders”. Related to estrogen
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Linea nigra
– pigmented line running from umbilicus to symphysis pubic; lightensafter pregnancy
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Chadwick’s sign
-change in color of cervix, becomes more bluish
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Goodell’s sign
– cervical softening
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Hegar’s sign
– softening of the uterine ishmus; it is easy flexion of the lower uterine segment during bimanual exam. It occurs about the 2nd or 3rd month
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Danger signs of pregnancy and need to be reported
- -Any leakage or gush of anything from the vagina
- -Vaginal bleeding – with or without discomfort; of any kind; ask amounts
- -Abdominal pain –persistent or severe; could be abruption, premature labor, gallbladder disease
- -Temp > 101 – and chills; indication of infection
- -Blurred vision, dimness, spots (scotoma), any form of visual disturbance – could be viral;
- -PIH
- -Persistent vomiting
- -Severe backache – could be way baby is laying or indicate hypertension (big vessels back there are distended/stretched), could be her posture, could be UTI
- -Headaches – if consistent could be PIH, pounding headache is characteristic of PIH
- -Edema or swelling in hands or face is NOT NORMAL and should be reported immediately.
- * *Edema of legs and feet which is worse
- after having been up and about for a period of time is normal.
- -Muscle rigidity/irritability or convulsions- may be preceded by epigastric pain (cardinal sign w/ PIH)
- -Oliguria – not drinking enough water, impaired intake, kidney stone – need lots of water!
- -Painful urination – bladder or kidney infection could cause preterm labor
- -Changes in frequency or strength of fetal movement
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At what point must mom take iron suppliment to be effective in creating RBC?
28 weeks
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Normal weight gain during pregnancy…
About 2 to 4 pounds during your first three months of pregnancy and 1 pound a week for the remainder of your pregnancy
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Calorie intake above normal for breast feeding mother (when sole-nutrient for baby)
100 calories per pound of baby
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VEAL CHOP
- Variable-Cord compression
- Early-Head Compression
- Acceleration-Other – food, movement, activity, fever
- Late-Placental Insufficiency
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Measuring fetus locations compared to ischial spine
- -2- above ischial spine
- -1
- 0- at Ischial Spine (tops of pelvis)
- 1
- 2-below ischial spine
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PURR of labor
=Position- have mom change positions =Urinate- have mom urinate often =Respiration- have mom breath through contractions not to starve uterus of O2. =Relaxation- relax
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Stages of labor
1) Dilation
- 0cm -------3-------4-------7---------------10cm
- Early active transition
-transition- very intense
2) Expulsion- starts when fully dilated and ends with birth of baby
3) Placental- Starts with birth of baby and ends with birth of placenta
4) Recovery- Starts with birth of placenta and ends with fully recovered mom.
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VEAL CHOP (infant response to contractions)
- Variable Cord compression
- Early Head compression
- Acceleration Other- (eats, sugar, pitocin, pain, hemorrhage)Late Placental insufficiency
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