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List 6 management strategies for H/A in pregnancy.
- 1. Tylenol 650mg Q4hr PRN (take early)
- 2. Avoid dietary triggers (chocolate, MSG, nitrates)
- 3. Avoid skipping meals
- 4. Avoid stimuli in environment
- 5. Adequate rest and sleep
- 6. Massage, moist heat/cold to back of neck
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What are 4 possible causes of constipation in pregnancy?
- 1. progesterone (relaxes)
- 2. mechanical obstruction
- 3. Increased fluid absorption from GI tract
- 4. Iron supplements
- ***change in activity, excess Ca+, antihistamines
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What do you want to rule out with a pregnant woman presenting w/ constipation?
-bowel obstruction, appendicitis, IBS
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What are some management options for constipation?
- 1. high fluid/fiber intake
- 2. bulk laxatives
- 3. stool softeners
- 4. time-released Fe
- 5. warm beverages
- 6. establish regular bowel routine
- 7. exercise
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T or F. Laxative and enemas are appropriate management for constipation in pregnant women?
no
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What are 3 sources of management options to treat hemorrhoids during pregnancy?
- 1. Steroids (anusol, Prep H)
- 2. Topical (sitz, ice packs, salt bath, tucks)
- 3. systemic (mineral oil, stool softeners)
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T or F. Nose bleeds occur mostly in the 3rd trimester?
False. Occurs in all 3 Trimesters
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What are 3 causes of epistaxis during pregnancy?
- 1. Estrogen--> vasodilation of mucous membranes
- 2. progesterone--> relaxation of vein walls
- 3. Blood vessel engorgement
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When is dyspnea most prevalent during pregnancy?
Late 2nd and all 3rd TM ( caused by elevation of diaphragm and increased CO)
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What should you rule out or look for with a pregnant lady presenting w/ dypsnea?
- 1. URI
- 2. COPD/asthma
- 3. Cardiac d/o
- 4. TB
- 5. Hemptysis
- 6. fever
- 7. cyanosis
- 8 retractions
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What are some management options for pregnant women with dyspnea?
- 1. Sleep (increase HOB, lay on side)
- 2. Rest (after exercise)
- 3. Avoid tight clothing
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When is urinary frequency most common during pregnancy?
1st and 3rd TM
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What should you consider or rule in a pregnant patient with urinary frequency?
-UTI/asymptomatic bacturia
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What are some management options for urinary frequency?
- 1. Reassurance
- 2. decrease caffeine/ETOH
- 3. Kegel
- 4. Frequent voids to avoid UTI
- 5. Review S/S of UTI
- 6. possibly panty liner
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When is fatigue a major complaint during pregnancy?
During all TM but worst in 3rd TM
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What should you rule out for fatigue in pregnancy?
- 1. infection
- 2. inadequate nutrition
- 3. anemia
- 4. PIH
- 5. Depression
- 6. anxiety
- 7. stress
- 8. cardiac/pulm problems
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When is dizziness most commonly seen during pregnancy?
-1st/3rd TM
Caused by vasomotor instability, hypoglycemia, or later vena caval compression
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How much water should be recommended for a pregnancy woman to drink daily?
3 quarts
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When are complaints of nausea most prevalent in pregnant women?
1st/3rd TM
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What are some causes of nausea during pregnancy?
- 1. Reflux
- 2. Elevated HCG
- 3. Progesterone smooth muscle relaxation
- 4. Increased gastric emptying time
- 5. Lower functional reserve of liver capacity
- 6. hypoglycemia
- 7. psychological stress
- 8. 3rd TM: relaxatio of cardiac sphincter
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What are some management options for pregnant women w/ nausea?
- -keep track of intake/output
- -avoid meal preparation
- -Dietary adjustments like small frequent meals, room temp foods, crackers b/f rising, fluids between meals and not with meals
- -Monitor: ketones, weight, specific gravity
- -Herbals: ginger root, peppermint, chamomile, raspberry leaf
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What are some medical management options for nausea during pregnancy?
- -Zofran 4-8mg TID
- -Emetrol upon waking, repeat q 3-4hr
- -Reglan 10mg TID
- -Doxylamine succinate (unisom) w/ Vit B6
- -Phenergan 1/4 tab QID
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When are wrist/hand complaints most common during pregnancy?
2nd/3rd TM
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What are some management options for wrist/hand pain?
- -Avoid fine motor activities
- -frequent rest with fine motor activities
- -wrist brace/cock-up splint
- -cortisone injections
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When is Leukorrhea most prevalent during pregnancy?
Throughout pregnancy
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What should you rule out with Leukorrhea?
vaginitis and PROM
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What should you rule out with back pain?
- 1. Pyelonephritis
- 2. UTI
- 3. Preterm labor
- 4. Disc problems
- 5. Ortho problems
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What are 3 causes of sciatica pain during pregnancy?
- 1. Shifting of pelvic bone
- 2. Relaxed ligaments
- 3. Fluid retention
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What are some management options for leg cramps during pregnancy?
- 1. Reduce Phos/increase Ca
- 2. Dorsiflex foot
- 3. Compress muscle/massage
- 4. apply warm compresses
- 5. Keep legs warm
- 6. Avoid heels
- 7. support hose
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What are some management options for varicosities?
- -Support hose
- -elevate legs
- -Avoid: prolonged standing, constrictive clothing, crossing legs at the knee, sitting for more than 1 hr
- -Vulvar support like a pad
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