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What needs to be ruled out when hemorrhoids are suspected?
What
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- LESIONS
- CONDYLOMATA
- ANAL FISSURES
- ANAL POLYPS
- ABSCESS
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What are causes of urinary frequency?
Mechanical compression by uterus
Vascular engorgement of pelvis
Progesterone relaxation of bladder
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Causes of fatigue
- Fetal movement
- ↑ CO and 02 use
- ↑ progesterone
- weight gain
- nocturia
- increased metabolic rate
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Causes of dizziness
Vasomotor instability (blood pooling in lower extremities and pelvis
Hypoglycemia
Vena caval compression
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With dizziness rule out
- Middle ear problem
- Orthostatic hypotension
- cardiac insufficiency
- anemia
- ocular strain
- MS
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With nausea rule out:
- hyperemesis
- hiatal hernia
- eating disorder
- molar pregnancy
- DKA
- hyperthyroidism
- ↑ ICP
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Obstetric history includes:
- Gest age at deliver, preterm labor, prenatal complications (GDM, previa, GYN, abruption
- Vag or C/S
- Status of infant
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OB physical includes
- HEENT
- Thyroid
- CV and respiratory
- Abdominal (fundal height), FHTs
- Pelvic: Pap, cultures, pelvimentry, uterine size
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What are some adverse outcomes related to smoking?
- LBW
- Perinatal death (SAB)
- Carbon monoxide (deactivates Hgb)
- Nicotine - vasoconstriction and ↓ placental perfusion
- Reduced appetite
- Decreased plasma volume
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Fetal Alcohol Syndrome
- Pre/Postnatal growth deficiency
- Behavioral disorders and mental retardation
- Atypical facial features
- Congenital heart defects
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Functions of amniotic fluid
- Allows movement
- cushions and protects fetus
- Temperature maintenancebarometer for health and maturity
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Stage I of labor
- Cervical changes
- 0-3 - early
- 4-7- active8-10 - transition
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Stage II
Pushing and Delivery of baby
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Stage III
Expulsion of placenta
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