Chapter 1>>>
Contraception>>>
Barrier method>>> *condoms
*diaphragms:
-must be refitted:
- by a provider every 2 years!
-if they gained more then 15 pounds (7 kilograms) -if they had full term pregnancy
-if they had second-term abortion
*use spermicide (for d...
-if they gained more then 15 pounds (7 kilograms) -if they had full term pregnancy
-if they had second-term abortion
*use spermicide (for diaphragm) for each act of sex
*diaphragm must remain in place for 6 hours after sex
hormonal methods>>> *side effects (look for signs of):
-chest pain, shortness of breath, leg pain from possible clot, headache, eye problems (from stroke or
hypertension)
-if a smoker, this type of contraceptive is not recommended.
*contraindications:
-history of blood clot
-stroke
-cardiac problems
-breast or estrogen cancers: pill contains estrogen ---> cause more estrogen in body
-smoker
depoprovera (injection of progesterone)>>> *can cause decrease of bone mineral density or loss of
calcium
,*interventions: adequate amount of calcium and vitamin D to protect bones
IUDs>>> *increase the risk of pelvic inflammatory disease
*cause uterine perforation
-increase risk of ectopic pregnancy
*look for:
-change in string length (IUD has moved/dislocated)
-foul smelling vaginal discharge
-pain with intercourse
-fevers, chills (infection)
chapter 2>>>
infertility>>> *the inability to conceive over 12 months
infertility workup>>> *start with the guy (because cost effective and easier): sperm analysis ---> comes
out as clear --->
*then look at woman
-any tests that require dye: make sure woman does not have history of allergy to iodine or seafood
chapter 3>>>
signs of pregnancy>>>
presumptive>>> *things that can be explained other then pregnancy
*ex: amenorrhea (could be pregnant OR anorexic, exercising too much), fatigue (maybe didn't sleep
well!), n/v (could be sick), urinary frequency (could have a UTI), breast changes, quickening (gas in
stomach)
probable>>> *everything else in-between
*abdominal enlargement
*hegar sign: softening of uterus
*chadwick's sign: blueish color of cervix
*goodelles: softening of cervix
, *ballotment: rebound of the unengaged fetus
*Braxton Hicks: false contractions
*positive pregnancy test
*fetal outline felt by examiner
positive>>> *hear FHR
*see the baby with ultrasound
*feel movement in uterus
nagale's rule>>> *when due date is based on last menstral cycle
-add 9 months and 1 week
GTPAL>>> *g: gravity: number of times woman has been pregnant, including current pregnancies
*t: term births: pregnancies that have gone to 38 weeks or more
*p: preterm births: below 38 weeks
*a: abortions or miscarriages
*l: living children
chapter 5>>>
normal weight gain in pregnancy>>> *25-35 lbs
-if overweight (a little less): 15-25 lbs
-if underweight: 28-40 lbs
first trimester>>> *shouldn't gain more than 1-2 kg (2-4 lbs) for the entire trimester
-once pass the trimester, expected weight gain of 1 lb/wk for the last two trimester
extra calories>>> *340 calories/day for second trimester
*450 calories/day for third trimester
*don't need much extra calories during the first trimester
if breastfeeding after pregnancy>>> *still need extra calories (300-400/day)
folic acid>>> *help to prevent fetal neural tube defects
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