NR 602 MIDTERM REVIEW YEAR 2023 SUMMARY 4TH EDITION BY MASH DOKE

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NR 602 MIDTERM REVIEW YEAR 2023 SUMMARY 4TH EDITION BY MASH DOKE Signs of pregnancy (presumptive, probable, positive) Presumptive – Subjective signs. Amenorrhea, nausea, vomiting, increase... d urinary frequency, excessive fatigue, breast tenderness, quickening at 18-20 weeks. Probable – Objective Signs. Goodell sign (softening of cervix), Chadwick sign (cervix is blue/purple), Hegar’s sign (softening of lower uterine segment), uterine enlargement, Braxton Hicks contractions (may be plapated by 28 weeks), uterine souffle (soft blowing sound due to blood pulsating through the placenta), integumentary pigment changes, ballottement, fetal outline definable, positive pregnancy test (could be hydatidiform mole, choriocarcinoma, increased pituitary gonadotropins at menopause). Positive – Diagnostic. Fetal heart rate auscultated by fetoscope at 17-20 weeks or by Doppler at 10-12 weeks, Palpable fetal movement after 20 weeks, visualization of fetus with cardiac activity by ultrasound (fetal parts visible by 8 weeks). Pregnancy and fundal height measurement As pregnancy progresses, the fundus rises out of the pelvis. At 12 weeks gestation, the fundus is located at the level of the symphysis pubis and the umbilicus. By 20 weeks gestation, the fundus is at the same height as the umbilicus. Until term, the fundus enlarges 1 cm per week. As the time for birth approaches, the fundal height drops slightly. This process is called lighting and occurs mostly for primigravida and may not occur for woman who are multigravida until she goes into labor. Naegele’s rule The EDB for women with 28 day cycles – Nagele’s rule – Add 7 days to LMP then subtract 3 months. The EDB for women with 30 days cylces – Add 2 days to the calculated EDB The EDB for women with 26 day cycles – Subtract 2 days to the calculated EDB If the woman is not certain for the LMP, an ultrasound is needed to date the pregnancy. Transvaginal ultrasound if the top of the uterine fundus is below the pubic bone. Example: 4/23 LMP of April 23 + 7 days = 4/30 (April 30th) – 3 months = January 30th (following year) [Show More]

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