Nurse Z

LECTURE 1

Pregnancy
1st
2nd
3rd: feeling pangit si mommy, therefore kausapin si hubby 

S/Sx:

Presumptive (subj) - BAUN QC
breast changes,
 amenorrhea,
urinary changes,
n/v,
quickening,
 chloasma

Probable (obj) -hcg

Positive (confirmatory)-utz ...
 abd - drink water
transvaginal - void

stages of fetal development-
fertilization (ampulla) -> implantation (uterus/upper uterine segment)
ouside -ectopic preg
lower uterine segment - placenta previa

conceptus - period
ovum - > ovulation to fertilization
zygote -> fertilization to implantation
embryo -> implantation to 8 weeks
fetus -> 8 weeks to full term

Membranes-chorion - outer (protect)- amnion - inner layer

and it consist to:

amniotic fluid (approximately 500-1000ml) 

some books are 800-1200ml
iinom, ihi kaya namamaeintain ang 500-1000ml

<500ml: oligohydramnios 

inom ng inom, hindi nakakaihi kaya nag dedecrease ang amniotic fluuid kasi di naibabalik ng bata ang fluid
- kidney/renal problems

>1000ml: polyhydramnios - 

ihi ng ihi pero di nakakinom, di nya naiinom ang amniotic fluid
possible esophageal problems or esophageal atresia
atresia means failure to develop

ang tinatanong sa board exam: what is the possible cases?

amniotic fluid -always rfemember anong meron sa amniotic fluid

merong functions

1. for protection from impact from sudden injuries
2. for temperature regulation
3. supports growth and of course it facilitates fetal movement

umbilical cord - consist 3 blood vessels

you will have your AVA
what is ava?
2 arteries, 1 vein

possible ba na magkarroon ng cases na magkabaliktad?

2 veins, 1 artery
usually pag ganyan bata it means that the child has congenital heart defect

whartons jelly - protective covering of umbilicus

antepartum care
-care given between conception to onset of labor
inclusions:
-fetal well being 
-maternal well being
*dalawa ang pasyente mo, mother and child. 

fetal well being
-fht monitoring, FHR monitoring. always remember that is being monitored via auscultation
3 mos, 4 mos, 5 mos
3mos- doppler
4mos- fetoscope
5mos- stethoscope - can use both bell and diaphragm but usually bell. deep ung fht 
normal value: 120-160bpm
loud enough to be heared by steth
<120 fetal bradycardia
>160 fetal tachycaRDIA

fetal movement
-quickening, commonly felt by 5th month
-movement felt by the mother

electronic fetal heart rate monitoring- 
-stress test
-nst / non stress test
unang ginagawa is non stress test.  from the word non stress., you will not employ stress. hihintayin mo lang magkaroon ng contraction. ang hinahanap sa non stress test ay ang normal. ano ang normal? acceleration or deceleration? ACCELERATION. pag taas.
merong rule na sinusundan. rule of 15x15. 15 beats increase ung baby in the 15 second duration
it will last for 15 seconds bago bumaba sa normal.
hindi yan ang tinatanong sa board. kundi ang result: REACTIVE and NON REACTIVE
reactive-good result. nakakita ka ng normal
non reactive- bad result. hindi ka nakakita ng normal.