Prenatal Care

Prenatal Care

Health Promotion PRECONCEPTUAL VISIT: -This is for the early detection -obtaining the accurate reproductive life planning information, -receiving assurance regarding fertility. 1.

2.Health Assessment: PRENATAL VISIT: -know the possible complications and screen for the danger signs. -To know some complication regarding the health threats during pregnancy.

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The first prenatal visit should be as early as possible during first trimester. Second Visit during the second trimester More frequent should be done for those at risk/with complications. All pregnants shall be given TTI as recommended. Fe- on the 5th month. 100-200mg PO daily for 210 days.

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In goiter endemic areas, pregnant Women should be given iodized oil capsule every year.

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Malaria infested areas, all pregnant women shall be given prophylaxis in the form of CHLOROQUINE(150 mg base/tab) 2 every week.

Gather a Initial Interview -Provide information regarding the status of the client. Components Health Assessment - Establish rapport. - Gaining physical and psychosocial info regarding the Mother. - Obtaining basis for the anticipatory guidance on pregnancy. BASELINE INFORMATIONS are important for the symptoms that can be detected during pregnancy.

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Look for Chief Complains

-“Think that she is pregnant”. -Inquire the date of the last menstrual period. -Ask for some early signs of pregnancy. -Think PLANNED

Check for Past illness 

These past condition may be active during pregnancy such as chicken pox and measles.

Check for Day history: -Current Nutrition -Elimination,sleep and recreation -Medicine intake. -Contraceptions.

Obstetric and Gynecologic History Ask for:  Previous child, sex place and date of birth.  Abortion.  Ask for past surgery on the R.T.  Ask for monthly perineum self exam

Review of the Body System: For subjective Information Conclusion: Discuss the things which are normal or not.

BASELINE INFORMATIONS: 

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VS – baseline info and to know the danger signs. Check for the mental status. Head and scalp – check for chloasma Eyes – edema-may lead to hypertension. Nose-Nasal congestion due to ↑ of estrogen level. Ears – Hearing should be normal, nasal stuffiness adjust because of ↑ of estrogen level.

Neck – check for thyroid contents.  Lymph nodes – check for palpable lymph.  Breast – Changes notice during pregnancy.  Heart-normal no murmur sounds.  Mouth, Teeth, Throat – gingival hypertrophy because of estrogen.  Assess: Pinpoint lesion for herpes. DO NOT NEGLECT GOOD DENTAL HYGIENE.  Back- assess for scoliosis.  Rectum – Asses for hemorrhoidal tissue. 

Fundal Height: Normal at range of 31 cm by 9 mos. 

16 weeks – 1-2 fingers above the symphysis. 20 – 2-3 fingers below the umbilicus 24- level of umbilicus 28 – 2-3 fingers above umbilicus 32 – midway bet umb. And xiphoid porcess. 40- below the coastal margin. FHT: 120-160 bpm 28th week – fetal outline

Pelvic exam: External Genitalia – Pap smear Internal Genitalia – Normal colors: 4. Pink – Non pregnant 5. Pregnant – Purple 6. Lesions + abnormal discharges

History of Diabetes: -this includes when the baby is very large for the gustational age. 

Check for some Blood Lab Assessment: 1.CBC 2. Serologic test for syphilis 3. Blood typing(Rh factor) 4. Maternal serum for AFP 5. Indirect Coomb’s test 6. Antibody titers for rbubella, hepa(HBsAG) 7. HIV screening

VITAMIN INPUT:          

Calories – 2500 ug CHON – 60 ug Vit A – 800ug Vit D – 5 ug Vit E – 15 mg Vit - 85 ug Folic Acid – 600 ug Niacin – 17 mg Thiamine – 1.6 mg Riboflavin – 16mg

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B12 – 2.6 ug B6 – 2 mg D – 5ug Calcium – 1200 mg Potassium 700 mg Iodine – 175 ug Iron – 30 mg Mg – 350 mg Zinc – 15mg Flouride – 3 mg

Avoid during pregnancy: 

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Saccharides are not allowed because it may slows down the fetal bloodstream. Limit caffeine intake bec. it may increase the heart rate. Eat fiber rich foods to avoid constipation. Increase of milk input. Artificial Sweeteners may take in low consumption.

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Reducing diets and calorie restrictions are contraindicated during pregnancy. For Nausea and Vomiting - ↑ CHO intake. -Eating dry crackers before getting out of her bed. Craving is result of physiologic need for CHO, vitamins and Minerals. For Pyrosis- ↓ gastric motility, which slows gastric emptying and pressure of the expanding uterus in the stomach. Advice to take MAALOX or AMPHOJEL.

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With Hypercholesterolemia-exercise daily, eating oats, broiling rather than frying, eating foods enriched with Omega-3 For vegetarian Mother- lack of B12 and Calcium. They have to take daily prenatal supplement, inadequate Iron and folic acid. Lactose intolerance – take calcium and Vit D supplement, fortified soy. They may take cheese or yogurt because they are tolerated. Women may take Lactase tablet before taking Milk products.

Thank You!!!