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MARK KLIMEK LECTURE NOTES
Lecture 10 Maternal Newborn Pregnancy – Due date
• -Take the first day of the last menstrual period add 7 days, subtract 3 months
• example: June 10-15- March 17 is the due date
• -Weight gain- need to know how much weight a woman should have to gain- 28 lbs + or – 3 • -First trimester- 1 pound each month- 3 months long • -Second and third- 1 lb per week- need to be able to predict what her weight gain should be
o Example: 28
th week – she has gained 22 lbs, what is your impression?• --Week 12 is end of first trimester- 3 lbs • -13 weeks- 4lbs, 14 weeks- 5lbs, 15 weeks- 6 lbs, 16 weeks- 7lbs, 17 weeks- 8 lbs, 18 week- 9 lbs +10= 19 lbs • -Difference of 9 in each so all you have to do is 22-9=19lbs- she gained 3 more than she was supposed to so she should be assessed- 3 lbs off- just assess but if it was 4 lbs off that means something is wrong • -ex. 31 week and gained 15 lbs- 31-9=22, so there is a difference of 7 lbs so she would need a biophysical profile on the baby because the baby may have died last month • -Ideal weight gain=3-9
• Fundal height- top part of the uterus- not palpable until week 12, cannot palpate during the first trimester
- When is the fundus at the belly button=20-22 weeks of gestation
• That’s important for a nurse to know- because your dealing with date of viability • Can you use fundal height to determine what trimester woman is in- good for when there is an emergency • Mom is priority if she’s in the first trimester • If your able to palpate the fundus that means she’s in the second trimester and she is still the priority • If the fundus is above the umbilicus- she is in the third trimester- and the baby becomes the priority
Signs of Pregnancy • Positive and everything else • Fetal skeleton on x-ray 1 / 2
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• Fetal presence on ultrasound • Auscultation of a fetal heart rate of 140- it’s a baby- somewhere between 8 and 12 weeks it can actually be heard but it starts at week 5
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