Final-Antenatal Care(Latest) 7

8/9/2019 Final-Antenatal Care(Latest) 7

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EXERCISE

should be done in moderation

should be individualized: according to age,physical condition, customary amount of

exercise ( swimming or tennis) notcontraindicated unless done for the rsttime ; & stage of pregnancy

al!ing is best

"wimming is good as long as themembranes are intact


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SLEEP AND REST

#ssess activities to identify need for rest andsleep

#verage number of hours of sleep is $hours;may need % to hours of after few

hour afternoon nap' n the second half of pregnancy, advise to

avoid the supine position in bed( position on"*s position

+lan rest time during the day #t wor!, get to stand and wal! about for few

minutes at last once in every hours(if tas!reuires prolong standing, there should be

time to wal! about and sit at intervals


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TRAVELLIN G no travel restrictions but postpone a trip during the

last trimester' on long rides , %-./ minute rest periodsevery .0 hours to wal! about or empty the bladder isadvisable'

1ong distance travel by land needs stop.overs sopregnant women can get out of the car and wal!'

"eatbelts are needed

2raveling by air reuires pressurized planes;n latepregnancy, airlines will reuire a medical certicateindicating tness to travel by air

3est time to travel is during the second trimesterbecause:

2he pregnant women is most comfortable

2he danger of abortion is not great

2he threat of premature labor is at a minimum


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EM PLO YM EN T

as long as the 4ob does not entail handlingtoxic substances or lifting heavy ob4ects , orexcessive emotional strain, there is no

contraindication to wor!ing' advise to wal! about every few hours of her

wor!day during long periods of standing orsitting to promote circulation thereby

minimizing varicose veins'


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H. Physical Exam ination

3aseline 5eight6eight

7ital "ign measurement

#ssessment of "ystems easurement of 8undal 5eight

8etal heart sounds


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#ssessment of "ystems

%' 9eneral #ppearance and ental"tatus

anner of dressing

ay of spea!ing

3ody posture


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5ead and scalp "ymmetry

ormal contour

2enderness

5air distribution, thic!ness, excessivedryness or oiliness,cleanliness


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yes dema of the eyelids combined with a

swollen optic dis! suggests edema frompregnancy induced hypertension

#ssess for diplopia(double vision)


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ose ncrease level of estrogen associated

with pregnancy cause nasal congestionor the appearance of swollen nasalmembranes


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ars 2he nasal stu in the ears or dampening ofsound during early pregnancy

?sually this disappears as the bodyad4usts to the new estrogen level'

ormal hearing level and normaltympanic landmar!s should be present


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outh, 2eeth and 2hroat 9ingival(9um) hypertrophy may result

from estrogen stimulation

9ums slightly swollen and tender totouch but not reddened

+rone to vitamin deciency due to rapid

fetal growth #ssess for crac!ed corners of the mouth

which would reveal 7itamin # deciency

#ssess for pinpoint lesions with an

erythematous bas e on the lips(suggest


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2each dental hygiene

@ental carries are source of infection

and should be treated beforeabscesses develop and cause moreserious problems


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AB "light thyroid hypertrophy due to

increased metabolic rate

1C+5 D@" o palpable lymph nodes should be

present


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3E#"2" #reola dar!en

"econdary areola develop

ontgomery tubercles(sebaceous glandsin the areola) become prominent

Dverall breast size increases

3reast consistency rms 3lue strea!ing of veins becomes

prominent

Aolostrum may be expelled as early as

the %Fthwee! of pregnancy


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5eart Eanges G/ to $/ beats6minute

accessory sounds or murmurs should beabsent

Dccasional palpitations(heart s!ipping abeat) especially when lying supine

should rest or sleep on their left side


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TETAN US TO XO ID

IM M UN IZATIO N : 22% 97 #C2 @?E9

+E9#AC

22 D D25 #82E 22% ( 0 C#E"+ED2A2D)

220 "H D25" #82E 22 ( - C#E"+ED2A2D)

22I D C#E #82E 220 ( %/ CE")

22- D C#E #82E 22I DE H2+E9#AC ( 182 +ED2A2D)

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Final-Antenatal Care(Latest) 7