EHR Tutor - Tcuguil PDF

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EHR TUTOR: First Trimester: 1) Morning sickness can cause decreased appetite, low level nausea, or vomiting. This is different from true hyperemesis because people are typically still able to eat and drink fluids some of the time. Symptoms of hyperemesis gravidarum are much more severe including dehydration, excessive weight loss, and electrolyte imbalances. 2) EHR 3) This patient is more likely to have gestational diabetes, placenta previa, breech positioning, emergency c-section, postpartum hemorrhage, preterm birth, low birth weight, and high birth weight. Maternal mortality also increases with age. Second Trimester: 1) Placenta Previa: This diagnosis affects the pt’s birth plan because she wanted a natural delivery which will be impossible and dangerous with this new diagnosis. It is important to educate why the pt will be required to have a C-section and how it will keep both mom and baby safe. 2) Gestational Diabetes: As the placenta grows, hormones such as estrogen and cortisol are produced, which have a blocking effect against insulin which causes insulin resistance. Normally, the pancreas is able to make additional insulin to overcome insulin resistance, but when the production of insulin is not enough to overcome the effect of the placental hormones, gestational diabetes results 3) MANAGEMENT: Special diet, Exercise, Daily blood glucose monitoring, Insulin injection 4) Mom is RH negative. Baby’s blood will be tested for RH after she delivers. In the next pregnancy, the antibodies that you make when you're exposed to Rh-positive blood at your first birth can cross the placenta and attack the Rh-positive red blood cells, if your next baby has Rh-positive blood. This can cause fetal anemia, miscarriage, stillbirth, or serious illness for the newborn Third Trimester: 1) Abruptio placentae: placenta detaches from the womb. (S: Vaginal bleeding, belly pain, back pain, uterine tenderness, premature labor.) Placenta Previa: when the placenta covers the opening in the mother’s cervix. (S: Vaginal Bleeding without pain during 2nd half of pregnancy, contractions) 2) BPP: Prenatal test used to check on baby’s well-being. The test combines fetal heart rate monitoring, and fetal ultrasound movement to evaluate babys HR, RR, movements, muscle tones, and amniotic fluid level. Result 8/10. This is considered normal. A score of less than 8 may be an indicator of oxygenation issues I would recommend putting the mom on O2 3) Since mom is allergic to penicillin and is GBS positive cephalexin, cefadroxil, or macrolides are recommended instead before labor....