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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)