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CARE OF THE MOTHER, CHILD AND ADOLESCENT

(WELL CLIENT)
FALSE POSITIVE FALSE NEGATIVE
RESULTS RESULTS
NAEGELE’S RULE AND AGE OF HUMAN -error in reading, -error in reading,
GESTATION error in recording error in recording

SOURCE: POOR TEST -Hematuria -too early, too

SAMPLE -Polyuria late
 Lecturer- Ma’am Viray
SUBSTANCE -Marijuana, Aspirin N/A
etc.
NAEGELE’S RULE OTHERS
- Named after France Kal Naegel, a German PRESUMPTIVE PROBABLE POSITIVE
Obstetrician. -Amenorrhea -Uterine - FHR detected
- Standard way of calculating the due date of -Nausea and Enlargement by the Dropper
pregnancy Vomiting -Chadwick’s Sign Transducer (10-
-Increased sixe -Goodell’s Sign 12 weeks),
- The rule, estimates the expected time of delivery
and fullness of -Hegar’s Sign Fetoscope (at
by adding one year, subtracting three months
breast -Ballotment 20 weeks of
and adding seven days to the first day of a
-Pronounced -Braxton’s Hicks gestation)
woman’s LMP nipples -Positive - palpable fetal
EDD/EDC FORMULAS: -Urinary frequency pregnancy test movement by
 January to March - (+9 +7) -Discoloration of the examiner
 April to December- (-3 +7 +1) the vaginal - Outline of
*examples are in the last page mucosa fetus via UTZ

GESTATIONAL AGE/ AGE OF GESTATION (AOG)
- Term used during pregnancy to describe how far
along the pregnancy is
- Measured by weeks from the first day of the
woman’s LMP
 38 to 42 weeks- normal pregnancy
 Born before week 37- premature
 34-37 weeks- late preterm
 24-33 weeks- early preterm
*examples are in the last page
PREGNANCY TEST- (urine, serum/bld)- can be done at
home or in the healthcare facility
SCHEDULE OF PRE-NATAL VISITS:
1. First Visit- as soon as the woman missed a
menstrual period when pregnancy is suspected
2. First week to 27th week- every four weeks
3. 28 to 32nd week- every two weeks
4. 33 to 36th week- every week or four times a
month

FUNDAL HEIGHT
- Measured to evaluate (?) the AOG of the fetus
PREGNANCY - Done during the 2nd and 3rd trimester
COMPLETE BLOOD COUNT (CBC)
SOURCE: - Determines hemoglobin and hematocrit
 Lecturer - A decline during gestation period as a result of
PREGNANCY increased plasma volume
- Occurs when a sperm fertilizes an egg after its Interventions:
release from the ovary during ovulation 1. Check hgb and hct levels every two weeks
- The fertilized egg then travels down to the uterus 2. Encourage intake of diet rich in iron and folic acid
where implantation occurs BLOOF TYPE AND RH FACTOR
1. ABO Typing- performed to determine the
mother’s bld type in the ABO system

Transcribed by: Kristine Maderazo and Vance Jowie Anne S. Sedilla

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CARE OF THE MOTHER, CHILD AND ADOLESCENT
(WELL CLIENT)
2.Rh Typing- done to determine the blood type in  ABDOMINAL UTZ- more common and non-
the Rhesus *blank* system invasive
GLUCOSE LEVEL  TRANSVAGINAL UTZ- used and done only
- To screen for diabetes during first trimester
- Usually done b/w the 24th and 28th week of Interventions:
gestation because of hormonal effects that block  ABDOMINAL- full bladder is needed
insulin usage  TRANSVAGINAL- lubricated probe is inserted
1. Glucose Challenge Test- 50g glucose oral solution  Inform the client that the procedure is not known
is administered and a bld sample is taken after an to risks
hour of administration 1. 2D UTZ- done during the 20th week
- No need for preparation and fasting - Shows a grey, blurry outline of fetus
2. 3- Hour OGTT- requires fasting pt. to ingest 100 - Reveals the fetus’ internal organs
g. of glucose with the bld withdrawn at 1-hour 2. 3D and 4D UTZ- you can see the mouth, nose,
interval skin
NORMAL VALUES: - You can see is the baby is yawning or sticking her
FBG <95 mg/dl tongue out
1 Hour< 180 mg/dl BIOPHYSICAL PROFILE
2 Hours <155 mg/dl - Non-invasive Ax of the fetus
3 Hours < 1440 mg/dl - Normal biophysical activities include the CNS
MANAGEMENT: (If positive) Components: (2 points each)
-Diet 1. Non- Stress Test
-Exercise 2. Amniotic Fluid Volume
-Insulin 3. Fetal Breathing Movements
INTERVENTIONS: 4. Fetal Movements
- Instruct the client regarding 5. Fetal Tone
1. Diet CHRONIC VILLI SAMPLING
2. BGM - Purpose is to detect genetic abnormalities
3. Complication - The HCP asoirates a sample of chorionic villus
- Monitor weight and signs of infx tissues at 10-13 weeks of gestation
- Assess fetal status Interventions:
- Assess insulin need - Consent is obtained
URINALYSIS AND URINE CULTURE - Full Bladder
- Urine specimen for glucose and CHON - Obtain VS and FHR
determinations should be obtained at every visit AMNIOCENTESIS
 Glycosuria- a common result of decreased renal - Aspiration of amniotic fluid
threshold during pregnancy - Best performed b/w 15 and 20 weeks of
 WBC in Urine- Infx pregnancy
 Ketonuria- results from insuffiecient food intake - Performed to determine genetic disorders,
and vomiting metabolic effects and fetal lung maturity
 Levels +2 to +4 CHON in the urine- infx or KICK COUNTS (Fetal Movement Counting)
preeclampsia - The client sits quietly and counts the kicks
ULTRASONOGRAPHY - If there is <10 in 2 hours, it must be reported
- Identifies fetal outline and maternal structures FERN TEST
- Assists in confirming AOG and EDD and - Fern-like pattern is produced
evaluating amniotic fluid volume - Microscopic slide test is done to determine
- Can be used to determine the presence of presence of amniotic fluid leakage
premature dilation of the cervix

Transcribed by: Kristine Maderazo and Vance Jowie Anne S. Sedilla

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CARE OF THE MOTHER, CHILD AND ADOLESCENT
(WELL CLIENT)
- Using a sterile technique, specimen is obtained in
the cervix outside the vaginal area
Interventions:
- Position the client in DORSAL LITHOTOMY
NITRAZINE TEST
- Determines the pH level
- Detects the presence of amniotic fluid in the
vagina
- BLUE: presence of alkaline
Intervention:
- Dorsal Lithotomy Position
- Touch the test tape to the fluid
- Assess the tape for color
NON-STRESS TEST (NST)
- Performed to test placental function
NORMAL FHR= 120-160 bpm
CONTRACTION STRESS TEST
- The same with NST but the baby is disturbed to
produce a reaction

TEST TIMING SIGNIFICANT

VALUE

Hct -Initial Visit < 32%

-28th and 36th
week
Hgb -Initial Visit < 11 mg/dl
-28th and 36th
week
Bld type and RH Initial Visit Mother RH-
Father RH +

Serum Glucosee 24-28 weeks >140 mg/dl

URINALYSIS -Initial Visit Positive if greater

-Glucose -Each visit the 2+
-Protein -Each visit
Biophysical Profile 3rd Trimester < 8-10 mg/dl

Transcribed by: Kristine Maderazo and Vance Jowie Anne S. Sedilla

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CARE OF THE MOTHER, CHILD AND ADOLESCENT
(WELL CLIENT)

Transcribed by: Kristine Maderazo and Vance Jowie Anne S. Sedilla