28-40 weeks
· Rhogam: RhoGAM is used to prevent an immune response to Rh positive blood in people with an Rh-negative blood type. If dad is Rh Negative, you do not need to give Rhogam as long as you know he is the father.
Labs:treponema, GC/CT, UA, CBC or Ferritin, C&S
36 weeks; test mother for GBS (Group Beta Strep) vaginal rectal swab
-Appts with provider and Fetal monitoring more frequently
TORCH Titers: toxoplasmosis, other Hep B, Rubella, Cytomegalovirus, Herpes Simplex HSV 1 & 2 (do not eat nuts or chocolate)
Rhogam: prevents immune response to Rh positive blood in people with Rh negative blood type.
Vaccines: Tdap if not UTD
NST - Non stress test fetal monitoring at the office or hospital for heart rate and contractions
Growth US: monitor amniotic fluid, evaluate placenta anatomy, determine presentation
Fundus Ht- CM= Weeks
BPP 5: Biophysical Profile: assesses 5 parameters: NST fetal breathing, movements, Tone ( fine movements) Gross movements ( trunk) amniotic fluid , scored normal range 8/8
· All women should be screened for GDM between 24 and 28 weeks gestation with a 50g oral glucose solution followed by a 1 hour venous glucose measurement.
o 130 or 135 mg/dL - lower cut-off threshold - which may identify women who may have GDM but also increase false positive rates
o 140 mg/dL - higher cut-off threshold - which may limit the number of screen positive women · ◦ Fetal doppler in office Fetal heart tones (FHT) 120-180
· ◦ NST Non Stress Test: fetal monitoring at the office or hospital for heart rate and contractions
· ◦ Third Trimester growth ultrasound: will evaluate Amniotic Fluid, determine presenting part, evaluate placental anatomy
· ◦ "BPP" Biophysical Profile: assesses 5 parameters: NST fetal breathing, movements, Tone (fine movements) Gross movements (trunk) amniotic fluid, scored normal range 8/8
· ◦ Fundal Heights: measure Fundus CM=Weeks
· Gestational Age Assessment (GAA): Assessment of the newborn's gestational age and birth weight, helps determine if the newborn is appropriate for gestational age (AGA), small for gestational age (SGA), or large for gestational age (LGA). The New Ballard Score is used to measure maturity and focuses on neuromuscular maturity (posture, square window [wrist], arm recoil, popliteal angle, scarf sign, heel to ear) and physical maturity (skin, lanugo, plantar surface, breast, ear/eye, genitals [male], genitals [female]). Ethics of nursing integrity, honesty, compassion, etc (nursing standards). based on professional standards of ethical conduct as well as professional values
Nurses should:
· Cultivate the virtues of nursing
· Understand ethical theories that dictate and justify professional conduct
· Be familiar with codes of ethics for nurses and standards for professional nursing conduct
· Virtues are human excellences, cultivated dispositions of character and conduct that motivate and enable us to be good human beings. Clinical virtues enable nurses to provide good care to patients. While there is no official list of essential virtues of nurses, the following virtues are frequently named:
• Competence
• Compassionate caring
• Subordination of self-interest to patient interest
• Self-effacement
• Trustworthiness
• Conscientiousness
• Intelligence
• Practical wisdom
• Humility
• Courage
• Integrity
Since these human qualities cannot be "put on" the way one puts on a set of scrubs or identity badge, it is important that they are part of the nurse's character, part of who the nurse is. As you read the above list, reflect on which virtues are already strengths and which you will need to practice until they become part of who you are. Once again, nurses must work hard to cultivate the dispositions of character that invite, and keep earning, the public's trust. 1) Disrupted neurodevelopment. Social, emotional, and cognitive impairment. Adoption of health risk behavior. Disease, disability, and social problems. Early death
Adverse childhood Events
· Exposure to abuse, neglect, violence, addiction, depression increases risk for emotional/behavioral problems as an adult
· ACEs create stress response to stay active prolonged activation of stress hormones is toxic to the brain (impacts the control center, emotional center, memory & learning center)
ACEs cause changes in gene expression Epigenetic changes
2) (5th Vital Sign) create safety, trustworthiness and transperency, peer support and mutual self-help, collaboration and mutuality, empowerment, voice, and choice, move pass cultural, historical, and gender issues/biases.