الدفعة 38 المجموعة "2" (دفعة روان عبدالحميد)

2022-06-21 01:24:25 دي اهم النقط في الأسرة باز کردن / نظر دهید

2022-06-21 01:24:25 Nutritional care

Component of nutriental care ( assesment - education _ supplimintation- correction of deficiency )
nutritional assessment
History=screening questionnaire
Score 0=health eating habits
Score 1= less health eating habits
Score 2= least health eating habits
Summary score range from 0_16
Lower numberd indicate good habits
higher number indicate bad habits

جدول مهم بتاع body mass index
0.5 _ 2 kg weight gain in first trimester
lab investigation
Hemoglobin/hematocrit....
Check at first prenatal visit
Late second trimester
Early third trimester
بص علي قيم بتاع ال anmia
vitamin D not necessary to be done
measurements is reasonable
(Obese- minimum sin exposure - malabsorptive disease)

food Guide Pyramid
Base ( rice ..pasta..bread..cereal )
Second layer (vegetables and fruits )
Third layer (milk group cheese yogurt ) and meet .. poultry..egg )
Fourth layer ( fat ..oil ..suger)

supplimintation-

1_ routine in pregnancy iron and folic acid after third trimester
200 mg ferrous fumurate
400 ug folic acid
2 At high risk of neural tube defect should receive 4 mg folic acid prior to consepaton and first 12 weeks

3. Vitamin A above 700 teratogen
4 ca (second trimester )500mg
most common deficiency is anamia
Indication to iron iv ..
1 cannot tolerate oral iron
2 sevee symptomatic anamia
3 impaired absorption of oral
Expected response to iron
1 start reticulocytosis with week
2 increase Hb with two weeks
3 return s ferritin to normal .

indication of referal in iron deficiency anaemia
..HB <7
Intolerance to oral iron
Presist anmia
most common cause of megaloblastic anmia is folic acid deficiency
effect of folic acid deficiency
Neural tube defect
Spina bifida
Anencephaly
supplimintation-of folic acid is recommended at (periconceptional and first trimester )0.4 mg
all women in childbearing should receive folic acid once per day
Previous pregnancy by NTD
= 4 mg of folic acid every day
Prior to conception and in first
Trimester
Then decrease dose to (0.4 )
After first trimester.

measurement of folic acid before and after supplimintation-is not recommended باز کردن / نظر دهید

2022-06-21 01:24:25 باز کردن / نظر دهید

2022-06-21 01:24:25 Premarital care

components of premarital care
Assessment - counseling - immunization

Assessment= screening
History.( Chronic disease DM .. family history of genetic disease Thalassemia... sickle cell anemia... congenital anomalies in families.. Rubella history for female.. Mumps for male )

. clinical examination..lab investigation
Lab investigation during perimarital
CBC- ABO- RH - Hb- Hepatitis c - Hepatitis B s antigen - infertility test

counseling
Interpersonal communication to help other to take disicion
Including 2 G+ 2R
1 general counsel and health education( life style.. prevent smoking.. prevent alcohol)

2 gentic counseling( Study of genogram of both parents..)

3 reproductive health counseling(appropriate tome for first pregnancy.. importance of antenatal visit ..
4 relevant health problems( management if has DM ..HTN)

Immunization not less than 3 months to plan of pregnancy against Rubella

Iterconceptional care

Care of femal in between pregnancies

Timing of interconceptional care
Post partum care
Post abortive care.
Home visit
At MCH for child care باز کردن / نظر دهید

2022-06-21 01:24:25 باز کردن / نظر دهید

2022-06-21 01:24:25 Five visits during antenatal.. باز کردن / نظر دهید

2022-06-21 01:24:24 باز کردن / نظر دهید

2022-06-21 01:24:24 Component of antenatal care
History. Examination Investigation
Social care Nutritional care
Health education..detect high risk pregnancy.. immunization (tetanous).. emotional and social care

timing of antenatal care
28week .... every 4 weeks
28..36week every 2weeks
From 36 every week
Local examination
Asses fundel level ...after 12 week

Asses fetal heart sounds
10..12 week by hand Doppler
Afetr 20 week by pinard

lab investigation (CBC. Urine anylasis. ABO. RH US )

US dating مهم ..
First trimester. (4 to 7 ) days
Second trimester (10 to 14) Days
Third trimester. (21 )

Optimal time for fetal anatomic screening 18 ..20 week

Pregnancy dating confirmation by ..
auscultation fetal heart 10..12 week.
Quickning multipara ..16_18 week
Primi 18 _ 20

Weight gain مهم
Totally weight gain during pregnancy ( 11_16) kg
At 20 week increase (3.5 ) kg
Each weak after ( increase. 0.5 kg
الجدول صفحه 11 مهم

Urine anylasis recommend at each visit

Screening during pregnancy
For trisomy. At (15 _20) week
Triple screen ( HCG_Alphafetoprotein _estriol)
Quadrable test of Down .. adding ( inhibin A)

Screening for gestational DM
At 24 - 28 weeeks
- challenge test
50 gram glucose
Value above 140 abnormal
If test positive..do GTT
GTT ...
Fasting 8 hours
75 gram glucose ..في كتاب النسا
100 gram ..في داتا الأسرة
لازم( 2). Abonrmal

.. immunization during pregnancy
Tetanous toxoid..2 doses with 4 weeks apart + subsequent pregnancy one dose

CoviD 19

educational message
dates of visit - personal hygiene - clothing - exarise - sleep- dental care - avoid smoking and alcohol - breas feedin - labor sign- baby care nutrition care- contraception cara ..
Red flags during pregnancy
Bleeding
Presist headache
Blurred vision
Fever
Leakage of fluid
Stop fetal movement more than.
4 hours باز کردن / نظر دهید

2022-06-21 01:24:24 باز کردن / نظر دهید

2022-06-21 01:24:24 Postpartum..
Objectives
.. newborn ( health promotion - breast feeding - counseling and propre care)
... maternal ( health promotion -prevent complications - contraception space- counseling for supporting family - ...)
Visit during postpartum
Clinical visit during 40 day by physicion
Home visit during 1-4-7 days by nurse
Maternal management..
History(ask about bleeding.. epigastric pain .. visual disturbances..urin ... nutrition)
local examination
Vaginal ( bleeding)
Perineum ( infections.. laceration..hematoma)

lab
HB at 40 day
Urine anylasis

fetal management
History
Ask about danger Signs jundice.. cyanosis..pallor
General Examination
Tone ..color .. weight. Pulse .. temperature..RR ..
Abdominal
Umbilical stump
Lab ..
Screening for congenital
Hypothyroidism on the 3 day ..to
7 day
Phenylketonuria
Red flags ..
Health education
For mother ( Early Ambulate -good nutrition - to know danger Signs - Abdominal muscle exercise - contraception - importance of breast feeding - visit health care- vitamin A
... infant health education
( Temperature regulation - umbilical cord - eyes )

Timing of post partum care.
1 ..4..7..40 days باز کردن / نظر دهید