Exercise And Nutrition During Pregnancy

G4 P3003 (4 Gestations, 3 Full Term, 0 Preterm, 0 Miscarriages, 3 Currently Living); 3 Spontaneous Vaginal Deliveries; Last birth was 7 years ago by SVD, weighed 4000 grams; No previous obstetrical complications or morbidity; No past medical history; No past surgical history; No prior antenatal care

During our initial assessment of Ms. K.R., the following vital signs were noted: blood pressure was 147/67, temp 36.6 degrees Celsius, pulse 80 beats per min., respiratory rate of 20, pulse ox 99% on room air, a pain score of 8 during contractions, and fetal heart tones had a baseline of 130 over the last two hours. Her labs showed 2+ protein in her urine but she denied any headaches, vision changes, right upper quadrant pain, and no DTRs or colonus were observed. Ms.K.R. seemed to be handling her labor well, with the exception of being in a lot of pain and unable to find a comfortable position.

Erin is a 33yo, G3 P1101, who was seen for an ultrasound evaluation and consultation. The patient has a longstanding past history of substance abuse as well as alcohol abuse and she is HIV positive with a positive viral load. She is followed by infectious disease and is on numerous medications including Genvoya and Prezista. She also is reportedly hepatitis C positive. She has a history of alcohol abuse in the past but states that she has not had any alcohol since early June. Her LMP was 08/06/17. She also has a history of cocaine usage but again denies any usage in the past year. She does have a longstanding history of physical abuse and has had issues with anxiety. She has 2 previous deliveries. The 1st of which was in 2004 that occurred

Ms. Pedroso is a pleasant 36 years old, pregnant females. She became pregnant after a first in-vitro attempted. Currently, the patient is 25 weeks of gestation and has come to the clinic with a chief complaint of recurring heartburn, which she described as a flame-throwing sensation in the epigastric area, abdominal bloating, and a sour taste in the back of her mouth. Ms. Carrillo states noting her symptoms two weeks ago and verbalized the symptoms worsen after eating; particularly after a heavy meal and with certain foods. She describes her pain 8/10 on the pain scale. The patient denies any chest pain or shortness of breath. Ms. Pedroso only known health problem is primary hypertension.

Keia is a 31yo, G2 P0100, who is currently 9 weeks 6 days as dated by a 6-week scan that was off from her LMP. She has a history of an IUFD at 29 weeks. She reports that she had decreased fetal movement prior to coming in and there being no fetal heart tones on examination, but other than that there were no other significant precipitating events. She did have an increased risk for Down syndrome at 1:140 but per the old reports all of her analytes were within normal limits. At the time of delivery, the baby did appear to be appropriate weight and there were no obvious causes at the time of delivery. She reports that she had chromosomes performed after and the chromosomes were negative. She also thinks she had a full autopsy that was unremarkable. She did have a work-up for clotting disorders due to the history of loss and according to the chart everything is relatively within normal limits except for MTHFR which was heterozygous for C677T and A1298C. I did not see beta-2 glycoprotein or antithrombin III. Because of the relatively normal work-up she is on a baby aspirin and Metanx. She is here today to discuss her history and plans for this pregnancy.

Serrita is a 26yo, G3 P1011, who was seen for an ultrasound evaluation and fetal anatomy assessment. As you know, she has chronic HTN and is on methyldopa 500 mg b.i.d. Her BP is normal on today’s assessment at 130/78. Her urine evaluation was negative. She is also hypothyroid status-post a diagnosis of Hashimoto’s thyroiditis. She is on replacement therapy. She did undergo noninvasive prenatal testing (NIPT) that returned low-risk, female and her maternal serum AFP was normal at 0.58 MoM. Based on her height and weight at the start of the pregnancy, her BMI was about 38. Lastly, she is on metformin 500 mg b.i.d. She states that she believes that she was on this due to abnormal insulin levels but she was not completely certain as to why

Kecia is a 25yo, G3 P2002, who was seen for an ultrasound evaluation to evaluate the fetal abdomen. She overall denies any major medical disorders. She reportedly had a seizure related to an anesthesia event in a prior surgery but denies any history of epilepsy and therefore is not on an anticonvulsant. She has 2 previous term uncomplicated vaginal deliveries in 2012 and 2016. On today’s evaluation, overall, she has no obstetrical complaints and has positive fetal movement.

Throughout most of the shift, my nurse preceptor and I were in the patient’s room either evaluating her and the fetus, performing exams, taking vital signs, administering medications and fluids, charting, or reading the fetal monitoring strips. We also kept in regular contact with the physician to keep him up to date on the patient’s status and to receive new orders. We also spent a lot of time talking to the patient, her mother, and her boyfriend. They were concerned for the status of the mother and the baby. We explained to them that both the mother and the baby’s heart rate was high and their goal was to decrease them both. In addition, my nurse preceptor explained how we were administering Tylenol and amoxicillin to reduce the fever and

The patient is an 18 year old Spanish female who came to the unit on 11/31/2016 at 23:10 complaining of cramping and she had thought that her water had broken. Her pain was a 4 on a scale of 0-10 in her abdomen described as cramping. Upon examination she was dilated to 3cm, 80% effaced and the position of the baby was -2 and vertex. Her membranes remained intact. Her estimated due date was 10/28/2016. This is her first pregnancy. She has no history of abortion or miscarriage. She has had her flu vaccine and tdap vaccine in October, 2016. She has never smoked or done illegal drugs. She is negative for group b strep, hepatitis, HIV, and syphilis, gonorrhea, and chlamydia. She is rubella immune. There is a language barrier between the patient and the staff. The patient and her family only speak Spanish and only knew very little

Writer called Patricia to congratulate her on her new place. Care manager asked Patricia if she is already for us to go to the Baby Pantry. Patricia can’t go because she is waiting for her furniture to be delivered. Care manager discussed with Patricia the importance of calling

Patient is a G1P0, 23-year-old Caucasian female patient, LMP is January 10, 2013, EDC is October 17, 2006 and gestation of 384/7 weeks confirmed by an ultrasound per chart. Pre-pregnancy weight was 110 lbs and pregnancy weight is 145 lbs for a total gain of 35 pounds. Patient stated she eats a normal diet, does not drink alcohol and she has never smoked cigarettes nor taken any kind of recreational drugs. Was admitted 0430 hrs on October 5, 2014 with intact membranes with 2cm dilation and 50% effaced. Birthing plan shows she plans on a natural birth, patient states “I plan on following my birthing plan to have no drugs during my labor, but am open to hearing my choices.” Patient plans on breastfeeding her infant for at least 1 year. Supportive husband was at bedside throughout the labor, delivery and postpartum.

PMH/PSH: My patient’s past history is sickle cell disease, hypothyroidism, hypertension, and obesity. My patient’s surgical history is a cesarean

I asked Otis to tell me about what is going on. Otis said his daughter is sick and they do not know what is causing it. Otis said he is frustrated because ever since he arrived at St. John’s Hospital, the nurses have ignored him and even said they won’t tell him any information until the mother of the child arrives. Otis said he rode in the ambulance with Oddesty, but they won’t tell him anything that is going on with his daughter. I asked Otis if the hospital knew that he is the biological father and not just mom’s boyfriend. Otis said he would assume they knew. I explained that might have been the reason for them not providing you with information.

Gestational diabetes is also known to increase the risk of caesarean delivery in expecting mothers, due to the larger birth weights of infants born to these mothers. The rate of cesarean sections in the United States is at an all time high, as professor Martin discussed in lecture. Best outcomes estimate that an average of 5-10% of births should result in c-sections, yet as a country we are between double and triple that rate (Martin, 2015, Lecture #1). Recent studies have shown that exercise can lower the risk of having cesarean sections. In a study titled Exercise during pregnancy and gestational diabetes-related adverse effects: a randomized controlled trial, researchers took it upon themselves to examine the effects of exercise on

It is good for any woman to be physically fit throughout her life. However, being in good physical condition before becoming pregnant is substantial. Being fit helps a woman’s body meet the physical demands of carrying and delivering a baby. Regular exercise reduces the occurrence of common pregnancy ailments. Unless a doctor decides against it for medical reasons, pregnant women can and should be active before, during and after pregnancy.