Laroselinda is a 30yo, G6 P5006, who is currently 19 weeks. She follows in our Subutex Abuse Clinic as well as Cherokee Health System. She has a history of polysubstance abuse but is now on Subutex through Westbrook Clinic. She currently is on 8 mg b.i.d. and does want to wean throughout the pregnancy. She is here today for her anatomic survey.
On ultrasound there is a live fetus in breech presentation. Fetal biometry is consistent with dates. A detailed anatomic survey was unremarkable but slightly suboptimal. We were unable to visualize the spine or genitalia. Heart views appeared normal but I would like to repeat them at her next visit. Fetal heart rate and amniotic fluid appeared within normal limits.
Today’s scan was overall
Saunders (2012) states that the treatment of a breech delivery requires the paramedic team to work simultaneously and efficiently to perform several interventions. He states that the paramedic team should undertake a primary survey and introduce themselves to the patient on arrival. From the initial patient contact, the paramedics should begin providing reassurance to the patient and their family, both verbally and non-verbally (Saunders, 2012). Reassurance aims to reduce patient anxiety, create a rapport with the patient and encourage an environment of care, respect and understanding (Pincus et al., 2013). The paramedic team should complete a secondary survey, including vital signs and a complete patient history, particularly pregnancy relevant
The profession of sonography has been around for over thirteen years; however, if one were to ask the average American what the occupation of a Sonographer entitled, there would likely be a wide-range of answers. When most individuals hear the word “Ultrasound” they will automatically pair this term with “pregnant women.” Very seldom would one put the profession of sonography with other aspects of Health Care such as Cardiac output, or Liver functionality. “Diagnostic sonography is medical two-dimensional and three-dimensional anatomic flow imaging using ultrasound. Ultrasound imaging is not a passive push-button activity but rather an interactive process involving the sonographer, patient, transducer, instrument and sonologist” (Kremkau, 2006, p.3). With its real-time scanning results and its precision capabilities, sonography is a safer and more cost-efficient alternative to other imaging procedures such as X-Ray and MRI’s. These benefits make it an excellent alternate in numerous health care fields, not just in Obstetrics like many presume the practice to be primarily used for.
Peterson-Iyer, Karen. "Confronting a Fetal Abnormality." http://www.scu.edu. Santa Clara University, Jan. 2008. Web. 13 Mar. 2014. .
Obstetric Ultrasound -- a Comprehensive Guide to Ultrasound Scans in Pregnancy. Mar. 2006. Web. 13 Apr. 2011. .
Imagine being in a family that is expecting their first child. Articles in the newspaper are showing how the chances of miscarriages are increasing. As soon as anxiety starts to take over, a flip of a page in the newspaper changes everything. An article about a new drug called Diethylstilbestrol seems to be on the next page. Diethylstilbestrol, also known as DES, is a medicine that helps prevent women from having pregnancy complications including miscarriages. “This is amazing!” one may say, but do they really know the consequences of taking this new medication? Diethylstilbestrol was a huge turning point for most pregnant women in the early twentieth century; however, it had many underlying negative consequences that would later affect the mother and child with the word no one ever wants to hear; cancer.
At birth the neonate goes through many physical changes (Fraser & Cooper, 2009). The most dramatic and difficult being when the newborn takes its first breath (Meeks & Hallsworth, 2010). This breathing triggers change within the heart, lungs, blood flow and every other system of the neonate (Coad & Dunstall, 2009). During the first few minute until 6 hours of life, the neonate is considered to be transitioning from intrauterine to extra-uterine life (Sinha, Miall, & Jardine, 2012). It is within this time that the neonate needs close observations to evaluate their progress into their new life, thus showing the importance of newborn examinations within neonatal care (Fraser & Cooper, 2009).
In my previous role as a Licensed vocational nurse, I worked in the outpatient setting, Perinatology, where there are high-risk pregnant patients. The patient I helped take care of, was early in her pregnancy, approximately 29 weeks, and was a patient who had been seen in this clinical office
19. Benn PA, Borgida A, Horne D, Briganti S, Collins R, Rodis J. Down syndrome and neural tube defect screening: the value of using gestational age by ultrasonography. Am J Obstet Gynecol. 1997;176:1056–61.
Substance abuse is a problem that exist all over the world, it’s affecting men, women, and children from all society level. Prenatal substance abuse remains a major problem in the United States and poses important health risk for a growing baby (Behnke & Smith, 2013). Treatment 4 addiction (T4a) mentioned approximately 2 to 3% of birth deficiency are the consequences of using other drugs than alcohol. Drug and alcohol or any other substances are recognized to have dangerous effect on the fetus. All drugs that that cross the placenta have somehow affected the fetus (Behnke & Smith, 2013).
if there is fetal anomaly and no clear risk of health problems for the mother. In one case,
Prenatal tests show the possibility of a child having a genetic disorder, such as Down Syndrome which leads many parents to choose abortion. When it comes to prenatal testing there are many different testing options. Screening tests for example, which are the first tests that are done on the fetus. During the first ten to thirteen weeks of a pregnancy, a woman can get a first trimester screening done. This is an ultrasound and maternal blood test that tests for the genes of Down Syndrome and Trisomy 18. In a first trimester screening, a result of 1/50 means a woman has a 2% chance of having a baby with a chromosome disorder (The Facts on Prenatal Testing). The next testing window is the fifteenth – twentieth week of pregnancy. This is a Quad screening and consists of a maternal blood test the looks for Down Syndrome, Trisomy 1, and neural tube defects in the fetus. In this test there is a 5% false positive rate (The Facts on Prenatal Testing). Lastly, in the screening test options is the anatomy ultrasound, which is done eighteenth-twenty-second weeks into pregnancy. This screening is an ultrasound that assesses for birth defects. Screening tests are non-invasive and therefore leave very few negative impacts on the fetus. The majority of this paper will focus on the more invasive tests, such as diagnostic tests.
This is a similar procedure to a cesarean section. The only difference is, in this operation, is that the cut is smaller and lower. The fourth type is available in the first fifty days. It is a drug called RU-486. It was developed in France and approved for sale there in 1988. Clinical trials in the United States began in 1994.When performed under proper conditions, the sooner the person has the baby, the less risk she is at.
There is also a high-resolution ultrasound scanning that can detect chromosomal and physical abnormalities in the first trimester as opposed to the second trimester. A technology such as this can create many ethical problems. Mcfadyen describes the biggest problem as being informed consent. “They may believe that it will provide information only about gestational age and be unaware of the range of abnormalities that can be detected. Recent research suggests that many women are not told beforehand of the first scan’s potential to detect fetal anomalies.”
A standing broad jump is a jump for distance from a standing position. It can be divided into four temporal phases: countermovement, propulsion, flight, and landing. In the countermovement phase, the subject squats to load up and extends the shoulders and the arms. In the propulsion phase, the goal is to generate enough force to propel the body forward. The person must stand erect in full extension of the trunk, hips, and knees. Then, the person flexes at the hip and the knee, which results with the trunk being rotated in a forward direction. Next, the arms become slightly flexed to hyperextension, to full flexion. Prior to the flight phase, the body goes into full extension. The flight phase begins as soon as the feet have left the ground. During this phase, the body stays in full extension or can become hyperextended. Towards the end of the flight phase, the trunk rotates forward in an anterior direction along with minor hip and knee flexion just before landing. During the landing phase, the knees and the hips are in maximum flexion and forward rotation of the trunk. There is also arm movement by moving both arms in the vertical direction to improve jumping distance. At the onset of the jump, the arm swings forward and during landing, they swing back and forth.
"Transactions of the Washington Obstetrical and Gynecological Society."Google Books. N.p., n.d. Web. 20 May 2014.