Family Exam - Pathway to Passing

Study Notes

Gravida (Grava): total pregnancies, including current. It counts all pregnancies, including term, premature, abortions, and current.
Para (Para): previous pregnancies that lasted more than 20 weeks. It only counts pregnancies that went past 20 weeks, including term and premature babies.
TPAL: a system to track pregnancies. T = term pregnancies, P = premature, A = abortions, L = living children.
Chadwick's signs: bluish color of the cervix.
Haegar's Sign: softening of the isthmus.
Goodell's sign: softening of the cervix.
Quickening: fluttering feeling that occurs around 20 weeks.
Pap Smear Results:
- Under 21: no screening.
- Ages 21-29: every 3 years.
- Ages 30-65: every 3-5 years with HPV co-testing. If over 65 with no abnormal signs, screening can stop.
- Women with hysterectomies: no more pap smears unless for pre-cancer diagnosis.
Cervical cancer screening starts at age 21 for vaccinated or unvaccinated women.
Prenatal Visits: complete medical history & physical; fetal heart tones, fundal height, blood pressure, lab results, urine dipstick; estimated date of conception; check for headaches, rapid weight gain, vaginal discharge, vaginal bleeding, fetal movement.
Doctor Visits During Pregnancy:
- Initial visit: 8 weeks
- 8-28 weeks: monthly
- 28-36 weeks: every 2 weeks
- 32-40; 40+: weekly/ bi-weekly as needed.

First Trimester: nausea, vomiting; weight gain of ½ – 1 lb per week after the first trimester.
Second Trimester: backache, round ligament pain, constipation, indigestion, excessive vaginal bleeding (1-12 weeks can be ectopic).
Third Trimester: cramps, edema, frequent urination.

Bright red bleeding
Painful contractions with dark brown blood, hypotension, and shock-like symptoms.
Fetal distress (abruptio placentae)
Fetal heartbeat not heard after 12 weeks.
Shortness of breath, swelling, deep vein thrombosis.

Anorexia
- Risk factors: perfectionist, high expectations of self and family history of eating disorders, mood disorders, and alcoholism.
- Symptoms include: dental erosion, gum disease, esophagitis
Bulimia: episodes of overeating followed by purging.
Risks for bulimia include: poor impulse control, low self-esteem, family history of issues and obesity, substance abuse.
Anxiety/Depression: frequent and severe anxiety and depression can be symptoms to look for and treat.

Diabetes: No glucose/ketones in the urine of pregnant woman.
Obesity: Excessive body fat over 20% over ideal body weight and a BMI over 28
ADHD: cluster of behaviors inattention and impulsivity that are more frequent and severe for same age peers

Obesity: Calculate height & weight (BMI), skin tags, hyperpigmented skin, Waist > 35 inches for women and and > 40 inches for men. Waist size 35 inches (women) or over 40 inches (men) is a concern.
Pediatric Obesity: Develop an alliance with family, use non-controversial food diets, and exercise regularly to help lose weight. Child weighing >120% of their expected height is obese.
Elder Abuse: Notice if there are any missing funds, unusual activity in financial accounts; check for bruising, wounds, fractures; be attentive to fear or depressive mood.