Kasier Check-Up Info

General information

What:

Ob Office Visit with RITA T MURRAY NP

When:

Wednesday April 07, 2010 4:20 PM

Where:

• OBSTETRICS & GYNECOLOGY (WILDOMAR MEDICAL OFFICES U)

Phone:

866-984-7483

Vitals

Blood Pressure:

122/80

Pulse:

117

Weight:

184 lb (83.462 kg)

Patient instructions

Your Kaiser Permanente Care Instructions


Weeks 10 to 12 of Your Pregnancy: After Your Visit

Your Care Instructions

By weeks 10 to 12 of your pregnancy, the placenta has formed inside your uterus. It may be possible to hear your baby's heartbeat with a special ultrasound device.

This is the perfect time to think about an alpha fetoprotein (AFP) test. This test can tell you if you are more at risk for having a baby with birth defects. It is also not too soon to think about breast-feeding your baby after it is born. Only you know your feelings about breast-feeding. But it is important to learn about the benefits of breast-feeding.

Several changes in your body can occur during these few weeks. You may notice changes in your appetite, energy level, moods, or the way your breasts look and feel. You may feel dizzy or have headaches, vaginal discharge, nosebleeds, or a stuffy nose. These are normal, often temporary, changes. Although some of these changes may be uncomfortable, this care sheet can help you take steps to feel more comfortable.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. Its also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

Decide about an alpha fetoprotein (AFP) test

- An AFP is a blood test done between the 15th and 20th weeks of pregnancy. Talk to your doctor if you want to have it.
- The test can tell you if you are more at risk for having a baby with birth defects. The test screens for:
- Problems with how the spine, brain, belly, or bowels form.
- Down syndrome and Trisomy 18. These conditions cause mental and physical problems.
- If you have a positive AFP result, it does not mean that your baby has a problem. But your doctor will want to watch your pregnancy closely and talk to you about next steps.

Ease discomfort

- Slow down and take naps when you feel tired.
- If your emotions swing, talk to someone. Crying, anxiety, and concentration problems are common.
- If your gums bleed, try a softer toothbrush. If your gums are puffy and bleed a lot, see your dentist.
- If you feel dizzy:
- Get up slowly after sitting or lying down.
- Drink plenty of fluids.
- Eat small snacks to keep your blood sugar stable.
- Put your head between your legs as though you were tying your shoelaces.
- Lie down with your legs higher than your head. Use pillows to prop up your feet.
- If you have a headache:
- Lie down.
- Ask your partner or a good friend for a neck massage.
- Try cool cloths over your forehead or across the back of your neck.
- Take 1 or 2 regular-dose tablets of acetaminophen (Tylenol) every 4 to 6 hours. Do not take aspirin or migraine medicine unless your doctor says it is okay.
- Treat a yeast infection if you get one. Thick, whitish vaginal discharge is normal. But if the discharge itches, burns, or looks like cottage cheese, you may have a yeast infection. To treat a yeast infection:
- Use over-the-counter products, such as Monistat or Gyne-Lotrimin, for the infection.
- Use 1% hydrocortisone cream for itching.
- When you take a bath or shower, wash and rinse carefully.
- Wear cotton underwear, change it often, and be sure it is dry.
- If you have a nosebleed, pinch your nose gently, and hold it for a short while. To prevent nosebleeds, try massaging a small dab of petroleum jelly, such as Vaseline, in your nostrils.
- If your nose is stuffed up, try saline (saltwater) nose sprays. Do not use decongestant sprays.

Care for your breasts

- Wear a bra that gives you good support.
- Know that changes in your breasts are normal.
- Your breasts may get larger and more tender. Tenderness usually gets better by 12 weeks.
- Your nipples may get darker and larger, and small bumps around your nipples may show more.
- The veins in your chest and breasts may show more.
- Do not worry about "toughening'" your nipples. Breast-feeding will naturally do this.

Consider breast-feeding

- Experts recommend that women breast-feed for 1 year or longer. Breast milk is the perfect food for babies.
- Breast milk is easier for babies to digest than formula, and is always available, just the right temperature, and free.
- In general, babies who are breast-fed are healthier than formula-fed babies.
- Breast-fed babies are less likely to get ear infections, colds, diarrhea, and pneumonia.
- Breast-fed babies who are fed only breast milk are less likely to develop asthma and allergies.
- Breast-fed babies are less likely to be obese or develop diabetes or heart disease.
- Women who breast-feed bleed less after birth. Their uteruses also shrink back faster.
- Some women who breast-feed lose weight faster. Making milk burns calories.
- Breast-feeding can lower your risk of breast cancer, ovarian cancer, and osteoporosis.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

- You pass out (lose consciousness).

Call your doctor now or seek immediate medical care if:

- You have any vaginal bleeding or belly pain or cramping.
- You have a fever.
- You have vaginal discharge that smells bad.
- You have severe vomiting with pain or fever, you vomit 3 or more times a day, or you vomit continuously for more than 1 hour each day.
- You have frequent or severe headaches.
- You have frequent nosebleeds that are hard to stop.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

Where can you learn more?

Go to http://www.kp.org

Enter E090 in the search box to learn more about "Weeks 10 to 12 of Your Pregnancy: After Your Visit".

© 2006 - 2009 Healthwise, Incorporated. Care instructions adapted under license by Kaiser Permanente . This care instruction is for use with your licensed healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise disclaims any warranty or liability for your use of this information.



Your Kaiser Permanente Care Instructions


Nutrition During Pregnancy: After Your Visit

Your Care Instructions

Healthy eating when you are pregnant is important for you and your baby. It can help you feel well and have a successful pregnancy and delivery. During pregnancy your nutrition needs increase. Even if you have excellent eating habits, your doctor may recommend a multivitamin to make sure you get enough iron and folic acid.

Many pregnant women wonder how much weight they should gain. In general, women who were at a healthy weight before they became pregnant should gain between 25 and 35 pounds. Women who were overweight before pregnancy are usually advised to gain 15 to 25 pounds. Women who were underweight before pregnancy are usually advised to gain 28 to 40 pounds. Your doctor will work with you to set a weight goal that is right for you. Gaining a healthy amount of weight helps you have a healthy baby.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. Its also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

- Eat plenty of fruits and vegetables. Include a variety of orange, yellow, and leafy dark-green vegetables every day.
- Choose whole-grain bread, cereal, and pasta. Good choices include whole wheat bread, whole wheat pasta, brown rice, and oatmeal.
- Get 4 or more servings of milk and milk products each day. Good choices include nonfat or low-fat milk, yogurt, and cheese. If you cannot eat milk products, you can get calcium from calcium-fortified products such as orange juice, soy milk, and tofu. Other non-milk sources of calcium include leafy green vegetables, such as broccoli, kale, mustard greens, turnip greens, bok choy, and brussels sprouts.
- If you eat meat, pick lower-fat types. Good choices include lean cuts of meat and chicken or turkey without the skin.
- Do not eat shark, swordfish, king mackerel, tilefish, or albacore tuna. They have high levels of mercury, which is dangerous to your baby. You can eat up to 12 ounces a week of fish or shellfish that have low mercury levels. Good choices include shrimp, canned light tuna, wild salmon, pollack, and catfish.
- Heat lunch meats (such as turkey, ham, or bologna) to 165°F before you eat them. This reduces your risk of getting sick from a kind of bacteria that can be found in lunch meats.
- Do not eat unpasteurized soft cheeses, such as brie, feta, fresh mozzarella, and blue cheese. They have a bacteria that could harm your baby.
- Limit caffeine. If you drink coffee or tea, have no more than 1 cup a day. Caffeine is also found in colas.
- Do not drink any alcohol. No amount of alcohol has been found to be safe during pregnancy.
- Do not diet or try to lose weight. For example, do not follow a low-carbohydrate diet. If you are overweight at the start of your pregnancy, your doctor will work with you to manage your weight gain.
- Tell your doctor about all vitamins and supplements you take.

When should you call for help?

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

Where can you learn more?

Go to http://www.kp.org

Enter Y785 in the search box to learn more about "Nutrition During Pregnancy: After Your Visit".

© 2006 - 2009 Healthwise, Incorporated. Care instructions adapted under license by Kaiser Permanente . This care instruction is for use with your licensed healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise disclaims any warranty or liability for your use of this information.

Follow-up instructions

Return in about 4 weeks (around 5/5/2010).

Medications Dispensed During This Visit

Name	Start date	Date stopped
Prenatal Vit-Iron Fumarate-FA (PRENATAL S) 27-0.8 mg Oral Tab	4/7/2010	4/7/2010