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The correct one is: https://padlet.com/nena_harris/bh7wpr5d4mal

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BP, HR, RR, PO2, T, BMI, height, weight for mother
auscultate and measure fetal heart tones and rate
Rationale: Vital signs should be collected on every patients to establish a baseline, recognize underlying conditions and assess patient's health status before conniving with exam. Assessing fetal heart rate and tone is necessary to ensure the fetus is not in distress.

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Physical Exam: Appearance, Mental Status 

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Physical Exam: Appearance, Mental Status 

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Assess mental status and orientation as well as hygiene, mood, and affect.
Rationale: Assess for signs of disorientation, distress, depression, mania, pain, cooperation, general hygiene and personal car ability.

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Utilize inspection and palpitation to assess vagina and cervix via pelvic exam.
Rationale: Examine external genitalia for abnormalities like excoriation, lesions, bleeding, erythema, edema or any evidence of STI that could cause preterm labor or be harmful to the mother and or fetus. Inspect cervix for dilation, discharge, erythema, lesions, leakage of amniotic fluid to assess for preterm labor and STIs.

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Inspect and auscultate all 4 quadrants then proceed to palpating the abdomen. Measure fundal height.
Rationale: Inspect abdomen for rash, peristalsis, inflammation and symmetry. Inspect and auscultate before palpating since palpating may elicit pain. Listen for hypo or hyperactive bowel sounds to assess for things like diarrhea, constipation, obstruction. Palpate to assess for pain, guarding, rebound tenderness, McBurney's point and for fetal movement. Contractions in a pregnant women can be felt during palpitation d/t muscular tightening and relaxing. Sharp pain associated with ligament spasms elicited by movement is common with this dx. Appendicitis pain would be constant and severe. GI exam would be normal unless pt experienced a round ligament spasm during exam. Measure fundal height and compare it to length of gestation to ensure proper fetal growth.

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Assess abdomen and groin area for inflammation, spasm or pain on palpation or with movement. Assess gait and ability to move from sitting to standing
Rationale: Important to assess strength and stability while ambulating, pregnancy offsets the pt's center of gravity and falls could be detrimental to the women and fetus. Round ligament pain is usually brought on by sudden movements such as changing positions or moving from sitting to standing- pain would be sharp and knifelike in lower abdomen or groin.

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Perform STI screening to rule out infections that may lead to preterm labor.
Ask patient to stand up suddenly from seated position to see if round ligament pain can be elicited.
If patient is currently experiencing pain ask them to flex their knees towards their abdomen to see if this relieves the pain by shortening the ligament.
Pelvic exam to assess cervix dilation and rule out preterm labor.

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1. Round Ligament Pain
2. Early Labor
3. Apendicitis

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Pertinent positives: worse when standing, worse when side-lying, late first trimester or early in the second trimester, may have sharp and sudden pain, shooting pain after sudden movement, stabbing pain in the lower abdomen or on one side, more common on the right side, worse when rising from seated to standing

Pertinent negatives: abdominal tenderness to palpation, rebound tenderness, masses, ectopic pregnancy, uterine contractions, normal white blood cell count, fever, cervical dilation and/or effacement

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Pertinent positives: cramping pain, uterine contractions, cervical effacement and/or dilation, pain at regular intervals

Pertinent negatives: no fever, normal white blood cell count, rebound tenderness, abdominal tenderness to palpation, pain worse with position changes

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Pertinent positives: sharp pain in right lower abdomen, RLQ tenderness can be higher in pregnant females due to gravid uterus, fever, elevated white blood cell count, rebound tenderness, enlarged appendix on MRI (only done if unable to come up with diagnosis based on clinical exam)

Pertinent negatives: uterine contractions, ectopic pregnancy, cervical dilation and/or effacement