{"id":17,"date":"2016-09-06T12:31:47","date_gmt":"2016-09-06T12:31:47","guid":{"rendered":"http:\/\/esenler17noluasm.com\/?page_id=17"},"modified":"2016-09-06T12:41:52","modified_gmt":"2016-09-06T12:41:52","slug":"gebe-izlemleri","status":"publish","type":"page","link":"https:\/\/esenler17noluasm.com\/index.php\/gebe-izlemleri\/","title":{"rendered":"Gebe \u0130zlemleri"},"content":{"rendered":"

Birinci\u00a0 \u0130zlem<\/strong><\/p>\n

(Gebeli\u011fin 14. haftas\u0131nda veya ilk 14 hafta i\u00e7erisinde,\u00a0 s\u00fcresi 30 dakika olmal\u0131)<\/p>\n

\u00d6yk\u00fc Alma<\/strong><\/p>\n

Ki\u015fisel bilgilerini alma<\/h1>\n
    \n
  • T.C Kimlik Numaras\u0131 (biliniyorsa)<\/li>\n
  • Ya\u015f (Do\u011fum tarihi)<\/li>\n
  • Adres ve telefon numaras\u0131<\/li>\n
  • Medeni hali<\/li>\n
  • Akraba evlili\u011fi\/derecesi<\/li>\n<\/ul>\n
      \n
    1. Birinci derece akraba (karde\u015f \u00e7ocuklar\u0131 aras\u0131nda)<\/li>\n
    2. \u0130kinci derece akraba\u00a0 (karde\u015f torunlar\u0131 aras\u0131nda)<\/li>\n<\/ol>\n
        \n
      • Ya\u015fad\u0131\u011f\u0131 ev tipi,b\u00fcy\u00fckl\u00fc\u011f\u00fc ve hane halk\u0131 say\u0131s\u0131<\/li>\n
      • Ya\u015fad\u0131\u011f\u0131 mekan\u0131n alt yap\u0131 ko\u015fullar\u0131; tuvalet, su kayna\u011f\u0131<\/li>\n
      • Ya\u015fad\u0131\u011f\u0131 mekan\u0131n elektrik ve \u0131s\u0131nma\u00a0 kayna\u011f\u0131<\/li>\n
      • E\u011fitim d\u00fczeyi<\/li>\n
      • Ekonomik kaynaklar\u0131;<\/li>\n<\/ul>\n
          \n
        1. Kendi mesle\u011fi ve \u00e7al\u0131\u015fma durumu<\/li>\n
        2. E\u015finin mesle\u011fi ve \u00e7al\u0131\u015fma durumu<\/li>\n<\/ol>\n
            \n
          • Ya\u015fad\u0131\u011f\u0131 yerin en yak\u0131n sa\u011fl\u0131k kurulu\u015funa uzakl\u0131\u011f\u0131<\/li>\n
          • Ula\u015f\u0131m \u015fartlar\u0131<\/li>\n
          • Sosyal g\u00fcvencesi<\/li>\n<\/ul>\n

            \u00a0T\u0131bbi \u00f6yk\u00fc <\/strong>alma<\/strong><\/p>\n

              \n
            • Kronik sistemik hastal\u0131klar<\/li>\n
            • (Diabetes Mellitus, hipertansiyon, kardiyovask\u00fcler hastal\u0131klar,<\/li>\n
            • kr.b\u00f6brek hastal\u0131\u011f\u0131, epilepsi, tiroid hastal\u0131klar\u0131 vb.)<\/li>\n
            • Ge\u00e7irilmi\u015f veya tedavisi s\u00fcrmekte olan enfeksiyon hastal\u0131klar\u0131<\/li>\n
            • (T\u00fcberk\u00fcloz, Brucella, paraziter hastal\u0131klar, vb)<\/li>\n
            • Cinsel Yolla Bula\u015fan Enfeksiyon (CYBE) \u00f6yk\u00fcs\u00fc<\/li>\n
            • Madde ba\u011f\u0131ml\u0131l\u0131\u011f\u0131<\/li>\n
            • Toprak vb yeme<\/li>\n
            • Psikiyatrik hastal\u0131klar<\/li>\n
            • Kan transf\u00fczyonu<\/li>\n
            • Talasemi ta\u015f\u0131y\u0131c\u0131l\u0131\u011f\u0131<\/li>\n
            • Ge\u00e7irilmi\u015f operasyonlar<\/li>\n
            • Ge\u00e7irilmi\u015f jinekolojik operasyonlar<\/li>\n
            • ( Histerotomi, myomektomi vb)<\/li>\n
            • \u0130la\u00e7 allerjisi<\/li>\n
            • Aile \u00f6yk\u00fcs\u00fc<\/li>\n
            • (Diabetes mellitus, tekraralayan fetal anomaliler, \u00e7ift<\/li>\n
            • yumurta ikizi vb.)<\/li>\n
            • S\u00fcrekli kullanmak zorunda oldu\u011fu ila\u00e7lar<\/li>\n
            • (Antiepileptikler, ins\u00fclin, antihipertansifler vb).<\/li>\n
            • Gebelik \u00f6ncesi kullan\u0131lan aile planlamas\u0131 y\u00f6ntemi<\/li>\n<\/ul>\n

              \u0130nfertilite mevcut ise s\u00fcresi, g\u00f6rd\u00fc\u011f\u00fc tedaviler<\/p>\n

               <\/p>\n

              Obstetrik \u00f6yk\u00fc (Daha \u00f6nceki gebelikleri ile ilgili)alma<\/strong><\/p>\n

              Bu gebeli\u011fi dahil toplam gebelik say\u0131s\u0131 ( Gravida)<\/p>\n

              Daha \u00f6nceki do\u011fum say\u0131s\u0131 (Parite)<\/p>\n

              Ya\u015fayan \u00e7ocuk say\u0131s\u0131<\/p>\n

              Son gebeli\u011fin sonlanma tarihi-yeri<\/p>\n

              Gebenin her gebeli\u011fi ile ilgili \u00f6yk\u00fcs\u00fcn\u00fcn ve gebelik sonucunu a\u015fa\u011f\u0131dakilere g\u00f6re irdelenmesi;<\/p>\n

                \n
              1. Do\u011fumlar\u0131n kim taraf\u0131ndan nerede yap\u0131ld\u0131\u011f\u0131<\/li>\n
              2. Gebeliklerin sonlanma \u015fekli ve gebelik haftas\u0131 (Canl\u0131 do\u011fum, \u00f6l\u00fc do\u011fum, kendili\u011finden d\u00fc\u015f\u00fck,\u00a0 isteyerek d\u00fc\u015f\u00fck, ektopik gebelik, mol<\/li>\n<\/ol>\n

                gebelik)<\/p>\n

                  \n
                1. Bebek \u00f6l\u00fcm\u00fc ve nedenleri<\/li>\n
                2. \u00c7ocuk \u00f6l\u00fcm\u00fc\u00a0 ve nedenleri<\/li>\n
                3. Premat\u00fcr do\u011fum<\/li>\n
                4. Postmat\u00fcr do\u011fum<\/li>\n
                5. \u0130kiz veya \u00e7o\u011ful gebelik<\/li>\n
                6. Tekrarlayan birinci trimester d\u00fc\u015f\u00fckleri<\/li>\n
                7. Tekrarlayan ikinci trimester d\u00fc\u015f\u00fckleri<\/li>\n
                8. Yasal tahliye ve isteyerek d\u00fc\u015f\u00fck ve komplikasyonlar\u0131<\/li>\n
                9. Gebelik s\u0131ras\u0131nda ya\u015fanan komplikasyonlar (Kanama, preeklampsi,eklampsi, gestasyonel diyabet, tromboz, emboli)<\/li>\n
                10. Do\u011fum s\u0131ras\u0131nda ya\u015fanan komplikasyonlar (Plasentan\u0131n erken ayr\u0131lmas\u0131, plasenta previa, makat, transvers ve di\u011fer\u00a0 prezentasyon anomalileri, uzam\u0131\u015f do\u011fum eylemi, \u00fc\u00e7\u00fcnc\u00fc derece perine y\u0131rt\u0131klar\u0131 ve masif kanama, plasentan\u0131n elle \u00e7\u0131kar\u0131lmas\u0131 )<\/li>\n
                11. Do\u011fumun \u015fekli (Normal do\u011fum, sezaryen do\u011fum, forseps veya vakumla m\u00fcdahaleli do\u011fum)<\/li>\n
                12. Do\u011fum sonras\u0131 d\u00f6nemde ya\u015fanan komplikasyonlar<\/li>\n<\/ol>\n

                  (Sepsis, kanama, depresyon, meme absesi vb.)<\/p>\n

                    \n
                  1. Daha \u00f6nceki canl\u0131 do\u011fumlara ait ya\u015fanan komplikasyonlar (Hidrops Fetalis, res\u00fcsitasyon veya ba\u015fka tedavi alm\u0131\u015f yenido\u011fan, kromozomal anomali veya malformasyon,\u00a0 d\u00fc\u015f\u00fck do\u011fum a\u011f\u0131rl\u0131\u011f\u0131, intrauterin geli\u015fme gerili\u011fi ve makrozomi)<\/li>\n
                  2. Daha \u00f6nceki canl\u0131 do\u011fumlara ait bilgiler (cinsiyeti, do\u011fum a\u011f\u0131rl\u0131\u011f\u0131, anne s\u00fct\u00fc alma s\u00fcresi)<\/li>\n
                  3. Tetanoz toksoid imm\u00fcnizasyon uygulamas\u0131<\/li>\n<\/ol>\n

                    Mevcut gebelik \u00f6yk\u00fcs\u00fcn\u00fc alma<\/strong><\/p>\n

                      \n
                    • Son Adet Tarihi (Son adetin ilk g\u00fcn\u00fc)<\/li>\n<\/ul>\n

                      Son adet tarihine (SAT) g\u00f6re tahmini do\u011fum tarihi Nagele form\u00fcl\u00fcne g\u00f6re hesaplan\u0131r: Tahmini Do\u011fum Tarihi = SAT -3 ay + 7 g\u00fcn<\/p>\n

                      Adetleri d\u00fczenli olmayan hastalarda gebelik haftas\u0131n\u0131n SAT ile uyuml\u00a0 olmayabilece\u011fi unutulmamal\u0131d\u0131r.<\/p>\n

                      Bilinmiyorsa; \u0130lk gebelik testi tarihi<\/p>\n

                      Gebelikten ilk \u015f\u00fcphelendi\u011fi tarih<\/p>\n

                      Fetus hareketlerinin ilk hissedildi\u011fi tarih<\/p>\n

                      \u00dcYT gebeli\u011fi ise embriyo transfer tarihi<\/p>\n

                        \n
                      • Adetlerinin d\u00fczeni<\/li>\n
                      • Beklenen do\u011fum tarihi<\/li>\n
                      • Gebelik yak\u0131nmalar\u0131 (Bulant\u0131 kusma, a\u015f\u0131r\u0131 t\u00fckr\u00fck salg\u0131lanmas\u0131, toprak vb.yeme, s\u0131k idrara \u00e7\u0131kma, meme hassasiyeti, kab\u0131zl\u0131k, mide yanmas\u0131, bacaklarda kramplar, nefes darl\u0131\u011f\u0131, \u00e7arp\u0131nt\u0131, halsizlik vb…)<\/li>\n
                      • Gebelik tehlike i\u015faretlerine ait yak\u0131nmalar (Vajinal kanama, y\u00fcksek ate\u015f, kar\u0131n a\u011fr\u0131s\u0131, solunum g\u00fc\u00e7l\u00fc\u011f\u00fc veya s\u0131k solunum, g\u00fcnl\u00fck aktivitelerin ger\u00e7ekle\u015ftirilememesi)<\/li>\n
                      • Al\u0131\u015fkanl\u0131klar\u0131n sorgulanmas\u0131 (sigara, alkol, madde ba\u011f\u0131ml\u0131l\u0131\u011f\u0131)<\/li>\n
                      • Kulland\u0131\u011f\u0131 ila\u00e7lar<\/li>\n<\/ul>\n

                         <\/p>\n

                        \u00a0Fizik Muayene:<\/strong><\/p>\n

                        \u00a0<\/strong><\/p>\n

                          \n
                        • Gebenin boy ve kilosunu \u00f6l\u00e7\u00fcn\u00fcz.<\/li>\n
                        • Kan Bas\u0131nc\u0131n\u0131 \u00f6l\u00e7\u00fcn\u00fcz ( Sistolik kan bas\u0131nc\u0131n\u0131n 140, diastolik kan bas\u0131nc\u0131n\u0131n 90 mmHg alt\u0131nda olmas\u0131 normal kabul edilir).Nabz\u0131n\u0131 say\u0131n\u0131z.<\/li>\n
                        • Ciddi anemi bulgular\u0131n\u0131 kontrol ediniz.<\/li>\n<\/ul>\n

                          El t\u0131rnaklar\u0131, konjunktiva, a\u011f\u0131z mukozas\u0131nda solukluk, nefes almakta\u00a0 g\u00fc\u00e7l\u00fck, 30\u2019un \u00fczerinde solunum say\u0131s\u0131<\/p>\n

                            \n
                          • Hastal\u0131\u011f\u0131 g\u00f6steren di\u011fer tehlike i\u015faretlerini kontrol ediniz.<\/li>\n<\/ul>\n

                            Nefes darl\u0131\u011f\u0131, \u00f6ks\u00fcr\u00fck, y\u00fcksek ate\u015f vb.<\/p>\n

                              \n
                            • G\u00f6\u011f\u00fcs ve kalp osk\u00fcltasyonu yap\u0131n\u0131z.<\/li>\n
                            • Pretibial \u00f6dem tespiti i\u00e7in muayene yap\u0131n\u0131z.<\/li>\n
                            • Gebelik haftas\u0131 ile uterus b\u00fcy\u00fckl\u00fc\u011f\u00fcn uygunlu\u011funu de\u011ferlendirmek i\u00e7in vajinal muayene yap\u0131n\u0131z.<\/li>\n
                            • Semptomatik\u00a0 CYBE\u00a0 bulgusu\u00a0 varsa\u00a0 de\u011ferlendiriniz<\/li>\n
                            • Fetus kalp seslerini de\u011ferlendiriniz.\u00a0 Fet\u00fcs\u00a0 kalp at\u0131mlar\u0131 fetal steteskop ile 16-20., el\u00a0 Doppleri ile 10-12. haftalardan itibaren duyulabilir.<\/li>\n
                            • Bebe\u011fin ilk hareketlerini hissetme zaman\u0131n\u0131 kaydetmesini isteyiniz.<\/li>\n
                            • Uterus b\u00fcy\u00fckl\u00fc\u011f\u00fc ile gestasyonel hafta aras\u0131nda uyumsuzluk durumunda sevk ediniz.<\/li>\n<\/ul>\n

                               <\/p>\n

                              Laboratuvar Testleri<\/strong> :<\/strong><\/p>\n

                              \u0130drar tahlili:<\/strong><\/p>\n

                                \n
                              • Bakteri\u00fcri ve protein\u00fcri a\u00e7\u0131s\u0131ndan test \u00e7ubu\u011fu ile ve m\u00fcmk\u00fcnse mikroskobik olarak idrara bak\u0131n\u0131z.<\/li>\n<\/ul>\n

                                Kan say\u0131m\u0131 veya Hb-Hct \u00f6l\u00e7\u00fcm\u00fc:<\/strong><\/p>\n

                                  \n
                                • \u0130lk izlemde ve sonraki t\u00fcm izlemlerde gebenin hemoglobinine bak\u0131n\u0131z.<\/li>\n<\/ul>\n

                                  Kan grubu tayini:<\/strong><\/p>\n

                                    \n
                                  • \u0130lk izlemde gebenin\u00a0 ve e\u015finin kan grubuna Rh uygunsuzlu\u011fu a\u00e7\u0131s\u0131ndan mutlaka bak\u0131n\u0131z.\u00a0\u00a0\u00a0\u00a0\u00a0 HBs Ag<\/strong> bak\u0131n\u0131z.<\/li>\n<\/ul>\n

                                    Gebenin semptomlar\u0131na g\u00f6re gereken di\u011fer testler<\/strong> i\u00e7in sa\u011fl\u0131k kurulu\u015funda yap\u0131lam\u0131yor ise bir \u00fcst basama\u011fa y\u00f6nlendiriniz.<\/p>\n

                                     <\/p>\n

                                    \u00a0Gebeye Verilecek \u0130la\u00e7 Deste\u011fi, Tedaviler ve Ba\u011f\u0131\u015f\u0131klama:<\/strong><\/p>\n

                                    16. gebelik haftas\u0131ndan itibaren g\u00fcnde 40-60 mg\/g\u00fcn elementer demir preparat\u0131 deste\u011fine ba\u015flay\u0131n\u0131z.<\/p>\n

                                    \u201cGebelere Demir Destek Program\u0131\u201d ak\u0131\u015f \u00e7izelgesini kullanarak destek veya tedavi dozuna karar veriniz.<\/p>\n

                                    Tetanoz toksoidi ile a\u015f\u0131lamay\u0131 yap\u0131n\u0131z. Tetanoz ba\u011f\u0131\u015f\u0131klamas\u0131 12. haftadan itibaren yap\u0131labilir. Gebenin ge\u00e7 tespit edilebilece\u011fi d\u00fc\u015f\u00fcn\u00fcl\u00fcrse 4.ayda veya ilk izleminde birinci dozun yap\u0131lmas\u0131 uygundur. A\u015f\u0131 takvimine uygun olarak di\u011fer dozlar devam edilir.<\/p>\n

                                    Geli\u015fen idrar yolu enfeksiyonu ve di\u011fer enfeksiyonlarla ilgili gereken tedavileri veriniz. \u0130drar yolu enfeksiyonu tedavisinin ard\u0131ndan kontrol izlemde hala enfeksiyon devam ediyorsa bir \u00fcst basama\u011fa sevk ediniz.<\/p>\n

                                    Bilgilendirme Ve Dan\u0131\u015fmanl\u0131k:<\/strong><\/p>\n

                                    Gebeli\u011fe ba\u011fl\u0131 ola\u011fan yak\u0131nmalar hakk\u0131nda gebeyi bilgilendiriniz.<\/strong><\/p>\n

                                      \n
                                    1. Yorgunluk<\/li>\n
                                    2. Bulant\u0131 ve kusma<\/li>\n
                                    3. S\u0131k idrara \u00e7\u0131kma<\/li>\n
                                    4. Ba\u015f d\u00f6nmesi<\/li>\n
                                    5. Varis ve hemoroid<\/li>\n
                                    6. Kab\u0131zl\u0131k<\/li>\n
                                    7. Mide yanmas\u0131<\/li>\n
                                    8. Bacaklarda kramplar<\/li>\n
                                    9. Nefes darl\u0131\u011f\u0131<\/li>\n
                                    10. Ciltteki de\u011fi\u015fiklikler<\/li>\n
                                    11. Memelerde hassasiyet<\/li>\n
                                    12. Meme ba\u015f\u0131ndaki glandlarda belirginle\u015fme<\/li>\n
                                    13. Kolostrum sal\u0131n\u0131m\u0131<\/li>\n
                                    14. A\u015f\u0131r\u0131 t\u00fck\u00fcr\u00fck salg\u0131lanmas\u0131<\/li>\n
                                    15. Toprak vb. yeme<\/li>\n<\/ol>\n

                                      A\u015fa\u011f\u0131daki konularda gebeye dan\u0131\u015fmanl\u0131k veriniz.<\/strong><\/p>\n

                                      Beslenme ve diyet<\/p>\n

                                      Fiziksel aktivite ve \u00e7al\u0131\u015fma ko\u015fullar\u0131<\/p>\n

                                      Gebelikte cinsel ya\u015fam<\/p>\n

                                      Hijyen ve genel v\u00fccut bak\u0131m\u0131<\/p>\n

                                      A\u011f\u0131z ve di\u015f sa\u011fl\u0131\u011f\u0131<\/p>\n

                                      Sigara al\u0131\u015fkanl\u0131\u011f\u0131<\/p>\n

                                      Alkol al\u0131\u015fkanl\u0131\u011f\u0131 ve madde ba\u011f\u0131ml\u0131l\u0131\u011f\u0131<\/p>\n

                                      \u0130la\u00e7 kullan\u0131m\u0131<\/p>\n

                                      Tetanoz toksoid imm\u00fcnizasyonu<\/p>\n

                                      Gebelikte tehlike i\u015faretleri:<\/strong><\/p>\n

                                      Vajinal kan<\/p>\n

                                      Konv\u00fclziyon (Sara n\u00f6beti gibi kas\u0131lmalar)<\/p>\n

                                      Ba\u015fa\u011fr\u0131s\u0131 ile beraber g\u00f6rmede bozulma<\/p>\n

                                      Ate\u015f ve\/veya ciddi g\u00fc\u00e7s\u00fczl\u00fck<\/p>\n

                                      Ciddi kar\u0131n a\u011fr\u0131s\u0131<\/p>\n

                                      Solunum g\u00fc\u00e7l\u00fc\u011f\u00fc veya s\u0131k solunum<\/p>\n

                                      Suyunun gelmesi<\/p>\n

                                      Y\u00fcz, el ve bacaklarda \u015fi\u015fme<\/p>\n

                                      Acil durumlarda gebe ve ailesinin izleyece\u011fi y\u00f6ntem konusunda bilgilendirilmesi<\/p>\n

                                      Do\u011fum eylemi ve do\u011fum<\/p>\n

                                      Do\u011fumun nerede ve kim taraf\u0131ndan yap\u0131laca\u011f\u0131n\u0131n planlanmas\u0131<\/p>\n

                                      Emzirme<\/p>\n

                                      Postpartum aile planlamas\u0131 dan\u0131\u015fmanl\u0131\u011f\u0131<\/p>\n

                                      Fetal anomaliler, tarama testleri ve USG incelemeleri hakk\u0131nda bilgilendirme yap\u0131n\u0131z.<\/p>\n

                                       <\/p>\n

                                      \u0130K\u0130NC\u0130\u00a0 \u0130ZLEM\u00a0<\/strong><\/p>\n

                                      \u00a0<\/strong>( Gebeli\u011fin 18-24. haftalar\u0131 (tercihan 20-22. haftalar) aras\u0131nda yap\u0131lmal\u0131, s\u00fcresi 20 dakika olmal\u0131d\u0131r.)<\/p>\n

                                      \u00d6yk\u00fc Alma<\/strong><\/p>\n

                                      Ki\u015fisel bilgilerini alma<\/strong><\/p>\n

                                        \n
                                      • \u0130lk izlemin ard\u0131ndan herhangi bir de\u011fi\u015fiklik olup olmad\u0131\u011f\u0131n\u0131 sorgulay\u0131n\u0131z.<\/li>\n<\/ul>\n

                                         <\/p>\n

                                        T\u0131bbi\u00a0 \u00f6yk\u00fc alma<\/strong><\/p>\n

                                          \n
                                        • \u0130lk izlemde kay\u0131t edilen t\u0131bbi \u00f6yk\u00fcy\u00fc g\u00f6zden ge\u00e7iriniz.<\/li>\n
                                        • \u0130lk izlemden bu yana olu\u015fan hastal\u0131k, kaza, yaralanma, hastaneye yat\u0131\u015f varsa sorgulay\u0131n\u0131z.<\/li>\n<\/ul>\n

                                          Obstetrik \u00f6yk\u00fc (Daha \u00f6nceki gebelikleri ile ilgili)alma<\/strong><\/p>\n

                                          \u00a0<\/strong><\/p>\n

                                            \n
                                          • \u0130lk izlemde kay\u0131t edilen obstetrik \u00f6yk\u00fcy\u00fc g\u00f6zden ge\u00e7iriniz.<\/li>\n<\/ul>\n

                                            Mevcut gebelik \u00f6yk\u00fcs\u00fcn\u00fc al\u0131n\u0131z.<\/strong><\/p>\n

                                              \n
                                            • Al\u0131\u015fkanl\u0131klar\u0131 sorgulayarak (sigara, alkol, madde ba\u011f\u0131ml\u0131l\u0131\u011f\u0131) kontrol ediniz.<\/li>\n
                                            • \u0130lk izlemden bu yana olan gebelik yak\u0131nmalar\u0131n\u0131 sorgulay\u0131n\u0131z.<\/li>\n<\/ul>\n

                                              (Bulant\u0131 kusma, a\u015f\u0131r\u0131 t\u00fck\u00fcr\u00fck salg\u0131lanmas\u0131, toprak vb. yeme, s\u0131k idrara \u00e7\u0131kma, meme a\u011fr\u0131s\u0131, kab\u0131zl\u0131k, mide yanmas\u0131, bacaklarda kramplar, nefes darl\u0131\u011f\u0131, \u00e7arp\u0131nt\u0131, halsizlik vb…)<\/p>\n

                                                \n
                                              • \u0130lk izlemden bu yana olan gebelik tehlike i\u015faretlerine ait yak\u0131nmalar\u0131 sorgulay\u0131n\u0131z.<\/li>\n<\/ul>\n

                                                (Vajinal kanama, kas\u0131lma n\u00f6beti, ba\u015f a\u011fr\u0131s\u0131 ile\u00a0 beraber g\u00f6rmede bulan\u0131kl\u0131k, y\u00fcksek ate\u015f, kar\u0131n a\u011fr\u0131s\u0131, solunum g\u00fc\u00e7l\u00fc\u011f\u00fc veya s\u0131k solunum, y\u00fcz parmak ve\u00a0 bacaklarda \u015fi\u015fme, fetus hareketlerinin hissedilmemesi, g\u00fcnl\u00fck aktivitelerin ger\u00e7ekle\u015ftirilememesi, sular\u0131n gelmesi)<\/p>\n

                                                  \n
                                                • Demir d\u0131\u015f\u0131nda ila\u00e7 al\u0131m\u0131 varsa kay\u0131t ediniz.<\/li>\n
                                                • Demir al\u0131m\u0131 ile ilgili yak\u0131nmas\u0131 varsa sorgulay\u0131n\u0131z.<\/li>\n<\/ul>\n

                                                   <\/p>\n

                                                  \u00a0Fizik Muayene:<\/strong><\/p>\n

                                                  \u00a0<\/strong><\/p>\n

                                                    \n
                                                  • Gebenin kilosunu \u00f6l\u00e7\u00fcn\u00fcz.<\/li>\n
                                                  • Kan bas\u0131nc\u0131n\u0131 \u00f6l\u00e7\u00fcn\u00fcz ve nabz\u0131n\u0131 say\u0131n\u0131z.<\/li>\n
                                                  • Ciddi anemi bulgular\u0131n\u0131 kontrol ediniz .El t\u0131rnaklar\u0131, konjunktiva, a\u011f\u0131z mukozas\u0131nda solukluk, nefes almakta\u00a0 g\u00fc\u00e7l\u00fck, 30\u2019un \u00fczerinde solunum say\u0131s\u0131<\/li>\n
                                                  • Hastal\u0131\u011f\u0131 g\u00f6steren di\u011fer tehlike i\u015faretlerini kontrol ediniz.\u00a0 Nefes darl\u0131\u011f\u0131, \u00f6ks\u00fcr\u00fck, y\u00fcksek ate\u015f vb.<\/li>\n
                                                  • G\u00f6\u011f\u00fcs ve kalp osk\u00fcltasyonu yap\u0131n\u0131z. (Hekim Taraf\u0131ndan)<\/li>\n
                                                  • Uterus y\u00fcksekli\u011fini \u00f6l\u00e7\u00fcn\u00fcz ve kaydediniz. Uygunsuzluk durumunda (4cm fark varsa) sevk ediniz.<\/li>\n
                                                  • Yayg\u0131n \u00f6dem kontrol\u00fcn\u00fc yap\u0131n\u0131z.Gebeli\u011fin son aylar\u0131nda ayaklarda hidrostatik bas\u0131nca ba\u011fl\u0131 olarak \u00f6dem ortaya \u00e7\u0131kabilir.<\/li>\n<\/ul>\n

                                                    V\u00fccudun \u00fcst k\u0131sm\u0131nda (eller, g\u00f6z kapaklar\u0131) \u00f6dem g\u00f6zlenmesi preeklampsinin ilk belirtisi olabilir.<\/p>\n

                                                      \n
                                                    • Di\u011fer sistemik muayenelerini yap\u0131n\u0131z<\/li>\n<\/ul>\n

                                                      (varis, tromboflebit bulgular\u0131 a\u00e7\u0131s\u0131ndsan muayene edilir.)<\/p>\n

                                                        \n
                                                      • Vajinal muayene, kar\u0131n a\u011fr\u0131s\u0131 olan gebelerde yap\u0131l\u0131r. Suyu gelen ve kanamas\u0131 olan gebelerde ise spekulum muayenesi yap\u0131l\u0131r. Bu hastalar II. basamakta takip edilir.<\/li>\n
                                                      • Semptomatik Cinsel Yolla Bula\u015fan Enfeksiyon bulgusu varsa de\u011ferlendiriniz.<\/li>\n
                                                      • Fet\u00fcs kalp seslerini uygun teknikle de\u011ferlendiriniz. (Fetal kalp at\u0131m\u0131 120-160\/dakika olmal\u0131)<\/li>\n<\/ul>\n

                                                         <\/p>\n

                                                        \u00a0\u00a0Laboratuvar Testleri :<\/strong><\/p>\n

                                                        \u0130drar tahlili:<\/strong><\/p>\n

                                                          \n
                                                        • Bakteri\u00fcri ve protein\u00fcri a\u00e7\u0131s\u0131ndan test \u00e7ubu\u011fu ile ve m\u00fcmk\u00fcnse mikroskobik olarak idrara bak\u0131n\u0131z.<\/li>\n<\/ul>\n

                                                          Kan say\u0131m\u0131 veya Hb-Hct \u00f6l\u00e7\u00fcm\u00fc:<\/strong><\/p>\n

                                                            \n
                                                          • Mutlaka her izlemde gebenin hemoglobinine bak\u0131n\u0131z.<\/li>\n<\/ul>\n

                                                            Kan grubu tayini:<\/strong><\/p>\n

                                                              \n
                                                            • \u0130lk izlemde bak\u0131lmad\u0131 ise gebenin\u00a0 ve e\u015finin kan grubuna Rh uygunsuzlu\u011fu a\u00e7\u0131s\u0131ndan mutlaka bak\u0131n\u0131z. Anne Rh (-), baba Rh (+) ise \u0130ndirekt Coombs Testi yap\u0131lmal\u0131d\u0131r. \u0130ndirekt Coombs testi sonucu (-) olanlar I.basamakta, (+) olanlar II. basamakta takip edilmelidir.<\/li>\n<\/ul>\n

                                                              Di\u011fer muayene ve testler:<\/strong><\/p>\n

                                                                \n
                                                              • Sa\u011fl\u0131k kurulu\u015funda yap\u0131lam\u0131yor ise bir \u00fcst basama\u011fa y\u00f6nlendiriniz. (Glukoz tarama\u00a0 testi)<\/li>\n
                                                              • Bu izlemde Temel Obstetrik Ultrasonografi \u00f6nerilir. ( Fetus say\u0131s\u0131, fetal kalp at\u0131m\u0131, fetal biometrik \u00f6l\u00e7\u00fcmler, plasenta lokalizasyonu, amniyotik s\u0131v\u0131 miktar\u0131 de\u011ferlendirilir.)<\/li>\n<\/ul>\n

                                                                 <\/p>\n

                                                                \u00a0Gebeye Verilecek \u0130la\u00e7 Deste\u011fi, Tedaviler ve Ba\u011f\u0131\u015f\u0131klama:<\/strong><\/p>\n

                                                                Ba\u015flam\u0131\u015f oldu\u011funuz, g\u00fcnde 40-60 mg\/g\u00fcn demir preparat\u0131 deste\u011fine devam ediniz.<\/p>\n

                                                                \u201cGebelere Demir Destek Program\u0131\u201d ak\u0131\u015f \u00e7izelgesini kullanarak destek veya tedavi dozuna karar veriniz.<\/p>\n

                                                                Gerekiyorsa tetanoz toksoidi ile a\u015f\u0131laman\u0131n 20. ve 24. haftalarda birinci ve ikinci dozunun yap\u0131l\u0131p yap\u0131lmad\u0131\u011f\u0131n\u0131 kontrol ediniz.<\/p>\n

                                                                Bilgilendirme Ve Dan\u0131\u015fmanl\u0131k:<\/strong><\/p>\n

                                                                Gebeli\u011fe ba\u011fl\u0131 yak\u0131nmalar hakk\u0131nda gebeyi bilgilendiriniz.<\/strong><\/p>\n

                                                                  \n
                                                                • Yorgunluk<\/li>\n
                                                                • Bulant\u0131 ve kusma<\/li>\n
                                                                • S\u0131k idrara \u00e7\u0131kma<\/li>\n
                                                                • Ba\u015f d\u00f6nmesi<\/li>\n
                                                                • Varis ve hemoroid<\/li>\n
                                                                • Kab\u0131zl\u0131k<\/li>\n
                                                                • Mide yanmas\u0131<\/li>\n
                                                                • Bacaklarda kramplar<\/li>\n
                                                                • Nefes darl\u0131\u011f\u0131<\/li>\n
                                                                • Ciltteki de\u011fi\u015fiklikler<\/li>\n
                                                                • Mastodini<\/li>\n
                                                                • Meme ba\u015f\u0131ndaki glandlarda belirginle\u015fme<\/li>\n
                                                                • Kolostrum sal\u0131n\u0131m\u0131<\/li>\n
                                                                • A\u015f\u0131r\u0131 t\u00fckr\u00fck salg\u0131lanmas\u0131<\/li>\n
                                                                • Toprak vb. yeme<\/li>\n<\/ul>\n

                                                                  \u00a0A\u015fa\u011f\u0131daki konularda gebeyi dan\u0131\u015fmanl\u0131k veriniz.<\/strong><\/p>\n

                                                                    \n
                                                                  • Beslenme ve diyet<\/li>\n
                                                                  • Fiziksel aktivite ve \u00e7al\u0131\u015fma ko\u015fullar\u0131<\/li>\n
                                                                  • Gebelikte cinsel ya\u015fam<\/li>\n
                                                                  • Hijyen ve genel v\u00fccut bak\u0131m\u0131<\/li>\n
                                                                  • A\u011f\u0131z ve di\u015f sa\u011fl\u0131\u011f\u0131<\/li>\n
                                                                  • Sigara al\u0131\u015fkanl\u0131\u011f\u0131<\/li>\n
                                                                  • Alkol al\u0131\u015fkanl\u0131\u011f\u0131 ve madde ba\u011f\u0131ml\u0131l\u0131\u011f\u0131<\/li>\n
                                                                  • \u0130la\u00e7 kullan\u0131m\u0131<\/li>\n
                                                                  • Tetanoz toksoid imm\u00fcnizasyonu<\/li>\n
                                                                  • Gebelikte tehlike i\u015faretleri:<\/li>\n
                                                                  • Vajinal kanama<\/li>\n
                                                                  • Konv\u00fclziyon (Sara n\u00f6beti gibi kas\u0131lmalar)<\/li>\n
                                                                  • Ba\u015fa\u011fr\u0131s\u0131 ile beraber g\u00f6rmede bozulma<\/li>\n
                                                                  • Ate\u015f ve\/veya ciddi g\u00fc\u00e7s\u00fczl\u00fck<\/li>\n
                                                                  • Ciddi kar\u0131n a\u011fr\u0131s\u0131<\/li>\n
                                                                  • Solunum g\u00fc\u00e7l\u00fc\u011f\u00fc veya s\u0131k solunum<\/li>\n
                                                                  • Suyunun gelmesi<\/li>\n
                                                                  • Y\u00fcz, el ve bacaklarda \u015fi\u015fme<\/li>\n
                                                                  • Fetus hareketlerinin hissedilememesi<\/li>\n
                                                                  • H\u0131zl\u0131 kilo al\u0131m\u0131<\/li>\n<\/ul>\n

                                                                    Acil durumlarda gebe ve ailesinin izleyece\u011fi y\u00f6ntem konusunda bilgilendirilmesi<\/p>\n

                                                                    Do\u011fum eylemi ve do\u011fum<\/p>\n

                                                                    Do\u011fumun nerede ve kim taraf\u0131ndan yap\u0131laca\u011f\u0131n\u0131n planlanmas\u0131<\/p>\n

                                                                    Emzirme<\/p>\n

                                                                    Postpartum aile planlamas\u0131 dan\u0131\u015fmanl\u0131\u011f\u0131<\/p>\n

                                                                     <\/p>\n

                                                                    \u00a0Sevk Edilecek Durumlar:<\/strong><\/p>\n

                                                                    \u00a0<\/strong><\/p>\n

                                                                      \n
                                                                    • Hemoglobinin 7 gr\/dl ve alt\u0131nda olmas\u0131<\/li>\n
                                                                    • Kanama ve lekelenme olmas\u0131<\/li>\n
                                                                    • Preeklampsi belirtileri, hipertansiyon ( 140\/90mmHg \u00fczerinde olmas\u0131, ba\u015flang\u0131\u00e7 tansiyonunun sistolik 30 veya diastolik 15 mmHg\u2019dan daha fazla y\u00fckselmesi) ve\/veya protein\u00fcri olmas\u0131<\/li>\n
                                                                    • Uterus y\u00fcksekli\u011fi de\u011ferlendirildi\u011finde beklenen haftayla uyumlu olmamas\u0131 (b\u00fcy\u00fck veya k\u00fc\u00e7\u00fck)<\/li>\n
                                                                    • Gebenin fetus hareketlerini hissetmemesi veya el doppleri ile fetal kalp seslerinin duyulmamas\u0131<\/li>\n
                                                                    • Bir \u00f6nceki izlemde bakteri\u00fcri tespit edilen gebenin tedaviye ra\u011fmen bakteri\u00fcrinin devam ediyor olmas\u0131<\/li>\n
                                                                    • Tehlike i\u015faretlerinin varl\u0131\u011f\u0131<\/li>\n
                                                                    • Gebeli\u011fe e\u015flik eden sistemik hastal\u0131klar\u0131n varl\u0131\u011f\u0131 (Kalp Hastal\u0131\u011f\u0131, B\u00f6brek hastal\u0131\u011f\u0131, Diyabet, Ast\u0131m, Tiroid Fonksiyon Bzk.lu\u011fu vb)<\/li>\n<\/ul>\n

                                                                       <\/p>\n

                                                                      \u00dc\u00c7\u00dcNC\u00dc\u00a0 \u0130ZLEM<\/strong><\/p>\n

                                                                      ( Gebeli\u011fin\u00a0 30-32. haftalar\u0131 aras\u0131nda yap\u0131lmal\u0131, s\u00fcresi 20\u00a0 dakika\u00a0\u00a0 olmal\u0131d\u0131r.)<\/p>\n

                                                                      \u00d6yk\u00fc Alma<\/strong><\/p>\n

                                                                      Ki\u015fisel bilgilerini al\u0131n\u0131z<\/strong><\/p>\n

                                                                      \u0130kinci izlemin ard\u0131ndan herhangi bir de\u011fi\u015fiklik olup olmad\u0131\u011f\u0131n\u0131 sorgulay\u0131n\u0131z.<\/p>\n

                                                                      T\u0131bbi\u00a0 \u00f6yk\u00fc<\/strong><\/p>\n

                                                                        \n
                                                                      • \u0130lk ve ikinci izlemde kay\u0131t edilen t\u0131bbi \u00f6yk\u00fcy\u00fc g\u00f6zden ge\u00e7iriniz.<\/li>\n
                                                                      • \u0130kinci izlemden bu yana olu\u015fan hastal\u0131k, kaza, yaralanma, hastaneye yat\u0131\u015f varsa sorgulay\u0131n\u0131z.<\/li>\n<\/ul>\n

                                                                        Obstetrik \u00f6yk\u00fc (Daha \u00f6nceki gebelikleri ile ilgili)alma<\/strong><\/p>\n

                                                                        \u0130lk izlemde kay\u0131t edilen ve ikinci izlemde kontrol edilen obstetrik \u00f6yk\u00fcy\u00fc g\u00f6zden ge\u00e7iriniz.<\/p>\n

                                                                        Mevcut gebelik \u00f6yk\u00fcs\u00fcn\u00fc alma<\/strong><\/p>\n

                                                                          \n
                                                                        • Al\u0131\u015fkanl\u0131klar\u0131 sorgulayarak (sigara, alkol, madde ba\u011f\u0131ml\u0131l\u0131\u011f\u0131) kontrol ediniz.<\/li>\n
                                                                        • \u0130kinci izlemden bu yana ortaya \u00e7\u0131kan gebelik yak\u0131nmalar\u0131n\u0131 sorgulay\u0131n\u0131z.<\/li>\n<\/ul>\n

                                                                          (Bulant\u0131 kusma, a\u015f\u0131r\u0131 t\u00fck\u00fcr\u00fck salg\u0131lanmas\u0131, toprak vb. yeme, s\u0131k idrara \u00e7\u0131kma, memede hassasiyet, kab\u0131zl\u0131k, mide yanmas\u0131, bacaklarda kramplar, nefes darl\u0131\u011f\u0131, \u00e7arp\u0131nt\u0131,\u00a0\u00a0\u00a0\u00a0\u00a0 halsizlik vb…)<\/p>\n

                                                                            \n
                                                                          • \u0130kinci izlemden bu yana ortaya \u00e7\u0131kan gebelik tehlike i\u015faretlerine ait yak\u0131nmalar\u0131 sorgulay\u0131n\u0131z.<\/li>\n<\/ul>\n

                                                                            (Vajinal kanama, konv\u00fclziyon, ba\u015f a\u011fr\u0131s\u0131 ile beraber g\u00f6rmede bulan\u0131kl\u0131k, y\u00fcksek ate\u015f, kar\u0131n a\u011fr\u0131s\u0131, solunum g\u00fc\u00e7l\u00fc\u011f\u00fc veya s\u0131k solunum, y\u00fcz parmak ve bacaklarda \u015fi\u015fme, fetus hareketlerinin hissedilmemesi, g\u00fcnl\u00fck aktivitelerin ger\u00e7ekle\u015ftirilememesi, suyunun gelmesi)<\/p>\n

                                                                              \n
                                                                            • Fetus hareketlerinin varl\u0131\u011f\u0131n\u0131 sorgulay\u0131n\u0131z.<\/li>\n
                                                                            • Demir d\u0131\u015f\u0131nda ila\u00e7 al\u0131m\u0131 varsa kay\u0131t ediniz.<\/li>\n
                                                                            • Demir al\u0131m\u0131 ile ilgili yak\u0131nmas\u0131 varsa sorgulay\u0131n\u0131z.<\/li>\n<\/ul>\n

                                                                               <\/p>\n

                                                                              \u00a0Fizik Muayene:<\/strong><\/p>\n

                                                                              \u00a0<\/strong><\/p>\n

                                                                                \n
                                                                              • Gebenin kilosunu \u00f6l\u00e7\u00fcn\u00fcz.<\/li>\n
                                                                              • Kan\u00a0\u00a0 bas\u0131nc\u0131n\u0131\u00a0 \u00f6l\u00e7\u00fcn\u00fcz ve nabz\u0131n\u0131 say\u0131n\u0131z.<\/li>\n
                                                                              • Ciddi anemi bulgular\u0131n\u0131 kontrol ediniz<\/li>\n<\/ul>\n

                                                                                El t\u0131rnaklar\u0131, konjunktiva, a\u011f\u0131z mukozas\u0131nda solukluk, nefes almakta\u00a0 g\u00fc\u00e7l\u00fck, 30\u2019un \u00fczerinde solunum say\u0131s\u0131<\/p>\n

                                                                                  \n
                                                                                • Hastal\u0131\u011f\u0131 g\u00f6steren di\u011fer tehlike i\u015faretlerini kontrol ediniz.Nefes darl\u0131\u011f\u0131, \u00f6ks\u00fcr\u00fck, y\u00fcksek ate\u015f vb.<\/li>\n
                                                                                • Uterus y\u00fcksekli\u011fini \u00f6l\u00e7\u00fcn\u00fcz\u00a0 ve kaydediniz.<\/li>\n
                                                                                • \u00c7o\u011ful gebelik varsa kar\u0131n palpasyonu ve osk\u00fcltasyonu ile tespit edilmesi<\/li>\n
                                                                                • Yayg\u0131n \u00f6dem kontrol\u00fcn\u00fc yap\u0131n\u0131z.<\/li>\n<\/ul>\n

                                                                                  Gebeli\u011fin son aylar\u0131nda alt ekstremitede hidrostatik bas\u0131nca ba\u011fl\u0131 olarak \u00f6dem ortaya \u00e7\u0131kabilir.\u00a0 V\u00fccudun \u00fcst k\u0131sm\u0131nda (eller, g\u00f6z kapaklar\u0131) \u00f6dem g\u00f6zlenmesi preeklampsinin ilk belirtisi olabilir.<\/p>\n

                                                                                    \n
                                                                                  • Di\u011fer sistemik muayenelerini yap\u0131n\u0131z \u00a0(Varisler, tromboflebit bulgular\u0131 vb)<\/li>\n
                                                                                  • \u00a0Meme muayenesini yap\u0131n\u0131z.<\/li>\n
                                                                                  • Semptomatik\u00a0 CYBE\u00a0 bulgusu\u00a0 varsa\u00a0 de\u011ferlendiriniz.<\/li>\n
                                                                                  • Fetus kalp seslerini el Doppleri veya fetal steteskop ile de\u011ferlendiriniz. (Fetal kalp at\u0131m\u0131 120-160\/dakika olmal\u0131)<\/li>\n<\/ul>\n

                                                                                    \u00a0Laboratuvar Testleri :<\/strong><\/p>\n

                                                                                    \u0130drar tahlili:<\/strong><\/p>\n

                                                                                      \n
                                                                                    • Bakteri\u00fcri ve protein\u00fcri a\u00e7\u0131s\u0131ndan test \u00e7ubu\u011fu ile ve m\u00fcmk\u00fcnse mikroskobik olarak idrara bak\u0131n\u0131z<\/li>\n<\/ul>\n

                                                                                      Kan say\u0131m\u0131 veya Hb-Hct \u00f6l\u00e7\u00fcm\u00fc:<\/strong><\/p>\n

                                                                                        \n
                                                                                      • Mutlaka gebenin hemoglobinine bak\u0131n\u0131z.<\/li>\n<\/ul>\n

                                                                                        Kan grubu tayini:<\/strong><\/p>\n

                                                                                          \n
                                                                                        • \u0130lk iki izlemde bak\u0131lmad\u0131 ise gebenin ve e\u015finin kan grubuna Rh uygunsuzlu\u011fu a\u00e7\u0131s\u0131ndan mutlaka bak\u0131n\u0131z.<\/li>\n<\/ul>\n

                                                                                          Gebenin semptomlar\u0131na g\u00f6re gereken di\u011fer testler<\/strong> i\u00e7in sa\u011fl\u0131k kurulu\u015funda yap\u0131lam\u0131yor ise bir \u00fcst basama\u011fa y\u00f6nlendiriniz.<\/p>\n

                                                                                           <\/p>\n

                                                                                          4. Gebeye Verilecek \u0130la\u00e7 Deste\u011fi, Tedaviler ve Ba\u011f\u0131\u015f\u0131klama:<\/strong><\/p>\n

                                                                                          Ba\u015flam\u0131\u015f oldu\u011funuz, g\u00fcnde 40-60 mg demir preparat\u0131 deste\u011fine devam ediniz..<\/p>\n

                                                                                          \u201cGebelere Demir Destek Program\u0131\u201d ak\u0131\u015f \u00e7izelgesini kullanarak destek veya tedavi dozuna karar veriniz.<\/p>\n

                                                                                          Tetanoz toksoidi ile a\u015f\u0131laman\u0131n iki dozunun da yap\u0131l\u0131p yap\u0131lmad\u0131\u011f\u0131n\u0131 kontrol ediniz.<\/p>\n

                                                                                          Geli\u015fen idrar yolu enfeksiyonu ve di\u011fer enfeksiyonlarla ilgili gereken tedavileri veriniz.<\/p>\n

                                                                                           <\/p>\n

                                                                                          Bilgilendirme Ve Dan\u0131\u015fmanl\u0131k:<\/strong><\/p>\n

                                                                                          Gebeli\u011fe ba\u011fl\u0131 yak\u0131nmalar hakk\u0131nda gebeyi bilgilendiriniz.<\/strong><\/p>\n

                                                                                            \n
                                                                                          1. Yorgunluk<\/li>\n
                                                                                          2. Bulant\u0131 ve kusma<\/li>\n
                                                                                          3. S\u0131k idrara \u00e7\u0131kma<\/li>\n
                                                                                          4. Ba\u015f d\u00f6nmesi<\/li>\n
                                                                                          5. Varis ve hemoroid<\/li>\n
                                                                                          6. Kab\u0131zl\u0131k<\/li>\n
                                                                                          7. Mide yanmas\u0131<\/li>\n
                                                                                          8. Bacaklarda kramplar<\/li>\n
                                                                                          9. Nefes darl\u0131\u011f\u0131<\/li>\n
                                                                                          10. Ciltteki de\u011fi\u015fiklikler<\/li>\n
                                                                                          11. Memede hassasiyet<\/li>\n
                                                                                          12. Meme ba\u015f\u0131ndaki glandlarda belirginle\u015fme<\/li>\n
                                                                                          13. Kolostrum sal\u0131n\u0131m\u0131<\/li>\n
                                                                                          14. A\u015f\u0131r\u0131 t\u00fck\u00fcr\u00fck salg\u0131lanmas\u0131<\/li>\n
                                                                                          15. Toprak vb. yeme<\/li>\n<\/ol>\n

                                                                                            A\u015fa\u011f\u0131daki konularda gebeyi dan\u0131\u015fmanl\u0131k veriniz.<\/strong><\/p>\n

                                                                                              \n
                                                                                            1. Beslenme ve diyet<\/li>\n
                                                                                            2. Fiziksel aktivite ve \u00e7al\u0131\u015fma ko\u015fullar\u0131<\/li>\n
                                                                                            3. Gebelikte cinsel ya\u015fam<\/li>\n
                                                                                            4. Hijyen ve genel v\u00fccut bak\u0131m\u0131<\/li>\n
                                                                                            5. A\u011f\u0131z ve di\u015f sa\u011fl\u0131\u011f\u0131<\/li>\n
                                                                                            6. Sigara al\u0131\u015fkanl\u0131\u011f\u0131<\/li>\n
                                                                                            7. Alkol al\u0131\u015fkanl\u0131\u011f\u0131 ve madde ba\u011f\u0131ml\u0131l\u0131\u011f\u0131<\/li>\n
                                                                                            8. \u0130la\u00e7 kullan\u0131m\u0131<\/li>\n
                                                                                            9. Tetanoz toksoid imm\u00fcnizasyonu<\/li>\n
                                                                                            10. Gebelikte tehlike i\u015faretleri:<\/li>\n<\/ol>\n

                                                                                              Vajinal kanama<\/p>\n

                                                                                              Konv\u00fclziyon (Sara n\u00f6beti gibi kas\u0131lmalar)<\/p>\n

                                                                                              Ba\u015fa\u011fr\u0131s\u0131 ile beraber g\u00f6rmede bozulma<\/p>\n

                                                                                              Ate\u015f ve\/veya ciddi g\u00fc\u00e7s\u00fczl\u00fck<\/p>\n

                                                                                              Ciddi kar\u0131n a\u011fr\u0131s\u0131<\/p>\n

                                                                                              Solunum g\u00fc\u00e7l\u00fc\u011f\u00fc veya s\u0131k solunu<\/p>\n

                                                                                              Suyunun gelmesi<\/p>\n

                                                                                              Y\u00fcz, el ve bacaklarda \u015fi\u015fme<\/p>\n

                                                                                              Fetus hareketlerinin hissedilememesi<\/p>\n

                                                                                              H\u0131zl\u0131 kilo al\u0131m\u0131<\/p>\n

                                                                                              Acil durumlarda gebe ve ailesinin izleyece\u011fi y\u00f6ntem konusunda bilgilendirilmesi<\/p>\n

                                                                                              Erken do\u011fum eylemi (rahim kas\u0131lmalar\u0131n\u0131n d\u00fczenli ve kuvvetli gelmesi, kanaman\u0131n buna e\u015flik etmesi, ni\u015fan gelmesi) konusunda gebenin bilgilendirilmesi<\/p>\n

                                                                                              Do\u011fum eylemi ve do\u011fum<\/p>\n

                                                                                              Do\u011fumun nerede ve kim taraf\u0131ndan yap\u0131laca\u011f\u0131n\u0131n planlanmas\u0131<\/p>\n

                                                                                              Emzirme<\/p>\n

                                                                                              Postpartum aile planlamas\u0131 dan\u0131\u015fmanl\u0131\u011f\u0131<\/p>\n

                                                                                              \u00a0<\/strong><\/p>\n

                                                                                              Sevk Edilecek Durumlar:<\/strong><\/p>\n

                                                                                                \n
                                                                                              1. Hemoglobinin 7 gr\/dl ve alt\u0131nda olmas\u0131<\/li>\n
                                                                                              2. Kanama ve lekelenme olmas\u0131<\/li>\n
                                                                                              3. Preeklampsi belirtileri, hipertansiyon ve\/veya protein\u00fcri olmas\u0131<\/li>\n
                                                                                              4. Uterus y\u00fcksekli\u011finin (fundus \u2013 pubis mesafesi) beklenen haftaya g\u00f6re b\u00fcy\u00fck veya k\u00fc\u00e7\u00fck olmas\u0131 ( +4cm.)<\/li>\n
                                                                                              5. Gebenin fetus hareketlerini hissetmemesi veya el Doppleri ile fetal kalp seslerinin duyulmamas\u0131<\/li>\n
                                                                                              6. Bir \u00f6nceki izlemde bakteri\u00fcri tespit edilen gebenin tedaviye ra\u011fmen bakteri\u00fcrinin devam ediyor olmas\u0131<\/li>\n
                                                                                              7. Tehlike i\u015faretlerinin varl\u0131\u011f\u0131<\/li>\n
                                                                                              8. \u00c7o\u011ful gebelik \u015f\u00fcphesi olmas\u0131 (Do\u011frulamak ve do\u011fumu planlamak \u00fczere)<\/li>\n
                                                                                              9. Gebeli\u011fe e\u015flik eden sistemik hastal\u0131klar\u0131n varl\u0131\u011f\u0131 (Kalp Hastal\u0131\u011f\u0131, B\u00f6brek hastal\u0131\u011f\u0131, Diyabet, Ast\u0131m, Tiroid Fonksiyon Bzk.lu\u011fu vb)<\/li>\n<\/ol>\n

                                                                                                D\u00d6RD\u00dcNC\u00dc\u00a0 \u0130ZLEM<\/strong><\/p>\n

                                                                                                (Gebeli\u011fin\u00a0 36-38. haftalar\u0131 aras\u0131nda yap\u0131lmal\u0131, s\u00fcresi 20\u00a0 dakika olmal\u0131d\u0131r.)<\/p>\n

                                                                                                \u00d6yk\u00fc Alma<\/strong><\/p>\n

                                                                                                Ki\u015fisel bilgilerini al\u0131n\u0131z<\/strong><\/p>\n

                                                                                                \u00dc\u00e7\u00fcnc\u00fc izlemin ard\u0131ndan herhangi bir de\u011fi\u015fiklik olup olmad\u0131\u011f\u0131n\u0131 sorgulay\u0131n\u0131z.<\/p>\n

                                                                                                T\u0131bbi\u00a0 \u00f6yk\u00fc alma<\/strong><\/p>\n

                                                                                                  \n
                                                                                                • \u0130lk \u00fc\u00e7 izlemde kay\u0131t edilen t\u0131bbi \u00f6yk\u00fcy\u00fc g\u00f6zden ge\u00e7iriniz.<\/li>\n
                                                                                                • \u0130lk \u00fc\u00e7 izlemden bu yana olu\u015fan hastal\u0131k, kaza, yaralanma, hastaneye yat\u0131\u015f varsa sorgulay\u0131n\u0131z.<\/li>\n<\/ul>\n

                                                                                                  Obstetrik \u00f6yk\u00fc (Daha \u00f6nceki gebelikleri ile ilgili)al\u0131n\u0131z.<\/strong><\/p>\n

                                                                                                  Obstetrik \u00f6yk\u00fcn\u00fcn son kez g\u00f6zden ge\u00e7iriniz.<\/p>\n

                                                                                                  Mevcut gebelik \u00f6yk\u00fcs\u00fcn\u00fc alma<\/strong><\/p>\n

                                                                                                    \n
                                                                                                  • Al\u0131\u015fkanl\u0131klar\u0131 sorgulayarak (sigara, alkol, madde ba\u011f\u0131ml\u0131l\u0131\u011f\u0131) kontrol ediniz.<\/li>\n
                                                                                                  • \u00dc\u00e7\u00fcnc\u00fc izlemden bu yana ortaya \u00e7\u0131kan gebelik\u00a0 yak\u0131nmalar\u0131n\u0131 sorgulay\u0131n\u0131z.<\/li>\n<\/ul>\n

                                                                                                    (Kar\u0131n a\u011fr\u0131s\u0131, kas\u0131lmalar, bulant\u0131 kusma, ptializm, pika, s\u0131k idrara \u00e7\u0131kma, memede hassasiyet, kab\u0131zl\u0131k, mide yanmas\u0131, bacaklarda kramplar, nefes darl\u0131\u011f\u0131, \u00e7arp\u0131nt\u0131, halsizlik vb\u2026)<\/p>\n

                                                                                                      \n
                                                                                                    • \u00dc\u00e7\u00fcnc\u00fc izlemden bu yana ortaya \u00e7\u0131kan gebelik tehlike i\u015faretlerine ait yak\u0131nmalar\u0131 sorgulay\u0131n\u0131z.<\/li>\n<\/ul>\n

                                                                                                      (Vajinal kanama, konv\u00fclziyon, ba\u015f a\u011fr\u0131s\u0131 ile beraber g\u00f6rmede bulan\u0131kl\u0131k, y\u00fcksek ate\u015f, kar\u0131n a\u011fr\u0131s\u0131, solunum g\u00fc\u00e7l\u00fc\u011f\u00fc veya s\u0131k solunum, y\u00fcz parmak ve bacaklarda \u015fi\u015fme, fetus hareketlerinin\u00a0 hissedilmemesi, kostovertebral a\u00e7\u0131 hassasiyeti g\u00fcnl\u00fck aktivitelerin\u00a0 ger\u00e7ekle\u015ftirilememesi, sular\u0131n gelmesi)<\/p>\n

                                                                                                        \n
                                                                                                      • Fetus hareketlerinin varl\u0131\u011f\u0131n\u0131 sorgulay\u0131n\u0131z.<\/li>\n
                                                                                                      • Demir\u00a0 d\u0131\u015f\u0131nda ila\u00e7 al\u0131m\u0131 varsa sorgulay\u0131n\u0131z<\/li>\n
                                                                                                      • Demir al\u0131m\u0131 ile ilgili \u015fikayeti varsa sorgulay\u0131n\u0131z<\/li>\n<\/ul>\n

                                                                                                         <\/p>\n

                                                                                                        \u00a0Fizik Muayene:<\/strong><\/p>\n

                                                                                                        \u00a0<\/strong><\/p>\n

                                                                                                          \n
                                                                                                        • Gebenin kilosunu \u00f6l\u00e7\u00fcn\u00fcz.<\/li>\n
                                                                                                        • Kan\u00a0\u00a0 bas\u0131nc\u0131n\u0131\u00a0 \u00f6l\u00e7\u00fcn\u00fcz ve nabz\u0131n\u0131 say\u0131n\u0131z.<\/li>\n
                                                                                                        • Ciddi anemi bulgular\u0131n\u0131 kontrol ediniz<\/li>\n<\/ul>\n

                                                                                                          El t\u0131rnaklar\u0131, konjunktiva, a\u011f\u0131z mukozas\u0131nda solukluk, nefes almakta\u00a0 g\u00fc\u00e7l\u00fck, 30\u2019un \u00fczerinde solunum say\u0131s\u0131<\/p>\n

                                                                                                            \n
                                                                                                          • Hastal\u0131\u011f\u0131 g\u00f6steren di\u011fer tehlike i\u015faretlerini kontrol ediniz.<\/li>\n<\/ul>\n

                                                                                                            Nefes darl\u0131\u011f\u0131, \u00f6ks\u00fcr\u00fck, y\u00fcksek ate\u015f vb.<\/p>\n

                                                                                                              \n
                                                                                                            • Uterus y\u00fcksekli\u011fini \u00f6l\u00e7\u00fcn\u00fcz\u00a0 ve kaydediniz.<\/li>\n
                                                                                                            • Fetusun gelen k\u0131sm\u0131 ve pozisyonunun de\u011ferlendirilmesi a\u00e7\u0131s\u0131ndan Leopold manevralar\u0131n\u0131 yap\u0131n\u0131z.<\/li>\n
                                                                                                            • \u00c7o\u011ful gebelik varsa kar\u0131n palpasyonu ve osk\u00fcltasyonu ile tespit edilmesi<\/li>\n
                                                                                                            • Yayg\u0131n \u00f6dem kontrol\u00fcn\u00fc yap\u0131n\u0131z.<\/li>\n<\/ul>\n

                                                                                                              Gebeli\u011fin son aylar\u0131nda alt ekstremitede hidrostatik bas\u0131nca ba\u011fl\u0131 olarak \u00f6dem ortaya \u00e7\u0131kabilir. V\u00fccudun \u00fcst k\u0131sm\u0131nda (eller, g\u00f6z kapaklar\u0131) \u00f6dem g\u00f6zlenmesi preeklampsinin ilk\u00a0 belirtisi olabilir.<\/p>\n

                                                                                                                \n
                                                                                                              • Di\u011fer sistemik muayenelerini yap\u0131n\u0131z\u00a0 (varisler, tromboflebit bulgular\u0131 vb)<\/li>\n
                                                                                                              • Meme muayenesini yap\u0131n\u0131z.<\/li>\n
                                                                                                              • Semptomatik\u00a0 CYBE\u00a0 bulgusu\u00a0 varsa\u00a0 de\u011ferlendiriniz.<\/li>\n
                                                                                                              • Fetus kalp seslerini el Doppleri veya fetal steteskop ile de\u011ferlendiriniz. ( Fetal kalp at\u0131m\u0131 120-160\/dakika olmal\u0131)<\/li>\n
                                                                                                              • Obstetrik de\u011ferlendirme ama\u00e7l\u0131 vajinal muayene yap\u0131n\u0131z (pelvik yap\u0131, serviks, prezente olan k\u0131s\u0131m)<\/li>\n<\/ul>\n

                                                                                                                 <\/p>\n

                                                                                                                \u00a0Laboratuvar Testleri :<\/strong><\/p>\n

                                                                                                                \u0130drar tahlili:<\/strong><\/p>\n

                                                                                                                  \n
                                                                                                                • Bakteri\u00fcri ve protein\u00fcri a\u00e7\u0131s\u0131ndan test \u00e7ubu\u011fu ile ve m\u00fcmk\u00fcnse mikroskobik olarak idrara bak\u0131n\u0131z.<\/li>\n<\/ul>\n

                                                                                                                   <\/p>\n

                                                                                                                  Kan say\u0131m\u0131 veya Hb-Hct \u00f6l\u00e7\u00fcm\u00fc:<\/strong><\/p>\n

                                                                                                                    \n
                                                                                                                  • Do\u011fuma haz\u0131rl\u0131k a\u00e7\u0131s\u0131ndan mutlaka gebe hemoglobinine bak\u0131n\u0131z.<\/li>\n<\/ul>\n

                                                                                                                     <\/p>\n

                                                                                                                    Gebeye Verilecek \u0130la\u00e7 Deste\u011fi, Tedaviler ve Ba\u011f\u0131\u015f\u0131klama:<\/strong><\/p>\n

                                                                                                                    \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>Ba\u015flam\u0131\u015f oldu\u011funuz, g\u00fcnde 40-60 mg demir preparat\u0131 deste\u011fine devam ediniz..<\/p>\n

                                                                                                                    \u201cGebelere Demir Destek Program\u0131\u201d ak\u0131\u015f \u00e7izelgesini kullanarak destek veya tedavi dozuna karar veriniz.<\/p>\n

                                                                                                                    Geli\u015fen idrar yolu enfeksiyonu ve di\u011fer enfeksiyonlarla ilgili gereken tedavileri veriniz.<\/p>\n

                                                                                                                    Bilgilendirme Ve Dan\u0131\u015fmanl\u0131k:<\/strong><\/p>\n

                                                                                                                    \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Gebeli\u011fe ba\u011fl\u0131 yak\u0131nmalar hakk\u0131nda gebeyi bilgilendiriniz.<\/strong><\/p>\n

                                                                                                                      \n
                                                                                                                    1. Yorgunluk<\/li>\n
                                                                                                                    2. Bulant\u0131 ve kusma<\/li>\n
                                                                                                                    3. S\u0131k idrara \u00e7\u0131kma<\/li>\n
                                                                                                                    4. Ba\u015f d\u00f6nmesi<\/li>\n
                                                                                                                    5. Varis ve hemoroid<\/li>\n
                                                                                                                    6. Kab\u0131zl\u0131k<\/li>\n
                                                                                                                    7. Mide yanmas\u0131<\/li>\n
                                                                                                                    8. Bacaklarda kramplar<\/li>\n
                                                                                                                    9. Nefes darl\u0131\u011f\u0131<\/li>\n
                                                                                                                    10. Ciltteki de\u011fi\u015fiklikler<\/li>\n
                                                                                                                    11. Meme hassasiyeti<\/li>\n
                                                                                                                    12. Meme ba\u015f\u0131ndaki glandlarda belirginle\u015fme<\/li>\n
                                                                                                                    13. Kolostrum sal\u0131n\u0131m\u0131<\/li>\n
                                                                                                                    14. A\u015f\u0131r\u0131 t\u00fck\u00fcr\u00fck salg\u0131lanmas\u0131<\/li>\n
                                                                                                                    15. Toprak vb. yeme<\/li>\n<\/ol>\n

                                                                                                                      A\u015fa\u011f\u0131daki konularda gebeyi dan\u0131\u015fmanl\u0131k veriniz.<\/strong><\/p>\n

                                                                                                                        \n
                                                                                                                      • Beslenme ve diyet<\/li>\n
                                                                                                                      • Fiziksel aktivite ve \u00e7al\u0131\u015fma ko\u015fullar\u0131<\/li>\n
                                                                                                                      • Gebelikte cinsel ya\u015fam<\/li>\n
                                                                                                                      • Hijyen ve genel v\u00fccut bak\u0131m\u0131<\/li>\n
                                                                                                                      • A\u011f\u0131z ve di\u015f sa\u011fl\u0131\u011f\u0131<\/li>\n
                                                                                                                      • Sigara al\u0131\u015fkanl\u0131\u011f\u0131<\/li>\n
                                                                                                                      • Alkol al\u0131\u015fkanl\u0131\u011f\u0131 ve madde ba\u011f\u0131ml\u0131l\u0131\u011f\u0131<\/li>\n
                                                                                                                      • \u0130la\u00e7 kullan\u0131m\u0131<\/li>\n
                                                                                                                      • Tetanoz toksoid imm\u00fcnizasyonu<\/li>\n
                                                                                                                      • Gebelikte tehlike i\u015faretleri: *<\/li>\n
                                                                                                                      • Vajinal kanama<\/li>\n
                                                                                                                      • Konv\u00fclziyon (Sara n\u00f6beti gibi kas\u0131lmalar)<\/li>\n
                                                                                                                      • Ba\u015fa\u011fr\u0131s\u0131 ile beraber g\u00f6rmede bozulma<\/li>\n
                                                                                                                      • Ate\u015f ve\/veya ciddi g\u00fc\u00e7s\u00fczl\u00fck<\/li>\n
                                                                                                                      • Ciddi kar\u0131n a\u011fr\u0131s\u0131<\/li>\n
                                                                                                                      • Solunum g\u00fc\u00e7l\u00fc\u011f\u00fc veya s\u0131k solunum<\/li>\n
                                                                                                                      • Sular\u0131n\u0131n gelmesi<\/li>\n
                                                                                                                      • Y\u00fcz, el ve bacaklarda \u015fi\u015fme<\/li>\n
                                                                                                                      • Fetus hareketlerinin hissedilememesi<\/li>\n
                                                                                                                      • Do\u011fum eylemi ve do\u011fum *<\/li>\n
                                                                                                                      • Do\u011fumun nerede ve kim taraf\u0131ndan yap\u0131laca\u011f\u0131n\u0131n planlanmas\u0131 *<\/li>\n
                                                                                                                      • Emzirme *<\/li>\n
                                                                                                                      • Postpartum aile planlamas\u0131 dan\u0131\u015fmanl\u0131\u011f\u0131 *<\/li>\n<\/ul>\n

                                                                                                                        *\u00d6zellikle bu konulardaki dan\u0131\u015fmanl\u0131klar\u0131n verilmesi bu haftalardaki izlem i\u00e7in \u00f6nceliklidir.<\/strong><\/p>\n

                                                                                                                        \u00a0<\/strong><\/p>\n

                                                                                                                        *40. haftaya kadar do\u011fum ger\u00e7ekle\u015fmezse gebenin do\u011fumun yap\u0131laca\u011f\u0131 sa\u011fl\u0131k kurulu\u015funa hemen ba\u015fvurmas\u0131 konusunda bilgi verilmelidir.<\/strong><\/p>\n

                                                                                                                        Sevk Edilecek Durumlar:<\/strong><\/p>\n

                                                                                                                        \u00a0<\/strong><\/p>\n

                                                                                                                          \n
                                                                                                                        • Hemoglobinin 7 g\/dl ve alt\u0131nda olmas\u0131<\/li>\n
                                                                                                                        • Kanama ve lekelenme olmas\u0131<\/li>\n
                                                                                                                        • Preeklampsi belirtileri, hipertansiyon ve\/veya protein\u00fcri olmas\u0131<\/li>\n
                                                                                                                        • Gebenin fetus hareketlerini hissetmemesi veya el Doppleri ile fetal kalp seslerinin duyulmamas\u0131<\/li>\n
                                                                                                                        • Bir \u00f6nceki izlemde bakteri\u00fcri tespit edilen gebenin tedaviye ra\u011fmen bakteri\u00fcrinin devam ediyor olmas\u0131<\/li>\n
                                                                                                                        • Tehlike i\u015faretlerinin varl\u0131\u011f\u0131<\/li>\n
                                                                                                                        • \u00c7o\u011ful gebelik \u015f\u00fcphesi olmas\u0131 (Do\u011frulamak ve do\u011fumu planlamak \u00fczere)<\/li>\n
                                                                                                                        • Makat prezentasyonu \u015f\u00fcphesi<\/li>\n
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                                                                                                                          Birinci\u00a0 \u0130zlem (Gebeli\u011fin 14. haftas\u0131nda veya ilk 14 hafta i\u00e7erisinde,\u00a0 s\u00fcresi 30 dakika olmal\u0131) \u00d6yk\u00fc Alma Ki\u015fisel bilgilerini alma T.C Kimlik Numaras\u0131 (biliniyorsa) Ya\u015f (Do\u011fum tarihi) Adres ve telefon numaras\u0131 Medeni hali Akraba evlili\u011fi\/derecesi Birinci derece akraba (karde\u015f \u00e7ocuklar\u0131 aras\u0131nda) …<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"template-full.php","meta":[],"_links":{"self":[{"href":"https:\/\/esenler17noluasm.com\/index.php\/wp-json\/wp\/v2\/pages\/17"}],"collection":[{"href":"https:\/\/esenler17noluasm.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/esenler17noluasm.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/esenler17noluasm.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/esenler17noluasm.com\/index.php\/wp-json\/wp\/v2\/comments?post=17"}],"version-history":[{"count":1,"href":"https:\/\/esenler17noluasm.com\/index.php\/wp-json\/wp\/v2\/pages\/17\/revisions"}],"predecessor-version":[{"id":18,"href":"https:\/\/esenler17noluasm.com\/index.php\/wp-json\/wp\/v2\/pages\/17\/revisions\/18"}],"wp:attachment":[{"href":"https:\/\/esenler17noluasm.com\/index.php\/wp-json\/wp\/v2\/media?parent=17"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}