1.1 Flashcards
McGill model of nursing
key interventions are:
- ID family strengths & resources
- provision of feedback about strengths
- & assistance given to develop & elicit strengths & resources
ENGAGE FAM IN THE LEARNING PROCESS
menstrual cycle
length: 28 days
flow: 5 days
blessed loss: 50 ml
uterus changes during pregnancy
- enlarges
- increased vascularity
- hyperplasia (extra cells stay after preg)
- hypertrophy (bigger cells, that eventually shrink)
- after 12 wks (mechanical pressure)
- rotates to the right
- contractility increases: brixton-hicks contractions
cervix changes during pregnancy
- thick tenacious mucus
- mucus plug (SEAL) to decrease bacteria
- mucorrhea (discharge)
- softening “goodell sign” (hyperplasia)
- bluish/purple color- “chadwick’s sign” (increased vasculature)
- increased friability: become more vascular and easily bleed
ovaries changes during pregnancy
- increased hormone production esp. HCG (indicates + preg test)
- increase to maintain corpus luteum (10-12 wks)
- progesterone to maintain placenta
breasts changes during pregnancy
- increase size & nodules (increase E & P=darken)
- increase pigmentation of areola; tenderness
- nipples and montgomery follicles protrude more; striae or stretch marks
- colostrum secretion in 2nd trimester
respiratory system changes during pregnancy
- increased O2 demands
- increased E relaxes rib cage (flare out)
- increased chest circumference
- vascular congestion (nasal stiffness, epistaxis, ear issues from fluid)
- tidal vol increases
- diaphragm displaced: chest breathing replaces abdominal breathing (diaphragm is pushed up)
cardiovascular changes during pregnancy
- cardiac hypertrophy, stronger pulse
- position change
- increased audible murmurs
- increased HR (10-15 BPM)
- increased CO 30%-50%
- increased clotting factors (increased thrombus risk)
blood changes during pregnancy
- blood vol increases 50%, mainly plasma
- decreased Hgb d/t dilution effect, increased WBC (slight bc baby)
BP changes during pregnancy
1st trimester: no change
2nd trimester: slight decrease
3rd trimester: return to 1st change
vena cava syndrome or supine hypotensive syndrome (preg. uterus puts pressure on vena cava such as in lithotomy position so put pt with slight left tilt using wedge)
GI system changes during pregnancy
1st trimester (N/V r/t CG)
- sensitivity to odors, ptyalism (increased salivation), decreased acidity of GI secretions (good bc more reflux), heartburn-reflux (esophageal regurgitation); constipation/bloating (iron)
- slower GI transit (more gallbladder dz), bile thickens, empty slower
Renal changes during pregnancy
- anatomy: renal pelvis/ureters dilate, hold more urine
- compression of bladder 1st (uterus on top of bladder) & 3rd (so big it compresses it) trimesters
- increased GFR more blood so to increase to meet demand
- increased risk of UTI & pyelonephritis > checking CVA tenderness (if they say they do then don’t hit their back)
skin/hair changes during pregnancy
(increased melanotropin from anterior pituitary)
- areola, axillary vulva hair darken
- change in hair growth
- Chloasma: mask of pregnancy, incr. melanotropin in skin cx stark changes, babies attracted to sharp contrast btw black and white
- linea nigra, vascular spider nevi (angioma)=due to incr. Estrogen
- striae: where collagen separates from skin, can cause itching
musculoskeletal changes during pregnancy
- pelvic bones relax r/t hormones, progesterone and relaxin
- pelvis widens
- waddling gait
- lumbodorsal spinal curve
- extremity paresthesia (numbness/pain in hands)
- Diastasis recti: muscles separate in front or in back and can touch spine
- postural changes: lose center of gravity; lower/upper back pain
Metabolic changes during pregnancy
incr. BMR, incr. Wt (25-35 lb gain), water retention (incr. aldosterone), incr. prolactin, incr. thyroid size and activity, incr. parathyroid size and activity
