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OB > anatomy and physiology of pregnancy > Flashcards

anatomy and physiology of pregnancy Flashcards

1
Q

Parity?

A

number of pregnancies carried past 20 weeks – not number of fetuses born & regardless of alive or stillborn

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2
Q

Gravida?

A

a woman who has been pregnant

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3
Q

Primigravida?

A

a woman pregnant for the first time

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4
Q

Primipara?

A

a woman who has delivered one child past gestation of 20 weeks

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5
Q

multigravida?

A

a pregnant woman who has been pregnant before

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6
Q

multipara?

A

a woman who has carried two or more pregnancies to 20 weeks or more

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7
Q

Nulligravida

A

a woman who has never been and is not currently pregnant

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8
Q

Nullipara?

A

a woman who has not completed a pregnancy with a fetus or fetuses who have reached 20 weeks or more

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9
Q

Preterm?

A

pregnancy that has reached 20 weeks of gestation but before completion of 37 weeks of gestation (20- 26.6 wks)

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10
Q

Viability

A

capacity to live outside uterus; about 22 to 25 weeks gestation are on the threshold of viability
These very premature infants are vulnerable to brain injury

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11
Q

Name the term weeks

early term
full term
late term
post term

A

Early Term- 37 0/7wk- 38 6/7wks
Full Term- 39 0/7wks- 40 6/7wks
Late Term-41 0/7wks- 41 6/7wks
Post Term- 42 0/7wks and beyond Term: pregnancy from beginning of week 38 of gestation to end of week 42 of gestation

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12
Q

Two digits. define

G
P

A

G – gravida – number of pregnancy

P – para- over 20 weeks

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13
Q

what is

GTPAL stand for ?

A 
5 digits
GTPAL
Gravidity (# pregnancies)
Term (deliveries >37 wk)
Preterm (deliveries >20wk but <37wk)
Abortions (deliveries <20wks spontaneous or induced)
Living children
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14
Q

Tell me about pregnancy tests

A

Human chorionic gonadotropin (hCG) is earliest biochemical marker of pregnancy

Pregnancy tests based on recognition of hCG or β subunit of hCG

Can be detected in serum or urine as early as 7 to 8 days after ovulation

Enzyme-linked immunosorbent assay (ELISA)
testing is most popular method of testing for pregnancy
ELISA technology is the basis for most over-the-counter home pregnancy tests
Medication use, hormone based tumors, or improper collection may cause inaccurate results

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15
Q

Presumptive signs of pregnancy

A 
Least indicative of pregnancy
Amenorrhea
N/V
Breast changes
Quickening 
Skin changes
Linea nigra
Melasma
Striae gravidarum
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16
Q

Probable signs of pregnancy?

A 
More reliable &amp; more diagnostic, but not true diagnosis
Positive lab tests
Chadwick’s sign
Goodell’s sign
Hegar’s sign
Ballottement
Fetal outline felt by examiner
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17
Q

Positive signs of pregnancy

A

Ultrasound of fetus
Fetal heart tones by Doppler or ultrasound
Fetal movement felt by examiner

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18
Q

Cervix characteristics when uterine growth in pregnancy occurs

A

it becomes vascular and edematous

19
Q

define

goodells sign

chadwick sign

hegar sign

A

Goodell’s sign -Softening of cervix- throughout pregnancy to prepare for delivery

Chadwick sign- bluish hue of the cervix and vagina

Hegar Sign- Softening of the area between the cervix and body of the uterus

20
Q

what secretes progesterone and estrogen during the first 12 weeks? and why

A

Corpus luteum

Maintains pregnancy until placenta formed & functioning

21
Q

What happens to the vagina during the growth of the uterine during pregnancy?

A 
Chadwick’s sign
Vagina purplish (and cervix)Increased vascularity of vagina
Increased acidity to resist bacteria
Increased sensitivity
increased vaginal discharge - leukorrhea
22
Q

What happens to the breast during the growth of the uterine during pregnancy?

and what do you educate?

A

Increase in size, vascularity
Feelings of fullness & tenderness as early as 6 weeks
Colostrum as early as 16 weeks

*** Education- Supportive bra;
Discuss value of breastfeeding
early; Reinforce self breast exam

23
Q

What happens to the respiratory system during the growth of the uterine during pregnancy?

and what do you educate?

A 
Shortness of breath
Diaphragm displaced upward
Lungs expand horizontally
Nasal congestion
Elevated estrogen
Capillary engorgement

** Education:
Warm compresses, humidifier, position changes

24
Q

What happens to the cardiovascular system during the growth of the uterine during pregnancy in regards to just blood volume?

A

Blood volume increases 1500 ml
1000 ml plasma
450 ml RBCs

Blood volume 25-40% greater than nonpregnant levels

Physiologic anemia: apparent decrease in hemoglobin & hematocrit

RBC production increases 30-33%

25
Q

What happens to the cardiovascular system during the growth of the uterine during pregnancy in regards to blood cells?

and what do you educate?

A

Hemoglobin- less than 11.5 g/Dl or hematocrit less than 30% is considered anemia

WBCs -increase to 5000-12000/cubic mm.
Cardiac output increases – 30 – 50%
Increased Pulse (14-20-wk)
Increased Cardiac output
Decreased Blood Pressure (slight)- 1st trimester- 32wks Back to baseline in 3rd trimester
Supine hypotension syndrome
Lying supine obstructs blood return from extremities, decreases cardiac output, hypotension
** Education- Tilt; change positions slowly

26
Q

What happens to the renal system with urinary output?

what about specific gravity?

A

urine output increases

sg decreases

27
Q

What renal test do you do in pregnancies?

A

Creatinine clearance best test of renal function
Done on 24-hour urine sample
*** Education: Empty bladder completely; limit fluid intake in evening; avoid caffeine

28
Q

What happens to gastrointestinal system during pregnancy?

A 
Nausea/vomiting:  Causes
HCG &amp; progesterone increase
Estrogen increase
Glucose levels decrease
Heartburn due to displacement of stomach by uterus - pyrosis
Slowing of GI tract leads to constipation, flatulence, heartburnDecreased tone and motility GI- incr P4
Reflux; Heartburn (pyrosis)
Hemorrhoids common
Pica – cravings for non-food items such as clay, laundry starch, and ice
Gallstones
Cholestasis
Ptyalism – excessive 
salivation
29
Q

What do you want to educate in pregnancy in regards to gastrointestinal systems?

A 
*** Education***
Small frequent meals;
Separate liquids from solids
Ginger; B6 
Eat crackers before getting out of bed
Avoid greasy, spicy foods or triggers
Stool Softeners
30
Q

What happens to the musculoskeletal system in pregnancy?

A 
Pelvic ligaments soften
Excessive mobility of joints
Lordosis - pride of pregnancy
Diastasis recti
*** Education-
Maternity Belts
Posture &amp; mobility
31
Q

What happens to the integumentary system during pregnancy?

A

Chloasma - “mask of pregnancy”
Linea nigra - dark pigmentation down center of abdomen
Striae gravidarum - stretch marks

32
Q

Neurological changes during pregnancy?

A

Compression pelvic nerves
Carpal Tunnel Syndrome- 3rd trimester
Tension Headache

33
Q

Psychological changes during pregnancy?

A

Maternal adaptation
Emotional Lability
Fatigue (hemodynamic & metoblic changes)

  • ** Education- discuss normalcy of emotional mood swings and mixed feeling early in the pregnancy;
  • s/sx depression review;
  • encourage naps;
  • exercise and healthy diet
34
Q

Nursing management for Nausea and Vomitting?

A

N/V - usually between 4-5 week until 12th week
High hCG and progesterone levels & changes in carbohydrate metabolism
Avoid empty and overloaded stomach – eat more frequent smaller meals
Dry toast 30 minutes before getting out of bed
Hot drinks
Get up slowly
Avoid greasy foods
Sweet lemonade may help
Diclegis: Formerly Bendectin – off the market for 30 years, just returned to use in 2013 by FDA approval. It is composed of Vitamin B6 and an antihistamine-doxylamine.

35
Q

Nursing management for heartburn?

A

Heartburn
Pressure of fetus on stomach and decreased GI tract motility lead to reflux
Low fat diet
Pat of butter before meals to inhibit excretion of acid in stomach
Eat several small meals rather than 3 large ones
Aluminum or magnesium based antacids
Sit upright after meals
Avoid coffee & cigarettes (stimulate acid secretion)

36
Q

What do you want to do to help with flatulence in pregnancy?

A

Due to undesirable bacterial action
Eat small amounts of well-chewed foods
Avoid constipation
Avoid gas forming foods

37
Q

How can you help with frequent urination during pregnancy?

A

Frequent Urination
Early & Late pregnancy
Encourage to drink fluids in morning & afternoons, decreasing fluids in evening

38
Q

What can you do to help backache in pregnancies?

A

Backache
Teach good posture & body mechanics
Teach to bend from knees rather than back
Teach to wear shoes appropriate for activity
Exercises to strengthen back muscles

39
Q

Nursing management for dyspnea in pregnancy?

A

Dyspnea
Encourage mom to prop up with pillows when in bed
Teach to sit & stand erect to lift diaphragm up

40
Q

Nursing management of varicose veins in pregnancy?

A

Weight of fetus on saphenous veins of legs leads to increased pressure in veins
Can occur in legs & vulva
Prevention is easier than treatment
Avoid restricting clothing, knee-highs
Teach to elevate legs periodically
Good fitting elastic stockings are useful

41
Q

Nursing management of leg cramps in pregnancy?

A

Pressure of enlarged uterus/fetus on nerves of lower extremities, fatigue, chilling
Decreased serum calcium, increased serum phosphorus
Decrease milk intake and supplement with calcium supplements (Milk increases phosphorus)
Aluminum hydroxide gel removes some phosphorus
Regular exercise
Immediate relief: dorsiflex foot & put pressure on knee to straighten leg

42
Q

What are the potential complications during the first trimester?

A 
First Trimester:
Severe vomiting
Chills, fever
Burning on urination
Diarrhea
Abdominal cramping
 Vaginal bleeding
43
Q

What are the potential complications during the second and third trimester?

A

Persistent, severe vomiting
Sudden discharge of fluid from vagina before 37 weeks
Vaginal bleeding, severe abdominal pain
Chills, fever, burring on urination, diarrhea
Severe backache or flank pain
Change in fetal movement
Uterine contractions; pressure; cramping before 37 weeksVisual disturbances: blurring; double vision, spots
Swelling of face or fingers and over sacrum
Headaches; sever, frequent, or continuous
Muscular irritability or convulsions
Epigastric or abdominal pain (perceived as heartburn or severe stomachache)
Glycosuria, positive glucose tolerance test reaction

44
Q

What to avoid during pregnancy?

A

Avoid cat litter boxes – toxoplasmosis
Avoid exposure to infectious diseases
Avoid all drugs not prescribed during pregnancy
No alcohol
Avoid cigarettes – causes growth retardation

OB (6 decks)

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