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NURS 326 > Anatomy of Pregnancy > Flashcards

Anatomy of Pregnancy Flashcards

1
Q

Gravida

A

of times a woman has been pregnant

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2
Q

PARA

A

of deliveries (not children) that have occured after 20 weeks

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3
Q

TPAL

A

Term Birth, Preterm, Abortions, Living

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4
Q

PRIMIPARA

A

Woman who has completed 1 pregnancy with a fetus or fetuses

first time moms

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5
Q

TERM

A

pregnancy beginnning of wk 38 to the end of wk 42

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6
Q

Viability

A

Capacity to live outside the uterus

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7
Q

MUTIPAROUS

A

Woman who has completed more than 1 preg

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8
Q

Grandmaltip

A

at least 5 completed pregnancy

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9
Q

HUMAN CHRONIC GONADOTROPIN

HcG

A

a hormone produced by the placenta shortly after implantation of a fertilized egg.
Maintaining the Corpus Luteum: hCG signals the corpus luteum (the structure that forms in the ovary after ovulation) to continue producing progesterone. Progesterone is crucial for maintaining the uterine lining and supporting early fetal development.

Stimulating Hormonal Changes: hCG helps regulate other hormones necessary for pregnancy, promoting the growth and development of the placenta.

Monitoring Pregnancy: hCG levels are commonly measured in pregnancy tests, as they rise significantly in the early weeks of pregnancy.

progesterone/estrogen/Hcs

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10
Q

Uterus

A

Size of the pear to able to hold 5000ml
increase of muscle fiber in length/ width

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11
Q

Uterine Size

12wks

A

symphsis

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12
Q

Uterine Size

16 wks

A

~ 1/2 way to umbilicus

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13
Q

Uterine Size

20 wks

A

at umbilicus

you can palpate fundus at umbilicus

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14
Q

Uterine Size

36 wks

A

at xiphoid process

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15
Q

ligthening/engagement happens when

A

2wks before labor

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16
Q

Cervix

A

soften, increase cx mucous (leukorrhea)

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17
Q

CHADWICK’S SIGN

A

bluish color of the vagina, d/t increased vascularity

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18
Q

GOODELL’S SIGN

A

softening of the cervix

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19
Q

MUCOUS PLUG

A

thick mucous covers canal to protect fetus from infections

20
Q

VAGINA

A

Increased vascularity (estrogen) and secretions

21
Q

OVARIES

A

enlarges until 12-14 wks
secretes progesterone until wk 6-7 when placenta takes over

22
Q

Breasts

A

Become fuller and glandular
* more tender/”tingling” sensation
* increased vascularization
* nipples are larger and more erectile

23
Q

Under Breasts

COLOSTRUM

A

is expressed beginning of wk 12 in 3rd trimester

the is the first milk produced

24
Q

under breasts

Striae

A

streat marks

25
Q

CARDIO

A

plasma volume increases by 40-60%
RBC volume increases by 20-30%
Total volume increases by 30-50%

Changes in blood volume

26
Q

Hgb 10.5g/dl - 11g /dl

A

physiological anemia of pregnancy can occur due to hemodilutions

b/c plasma volume increases mmore e than RBC volume (2nd trim)

27
Q

ANEIMA OCCURS IN PREGNANCY BECAUSE

A

a woman’s blood volume increases significantly to support both her own body and the developing fetus, and this can dilute red blood cells

28
Q

TAKE IRON SUPPLEMENTS WITH…

A

w/ vit C/ orange juice

can also take prenatal vit, and folate acid
can cause consitaption

29
Q

Cardio Output

A

Stroke volume increase 50% by wk 2
HR increases 10-20 bpm
silght cardio enlargement
Maternal HR increases 5wk, 10-15 b/min
1st term low BP is normal

stroke increase = CO increases = Tachycardic

30
Q

BLOOD PRESSURE

A

BP does not go up, 1st trimester is Low ( norm) and increase gradually to their pre-pregnancy BP

High BP is very concerning in Pregnancy

31
Q

BLOOD COMPONENT

HYPERCOAGULABLE

A

Fibrin and fibrinogen increases by 50 % ( protective mechanism to prevent postpartum hemorrhage)
* increases in clotting factors 7, 8, 9, 10
Venous stasis ( long period of standing or sitting)
Increase risk of DVT

assessment for DVT: s/s- unilateral swelling, red, pain, dec pulse

can increase the risk of thrombotic disease

32
Q

VENA CAVA SYNDROME

(supine hypotensive syndrome)

A

As the uterus grows, it puts pressure on the vena cava/ iliac veins (blood from lower extremities)
Patients will feel dizzy and will sometimes faint b/c of this
During this, fetus’ heart rate decreases
Teach patients** NOT **to lay flat on back
* Left lateral or right lateral position (lying on side)
* Affects patients as pregnancy is growing

for >= 20 wks

33
Q

RESPIRATORY CHANGES

A

O2 consumptions increases by 20%
(RR remain unchanged)
baby takes up more space and presses against diaphragm
Patients often feel slightly out of breath
Starts w/ chest breathing rather than abdominal breathing
Progesterone relaxes smooth muscle
Estrogen leads to increased vascularity and congestion

Nasal/ sinus stuffiness ( cool mist in room, plain saline spray)
epitaxis ( nosebleed)
May also feel like ear canals/eustachian tubes are swollen/cannot hear as well
Sometimes gums will look red and beefy, will sometimes bleed

34
Q

GI changes

A

ptyalism/increased salivation
Patients may have a change in taste → dislike usual things and like previous dislikes
May also be cravings for food and items that are not food (pica)
Smooth muscle relaxation (progesterone)
Constipation
Slower emptying/reflux/pyrosis (heartburn)
Increased risk of gallstones

Nausea and vomiting (50-80% of pregnant women)
Usually disappears by the end of the first trimester, around 20 weeks
Prevention → dry crackers, small frequent meals, ginger ale, salty or tart foods (i.e. lemonade and pretzels

35
Q

Endocrine Changes

A

Changes throughout the endocrine system
estrogen/progesterone
Pancreas: **insulin fluctuations **(DOES NOT CROSS PLACENTA UNTIL AFTER 14 WKS)
Glucose levels in pregnancy fluctuate
Placental hormones:
HcG, estrogen, progesterone, hCS (growth hormone), relaxin

36
Q

RENAL/URINARY CHANGES

A

Increased GFR → pressure of the baby on the bladder = urinary freq
can lead to spilling of glucose in the urine

More prone to UTIs
Progesterons - smooth muscle relaxer and increased GFR - increased “spilling” of glucose in urine
increase workload d/t increase blood volume
* 30-60% increase blood flow

37
Q

Intergumentary changes

A

Hyperpigmentation (chloasma) = Brown patches
estrogen/progesterone & melanocyte -stimulating hormone
* Esp around breasts (areola) and face
* Linea nigra → dark line that does from the pubis to the fundus
**Changes to connective tissue **→ striae gravidarum (stretch marks)
Cutaneous vascular changes → increase spider veins, sometimes palmar erythema ( to increase estrogen)

Straie can be genetic

38
Q

Musculoskeletal changes

A

Changes are progressive
* Joint softening beginning weeks 10-12
* Swayback posture as center of gravity shifts forward
* Lordosis → cat arch and pelvic lift to relieve pain
Hormone “relaxin” → causes relaxation of pelvic joints
* Causes pregnancy waddle
Teaching for Pregnancy
Travel → some patients are limited
Can’t go to places without clean water or where zika virus is present
If driving in a car, should get out and walk frequently

39
Q

IMMUNIZATIONS

A

Live vaccines are contraindicated
EX: MMR, varcella, HPV
But flu and COVID vaccines are safe

40
Q

Normal weight gain during pregnancy

A

25-30 lbs, they need to get 300 cal extra

41
Q

BODY MECHANICS

A

stay as low to the ground as possible, to prevent from falling and impact

42
Q

Other changes during pregnancy

water metabolism

A

reguirements increase, causing dependent edema

43
Q

Other changes during pregnancy

Carbohydrate metabolism

A

more insulin is required b/c maternal insulin resistance later in preg (24-26 wks)
sometime have periodic hyperglycemia
gestational dm ( pregnancy induced)

44
Q

Other changes during pregnancy

Immune system

A

decrease in resistance to disease

45
Q

WBC increases during…

A

second trimester, primarily in the granulocytes

NURS 326 (14 decks)

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