Antaomy & Physiology or Pregnancy Flashcards
Gravide
Pregnant Women
Gravidity
Pregnancy
Viability
Capacity to live outside uterus (22-25 wks gestation or 500g weight)
How many wks is viability obtained?
22- 25
How many grams is viability obtained?
500 g
Multigravide
2 or more pregnancies
Nulligravida
Never pregnant
Primigravida
Pregnant 1st time
A woman who has never been pregnant is called a
Nulligravita
A woman who is 22wks pregnant with her 2nd child (1st child born at term is called a
Multipara
A woman pregnant with her 2nd child at 38 wks (1st child born at 38wks) is classified as
G2 P2
Children: 4 pregnancies
Born alive 3 (all at term)
Pregnant with 1 now
All pervious living
G4 T3 P0 A0 L3
What is parity?
of pregnancies that have reached viability.
Twin or toilets only constitute as how many parity?
1
Multipara is defined as?
completion of 2 or more pregnancies to 20 wks or more
Nullipara
No completion of pregnancy to viability
Primipara
One pregnancy that has reached viability.
Postdate or postterm
> 42 wks gestation
Preterm
> 20 wks but <37 wks
Term
38-42 wks
GTPAL
1st digit – Total # pregnancies 2nd digit - # term 3rd digit - # preterm 4th digit - # abortions (spontaneous or elective) 5th digit - # currently living.
What does Human chorionic gonadotropin (hCG) mark?
Pregnancy
What do high levels of hCG usually indicate?
Ectopic pregnancy
Abnormal gestation
DS
Multiple gestion
What test detects hCG in urine?
OTC pregnancy test
What kind of drugs can sometimes give false + results for pregnancy tests?
Anticonvulsant and Tranquilizer
What kind of drugs can sometimes give false - results for pregnancy tests?
Diuretics and phenergan
What are presumptive signs of pregnancy perceived by the mother?
Amenorrhea
Fatigue
N&V
Breast Changes
What are probable signs of pregnancy noticed by examiner?
Hegar sign (softening of lower uterine segment)
Ballotment (Floating the fetal head) - uterine mass could cause
Pregnancy tsts
What are some signs of pregnancy that are only + with the presences of a fetus?
Hearing FHT’s
Visualization of fetus – via x-ray or u/s
Palpating fetal movements
What is Leopold’s Maneuvers?
Palpation of fetus & utero to determine fetal position and presentation
A presumptive sign of pregnancy would be
Nausea and vomiting
When does the Hegar Sign occur?
6 wks gestation
What happens to the uterus during pregnancy?
Enlarges
When is the uterus palpated above the symphysis pubis?
12 - 14 wks
When is the uterus palpated at the umbilicus?
22-24
When is the uterus palpated at the xiphoid?
Term
When does lightening occur?
38-40wks
What is Braxton Hicks Sign?
Perceived uterine contractions after 4 months.
What do Braxton Hicks sign do?
Facilitate placental blood flow
What does uteroplacental blood flow do?
Helps uterus to grow
Helps fetoplacental unit to grow.
Help meet fetal needs.
Decreased perfusion occurs due to what?
HTN
IUGR
DM
multiple gestation
What is the goodell sign?
Softening of cervical tip
When does the goodell sign appear?
occurs at about 6 wks in unscarred cervix.
What happens to friability?
- increases due to increased vascularity. Spotting can occur with vaginal exams or sexual intercourse.
What enhances blood flow to the placenta?
Braxton Hicks contractions
What are two changes related to the presence of the fetus?
Ballottement and Quickening
What is ballottement?
+movement of unengaged fetus palpable between 16-18 wks.
What is quickening
feeling of fetal movement, can be mistaken for peristalsis or “flutter”.
When does quickening usually occur?
18=20 wks in nullipara
Around 16wks in multipara
What is chadwicks sign?
– Increased vascularity = violet-bluish color of vaginal mucosa and cervix.
When does the chadwick sign occur
6 wks
What is leukorrhea?
White or gray mucous discharge with faint musty odor.
What is operculum (mucus plug)?
leukorrhea and acts as cervical barrier against bacteria during pregnancy.
What is significant about vaginal mucous?
more acidic during pregnancy (pH 3.5-6.0; normal 4.0-7.0). Protects against some pathogens but harbors others.
What is significant about pelvic congestion?
– increase blood flow, pelvic sensitivity & also cause edema, varicosities of vulva, & hemorrhoids.
What happens to the nipples and areola during pregnancy?
Become darker
What is the role of montgomery’s tubercles?
(sebaceous glands around areola) Keep the nipple lubricated for breastfeeding
When does progressive breast enlargement occur?
2nd and 3rd trimester
On negative effect of altered vaginal pH in pregnancy is
Susceptibility to vaginal infections
Why does slight cardiac hypertrophy occur during pregnancy?
Increased blood volume and increased CO
What does the rising of the diaphragm do to the heart?
Pushes heart up to the left
PMI usually at 4th ICS
When can a murmur be heard in the mother during pregnancy?
Murmur (Sз) heard after 20 wks.
When does the mothers pulse increase?
2nd trimester
How should a nurse take a maternal blood pressure?
- brachial BP highest sitting, lowest lateral recumbent, intermediate supine.
BP is never elevated above normal levels unless ___.
PIH (pregnancy induced HTN)
What is an intervention a nurse can perform to reduce mother’s BP?
Turn on left side
What is Supine Hypotensive Syndrome?
SBP falls more than 30mm/Hg suddenly.
What usually causes Supine Hypotensive Syndrome?
Usually from lying on back and compressing vena cava.
What does an enlarging fetus rests on iliac veins & inferior vena cava do?
increased venous pressure & decreased blood flow to legs.
What do the findings of an increased venous pressure & decreased blood flow to legs.
These findings contribute to dependent edema of legs, varicosities of legs & vulva, & hemorrhoids.
What does the blood volume increase to?
1500 mL
What does the increased blood volume serve?
volume serves to supply uterus & fetus with O2 & provides extra fluid volume at delivery for potential blood losses.
When is a pregnant woman considered anemic?
If Hgb 11 g/dl or less or Hct drops to 32% or less woman considered truly anemic.
What is significant about clotting factors in pregnant women?
Clotting factors increase during higher risk for blood clots.
What does fibrinolytic activity do during pregnancy?
depressed as a protective mechanism – helps prevention of hemorrhage after birth = increases risk of thrombus formation.
How much blood is lost during vag delivery?
500mL
How much blood is lost during c-section?
1000mL
A cardiac finding that should concern the nurse in a pregnant client is
Elevated diastolic BP
What happens to the upper respiratory tract due to estrogen?
It becomes more vascular.
What happens to nasal passages and sinuses?
- become engorged & bleed easily, the voice can change, increases in respiratory tract infections can occur.
During late pregnancy is the right or left renal pelvis and ureter more dilated?
Right because heavy uterus tilted slightly to right by sigmoid colon
The bladder tone decreases and increases bladder capacity up to ______ ml
1500
What must the kidneys handle?
manage increase metabolic and circulatory demands of pregnancy.
How can renal function be improved?
Renal function improves if lying in lateral recumbent position d/t increased renal perfusion = increased urinary output & decreased edema.
What drug should pregnant women avoid?
Diuretics
What can diuretics cause in pregnant women?
risk of hypovolemia & altered tissue perfusion.
When is proteinuria normal?
not normal until labor begins and/or after birth.
What can proteninuria indicate?
Proteinuria along with HTN can indicate PIH & ^ risk for adverse outcomes.
What causes elevated glycosuria?
(2+ or greater) = extreme stress & maternal diabetes.
What intervention can a nurse do if glucosiura is 2+ or greater?
Dip stick the urine and call Dr.
What is linea nigra
darkly pigmented line from the symphysis pubis to top of fundus.
What should a pregnant woman NOT do to get rid of excess fluid in her legs?
Take diuretics
What is angiomas (vascular spiders)
slightly raised, pulsating end-arterioles usually found on the neck, thorax, face, & arms. Increased estrogen.
What is palmar erythema
pinkish mottling over palms of hands.
What is mild pruritus (pruritus gravidarium)
- itch associated with rash.
What is Epulis?
red, raised nodule on gums that bleeds easily.
Avoiding trauma to gums & use soft toothbrush.
The best technique to manage epulis is…
Soft toothbrush
What is significant about spinal curvature (lordosis)?
increases in late pregnancy - forward shift in center of gravity secondary to large abdomen.
Hypocalcemia
causes muscle cramps or tetany
Morning sickness
4-6 wks & usually decreases at 12 wk
What is morning sickness caused by?
Increased hCG
More hCG = what
less risk for miscarriage
What is pica?
food cravings such as clay, is, laundry starch.
Is pica harmful?
Not normally harmful if woman has adequate nutrition otherwise
What is ptyalism?
excessive salivation r/t pregnancy
Gums bleed easily
Use soft toothbrush
An expected GI finding in the pregnant client is
Heartburn
What does progesterone do to GI?
decreases GI tone & motility - increases pyrosis (heartburn) & constipation.
What does oxytocin stimulate?
contractions during pregnancy, stimulates let-down or milk ejection reflex in response to infant sucking.
Can be given exogenously.
