Assessment of Pregnant Client Flashcards
What does gravida mean?
Total number of pregnancies of any gestations regardless of weeks
What does para mean?
Total number of pregnancies carried greater than 20 weeks gestation
What does TPAL stand for?
T- term (number of pregnancies carried to full term, 38-43 weeks)
P- preterm (# of pregnancies carried/delivery preterm (after 20 weeks but before 38 weeks)
A- abortions (number of pregnancies lost priori to reaching 20 weeks (includes miscarriages)
L- living children (current living kids)
Trimester timelines?
1st trimester is 0-12 weeks, 2nd is 13-26 weeks, 3rd is 27-40 weeks.
What does anetpartum, intrapartum, and postpartum mean?
A- prenatal, period of pregnancy, usually the last 20 weeks
I- labour
P- period following birth, lasts approximately 6 weeks
What is the nageles rule to estimate due date?
Take first day of LMP (last period) and add a year then subtract 3 months and add 7 days.
Presumptive changes (subjective) in pregnancy?
Symptoms experiences by pregnancy client that suggest pregnancy, but can be caused by other conditions than pregnancy. Examples- N/V, amenorrhea, excessive fatigue, urinary frequency, changes in breasts, quickening
Probable (objective) changes in pregnancy?
Signs perceived by examiners and can be caused by other conditions than pregnancy. Examples- enlargement of abdomen, braxton hicks contractions, change in pelvic organs, positive pregnancy test, fetal outline palpable on exam,uterine soft blowing sounds when auscultating abdomen
What are diagnostic (positive) changes in pregnancy?
Signs that are completely objective/caused by pregnancy only. Examples- defect fetal heartbeat, fetal movements detected by trained examiners, verified gestational sac/heartbeat through ultrasound
CVS/hematological changes in pregnancy?
Blood volume will increase 30-50%, CO increase 40-50%, can have physiological anemia, supine hypotension, increased clotting factors, increase risk for thrombus formation
Respiratory changes?
Increased O2 consumption 15-20%, displacement of diaphragm as pregnancy progresses (SOB, thoracic breathing)
Endocrine changes?
Increased BMR, increase progesterone maintains o pregnancy, increased estrogen enlarges uterus/breasts/genitals, increased oxytocin at term
GI changes?
Increased hCG leads to alerted carbs metabolism, changes in taste/smell, decreased muscle tone, constipation, delayed stomach emptying, morning sickenesss
MSK changes?
Increased abdomen size, decreased muscle tone, compression of lumbar nerve roots, lower back pain, increase mobility of pelvic joints, and stretching of rectum abdominal muscle
Integ changes?
Hyperpigmentation (linear alba darkens), striae develop, cutaneous tissue becomes more fragile, increase estrogen=oily/acne
Childbearing age?
15-40+ yrs
Normal HR of fetus?
110-160 beats/minute with regular rhythm
What is supine hypotensive syndrome?
Pressure from growing fetus/gravity causes uterus to compress illiac veins and inferior vena cava. Results in decreased venous return in supine position (can lead to supine hypotension). S+S- mimic hypovolemic shock, reduced blood flow to placenta, fetal hypoxia/distress
