CH 11

Question 1

Presumptive Signs of Pregnancy
(Subjective)

Answer 1

1. fatigue
2. breast tenderness
3. nausea and vomit
4. amenorrhea
5. urinary frequency
6. hyperpigmentation of skin
7. fetal movements (can also just be a gas bubble)
8. uterine enlargement (we don’t know bc we can’t look inside)
9. breast enlargement

*could be, but not definitely. This is what the pt tells us.

Question 2

Probably Signs Pregnancy
(Objective)

Answer 2

1. Braxton Hicks contractions (cramping in the front, real contractions come from the back)
2. abdominal enlargement
3. Positive pregnancy test
4. Goodell’s sign
5. Chadwick’s sign
6. Hegar’s sign

Question 3

Chadwick’s Sign

Answer 3

BLUISH-PURPLE coloration of the vaginal mucosa and cervix

Question 4

Goodell’s Sign

Answer 4

Softening of the CERVIX

Question 5

Hegar’s Sign

Answer 5

Softening of the LOWER UTERINE segment or ISTHMUS

Question 6

Positive Signs of Pregnancy

Answer 6

1. ultrasound verification of fetus/embryo
2. fetal movement felt by experienced clinician
3. auscultation of fetal heart tones via Doppler

Question 7

Uterus increases in:

Answer 7

size, weight, length, width, depth, volume, overall capactiy

Question 8

Uterus Info:

Answer 8

-pear shape to ovoid shape
-ascent into abdomen after first 3 months
-fundal height by 20 weeks at level of umbilicus; reliable determination of gestational age until 36 weeks

Question 9

Fundal Height Measured from:

Answer 9

pelvic bone to the top of the fundus (muscle)

Question 10

Cervix info:

Answer 10

-softening (Goodell’s sign)
-mucus plug formation (1st defense for baby - if lost doesnt mean baby is coming, could be another 2-3 weeks)
-increased vascularization (Chadwick’s sign)
-ripening about 4 weeks before birth

Question 11

Vagina info:

Answer 11

-increased vascularity w/ thickening
-lengthening of vaginal vault
-secretions more acidic; white and thick, leukorrhea

Question 12

Ovaries info:

Answer 12

-enlargement until 12th to 14th week
-cessation of ovulation

Question 13

Breasts info:

Answer 13

-increase in size, increase in nipple size, become more erect and pigmented

-production of colostrum: antibody rich, yellow fluid that can be expressed after the 12th week; conversion to mature milk after delivery

Question 14

GI System Adaptations:

Question 15

Cardiovascular System Adaptations:

Question 16

Respiratory System Adaptations:

Question 17

Renal/Urinary System Adaptations:

Question 18

Musculoskeletal System Adaptations:

Question 19

Integumentary System Adaptations:

Question 20

Melasma / Hyperpigmentation

Answer 20

-Aka Mask of pregnancy
-dark skin
-usually goes away/lightens up after pregnancy

Question 21

Linea nigra

Answer 21

black line that goes down the abdomen

Question 22

Straie gravidarum

Answer 22

stretch marks

Question 23

Varicosities

Answer 23

varicose veins - damage to inside the vessels

Question 24

Vascular spiders

Answer 24

look like spiders

Question 25

Palmar erythema

Answer 25

rashes on the palm

Question 26

Endocrine System Adaptations

Question 27

Nutritional Needs/Avoidance:

Answer 27

NEED: increase in protein, iron, folate, calories

AVOID: some fish due to mercury content, artificial sweeteners, cheese from other countries bc of listeriosis

Question 28

Healthy Weight Gain BMI/pounds

Answer 28

25 to 35 lbs

first trimester: 3.5 to 5 lbs

second & third: 1lb/week