Ch. 13 Flashcards
What does GTPAL stand for?
Gravidity Term birth Preterm births Abortions, miscarriages Living children
A woman who is pregnant
Gravida
Pregnancy
Gravidity
A woman who has never been pregnant and is not currently pregnant
Nilligravida
A woman who is pregnant for the first time
Primigravida
A woman who has had 2 or more pregnancies
Miltigravida
The number of pregnancies in which the fetus or fetuses have reached 20 weeks of gestation, not the number of fetuses born
Parity
A woman who has not completed a pregnancy with a fetus beyond 20 weeks
Nullipara
A woman who has completed one pregnancy with a fetus to 20 weeks gestation
Primipara
A woman who has completed 2 or more pregnancies to 20 weeks gestation or more
Multipara
The capacity to live outside the uterus
Viability
Earliest biomarker of pregnancy
hCG
Teaching regarding an early pregnancy test?
- Follow all instructions on it and don’t omit steps
- Review the manufactures list of foods, meds, and other substances that may affect results
- Use first voided morning urine specimen
- If the test is done at the time of your missed period comes back negative, repeat the test in one week if you still haven’t had a period
- Contact provider for follow up if test is + or if test is - and you stillhavent had a period
What sign of pregnancy: amenorrhea
Presumptive
What sign of pregnancy: Braxton hicks
Probable
What sign of pregnancy: Ballottement
Probable
What sign of pregnancy: Fatigue
Presumptive
What sign of pregnancy: Urinary frequency
Presumptive
What sign of pregnancy: Fetal heart sounds detected by ultrasound, doppler, or fetoscope
Positive
What sign of pregnancy: Hegar sign
Probable
What sign of pregnancy: Quickening
Presumptive
What sign of pregnancy: Chadwicks sign
Probable
What sign of pregnancy: Goodell sign
Probable
What sign of pregnancy: N/V and breast changes
Presumptive
What sign of pregnancy: Fetal movement palpated to examiner and/or visible to examiner
Positive
What sign of pregnancy: Positive preg test
Probable
What sign of pregnancy: Visualization of fetus by ultrasound and or radiographic study
Positive
What is goodell sign?
Softening of CERVICAL tip in a normal, unscarred cervix
-occuring in 2nd month
What is chadwicks sign?
Violet, bluish vaginal mucous membrane and cervix that is visible about 4th week (caused by increased vascularity)
What is Hegar’s sign?
Softening of the LOWER UTERINE SEGMENT
-May be presented during 2nd-3rd month of preg
Rushing or blowing sound of MATERNAL blood flowing through the uterine arteries to the placenta
Uterine souffel or bruit
What is a uterine souffel or bruit synchronous with?
Maternal pulse
What is synchronous with the FHR?
Funic souffel
What is funic souffel caused by?
FETAL blood coursing though umbilical cord
Leukorhea mucous fills the endocervical canal, resulting in the mucous plug called ______.
Operculum
What does operculum do?
Acts as a barrier against bacterial invasion during pregnancy
What is the purpose of the Montgomery tubercles?
They may be seen around the nipples and w/in them are sebaceous and sweat glands that secrete lubricating and anti-infective substances to help protect the moms nipples and areolas during breastfeeding
“Liquid gold”
Colostrum
If a systolic murmur develops in preg, where would we hear it?
Left sternal border
How should we take BP at each visit?
The reading should be obtained in the same arm with woman in seated position with her back and arm supported and her upper arm at level of R. atrium
*positioning should be reordered with the reading
How does BP change during pregnancy?
It doesnt or it slightly decreases
Why is MAP useful to calculate?
Helps predict gestational hypertensive disorders
The increase in plasma is increased in pregnancy, but the increase in the plasma is greater than the production of RBC. What does this mean?
Hemodilution–> Psychologic anemia!!
During pregnancy, the woman is in a hyper coagulable state. What does this mean?
At greater risk for thromboembolic disorders
What clotting factors increase in pregnancy?
VII VIII IX X Fibronogen
How do women breathe in prenancy: chest breathing or abdominal?
Chest breathing via diaphragm
Why do preg women have nasal/sinus stuffiness, epistaxis, changes in the voice, and marked inflammatory response?
Because the URT is more vascular and the capillaries become engorged, have edema, and hyperemia develops
BMR: Does it increase or decrease in pregnancy?
Increase
What is the acid-base balance of a preg?
Respiratory alkalosis due to
- Increase TV
- Slight increase in pH
- Decrease in Pco2
- Decrease in HCO3 and bicarb
What does urinary stasis lead to?
UTI
What can happen when the center of gravity shifts forward?
Lordosis and exaggerated flexion of the head develops to help develop with balance
What hormones are responsible for loosening of ligaments of pubic symphysis and sacrioliac joints to facilitate labor and birth?
Relaxin and progesterone
What kind of gait to pregs have?
Waddling
What does edema in peripheral nerves lead to?
Carpal tunnel syndrome
- Parathesia
- Pain in hand radiating to elbow
What is a red, raised nodule on the gums that bleeds easily?
Epulis
Excessive salvation
Pytalism
GI effects due to increase in progesterone?
Reflux, slower emptying of stomach, reverse persalsis all leading to indigestion and heart burn
Due to the smooth muscle relaxation and peristalsis there is also increased water absporption causing constipation
What hormone: Maintains corpus luteum production of estrogen and progesterone until placenta takes over
hCG
What hormone:
- Suppresses secretion of FSH and LH
- Maintains preg by relaxing SM
- Decrease uterine contractility
- Causes fat to deposit in SQ over mom abdomen, back, and thighs
- Decreases mom ability to use insulin
Progesterone
What hormone:
- Suppresses secretion of FSH and LH
- Causes fat to deposit in SQ over mom abdomen, back, and thighs
- Promotes enlargement of breasts, genitals, and uterus
- Increases vascularity
- Relaxes pelvic lig and joints
- Interferes with folic acid metabolism
- Increases level of total body proteins
- Promotes retention of Na and H2O
- Decrease secretion of hydrochloric acid and pepsin
- Decreases mom ability to use insulin
Estrogen
What hormone: Prepares the breasts for lactation?
Serum prolactin
What hormone?
- Acts as growth hormone
- Contributes to breast development
- Decreases maternal metabolism of glucose
- Increases amount of FA for metabolic needs
Human chorionic somatomammotropin
EPT: Anticonvulsants and tranquilizers–can cause false positive or false negatives?
False positives
EPT: Diuretics and promethazine–can cause false positive or false negatives?
False negatives
Why aren’t probable signs of pregnancy enough to be a definitive diagnosis?
These signs can still be caused by something else like pelvic congestion or tumors
Changes that make an examine suspect a woman is pregnant
Probable signs
Changes felt by the woman that makes her think she is pregnant
Presumptive
Signs only explained by pregnancy
Positive signs
How many days is pregnancy?
280
How many lunar months is pregnancy?
10 lunar months
How many calendar months is pregnancy?
A little over 9 calendar months
How many weeks is pregnancy?
40 weeks
When does the upper uterus become palpable?
When it is above the symphysis pubis something between 12-14 weeks gestation
Where is the fundus at approx 20weeks on normal gestation?
Umbilicus and full bodied
When does lightening occur?
38-40 weeks
When would multipara feel quickening?
14-16 weeks
When would nillipara feel quickening?
18th week or later
Hormone responsible for milk production?
Prolactin
Hormone responsible for milk letdown?
Oxytocin
What are the absolutes for preclampsia?
140/90 OR
Systolic elevated 30 above baseline and diastolic elevated 15 above baseline
What are cardinal signs of preeclampsia?
Blurred Edema Elevated BP Proteinuria Headaches or dizziness
