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RNSG 1251 UNIT 1 > ch. 13: a&p of pregnancy > Flashcards

ch. 13: a&p of pregnancy Flashcards

1
Q

What is viability?

A

capacity to live outside the uterus

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2
Q

What is gravidity?

A

any pregnancy regardless of duration & outcome

-also includes current pregnancy

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3
Q

What is Nagele’s Rule?

A

formula to estimate delivery date

1) FIRST DAY OF LAST NORMAL PERIOD
2) MINUS 3 MONTHS
3) ADD 7 DAYS

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4
Q

What is the GTPAL method?

A

method to record a woman’s pregnancy hx using symbols

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5
Q

What does the G stand for in GTPAL?

A

Gravida- # of total pregnancies regardless of length and outcome

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6
Q

What does the T stand for in GTPAL?

A

Full Term (38-40 weeks)

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7
Q

What does the P stand for in GTPAL?

A

Preterm (20-37 weeks)

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8
Q

What does the A stand for in GTPAL?

A

Abortion (<20 weeks)

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9
Q

What does the L stand for in GTPAL?

A

Living- # of total living children

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10
Q

What is the earliest biological marker for pregnancy?

A

hCG

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11
Q

What do elevated levels of hCG indicate?

A

abnormal gestation, Downs, or multifetal pregnancy

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12
Q

What do lower levels of hCG indicate?

A

impending miscarriage, ectopic pregnancy

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13
Q

What urine specimen is the best to use for a pregnancy test?

A

first one in the morning bc it contains almost the same level of HCG as blood

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14
Q

What hCG blood levels are diagnostic for pregnancy?

A

> 25

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15
Q

How is fundal height measured?

A

in cm from the pubic symphysis to the top of the uterus

-cm same as weeks up until week 40 when the fundus drops

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16
Q

What hormones stimulate uterine growth?

A

estrogen and progesterone

17
Q

What are Braxton Hicks Contractions

A
  • irregular and painless

- facilitate uterine blood flow

18
Q

What 3 factors decrease uterine blood flow?

A

1) low maternal arterial pressure
2) contractions of uterus
3) maternal supine position

19
Q

What is quickening?

A

first recognition of fetal movement, “feeling life”

20
Q

How much does cardiac output increase during pregnancy?

A

reaches max of 30-50% above nonpregnant level

21
Q

How much does the blood volume increase?

A

40-50%

22
Q

The increase in ____ is more than the increase in RBC mass

A

plasma volume

-results in hemodilution (physiologic anemia)

23
Q

How much does the WBC level increase?

A
  • nonpregnant: 5k - 10k

- pregnant: 15k

24
Q

What coagulation changes occur during pregnancy?

A

-clotting factors 8, 7, 9, 10 DOUBLE
-fibrinogen increases
-fibrinolytic activity decreases
=HYPER-COAGULATIVE STATE

25
Q

Since pregnancy is a hyper-coagulative state, what are women at increased risk for?

A

5-6 fold ↑ risk for thromboembolic event

26
Q

What results from the enlarged uterus displacing the diaphragm up to 4 cm?

A
  • diaphragm mobility reduced
  • resp become mainly thoracic
  • ↑ estrogen relaxes ribs, ↑ chest expansion
27
Q

How does increased vascularity affect the upper resp system?

A

nasal stuffiness, ears, nose bleeds, voice changes

28
Q

How is pulmonary function affected by increased estrogen and progesterone?

A
  • CO2 threshold is lowered

- O2 demand and consumption is increased

29
Q

How is the acid/base balance affected?

A
  • 5mm Hg decrease in pCO2= decreased HCO3, increased pH
  • pregnancy is a state of RESPIRATORY ALKALOSIS
  • this facilitates transport of CO2 from fetus to mom and O2 release from mom to fetus
30
Q

What are the anatomic changes of the renal system?

A

renal pelves and ureters are enlarged/dilated

31
Q

How does the GFR change in pregnancy?

A

GFR increases by 50%

32
Q

What is the result of the increased GFR?

A

↑ creatinine clearance & reduced serum creat, BUN & uric acid

33
Q

Why is Na retained?

A

to meet fetal needs, fluid expansion, & to maintain isotonic state

34
Q

Can you give diuretics to a pregnant pt?

A

NO! IT MAY DROP THE BP AND DECREASE PLACENTAL PERFUSION

35
Q

How is tubular reabsorption of glucose affected?

A
  • it is impaired= glucosuria
  • nonpreg excrete 100mg/day
  • preg excrete 1-10 g/day ( still have to assess for gestational DM)
36
Q

What is the abnormal proteinuria level?

A

> 300 mg/24 hrs

37
Q

What is the abnormal albuminuria level?

A

> 30mg/ 24 hrs

38
Q

What happens if a woman has both proteinuria and HTN?

A

they are at risk for adverse outcome

39
Q

What are the effects on the GI system?

A

nausea, vomiting, indigestion. heartburn (pyrosis), increased r/o hiatal hernia, constipation

RNSG 1251 UNIT 1 (8 decks)

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