ch 14/15 Flashcards
helps maintain pregnancy while placental is still forming (signals to keep producing estrogen & progesterone); stimulates breast development to pre[are for lactation
hCG
stimulates uterine growth, gets extra bloodflow to placenta
estrogen
makes all joints very mobile, helps open up for delivery
relaxin
relaxes uterine muscles, causes breasts to develop, responsible for metabolism changes needed for pregnancy
progesterone
conception (2wks), pt doesn’t realize pregnant
preembyronic
2-8wks, main task is organ formation, neural tube fusion
embryonic stage
9-38wks+
fetal stage
the fetal side of the placenta
shiny shultze
what does the placenta do?
produces hormones (hCG, HPL, estrogen, progesterone, relaxin), protects fetus, removes waste
what can the placenta cause?
insulin resistance
presumptive signs of pregnancy
amenorrhea, breast tenderness, fatigue, constipation, cravings
probable signs pregnancy
Goodell sign (softening of cervix), chadwicks sign (blueish discoloration cervix), hegar sign (compressibility of cervix), ballottement (feel fetus move when uterus pushed), braxton hicks, postive serum/urine samples
umbilical cord has how many veins and artieres?
1 vein (oxygenated), 2 arteries (deoxygenated)
what does amniotic fluid do/help?
helps body temp control, symmetric growth/development, cushioning/protection, compression-free umbilical cord, allows fetal movement, stores waste
maternal changes in pregancy
O2 increases, mild hyperventialtion, cardiac output increases 50% & increased HR, physiologic anemia, BP slightly lower until mid-pregancy, increased iron demands, linea nigra, facial melisma, striae gravidum, imcreased insulin needs, breast development, fundal height increase, mucus plug formation, cessation ovulation, lordosis, metabolic rate increases
first trimester
conception-12wks
second trimester
13-28wks
third trimester
29-40wks
where should the fundus be at 20wks?
umbilicus
nagean’s rule
first day of last menstrual period - 3mo + 7 days + 1 year
how would you assess the nutritional status of a pt?
24h diet recall
number of pregnancies woman has had in her lifetime (GP and GTPAL)
gravidity/grava (G)
number of pregnancies that have ended at term (GTPAL)
T
the number of pregnancies that have ended preterm (GTPAL)
preterm (P)
number of pregnancies that end by spontaneous or elective abortion (GTPAL)
abortion (A)
the number of living children (GTPAL)
living children (L)
the number of pregnancies carries to viable gestational age (20-24wks) (GP)
parity/para (P)
s/s preeclampsia
vision changes, headache not relieved by acetaminophen
normal FHR
110-160
how is measuring the fundus performed?
laying down
when does a pregant client get screened for diabetes?
2nd trimester
when does testing for fetal anomalies start?
2nd trimester
collected via swab, normal bacterial living in mom’s vaginal canal. if baby gets this can cause infection
GBS (group beta step)
how many kcal/day do pregnant clients need?
300kcal/day
how many kcal/day do adolescent pregnant clients need?
350kcal/day additional plus 50kcal/kg/day
how many extra calories are required during lactation?
400-500kcal/day
how many mg/day of folic acid is needed in pregnancy?
0.6mg/day
folic acid can be found in what foods
citrus fruits/juices, green leafy veg, enriched grains, legumes, avocados, broccoli, papaya
BMI is
kg/m squared
a healthy weighted client should gain how many lbs during pregnancy
25-35lbs
an overweigh client should gain how many lbs during pregancy?
15-25lbs
pt education on what yo avoid during pregnancy
- litter boxes
- hot tubs
- raw/undercooked meat/eggs
- excessive caffeine
- soft cheeses
- fish
- gases/fumes
- resp infection exposures
eating non-food substances, eating low-nutrition foods
pica
- urinary frequency/incontinence
- fatigue
- n/v
- breast tenderness
- constipation
- cravings
- leukorrhea
- headache
1st trimester s/s
- backache
- hemorrhoids
- flatulence
- pelvic joint pain
- leg cramps
- varicosities
2nd trimester s/s
- 1st trimester discomforts return
- SOB, dyspnea
- heartburn, indigestion
- dependent edema ankles
- braxton hicks
- vaginal discharge
- insomnia
3rd trimester s/s
supine hypotension pt education
lay on side
heartburn pt education
avoid fatty foods and excess fluids, avoid lying down after eating, no eating 3h before bed
headaches pt education
use acetaminophen, not ibuprofen; cold compress, calming environment
T/F: you can still travel by plane after the 2nd trimester
F
T/F: pregnant clients cannot get live vaccinations but can get the flu shot
T
