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ATI: MNN > Ch 3: Normal Physiological Changes During Pregnancy > Flashcards

Ch 3: Normal Physiological Changes During Pregnancy Flashcards

1
Q

Signs of pregnancy are classified into 3 groups. What are they?

A

Presumptive
Probable
Positive

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2
Q

Changes that the woman experiences that make her think she may be pregnant

A

Presumptive signs

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3
Q

Are presumptive signs subjective or objective?

A

May be either

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4
Q

Presumptive signs: Signs also may result of physiological factors other than pregnancy. Examples?

A

Peristalsis
Infection
Stress

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5
Q

Changes that make the examiner suspect a woman is pregnant (primarily related to physical changes of the uterus)

A

Probable signs

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6
Q

Signs that can be explained only by pregnancy

A

Positive signs

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7
Q

What sign of pregnancy is this:

Amenorrhea

A

Presumptive

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8
Q

What sign of pregnancy is this:

Fetal outline felt by examiner

A

Probable

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9
Q

What sign of pregnancy is this:

Quickening (slight fluttering movements of the fetus felt by a woman, usually between 16-20 weeks gestation)

A

Presumptive

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10
Q

What sign of pregnancy is this:

Abdominal enlargement related to changes in uterine size, shape, and position

A

Probable

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11
Q

What sign of pregnancy is this:

Hegar’s sign (softening and compressibility of lower uterus)

A

Probable

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12
Q

What sign of pregnancy is this:

Fatigue, N/V

A

Presumptive

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13
Q

What sign of pregnancy is this:

Fetal heart sounds

A

Positive

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14
Q

What sign of pregnancy is this:

Braxton Hicks

A

Probable

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15
Q

What sign of pregnancy is this:

Chadwick’s sign: Deepened violet-bluish color or cervic and vaginal mucosa

A

Probable

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16
Q

What sign of pregnancy is this:

Urinary frequency

A

Presumptive

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17
Q

What sign of pregnancy is this:

Breast changes–darkened areolae, enlarged Montgomery’s glands

A

Presumptive

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18
Q

What sign of pregnancy is this:

Uterine enlargement

A

Presumptive

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19
Q

What sign of pregnancy is this:

Visualization of fetus by ultrasound

A

Positive

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20
Q

What sign of pregnancy is this:

Goodells sign: softening of cervical tip

A

Probable

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21
Q

What sign of pregnancy is this:

Ballottement: rebound of unengaged fetus

A

Probable

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22
Q

What sign of pregnancy is this:

Fetal movement palpated by an experienced examiner

A

Positive

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23
Q

What sign of pregnancy is this:

Positive pregnancy test

A

Probable

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24
Q

What is Hegar’s sign and what sign of pregnancy is this?

A

Softening and compressibility of lower uterus

Probable sign

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25
Q

What is Chadwick’s sign and what sign of pregnancy is it?

A

Deepened violet-bluish color of cervix and vaginal mucosa

Probable sign

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26
Q

What is ballottement and what sign of pregnancy is it?

A

Rebound of unengaged fetus

Probable

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27
Q

What are Braxton Hicks contractions and what sign of pregnancy is this?

A

False contractions that are painless, irregular, and usually relived by walking

Probable sign

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28
Q

Serum and urine tests provide an accurate assessment for the presence of ____

A

Human chorionic gondotropin (hCG)

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29
Q

When can hCG production begin? When does it peak? When does it decline? And when does it gradually increase again?

A

Production of hCG begins with IMPLANTATION, peaks at about 60-70 days, declines until around 80 days, then gradually increases until term

30
Q

What does higher levels of hCG indicate? (4)

A
  1. Multifetal pregnancy
  2. Ectopic pregnancy
  3. Hydatidiform mole (gestational trophoblastic disease)
  4. Genetic abnormality (DS)
31
Q

What does lower blood levels of hCG suggest?

A

A miscarriage

32
Q

When should we get a urine sample?

A

Urine samples should be first-voided morning specimens

33
Q

What is Nagele’s rule?

A

Take first day of womans last menstrual cycle, subtract 3 months, and then add 7 days and 1 year

34
Q

What does measurement of fundal height in cm from the symphysis pubis to the top of the uterine funds (between 18-32 weeks) approximate?

A

Gestational age

35
Q

What is gravidity?

A

Number of pregnancys

36
Q

Nulligravida

A

A woman who has never been pregnant

37
Q

Primigravida

A

A women in her first pregnancy

38
Q

Multigravida

A

A women who has had 2 or more pregnancys

39
Q

What is parity?

A

Number of pregnancies in which the fetus or fetuses reach viability (approx 20 weeks) regardless of whether the fetus is born alive

40
Q

Nillipara

A

No pregnancy beyond stage of viability

41
Q

Primipara

A

Has completed one pregnancy to stage of viability

42
Q

Multipara

A

Has completed 2 or more pregnancies to stage of viability

43
Q

What does GTPAL acronym stand for?

A

Gravidity
Term births (38 weeks or more)
Preterm births (from viability to 37 weeks)
Abortions/miscarriages (prior to viability)
Living children

44
Q

Physiological status of pregnant client: What goes on reproductively?

A

Uterus increases in size and changes shape and positions

Ovulation and menses cease during pregnancy

45
Q

Physiological status of pregnant client: What happens to the cardiovascular system?

A

CO and blood volume increase (45-50% at term) to meet the greater metabolic needs; HR increases

46
Q

Physiological status of pregnant client: What happens with respiratory?

A

Maternal oxygen needs increase

During last trimester, the size of the chest may enlarge allowing for lung expansion and the uterus pushes upward

RR increases and total lung capacity decreases

47
Q

Physiological status of pregnant client:

What happens in the musculoskeletal system?

A

Body alterations and weight increase necessitate an adjustment to posture; pelvic joints relax

48
Q

Physiological status of pregnant client:

What happens with GI?

A

N/V and constipation

49
Q

Physiological status of pregnant client:

What happens in the renal system?

A

Filteration rate increases secondary to the influence of preg. hormones and an increase in blood volume and metabolic demands

Amount of urine remains the same, but urinary frequency is common

50
Q

Physiological status of pregnant client:

What happens in the endocrine system?

A

The placenta becomes an endocrine organ–hormones are very active in pregnancy

51
Q

Physiological status of pregnant client:

Body image changes?

A

First trimester= not obvious–many women look forward to the changes of pregnancy to become more noticable

2nd trimester= enlargement of abdomen and breasts; skin changes (stretch marks, hyper pigmentation); back, leg discomfort and fatigue–> all lead to negative body image and the woman ready for pregnancy to be over

52
Q

How is BP like in first tri?

A

Within pre-pref range

53
Q

How is BP during 2nd tri?

A

Decreases 5-10 mmHg for both diastolic and systolic

54
Q

When should BP return to pre pregnancy baseline range?

A

Approx. 20 weeks gestation

55
Q

Why should preg woman not lay supine?

A

Affect BP–BP may be lower due to weight and pressure of uterus on the vena cava–this decreases blood flow to the heart—maternal hypotension and fetal hypoxia can occur

56
Q

What are signs of supine hypotensive syndrome/supine vena cava syndrome?

A

Dizziness
Lightheadedness
Pale, clammy skin

57
Q

What positions should we encourage the mom to be in when resting to prevent maternal hypotension and fetal hypoxia?

A

Left lateral side
Semi-fowlers
If supine, put a wedge under one hip to alleviate pressure to vena cava

58
Q

When does pulse increase? Does it stay elevated or decline back down for the remainder of pregnancy?

A

Increases 10-15/min around 20 weeks; it remains elevated

59
Q

How much do respirations increase by?

60
Q

What is normal fetal heart beat?

A

110-160, with reassuring FRH accelerations noted, which indicates an intact fetal CNS

61
Q

By 36 weeks gestation, the top of the uterus and the funds will reach the ____

A

Xiphoid process–this may cause preg woman to experience SOB as uterus pushes against diaphragm

62
Q

What are the cervical changes that occur?

A

Obvious as a purplish-blue color extends into vagina and labia, and the cervix becomes markedly soft

63
Q

How do breasts change?

A

Increase in size and aerials darken

64
Q

What are 3 skin changes?

A

Chloasma
Linea nigra
Striae gravidarum

65
Q

What is chloasma?

A

Pigmentation increases on the face

66
Q

What is line nigra?

A

Dark line of pigmentation from umbilicus extending to the pubic area

67
Q

What is striae gravid arum?

A

Stretch marks most notably found on abdomen and thighs

68
Q

A nurse is caring for a client who is pregnant and states that her last menstrual period was April 1st, 2013. Which of the following is the clients estimated date of delivery?

A. Jan 8th, 2014
B. Jan 15th, 2014
C. Feb. 8th, 2014
D. Feb 15. 2014

69
Q

A nurse in a prenatal clinic is caring for a client who is in the 1st trimester of pregnancy. The clients heath record includes this data: G3 T1 P0 A1 L1. How should the nurse interpret this information? (SATA)

A. Client has delivered one newborn at term
B. Client has experienced no preterm labor
C. Client has been through active labor
D. Client has had 2 prior pregnancies
E. Client has one living child

70
Q

A nurse is reviewing the health record of a client who is pregnant. The provider indicated the client exhibits probable signs of pregnancy. Which of the following should be included? (SATA)

A. Montgomery's glands
B. Goodall's sign
C. Ballottement
D. Chadwick's sign
E. QUickening
71
Q

A nurse in a prenatal clinic is caring for a client who is pregnant and experiencing episodes of maternal hypotension. The client asks the nurse what causes these episodes. Which of the following is an appropriate response by the nurse?

A. This is due to an increase in blood volume
B. This is due to pressure from the uterus on the diaphragm
C. This is due to the weight of the uterus on the diaphragm
D. This is due to increased CO

72
Q

A nurse in a clinic receives a phone call from a client who believes she is pregnant and would like to be tested in the clinic to confirm her pregnancy. Which of the following information should the nurse provide to the client?

A. You should weight until 4 weeks after conception to be tested
B. You should be off any meds for 24 hours prior to test
C. You should be NPO for at least 8 hours prior to test
D. You should collect urine from the first morning void

ATI: MNN (16 decks)

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