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Nursing of Childbearing Family > Chapter 13: Adaptations to Pregnancy (Part 1) > Flashcards

Chapter 13: Adaptations to Pregnancy (Part 1) Flashcards

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1
Q

Uterine growth is a result of (hypertrophy, hyperplasia) that is caused by stimulation from ___________ and _____________.

A

hypertrophy and hyperplasia, estrogen, growth factors

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2
Q

Irregular Braxton Hicks contractions during uterine growth occur from increased ________________

A

blood flow

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3
Q

As the uterus grows and expands, it rotates to the ________ and displaces the ___________.

A

right, intestines

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4
Q

Term for discoloration of cervix into a bluish-purple color (from estrogen-induced hyperemia) that extends to the vagina and labia

A

Chadwick’s sign

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5
Q

Term for cervical softening to a consistency like that of the lips or earlobe

A

Goodell’s sign

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6
Q

Purpose of the mucus plug in the cervical canal

A

Blocks ascent of bacteria from vagina into uterus

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7
Q

Vaginal changes in pregnancy: vascularity (decreases, increases), connective tissue (loosens, tightens), mucosa (thins, thickens), and vaginal rugae is (less, more) prominent.

A

increases, loosens, thickens, more

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8
Q

Vaginal discharge becomes more (acidic, basic) in pregnancy.

A

acidic

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9
Q

Sexual interest and orgasmic experiences (decrease, increase) during pregnancy.

A

increase

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10
Q

The ovaries secrete _____________ and inhibit __________ and _________ during pregnancy.

A

progesterone, FSH, LH

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11
Q

This structure secretes progesterone for the first 6-8 weeks of pregnancy

A

corpus luteum

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12
Q

The nipples and areolae become _________ and more __________. The nipples become more ________.

A

larger, pigmented, erect

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13
Q

Breast tissue becomes highly ____________ and may develop lineal tears called _______________.

A

vascular, striae gravidarum

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14
Q

Colostrum production begins at ______ weeks and can be excreted at ____________

A

12-16, the third trimester

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15
Q

Two hormones that suppress the secretion of milk during pregnancy

A

estrogen, progesterone

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16
Q

The uterus can hold up to ____ (volume) at term

A

5 L

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17
Q

Fundus of uterus can be palpated above symphysis pubis

A

by 12 weeks

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18
Q

Fundus of uterus midway between symphysis pubis and umbilicus

A

16 weeks

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19
Q

Fundus of uterus at umbilicus

A

20 weeks

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20
Q

Fundus of uterus at xiphoid process

A

36 weeks

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21
Q

Term for descent of the fetal head or “baby dropping”
This occurs at _______.

A

lightening, 40 weeks

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22
Q

Term for the softening of the isthmus of the uterus

A

Hegar’s sign

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23
Q

Breast size (indicates, does not indicate) how much milk will be produced

A

does not indicate

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24
Q

Changes in heart size during pregnancy

A

Slightly enlarged (due to increased workload)

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25
Q

Changes in heart location during pregnancy

A

Upward and toward left as uterus elevates (third trimester)

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26
Q

Three heart sound variations during pregnancy

A
  1. Split first sound
  2. Present third sound
  3. Systolic murmur
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27
Q

Total blood volume increases by ____%

A

45

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28
Q

Term for increased plasma volume diluting RBCs and decreasing Hgb/Hct

A

pseudoanemia

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29
Q

Maternal HR increases by ____-___ bpm

A

15, 20

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30
Q

faintness, lightheadedness, dizziness, nausea, agitation, syncope experienced when some pregnant women are in supine position

A

supine hypotensive syndrome (vena cava syndrome)

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31
Q

Which position quickly corrects supine hypotensive syndrome?

A

lateral recumbent position

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32
Q

Three areas of the body that receive more blood flow during pregnancy

A

maternal kidneys, skin, breasts

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33
Q

Increased blood flow to breasts results in these three things

A
  1. engorgement
  2. dilated veins
  3. feelings of heat and tingling
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34
Q

Varicose veins of the legs, vulva, or rectum may occur due to this

A

obstructed blood return from veins in legs

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35
Q

Maternal blood clots (less, more) readily due to this

A

more, increased platelets

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36
Q

Fluid increases by ____-____% in pregnancy

A

50, 60

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37
Q

In the first and third trimesters, anemia results when Hgb is <___ and/or Hct is <___%

A

11, 33

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38
Q

In the second trimester, anemia results when Hgb <___ and/or Hct <___%

A

10.5, 32

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39
Q

Leukocytes (increase, decrease) during pregnancy

A

increase

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40
Q

After ___ weeks, the pregnant woman should not lay on her back.

A

20

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41
Q

During pregnancy, oxygen consumption increases by ___%

A

20

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42
Q

An increased need for oxygen causes the pregnant woman to ____________, where she breathes ________ but respiratory rate ______________. This promotes the transfer of _______________ from fetal to maternal circulation.

A

hyperventilate, deeply, stays the same, carbon dioxide

43
Q

Pregnancy hormones can cause these two nose symptoms

A

nosebleeds
congestion

44
Q

Elevated levels of (estrogen, progesterone) cause hyperemia, which can lead to these two mouth symptoms

A

estrogen
gingivitis
gum bleeding

45
Q

Two causes of ptyalism (excessive salivation) in some pregnant women

A
  1. Increased stimulation of salivary glands by ingestion of starch
  2. Decreased swallowing from nausea and vomiting
46
Q

Increased (estrogen, progesterone) levels can cause the lower esophageal sphincter tone to (increase, decrease)

A

progesterone, decrease
(this can cause heartburn/pyrosis)

47
Q

Increased (estrogen, progesterone) causes (increased, decreased) intestinal motility and tone

A

progesterone, decreased

48
Q

To promote nutrient absorption during pregnancy, emptying time of intestines is (increased, decreased).

A

increased

49
Q

These six nutrients, vitamins, and/or minerals are better absorbed during pregnancy

A

calcium, amino acids, iron, glucose, sodium, chloride

50
Q

This nutrient, vitamin, or mineral absorption is reduced during pregnancy

A

B vitamin

51
Q

(Increased, Decreased) motility of the large intestine allows for (more, less) water absorption causing ____________, which increases the risk of _____________.

A

Decreased, more, constipation, hemorrhoids

52
Q

The gallbladder becomes _____________ and the emptying time is _____________, resulting in (thinner, thicker) bile and predisposing _____________.

A

hypotonic, prolonged, thicker, gallstones

53
Q

(Increased, Decreased) gallbladder tone leads to bile salt _________, which can cause ___________.

A

Decreased, retention, pruritus

54
Q

(Estrogen, Progesterone) causes functional changes of the liver and gallbladder.

A

Progesterone

55
Q

Serum alkaline phosphatase levels in pregnant women

A

Increased by 2-4 times

56
Q

Serum albumin and protein levels in pregnant women are (increased, decreased)

A

decreased

57
Q

Four reasons for more frequent urination in pregnancy

A
  1. uterine expansion in pelvis
  2. hormonal influences
  3. increased blood volume
  4. changes in GFR rate
58
Q

Bladder mucosa becomes congested with __________

A

blood

59
Q

Stimulation from (estrogen, progesterone) has this effect on bladder walls

A

estrogen, hypertrophy

60
Q

The base of the bladder is pushed __________ and _________.

A

forward, upward

61
Q

Ureters become _______________ and more ___________.

A

elongated, distended

62
Q

Renal blood increases by ___-___% by mid-pregnancy

A

50, 80

63
Q

GFR increases by ___% in second trimester. As a result, these three levels decline

A

50, blood urea, nitrogen, serum creatinine

64
Q

Obstructed ureters increase the risk of ______

A

UTIs

65
Q

It is common for mild ___________ to be present in the urine without indicating pre-eclampsia

A

proteinuria (protein)

66
Q

Do not give or advise pregnant women to take ____________ or __________ for constipation, but they may take ________________.

A

laxatives, enemas, stool softeners

67
Q

Pregnancy hormones can cause urinary _________ which can lead to urinary retention. Teach pregnant women to ___________________ to prevent ______.

A

stasis, empty bladder completely, UTIs

68
Q

Increased circulation to the skin encourages activity of _____________ and _____________ glands

A

sweat, sebaceous

69
Q

Skin feels (cooler, warmer) during pregnancy and has increased ________________

A

warmer, perspiration

70
Q

Increased pigmentation occurs from elevated levels of these three hormones and may begin as early as the ___ week of pregnancy

A

estrogen, progesterone, melanocyte stimulating hormone, 8th

71
Q

Women with (dark, light) skin or hair exhibit more hyperpigmentation than the other

A

dark

72
Q

Three terms for brownish patches of skin on the face

A

melasma, chloasma, mask of pregnancy

73
Q

Term for the line that marks the longitudinal division of the midline of the abdomen

A

linea alba

74
Q

Term for the darkened linea alba

A

linea nigra

75
Q

Term for slightly depressed pink to purple streaks on the abdomen, breasts, and buttocks that fade to white or silvery lines

A

striae gravidarum (stretch marks)

76
Q

Hair grows (more rapidly/more slowly), and (more, less) hair falls out.

A

more rapidly, less

77
Q

Fetal demands for calcium increase, especially in the ________ trimester

A

third

78
Q

Absorption of calcium from intestines is increased from the _________ trimester, and calcium is ________ to meet later fetal needs

A

first, stored

79
Q

The mother (loses, does not lose) bone density to supply fetal needs of calcium

A

does not lose

80
Q

Postural changes begin in the _____ trimester when estrogen and progesterone initiate increased mobility of pelvic ligaments, facilitating passage of fetus through pelvis at time of birth

A

2nd

81
Q

At ___-___ weeks, the pelvic symphysis separates

A

28, 30

82
Q

Progressive lordosis from leaning backwards occurs in the ___ trimester and may lead to __________

A

3rd, backache

83
Q

Term for the separation of the rectus abdominis muscles

A

diastasis recti

84
Q

A changing center of gravity from pelvic instability may cause the pregnant woman to assume a ________ stance and have a ___________ gait

A

wide, waddling

85
Q

Hormone that increases to prepare for milk production

A

prolactin

86
Q

Hormone that stimulates milk ejection reflex after childbirth and contractions of uterus during and after childbirth to prevent excessive bleeding

A

oxytocin

87
Q

Hormone that inhibits contractions during pregnancy by relaxing smooth uterine muscle

A

progesterone

88
Q

The thyroid enlarges from ____________ and increased _____________.

A

hyperplasia, vascularity

89
Q

These two thyroid hormones or molecules increase early in the first trimester

A
  1. total serum thyroxine T4
  2. thyroxine-binding globulin
90
Q

This thyroid hormone increases in early pregnancy and then returns to normal

A

serum free (unbound) T4

91
Q

Basal metabolic rate increases up to ___% from fetal metabolic activity

A

25

92
Q

Parathyroid hormone (increases, decreases) during first trimester and (increases, decreases) throughout pregnancy

A

decreases, increases

93
Q

Glucose levels are ___-___% (higher, lower) than prior to pregnancy for this reason

A

10, 20, lower
fetus draws glucose from mother (hypoglycemia can develop)

94
Q

During the second half of pregnancy, insulin sensitivity declines (insulin resistance increases) due to the effects of these five hormones

A

hCS, prolactin, progesterone, estrogen, cortisol

95
Q

The pregnant woman uses __________ to meet energy needs

A

fat stores

96
Q

Elevated free cortisol levels serve these two purposes in the pregnant woman

A
  1. Regulates carbohydrate and protein metabolism
  2. Stimulates gluconeogenesis when glucose supply is inadequate
97
Q

Purpose of increased aldosterone levels in the pregnant woman

A

Overcomes salt-wasting effects of progesterone to maintain sodium levels and meet fetal needs

98
Q

When does the placenta take over the function of estrogen and progesterone production from the corpus luteum?

A

10-12 weeks

99
Q

Hormone that is an insulin antagonist to reduce sensitivity of maternal cells to insulin and thereby increase availability of glucose for the fetus

A

hCS (human chorionic somatomammotropin)

100
Q

Hormone that inhibits uterine activity, softens cervical connective tissue, and lengthens pubic ligaments

A

relaxin

101
Q

The water requirement for the body and body water (decreases, increases) during pregnancy

A

increases

102
Q

Water metabolism is important for ___________ balance and ____________ function.

A

sodium, kidney

103
Q

_______________ causes edema during pregnancy, which decreases venous return and increases venous pressure.

A

Hemodilution

104
Q

Carpal tunnel syndrome may occur in pregnancy if __________ compresses the median nerve.

A

edema

Nursing of Childbearing Family (15 decks)

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