Chapter 13: Adaptations to Pregnancy (Part 1) Flashcards
Uterine growth is a result of (hypertrophy, hyperplasia) that is caused by stimulation from ___________ and _____________.
hypertrophy and hyperplasia, estrogen, growth factors
Irregular Braxton Hicks contractions during uterine growth occur from increased ________________
blood flow
As the uterus grows and expands, it rotates to the ________ and displaces the ___________.
right, intestines
Term for discoloration of cervix into a bluish-purple color (from estrogen-induced hyperemia) that extends to the vagina and labia
Chadwick’s sign
Term for cervical softening to a consistency like that of the lips or earlobe
Goodell’s sign
Purpose of the mucus plug in the cervical canal
Blocks ascent of bacteria from vagina into uterus
Vaginal changes in pregnancy: vascularity (decreases, increases), connective tissue (loosens, tightens), mucosa (thins, thickens), and vaginal rugae is (less, more) prominent.
increases, loosens, thickens, more
Vaginal discharge becomes more (acidic, basic) in pregnancy.
acidic
Sexual interest and orgasmic experiences (decrease, increase) during pregnancy.
increase
The ovaries secrete _____________ and inhibit __________ and _________ during pregnancy.
progesterone, FSH, LH
This structure secretes progesterone for the first 6-8 weeks of pregnancy
corpus luteum
The nipples and areolae become _________ and more __________. The nipples become more ________.
larger, pigmented, erect
Breast tissue becomes highly ____________ and may develop lineal tears called _______________.
vascular, striae gravidarum
Colostrum production begins at ______ weeks and can be excreted at ____________
12-16, the third trimester
Two hormones that suppress the secretion of milk during pregnancy
estrogen, progesterone
The uterus can hold up to ____ (volume) at term
5 L
Fundus of uterus can be palpated above symphysis pubis
by 12 weeks
Fundus of uterus midway between symphysis pubis and umbilicus
16 weeks
Fundus of uterus at umbilicus
20 weeks
Fundus of uterus at xiphoid process
36 weeks
Term for descent of the fetal head or “baby dropping”
This occurs at _______.
lightening, 40 weeks
Term for the softening of the isthmus of the uterus
Hegar’s sign
Breast size (indicates, does not indicate) how much milk will be produced
does not indicate
Changes in heart size during pregnancy
Slightly enlarged (due to increased workload)
Changes in heart location during pregnancy
Upward and toward left as uterus elevates (third trimester)
Three heart sound variations during pregnancy
- Split first sound
- Present third sound
- Systolic murmur
Total blood volume increases by ____%
45
Term for increased plasma volume diluting RBCs and decreasing Hgb/Hct
pseudoanemia
Maternal HR increases by ____-___ bpm
15, 20
faintness, lightheadedness, dizziness, nausea, agitation, syncope experienced when some pregnant women are in supine position
supine hypotensive syndrome (vena cava syndrome)
Which position quickly corrects supine hypotensive syndrome?
lateral recumbent position
Three areas of the body that receive more blood flow during pregnancy
maternal kidneys, skin, breasts
Increased blood flow to breasts results in these three things
- engorgement
- dilated veins
- feelings of heat and tingling
Varicose veins of the legs, vulva, or rectum may occur due to this
obstructed blood return from veins in legs
Maternal blood clots (less, more) readily due to this
more, increased platelets
Fluid increases by ____-____% in pregnancy
50, 60
In the first and third trimesters, anemia results when Hgb is <___ and/or Hct is <___%
11, 33
In the second trimester, anemia results when Hgb <___ and/or Hct <___%
10.5, 32
Leukocytes (increase, decrease) during pregnancy
increase
After ___ weeks, the pregnant woman should not lay on her back.
20
During pregnancy, oxygen consumption increases by ___%
20
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.
hyperventilate, deeply, stays the same, carbon dioxide
Pregnancy hormones can cause these two nose symptoms
nosebleeds
congestion
Elevated levels of (estrogen, progesterone) cause hyperemia, which can lead to these two mouth symptoms
estrogen
gingivitis
gum bleeding
Two causes of ptyalism (excessive salivation) in some pregnant women
- Increased stimulation of salivary glands by ingestion of starch
- Decreased swallowing from nausea and vomiting
Increased (estrogen, progesterone) levels can cause the lower esophageal sphincter tone to (increase, decrease)
progesterone, decrease
(this can cause heartburn/pyrosis)
Increased (estrogen, progesterone) causes (increased, decreased) intestinal motility and tone
progesterone, decreased
To promote nutrient absorption during pregnancy, emptying time of intestines is (increased, decreased).
increased
These six nutrients, vitamins, and/or minerals are better absorbed during pregnancy
calcium, amino acids, iron, glucose, sodium, chloride
This nutrient, vitamin, or mineral absorption is reduced during pregnancy
B vitamin
(Increased, Decreased) motility of the large intestine allows for (more, less) water absorption causing ____________, which increases the risk of _____________.
Decreased, more, constipation, hemorrhoids
The gallbladder becomes _____________ and the emptying time is _____________, resulting in (thinner, thicker) bile and predisposing _____________.
hypotonic, prolonged, thicker, gallstones
(Increased, Decreased) gallbladder tone leads to bile salt _________, which can cause ___________.
Decreased, retention, pruritus
(Estrogen, Progesterone) causes functional changes of the liver and gallbladder.
Progesterone
Serum alkaline phosphatase levels in pregnant women
Increased by 2-4 times
Serum albumin and protein levels in pregnant women are (increased, decreased)
decreased
Four reasons for more frequent urination in pregnancy
- uterine expansion in pelvis
- hormonal influences
- increased blood volume
- changes in GFR rate
Bladder mucosa becomes congested with __________
blood
Stimulation from (estrogen, progesterone) has this effect on bladder walls
estrogen, hypertrophy
The base of the bladder is pushed __________ and _________.
forward, upward
Ureters become _______________ and more ___________.
elongated, distended
Renal blood increases by ___-___% by mid-pregnancy
50, 80
GFR increases by ___% in second trimester. As a result, these three levels decline
50, blood urea, nitrogen, serum creatinine
Obstructed ureters increase the risk of ______
UTIs
It is common for mild ___________ to be present in the urine without indicating pre-eclampsia
proteinuria (protein)
Do not give or advise pregnant women to take ____________ or __________ for constipation, but they may take ________________.
laxatives, enemas, stool softeners
Pregnancy hormones can cause urinary _________ which can lead to urinary retention. Teach pregnant women to ___________________ to prevent ______.
stasis, empty bladder completely, UTIs
Increased circulation to the skin encourages activity of _____________ and _____________ glands
sweat, sebaceous
Skin feels (cooler, warmer) during pregnancy and has increased ________________
warmer, perspiration
Increased pigmentation occurs from elevated levels of these three hormones and may begin as early as the ___ week of pregnancy
estrogen, progesterone, melanocyte stimulating hormone, 8th
Women with (dark, light) skin or hair exhibit more hyperpigmentation than the other
dark
Three terms for brownish patches of skin on the face
melasma, chloasma, mask of pregnancy
Term for the line that marks the longitudinal division of the midline of the abdomen
linea alba
Term for the darkened linea alba
linea nigra
Term for slightly depressed pink to purple streaks on the abdomen, breasts, and buttocks that fade to white or silvery lines
striae gravidarum (stretch marks)
Hair grows (more rapidly/more slowly), and (more, less) hair falls out.
more rapidly, less
Fetal demands for calcium increase, especially in the ________ trimester
third
Absorption of calcium from intestines is increased from the _________ trimester, and calcium is ________ to meet later fetal needs
first, stored
The mother (loses, does not lose) bone density to supply fetal needs of calcium
does not lose
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
2nd
At ___-___ weeks, the pelvic symphysis separates
28, 30
Progressive lordosis from leaning backwards occurs in the ___ trimester and may lead to __________
3rd, backache
Term for the separation of the rectus abdominis muscles
diastasis recti
A changing center of gravity from pelvic instability may cause the pregnant woman to assume a ________ stance and have a ___________ gait
wide, waddling
Hormone that increases to prepare for milk production
prolactin
Hormone that stimulates milk ejection reflex after childbirth and contractions of uterus during and after childbirth to prevent excessive bleeding
oxytocin
Hormone that inhibits contractions during pregnancy by relaxing smooth uterine muscle
progesterone
The thyroid enlarges from ____________ and increased _____________.
hyperplasia, vascularity
These two thyroid hormones or molecules increase early in the first trimester
- total serum thyroxine T4
- thyroxine-binding globulin
This thyroid hormone increases in early pregnancy and then returns to normal
serum free (unbound) T4
Basal metabolic rate increases up to ___% from fetal metabolic activity
25
Parathyroid hormone (increases, decreases) during first trimester and (increases, decreases) throughout pregnancy
decreases, increases
Glucose levels are ___-___% (higher, lower) than prior to pregnancy for this reason
10, 20, lower
fetus draws glucose from mother (hypoglycemia can develop)
During the second half of pregnancy, insulin sensitivity declines (insulin resistance increases) due to the effects of these five hormones
hCS, prolactin, progesterone, estrogen, cortisol
The pregnant woman uses __________ to meet energy needs
fat stores
Elevated free cortisol levels serve these two purposes in the pregnant woman
- Regulates carbohydrate and protein metabolism
- Stimulates gluconeogenesis when glucose supply is inadequate
Purpose of increased aldosterone levels in the pregnant woman
Overcomes salt-wasting effects of progesterone to maintain sodium levels and meet fetal needs
When does the placenta take over the function of estrogen and progesterone production from the corpus luteum?
10-12 weeks
Hormone that is an insulin antagonist to reduce sensitivity of maternal cells to insulin and thereby increase availability of glucose for the fetus
hCS (human chorionic somatomammotropin)
Hormone that inhibits uterine activity, softens cervical connective tissue, and lengthens pubic ligaments
relaxin
The water requirement for the body and body water (decreases, increases) during pregnancy
increases
Water metabolism is important for ___________ balance and ____________ function.
sodium, kidney
_______________ causes edema during pregnancy, which decreases venous return and increases venous pressure.
Hemodilution
Carpal tunnel syndrome may occur in pregnancy if __________ compresses the median nerve.
edema
