Chapter 2

Question 1

Presumptive signs

Answer 1

Changed the client experiences that make them think that they might be pregnant. May be subjective or objective

•Amenorrhea
•Fatigue
•Nausea and vomiting
•Urinary frequency
•Breast changes: darkened stellar, enlarged Montgomery glands
•Quickening: slight fluttering movements if the fetus felt by the client, usually between 16 to 20 weeks of gestation
•uterine enlargement

Question 2

Probable signs

Answer 2

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

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

•Hegar’s sign: softening and compressibility of lower uterus

•Chadwick’s sign: deepened violet bluish color of cervix and vaginal mucosa

•Goodell’s sign: softening of cervical tip

•Ballottement: rebound of unengaged fetus

•Braxton Hicks contractions: false contractions that are painless, irregular and usually relieved by walking

•Positive pregnancy test

•Fetal outline: felt by examiner

Question 3

Positive signs

Answer 3

Signs that can be explained only by pregnancy

•Fetal heart sounds
•Visualization of fetus by ultrasound
•Fetal movement palpated by an experienced examiner

Question 4

Nagele’s rule

Answer 4

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

Question 5

Measurement of fundal height

Answer 5

From the symphysis pubis to the top of the uterine fundus (between 18 and 30 weeks of gestation approximates the gestational age, plus or minus 2 gestational weeks) in centimeters

Question 6

Gravidity

Answer 6

Number of pregnancies

•Nulligravida: a client who has never been pregnant

•Primigravida: a client in their first pregnancy

•Multigravida: a client who has had two or more pregnancies

Question 7

Parity

Answer 7

Number of pregnancies in which the fetus or fetuses reach 20 weeks of pregnancy, not the number fetuses. Parity is not affected whether the fetus is born stillborn or alive

•Nullipara: no pregnancy beyond the stage of viability

•Primipara: has completed one pregnancy to stage of viability

Multiparty: has completed two or more pregnancies to stage viability

Question 8

Viability

Answer 8

The point in time when an infant has the capacity to survive outside the uterus
(22 to 25 weeks are considered on the threshold of viability)

Question 9

GTPAL

Answer 9

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

Question 10

Fetal heart tones

Answer 10

Are heard at a normal baseline rate of 110 to 160/min with the reassuring FHR accelerations noted, which indicates an intact fetal CNS

Question 11

Chloasma

Answer 11

An increase of pigmentation on the face

Question 12

Linea nigra

Answer 12

Dark line of pigmentation from the umbilicus extending to the pubic area

Question 13

Striae gravidarum

Answer 13

Stretch marks most notably found on the abdomen and thighs

Question 14

Cardiac output

Answer 14

Increases 30% to 5%

Question 15

Blood volume

Answer 15

Increases 30% to 45% at term

Question 16

Heart rate

Answer 16

Increases 10 to 15/min above pre pregnancy rate

Question 17

Blood pressure

Answer 17

1 trimester the same, diastolic decreases around 24-32 weeks

Question 18

Supine hypotension

Answer 18

Lower bp in supine position due to the weight and pressure of the gravid uterus on the vena cava

Question 19

Supine hypotensive syndrome/supine vena cava syndrome

Answer 19

Maternal hypotension and fetal hypoxia due to supine position