Chapter 4-19

Question 1

What are probable signs of pregnancy?

Answer 1

Blood flow of uterus is increases
Goodell sign: Softening of cervix
Hegar’s Sign: Softening of lower uterine segment
Chadwick’s sign: bluish coloration of cervix, vaginal mucosa, and vulva

Question 2

Physiological changes: Breast (Prepare for lactation)

Answer 2

• Increased estrogen and progesterone levels→ Initially produced by the corpus luteum and then by the placenta.
• Increases weight of breast
• Tenderness, feeling of fullness, and tingling sensation
• Increased blood supply to breast
• Enlargement of breasts, nipples, areola, and Montgomery follicles
• Striae: Due to stretching of skin to accommodate to enlarging breast tissue
• Prominent veins due to twofold increase in blood flow

Question 3

Physiological changes: Reproductive System- Uterus, Cervix, and Vagina

Answer 3

• Hypertrophy of uterine wall
• Softening of vaginal muscle and connective tissue in
• Braxton Hicks contractions
• Acid environment inhibits growth of bacteria

Question 4

Physiological Changes: Cardiovascular System

Answer 4

-Decreased blood pressure
-Increased CO, Increased, -Blood volume and increase in heart size
-Increased RBC count and RBC volume
Leads to anemia a
-Increased WBC→ Values up to 16,000 in absence of infection
-Increased demand for iron in fetal development→ Hemoglobin <11g/dL
-Hyper-coagulability bc of plasma fibrin and fibrinogen

Question 5

Supine Hypotension Syndome

Answer 5

Decreased blood pressure because of compression pf IVC by fetus when laying on the back–> feeling dizzy and faint

Question 6

Physiological Changes: Respiratory System

Answer 6

• Increase in RR
• Decrease expiratory volume
• Slight hyperventilation
• Slight Alkalosis→ promotes Co2 away from fetus
• Estrogen, progesterone, and prostaglandins cause vascular engorgement and smooth muscle relaxation
• Dyspnea
• Nasal and sinus congestion
• Nose bleeds (epistaxis)

Question 7

Physiological Changes: Renal System

Answer 7

Increased renal blood flow in first trimester
Increased progesterone levels causes relaxation of smooth muscles
Urinary frequency and incontinence and UTI
Pressure enlarging uterus on renal structures
Urinary frequency and nocturia
Increased glycosuria and proteinuria

Question 8

Physiological Changes:

Gastrointestinal

Answer 8

Increased levels of hCG and altered carbohydrate metabolism
Nausea and vomiting during early pregnancy
Heartburn→ Slows stomach emptying and digestion process and movement of stool
Increased risk of gallstone formation and cholestasis
Increase of decrease of appetite
Pica
Increased levels of estrogen lead to increased vascular congestion and mucosa
Gingivitis, bleeding gums, increased risk of periodontal disease

Question 9

Physiological Changes:

Musculoskeletal

Answer 9

Altered gait: Waddle gait
Low back pain or pelvic discomfort
Increased lordosis and change in posture because of shift of gravity
Round ligament spasm
Increased risk of joint pain and injury
Diastasis recti

Question 10

Physiological Changes:

Integumentary System

Answer 10

Estrogen and progesterone stimulate increased melanin disposition, causing light brown and dark brown pigmentation
Linea nigra
Melasma(cholasama)
Increased pigmentation of nipples, areola, vulva, and moles
Hot flashes, facial flushing, alterations of hot and cold, increased perspiration
Stretchmarks
Angiomas
Palmar erythema
Increased oiliness of skin and increase of acne