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Maternity > Exam 1: Chapter 11 and 12 > Flashcards

Exam 1: Chapter 11 and 12 Flashcards

1
Q

Divide the weeks of pregnancy into their corresponding trimesters

A

first: week 1 through 13
second: week 14 through 26
third: week 27 through 40

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2
Q

Presumptive signs and symptoms of pregnancy

A

Amenorrhea (4 weeks)

Fatigue (12 weeks)

Breast tenderness (3 to 4 weeks)

N/V (4 to 14 weeks)

Urinary frequency (6 to 12 weeks)

Hyperpigmentation of skin

Fetal movements (quickening) –> could be gas

Uterine enlargement

Breast enlargement

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3
Q

Probable signs and symptoms of pregnancy

A

Braxton hicks contractions

Abdominal uterine enlargement

positive pregnancy test

Ballotement

Hegar’s signs: softening of the lower uterine segment or isthmus

chadwicks

Goodell’s sign

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4
Q

Pregnancy test: HCG can be detected as early as ___ to ___ days after conception

A

7 to 10

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5
Q

Positive signs and symptoms of pregnancy

A

ultrasound verification

fetal movement felt by experience clinician

auscultation of fetal heart with doppler

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6
Q

What is hegar’s sign

A

softening of the lower uterine segment or isthmus

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7
Q

What is chadwicks sign

A

bluish purple coloration of the vaginal mucosa and cervix

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8
Q

Purpose of ultrasound during the first trimester

A

confirm pregnancy, FHR, date

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9
Q

Purpose of ultrasound during the second trimester

A

congenital malformation, exclude multifetal pregnancies, verify date and growth, gender

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10
Q

Purpose of ultrasound during the third trimester

A

fetal size, fetal growth, placenttal position

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11
Q

_______ is the best method of dating a pregnancy

A

ultrasound

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12
Q

Define term

A

pregnancy from beginning of week 37 of gestation to end of week 42 of gestation

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13
Q

Define pre-term

A

less than 37 weeks gestation

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14
Q

Define post-term

A

more than 42 weeks of gestation

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15
Q

Viability

A

capacity to live outside uterus

about 22 to 24 weeks since LMP or fetal weight greater than 500 grams

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16
Q

G ?
T
P
A
L

A

Gravida: number of total pregnancies

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17
Q

G
T ?
P
A
L

A

term birth: term deliveries that are over 37 weeks gestation

T and P= multiple pregnancies (twins, triplets, etc) count as 1. This is the same for A.

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18
Q

G
T
P ?
A
L

A

pre term births: pre term deliveries over 20 weeks or viability but before 37 weeks

T and P= multiple pregnancies (twins, triplets, etc) count as 1. This is the same for A.

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19
Q

G
T
P
A ?
L

A

abortions/miscarriage: the number of pregnancies ending before 20 weeks or viability

T and P= multiple pregnancies (twins, triplets, etc) count as 1. This is the same for A.

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20
Q

G
T
P
A
L ?

A

Living children

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21
Q

How does the uterus change during the course of pregnancy

A

pear shape to ovoid shape

increase in size, weight, length
(fundal height by 20 weeks’ gestation at level of umbilicus (20cm))

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22
Q

What is Vena Cava Syndrome

A

The heavy gravid uterus in the last trimester can fall back against the inferiorvenacavain the supine position, resulting invenacavacompression, which reduces venous return and decreases cardiac output and blood pressure, with increasing orthostatic stress.

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23
Q

What do we tell expecting mothers to do to combat vena cava syndrome

A

Sleep on their sides never supine

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24
Q

What is colostrum

A

antibody rich yellow fluid that can be expressed after the 12th week; conversion to mature milk after delivery

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25
Q

GI system adaptations: ptyalism

A

excessive salivation

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25
Q

GI system adaptations: dental problems

A

gingivitis

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25
Q

GI system adaptations: gums

A

hyperemic, swollen, friable

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26
Q

GI system adaptations: ______ peristalsis and smooth muscle relaxation

A

decreased

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27
Q

_____ + _______ +________ = hemorrhoids

A

constipation, increased venous pressure, pressure from uterus

28
Q

______ + ______ = reflux/heartburn

A

slowed gastric emptying, relaxed cardiac sphincter

29
Q

Cardiac system adaptations: ______ in CO, venous return, heart rate

A

increased

30
Q

Cardiac system adaptations: BP during the different trimesters

A

1st: remain at pre pregnancy level
2nd: decreases (5 to 10 mmhg)
3rd: returns to the first trimester level

31
Q

Cardiac system adaptations: _________ in number of RBC

A

increase by about 30%

plasma volume is still greater than RBC leading to hemodilution and anemia

32
Q

Cardiac system adaptations: ________ demandes in iron, fibrin and plasma, fibrinogen levels, and some CF leading to…

A

increase

hypercoagulable state

33
Q

Cardiac system adaptations: WBC count is

A

increased –> leukocytosis

34
Q

Respiratory adaptations: breathing

A

more diaphragmatic than abdominal

35
Q

Respiratory adaptations: _____ in O2 consumption

A

increase

36
Q

Respiratory adaptations: Congestion secondary to increased vascularity (estrogen) =

A

epistaxis and rhinitis

37
Q

Renal/ Urinary system adaptations: _________ in GFR, urine flow, and volume

A

increase

38
Q

Renal/ Urinary system adaptations: ______ in kidney activity when a woman lies down, ______ on standing; greater _______ in later pregnancy when the woman lies on her side

A

increase; decrease; increase

39
Q

Musculoskeletal system adaptations: Ligaments and joint

A

soften and stretch

40
Q

Musculoskeletal system adaptations: posture

A

increased swayback and upper spine extension

41
Q

Musculoskeletal system adaptations: center of gravity

A

shifts forward

42
Q

Musculoskeletal system adaptations: _____ in lumbarsacral curve

A

increase

lordosis

43
Q

Musculoskeletal system adaptations: _____ gait

A

waddle

44
Q

Musculoskeletal system adaptations: what can happen to the muscles in our abdomen?

A

diastasis recti become flaccid and with time the hormones decrease and they strengthen again

45
Q

Integumentary system adaptations: hyperpigmentation

A

preogresterone, estrogen, melanocyte stimulating hormone levels

46
Q

Integumentary system adaptations:
what is the mask of prenancy

A

facial melasma or cholasma

47
Q

Integumentary system adaptations:
linae nigra

A

umbilicus

48
Q

Integumentary system adaptations:
striae gravidorum

A

stretch marks reduce connective tissue strenth

49
Q

Integumentary system adaptations:
varicosities

A

poor circulation, uterus compression

50
Q

Endocrine system adaptations: Thyroid

A

slight enlargement

increased activity

increased vascularity and hyperplasia

maternal thyroid hormone is transferred to the fetus beginning soon after the conception, this is critical for fetal brain development

51
Q

Endocrine system adaptations: Pituitary gland

A

decrease in TSH and GH

inhibition of FSH and LH

increase in prolactin, MSH

oxytoxin prodution increass as the fetus matures

52
Q

Maternal emotional responses: Ambivalence

A

conflicting feelings is the most common in the first trimester

53
Q

Maternal emotional responses: introversion

A

mother become increasingly preoccupied with herself and her fetus

54
Q

Maternal emotional responses: acceptance

A

physical changes of the growing fetus, enlarging abdomen and fetal movement bring reality and validity to the pregnancy (2nd trimester)

55
Q

Sexuality with pregnancy

A

sexual behavior modifies as pregnancy progresses

during second trimester your labido is up

56
Q

When are prenatal visits scheduled

A

every 4 weeks up to week 28

every 2 weeks from week 29 to 36

every week from 37 weeks to birth

57
Q

What are the main discomforts during the 1st trimester

A

urinary frequency: decrease fluid in before bedtime, reduce caffeine, kegels

fatigue: attempt full night sleep, side lying position

N/V: eat small frequent meals, bland and low fat

Breast tenderness

Constipation

Nasal stuffiness, bleeding gums, epistaxis

Cravings

Leukorrhea

58
Q

What are the main discomforts during the 2nd trimester

A

Backache

Varicosities of the vulva and legs

Hemorrhoids

Flatulence with bloating

59
Q

What are the main discomforts during the 3rd trimester

A

Return of the 1st trimester discomforts plus…

SOB

Heartburn and indigestion

Dependent edema

Braxton hicks contractions

60
Q

Childbirth education: Lamaze (psychoprophylactic) method

A

focus on breathing and relaxation techniques.

61
Q

Bradley (partner-coached childbirth) method:

A

focus on exercises and slow, controlled abdominal breathing.

62
Q

Dick-Read (natural childbirth) method:

A

focus on fear reduction via knowledge and abdominal breathing techniques.

63
Q

Micronutrients:

For fetus…
Iron is essential for
folic acid essential for

A

fetal growth and brain development

prevention of neural tube defects

64
Q

Pregnant women intake of

protein
calories
water

A

80 g/d

2500 cal/d

8 glasses/d

65
Q

lactating women intake of

protein
calories
water

A

80 g/d

2700 cal/day

8 glasses/day

66
Q

What fish do we avoid because they are high in mercury

A

shark
swordfish
king mackerel
orange roughy
ahi tuna
titlefish

67
Q

What fish can we eat because they are low in mercury level

A

shrimp
canned light tuna
pollock
catfish
tilapia
salmon
cod

68
Q

Maternal weight gain BMI

A

Below 18.5: underweight
25.0-29.9 overweight
Over 3.0 is obese

69
Q
A

Maternity (9 decks)

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