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NRSG 206: OB > [Exam 1] Chapter 11 - Maternal Adaptation During Pregnancy > Flashcards

[Exam 1] Chapter 11 - Maternal Adaptation During Pregnancy Flashcards

1
Q

S&S of Pregnancy: S&S have been grouped into what categories?

A

Presumptive, probable, and positive

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2
Q

S&S of Pregnancy - Subjective (Presumptive) Signs: What are these?

A

Signs that the mother can perceive. Most obvious sign is absence of menstruation

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3
Q

S&S of Pregnancy - Subjective (Presumptive) Signs: What signs are accompanied with skipping a period?

A

Amenorrhea, Consistent nausea, fatigue, breast tenderness, urinary frequency,

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4
Q

S&S of Pregnancy - Objective (Probably) Signs & Physical Signs: What are probable signs?

A

Probable signs of pregnancy are those that can be detected on physical examination

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5
Q

S&S of Pregnancy - Objective (Probably) Signs & Physical Signs: What probable signs of pregnancy are there?

A

Hegars Sign

Goodell’s Sign

Chadwicks Sign

Changes in Uterus, abdominal enlargement

Braxton Hicks contractions

Ballottement

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6
Q

S&S of Pregnancy - Objective (Probably) Signs & Physical Signs: What is Hegar’s Sign?

A

Softening of the lower uterine segement or isthmus

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7
Q

S&S of Pregnancy - Objective (Probably) Signs & Physical Signs: What is Goodell’s Sign?

A

Softening of the cervix

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8
Q

S&S of Pregnancy - Objective (Probably) Signs & Physical Signs: What is Chadwicks sign?

A

Blueish-purple coloration of the vaginal mucosa and cervix

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9
Q

S&S of Pregnancy - Objective (Probably) Signs & Physical Signs: What is Ballotement?

A

Examiner pushes against the womans cervix during a pelvic exaination and feels a rebound from the floating fetus

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10
Q

S&S of Pregnancy - Objective (Probably) Signs & Pregnancy Tests: When is Human Chorionic Gonadotropin (hCG) detectable in pregnancy test?

A

Detectabble in the serum of approximately 5% of clients 8 days after conception.

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11
Q

S&S of Pregnancy - Objective (Probably) Signs & Pregnancy Tests: What is an Agglutination Inhibition Tests?

A

Urine Specimen

If hCG present in urine, agglutination does not occur which is positive for pregnancy. 95% accurate in diagnosing

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12
Q

S&S of Pregnancy - Objective (Probably) Signs & Pregnancy Tests: What is Immunoradiometric Assay?

A

Blood Serum

Measures abulity of blodo sample to inhibit the binding of radiolabeled hCG to receptors. 99% accurate after 6-8 days

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13
Q

S&S of Pregnancy - Objective (Probably) Signs & Pregnancy Tests: What is Enzyme-Linked Immunosorbent Assay (ELISA)?

A

Blood serum or urine

Uses an enzyme to bond with hCG in the urine if present. Reliable 4 days after implantation

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14
Q

S&S of Pregnancy - Objective (Probably) Signs & Pregnancy Tests: What is hCG?

A

Glycoprotein and earliest biochemical marker for pregnancy.

Double every 48-72 hours until they peak 60-70 days after fertilization

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15
Q

S&S of Pregnancy - Objective (Probably) Signs & Pregnancy Tests: What are low hCG levels associated with?

A

Ectopic pregnancy

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16
Q

S&S of Pregnancy - Objective (Probably) Signs & Pregnancy Tests: What are higher than normal hCG levels associated with?

A

Molar pregnancy or multiple-gestational pregnancies

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17
Q

S&S of Pregnancy - Objective (Probably) Signs & Pregnancy Tests: How does hCG correspond with morning sickness?

A

Elevation in hCG corresponds to morning sicknes 6-12 weeks during early pregnancy

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18
Q

S&S of Pregnancy - Positive Signs: Positive signs of pregnancy confirm what?

A

Can be directly attributed to the fetus

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19
Q

S&S of Pregnancy - Positive Signs: How can a pregnancy be made certain?

A

Visualizing the fetus by ultrasound, palpating for fetal movements , and hearing a fetal heartbeat

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20
Q

Reproductive System Adaptations - Uterus: What stimules uterine growth?

A

Eestrogen

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21
Q

Reproductive System Adaptations - Uterus: Weight change of this?

A

70 g to 1100-1200 g

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22
Q

Reproductive System Adaptations - Uterus: Capacity change here?

A

10 mL to 5000 mL or more

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23
Q

Reproductive System Adaptations - Uterus: In early pregnancy, uterine growth is due to what?

A

Hyperplaia of uterine smooth muscle cells within the myometrium

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24
Q

Reproductive System Adaptations - Uterus: Major component of myometrial growth occurs after what?

A

gestation, due to smooth muscle cell hypertrophy caused by mechanial stretch of uterine tissue

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25
Q

Reproductive System Adaptations - Uterus: What changes occur in main uterine artery?

A

Doubles. Enlargement enhances the capacity of the uteroplacental vessels to accommodate the increased blood volume

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26
Q

Reproductive System Adaptations - Uterus: Braxton Hicks contractions occur. What are they?

A

Spontaneous, irregular, and painless contractions begin in first trimester. Become most noticeable during last month where they function to though out cervix before birth

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27
Q

Reproductive System Adaptations - Uterus: What happens to the lower portion of the uterus?

A

Does not undergo hypertrophy. Becomes thinenr as pregnancy progresses. Changes occur within the first 6-8 weeks, producing Hegars sign.

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28
Q

Reproductive System Adaptations - Uterus: What happens to the uterus because of Hegar Signs?

A

Softening and compressiblity of the lower urine segment results in exaggerated uterine anteflexion which adds to urinary frequency

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29
Q

Reproductive System Adaptations - Uterus: Where does the uterus remain for the first 3 months, and where does it move to?

A

Remains in pelvic cavity first, and then moves toward abdomen

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30
Q

Reproductive System Adaptations - Uterus: What does the uterus do to the inferior vena cava?

A

Falls against it, resulting in compression. Reduces venous return and decreases cardiac output and blood pressure. Occurs when women changes position from sitting to standing . Known as hypotensive syndrome

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31
Q

Reproductive System Adaptations - Uterus: Signs of hypotensive crisis?

A

Symptoms of weakness, light-headedness, nausea, dizziness, or syncope

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32
Q

Reproductive System Adaptations - Uterus: What do symptoms of hypotensive crisis change?

A

When women is in teh side-lying position, which displaces uterus to the left nd off the vena cava

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33
Q

Reproductive System Adaptations - Uterus: By 20 weeks, were is the fundus (top of uterus) located?

A

At the level of the umbilicus

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34
Q

Reproductive System Adaptations - Uterus: Fundus reaches high level when?

A

At 36 weeks

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35
Q

Reproductive System Adaptations - Uterus: What happens between weeks 38-40?

A

Fundal height drops at the fetus and begins to descent and engage into the pelvis. By 40 weeks, fetal head descents and engages in the pelvis which is termed lightening

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36
Q

Reproductive System Adaptations - Cervix: BEtween weeks 6-8 , what happens to cervix?

A

Goodells Sign (Cervixx softens) due to vasocongestion and influence of estrogen.

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37
Q

Reproductive System Adaptations - Cervix: Changes to endocervical gland?

A

Increase in size and number and produce more cervical mucus

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38
Q

Reproductive System Adaptations - Cervix: What happens because of influence of progesterone?

A

Thick mucus plug is formed that blocks the cervical os and protects the opening from bacterial invasion

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39
Q

Reproductive System Adaptations - Cervix: Chadwicks sign occurs here. What is this?

A

A cyanosis or blueish purple discoloration cervical ripening (softening, effacement, and icnreased distensibility) begins 4 weeks before birth

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40
Q

Reproductive System Adaptations - Cervix: The cervix preparing for labor results in changes in elasticity and strength. What hormones cause this?

A

Oxytocin, RElaxin, NitricOxide, and Prostaglandins

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41
Q

Reproductive System Adaptations - Vagina: What happens due to vascularity increasing?

A

Increases because of Estrogen. Results in pelvic congestion adn hypertrophy of vagina in preparation for the distention needed for birth

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42
Q

Reproductive System Adaptations - Vagina: What happens to vaginal mucos, connective tissue, and smooth muscle?

A

Vaginal mucosa thickens

CT begins to loosen

smooth muscle begins to hypertrophy

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43
Q

Reproductive System Adaptations - Vagina: What happens to vaginal secretions?

A

Become more acidic, white, and thick

Increases during pregnancy, called leukorrhea.

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44
Q

Reproductive System Adaptations - Vagina: What may happen if women reports increase of white discahrge, along with itching and irritation?

A

Candida albicans, a monilial vaginitis, which occurs in glycogen-rich environment , which can be passed to child

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45
Q

Reproductive System Adaptations - Vagina: How can candida alvicans be presented on child, and be treated?

A

White patches on the mucous membranes of their mouths and treated with local antifungal agents

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46
Q

Reproductive System Adaptations - Ovaries: Increased blood supply causes then to enlarge until when?

A

12-14 week

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47
Q

Reproductive System Adaptations - Ovaries: Why does ovulation cease during pregnancy?

A

Because of elevated levels of estrogen and progesterone, whichi block FSH and LH from anterior pituitary

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48
Q

Reproductive System Adaptations - Ovaries: Ovaries active in hormone production until 6-7 weeks, when what happens?

A

Corpus luteum mregresses and placenta takes over major production of progesterone

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49
Q

Reproductive System Adaptations - Breasts: What hormones cause them to grow?

A

Estrogen and progesterone

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50
Q

Reproductive System Adaptations - Breasts: What visual changes occur?

A

Become highly vascular and veins become visible. Nipples become larger and erect. Nipple and areola become deeply pigmented. Tubercles of Montogemery ecome prominent (keep nipples lubricated)

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51
Q

Reproductive System Adaptations - Breasts: What do changes in connective tissue of breasts lead to?

A

Striae (stretch marks) in half of women.

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52
Q

Reproductive System Adaptations - Breasts: What is colostrum?

A

Creamy, yellowish breast fluid that can be expressed by third trimester. Provides nourishment for breast-feeding

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53
Q

General Body System Adaptations - GI System: What happens to gums?

A

Become hyperremic, swollen, and friable and tend to bleed easily. Influenced by estrogen and increased proliferation of blood vessels

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54
Q

General Body System Adaptations - GI System: Excessive salivation (ptyalism) may occur, why?

A

By decrease in unconscious swallowing by woman when nauseated . Typically resolves spontaneously

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55
Q

General Body System Adaptations - GI System: Why is gingivitis and other dentral diseases an issue?

A

Because of increased production of female hormones during pregnancy.

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56
Q

General Body System Adaptations - GI System: What changes occur here related to influence of progesterone?

A

Smooth muscle relaxation and decreased peristalsis . Results in delayed gastric emptying

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57
Q

General Body System Adaptations - GI System: Why may constipation occur?

A

From low-fiber choices, reduced fluid intake, use of iron, decreased activity level, and intestinal displacement

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58
Q

General Body System Adaptations - GI System: What contributes to formation of hemorrhoids?

A

Constipation, increased venous pressure, and pressure of uterus

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59
Q

General Body System Adaptations - GI System: Emptying time of gallbladder is prolonged, which can lead to what issue?

A

Hypercholesterolemia, with increased risk of gallstone formation.

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60
Q

General Body System Adaptations - GI System: What drug has been approved ot treat morning sickness?

A

Doxylamine succinate 10 mg/pyridoxine hydrochloride 10 mg

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61
Q

General Body System Adaptations - Cardiovascular: What changes occur to heart rate, CO, blood volume, and plasma volume?

A

25% increase in HR

CO increased by 30-50%

Increased blood volume

Increased plasma volume

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62
Q

General Body System Adaptations - Cardiovascular and Blood Volume: What changes occur here?

A

Increase by 1500 mL (50%) by 32nd week.

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63
Q

General Body System Adaptations - Cardiovascular and Blood Volume: Why is there an increase in blood volume?

A

Needed to provide adequate hydration of fetal and maternal tissues to supply blood flow to perfuse and provde a reserve to compensate for blood loss

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64
Q

General Body System Adaptations - Cardiovascular and Blood Volume: What happens to the maternal blood because of this increase?

A

REsult in physiologic anemia and hemodilution

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65
Q

General Body System Adaptations - Cardiovascular and Blood Volume: Criteria for physiologic anemia?

A

Hemoglobin 10 g or less

RBC 3.5 million

Normal Morphology with Cenral Pallor

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66
Q

General Body System Adaptations - Cardiovascular with CO and HR: CO increases how much?

A

30-50 % by 32nd week and decliens to about 20% increase at 40 weeks

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67
Q

General Body System Adaptations - Cardiovascular with CO and HR: Why is there an increase in CO?

A

Associated with increase in venous return adn greater right ventricular output, especially in left lateral position

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68
Q

General Body System Adaptations - Cardiovascular and BP: What happens to his?

A

Declines slightly during pregnancy (especially diastolic) as a result of vasodilation from progesterone

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69
Q

General Body System Adaptations - Cardiovascular and BP: Changes in blood pressure during second trimester?

A

Decreases 5-10 mmHg

70
Q

General Body System Adaptations - Cardiovascular and BP: Gestational hypertension may occur, which is what?

A

Onset of hypertension (systolic of 140 or higher and distolic of 90 or higher) after 20 weeks

71
Q

General Body System Adaptations - Cardiovascular and Blood Components: How much of an increase is there of red blood cells?

A

25-33% higher.

72
Q

General Body System Adaptations - Cardiovascular and Blood Components: Although there is an increase in RBCs, ther is also an increase in what?

A

Greater in crease in plasma volume because of hormonal factors and sodium and water retention. This causes Hgb and Hct to decline

73
Q

General Body System Adaptations - Cardiovascular and Blood Components: What is the state of hemodilution referred to as?

A

physiologic anemia of pregnancy

74
Q

General Body System Adaptations - Cardiovascular and Blood Components: Changes in RBC volume due to what?

A

increased circulating erythropoietin and accelerated red blood cell production

75
Q

General Body System Adaptations - Cardiovascular and Blood Components: Rise in erythropoietin in last two trimesters is stimualted by what?

A

Progesterone, prolactin and human placental lactogen

76
Q

General Body System Adaptations - Cardiovascular and Blood Components: What nutrient is needed more?

A

Iron, to compensate for fetus requirements. Fetal tissues prevail over mothers tissues for iron stores.

77
Q

General Body System Adaptations - Cardiovascular and Blood Components: What happens to fibrin and plasma fibrinogen?

A

Levels increase along with various blood-clotting factors. Make pregnancy a hypercoagulable state. Contributes to slowed venous return, pooling, and dependent edema

78
Q

General Body System Adaptations - Respiratory: Oxygen consumption increases by howo much?

A

20-30% until full term is reached

79
Q

General Body System Adaptations - Respiratory: Because of increased tidal volume, what changes occur for woman?

A

Hyperventilation and hypocapnia. Breathing becomes more diaphragmatic than abdominal

80
Q

General Body System Adaptations - Respiratory: Increased vascularity of respiratory tract influenced by?

A

Increased estrogen levels, leading to congestion.

81
Q

General Body System Adaptations - Renal/Urinary: What changes occur to the kidneys?

A

Dilation of renal pelvis and uterus. Occurs as result of the hormonal influences of estrogen and progesterone, pressure from enlarging uterus, and increase in maternal blood volume

82
Q

General Body System Adaptations - Renal/Urinary: What changes does progesterone cause to kidney?

A

Renal pelvis becomes dilated, and the ureters elongate and become more curved

83
Q

General Body System Adaptations - Renal/Urinary: Blood flow to the kidneys increase by how much?

A

50-80% because of increased cardiac output and relaxin.

84
Q

General Body System Adaptations - Musculoskeletal: Why do the ligaments that hold sacroiliac joints and the pubis symphysis begin to soften and stretch?

A

Purpose is to increase pelvic cavity and to make delivery easier

85
Q

General Body System Adaptations - Musculoskeletal: What may result in lower back pain?

A

Increased swayback and an upper spine extension to compensate for enlarging abdomen coupled with loosening of sacroiliac joints

86
Q

General Body System Adaptations - Integumentary: What is responsible for most skin changes in preganancy?

A

Increased activity of maternal adrenal and pituitary glands

Increased cortisone levels

Accelerated metabolism

Enhanced production of progesterone and estrogenic hormones

87
Q

General Body System Adaptations - Integumentary: Why do womens skin become hyperpigmentated?

A

Because of estrogen, progesterone , and melanocyte-stimulating hormone levels

88
Q

General Body System Adaptations - Integumentary: What is Facial Melasma?

A

The increased pigmentation that occurs on the breasts and genitalia can also develop on the face to form a “mask of pregnancy”

89
Q

General Body System Adaptations - Integumentary: Some women develop linea nigra, what is this?

A

Skin in the middle of the abdomen may develop a pigemented lime

90
Q

General Body System Adaptations - Vascular Skin Changes: Vascular changes during pregnancy include what?

A

Varicosities of the legs, vuvlva, and perineum. Often result of distention, instability, and poor circulation

91
Q

General Body System Adaptations - Vascular Skin Changes: What decreases risk of developing varicosities?

A

Elevating both legs when sitting

Avoiding prolonges tanding

Resting in left position

Walking daily

92
Q

General Body System Adaptations - Vascular Skin Changes: What are vascular spiders?

A

Appearance of small blood vessels. May appear in neck, thorax, face, and arms.

93
Q

General Body System Adaptations - Thyroid Gland: Why does it become more active and enlarge?

A

Because of increase vascularity and hyperplasia

94
Q

General Body System Adaptations - Thyroid Gland: What hormone does the mother continue to provide, even when baby can produdce their own?

A

Thyroxin (T4).

95
Q

General Body System Adaptations - Thyroid Gland: Low maternal thyroid levels with thyroid insufficiency, hypothyroidism, or low inadeqate iodine may compromise what

A

fetal neurologic development

96
Q

General Body System Adaptations - Pituitary Gland: What happens to FSH and LH?

A

Are inhibited during pregnancy, because of hCG from placenta and increased secretion of prolactin by anterior pituitary gland

97
Q

General Body System Adaptations - Pituitary Gland: What happens to tSH?

A

Reduced during first trimester, but returns to normal. Thought to be a factor for morning sickness

98
Q

General Body System Adaptations - Pituitary Gland: What happens to GH?

A

Decrease in GH because action of human placental lactogen (hPL) is thought to decrease the need and use of HG

99
Q

General Body System Adaptations - Pituitary Gland: What happens to Prolactin?

A

Secreted in pulses and increases 10-fold to promote breast development . Progesterone released by placenta inhibit this during pregnancy, suppressing lactation

100
Q

General Body System Adaptations - Pituitary Gland: What is Oxytocin responsible for?

A

Uterine contractions, both before and after delivery. Muscle layers of uterus (myometrium) become more sensitive to oxytocin near term.

101
Q

General Body System Adaptations - Pituitary Gland: What happens near end of term for OXytocin?

A

PRogesterone declines and contractions are nol onger suppressed

102
Q

General Body System Adaptations - Pituitary Gland: What is Oxytocin responsible for breast wise?

A

Milk ejection durign breast feeding.

103
Q

General Body System Adaptations - Pancreas: What does a beta cell produdce and do?

A

Insulin which lowers blood glucose by increase rate of glucose uptake and utilization by most body cell.

104
Q

General Body System Adaptations - Adrenal Glands: Key change in here?

A

Increase in cortisol secretion, which regulates carbohydrate and protein metabolism and helpful in times of stress.

105
Q

General Body System Adaptations - Adrenal Glands: Cortisol increases in response to what?

A

Increased estrogen levels throughout pregnancy

106
Q

General Body System Adaptations - Adrenal Glands: What does cortisol help with during pregnancy?

A

Helps keep up level of glucose in plasma

Breaks down proteins to repair tissues

Gas anti-insulin, anti-inflammatory actions

Is needed to make precursors of adrenaline

107
Q

General Body System Adaptations - Adrenal Glands: What does Aldosterone help with?

A

Key regulator of electrolyte and water homeostasis and plays a central role in blood pressure regulation.

108
Q

General Body System Adaptations - Prostaglandin Secretion: What do they play a part in?

A

Softening the cervix and initiaitng and maintaining labor but exact mechanism unclear.

109
Q

General Body System Adaptations - Placental Secretion: Placenta produces what hormones?

A 
hCG
hPL
Relaxin
Progesterone
Estrogen
110
Q

General Body System Adaptations - Immune: What happens here?

A

General enhancement of innate immunuity (inflammatory response and phagocytosis) and suppression of adaptive immunity (protective response to a specific foreign antigen

111
Q

Changing Nutritional Needs of Pregnancy: Inadequate nutritional intake is associated with what?

A

preterm birth, low birth weight, and congenital anomalies

112
Q

Changing Nutritional Needs of Pregnancy: Excessive nutritonal intake is associated with what?

A

Fetal macrosomia (>4000g) leading to difficult birth, neonatal hypoglycemia, and continued obesity in the mother and potential for ochildhood obesity

113
Q

Changing Nutritional Needs of Pregnancy: What particular vitamins need to be supplemented?

A

Iron and folic acid because of their increased requirements during pregnancy

114
Q

Changing Nutritional Needs of Pregnancy: Why are iron and folic acid needed?

A

To form new blood cells for the expanded maternal blood volume and to prevent anemia

115
Q

Changing Nutritional Needs of Pregnancy: Why is iron essential?

A

for fetal growth and brain development and in the prevention of maternal anemia

116
Q

Changing Nutritional Needs of Pregnancy: Increase in folic necessary why?

A

to prevent neural tube defects in the fetus .

117
Q

Changing Nutritional Needs of Pregnancy: How much iron is supplemented?

118
Q

Changing Nutritional Needs of Pregnancy: How much folic acid is supplemented?

119
Q

Changing Nutritional Needs of Pregnancy: Which fats are the best to consume?

A

Unsaturated fats

120
Q

Gluten Free Diet During Pregnancy: Why are gluten free foods bad?

A

They contain more fat, including saturated, and sodium but fewer minerals and vitamins

121
Q

Gluten Free Diet During Pregnancy: Calories in pregnant and lactating woman?

A

2500 and 2700

122
Q

Gluten Free Diet During Pregnancy: What nutrients will a woman struggle with?

A

Folate, Vitamin B, Iron, ,Calcium, fiber, and Grain

123
Q

USDA and MyPlate: What did the USDA develop for pregnant women?

A

Interactive online diet-planning program called the Daily Food Plan for Moms that help personalize their dietary intake

124
Q

Food Concerns and Artifical Sweeteners: Can they be used?

A

Some recommend not using them at all, while others tell them to use it in moderation

125
Q

Food Concerns and Fish, Shellfish, Mercury Levels: Why are fish and shellfish important?

A

Contain high-quality protein, low in saturated fat, and contain omega-3 fatty acids

126
Q

Food Concerns and Fish, Shellfish, Mercury Levels: What fish should be avoided because of high levels of mercury?

A

Shark, swordfish, king mackerel, orange roughy, ahi tube, and tilefish

127
Q

Food Concerns and Listeriosis: What is this?

A

It is a gram-positive bacteria found in soil, water, and sometimes on plants. Commonly found in processed and prepared foods and in raw or unpasteurized milk

128
Q

Food Concerns and Listeriosis: What does this show itself as durign pregnancy?

A

Usually presents as an unremarkable febrile illness but can be fatal to fetuus

129
Q

Food Concerns and Listeriosis: This can be passesd to an unborn baby through placenta, leaidng to what issues?

A

Preterm births, miscarriges, stillbirths, and high neonatal mortality rates

130
Q

Food Concerns and Listeriosis: How to avoid this?

A

Don’t eat hotdogs, lunch meat until hot.

Don’t get fluid froom hot dog packages on food

Do not eat soft cheeses

Do not eat refrigerated smoked seafood

131
Q

Maternal Weight Gain: Normal infant birth weight?

132
Q

Maternal Weight Gain: What is considered to be an underweight BMI?

A

< 18.5 = Weight gain range 28-40 lbs

133
Q

Maternal Weight Gain: What is considered to be a normal weight BMI?

A

18.5 - 24.9 . Weight gain range 25 to 35

134
Q

Maternal Weight Gain: What is considered to be an overweight BMI?

A

25-29.9 with total weight gain range 15-25

135
Q

Maternal Weight Gain: What is an obese BMI?

A

30 0or higher. Total weight gain 11-20 lbs

136
Q

Maternal Weight Gain: Why should a woman who is underweight be monitored?

A

Shes at risk for giving birth to a low-birth weight infant (less than 5.5 lbs)

137
Q

Maternal Weight Gain: Women who are overweight during pregnancy should gain no more than how many lbs?

138
Q

Maternal Weight Gain: What is the best way to assess whether a pregnant woman is consuming enough calories?

A

To follow her pattern of weight gain. Should aim for a steady rate of weight gain throughout pregnancy

139
Q

Maternal Weight Gain: Weight gain during first trimester?

A

3.5 - 5 lbs

140
Q

Maternal Weight Gain: Weight gain during first trimester for underweight woman?

A

Should be at least 5 lbs

141
Q

Maternal Weight Gain: Weight gain during first trimester for overweight women?

A

About 2 lbs

142
Q

Maternal Weight Gain: During 2nd and 3rd trimester, how much weight should theyg ain?

A

About 1 lb per week

143
Q

Cultural Variations: Variations of Bread, Cereal, Rice?

A

Bolillo, Couscous, Flaxseed, Hau Juan

144
Q

Cultural Variations: Variations of Vegetable Group?

A

Agave, Bok Choy, Jicama, Okra, Water Chestnuts

145
Q

Cultural Variations: Variations of Proteins?

A

Bean paste, blood sausage, legums, shellfish

146
Q

Cultural Variations: Variations of Fruit group?

A

Catalpa, Kumquats, Plantain, Yucca Fruit

147
Q

Cultural Variations: Variations of Milk and Dairy?

A

Buffalo Milk, Buttermilk, Soy Milk

148
Q

Lactose Intolerance: Women here are unable to break down and absorb what?

A

Cannot break down lactose, and cannot consume simple sugars, glucose, and galactose

149
Q

Lactose Intolerance: Other sources to consume calcium?

A

Peanuts, almonds, sunflower seeds, broccoli, salon, kale, and molasses

150
Q

Vegetarians: What do Lacto–Ovo Vegans omit?

A

Red meat, fish and poultry, but eat eggs, milk, and dairy products along with plant foods

151
Q

Vegetarians: What do Lacto-Vegetarians consume?

A

Milk and dairy along with plant-based

Omit eggs, meat, fish, and poultry

152
Q

Vegetarians: What do vegans eliminate?

A

All foods from animals including milk, eggs, and cheese and eat only plant based foods

153
Q

Vegetarians: Problems that may occur because of vegan diet?

A

low gestational weight gain, iron-deficiency anemia, compromised protein utilization and decreased mineral absorption

154
Q

Vegetarians: What should be subbed for proteins?

A

Soy foods, beans, lentils, uts, grains and seeds

155
Q

Vegetarians: What should be subbed for iron?

A

Eat variety of meat alternatives along with vitamin c rich foods

156
Q

Vegetarians: Sub for clacium?

A

Sub soy, calcium-fortified orange juice, and tofu

157
Q

Vegetarians: Sub for Vit B12?

A

Fortified soy foods and B12 supplements

158
Q

Pica: Common substances consumed include what?

A

Dirt, Clay and LAundry Starch.

Burnt matches, stones, charcoal, mothballs, ice, cornstarch, toothpaste, soap, and sand

159
Q

Pica: The three main substances consumed by women with pica are what?

A

Soil or Clay (Geophagia)

Ice (Pagophagia) and

Laundry Starch (Amylophagia)

160
Q

Pica: When is suspect pica indicated?

A

When woman exhibits anemia although her dietary intake is appropriate

161
Q

Psychosocial Adaptations during Pregnancy and Maternal Emotional Response - Ambivalence: What is this?

A

Having conflicting feelings at teh same time. Usually during first trimester. Evolves into acceptance by second trimester when m ovement felt.

162
Q

Psychosocial Adaptations during Pregnancy and Maternal Emotional Response - Introversion: What is this?

A

Focusing on oneself. WOman may withdraw and become incresingly preoccupied with herself and her fetus. Heightens during 1st and 3rd trimester.

163
Q

Psychosocial Adaptations during Pregnancy and Maternal Emotional Response - Acceptance: What occurs during 2nd trimester?

A

Physical changes of growing fetus, including an enlarging abdomen bring reality and validity to the pregnancy.

164
Q

Pregnancy and the PArtner: Partners may experience couvade syndrome, which is what?

A

They main gain weight aroun hte middle and experience nausea and other GI disturbances which is a sympathetic response to otheir partners pregnancy

165
Q

What factors would change during a pregnancy if the hormone progesterone were reduced or withdrawn?

The woman’s gums would become red and swollen and would bleed easily.
The uterus would contract more and peristalsis would increase.
Morning sickness would increase and would be prolonged.
The secretion of prolactin by the pituitary gland would be inhibited.
A

The uterus would ocnract more and peristalsis would increase

166
Q

Which of the following is a presumptive sign or symptom of pregnancy?

Restlessness
Elevated mood
Urinary frequency
Low backache
A

Urinary Frequency

167
Q

When obtaining a blood test for pregnancy, which hormone would the nurse expect the test to measure?

Human chorionic gonadotropin (hCG)
Human placental lactogen (hPL)
Follicle-stimulating hormone (FSH)
Luteinizing hormone (LH)
A

Human chorionic gonadotropin (hCG)

168
Q

During pregnancy, which of the following should the expectant mother reduce or avoid?

Raw meat or uncooked shellfish
Fresh, washed fruits and vegetables
Whole grains and cereals
Protein and iron from meat sources
A

Raw meat or uncooked shellfish

169
Q

A feeling expressed by most women upon learning they are pregnant is:

Acceptance
Depression
Jealousy
Ambivalence
A

Ambivalence

170
Q

Reva Rubin identified four major tasks that the pregnant woman undertakes to form a mutually gratifying relationship with her infant. What is “binding in”?

Ensuring safe passage through pregnancy, labor, and birth
Seeking acceptance of this infant by others
Seeking acceptance of self as mother to the infant
Learning to give of oneself on behalf of the infant
A

Seeking acceptance of self as mother ot the infant

171
Q

A pregnant client close to term comes into the clinic for an exam. The woman complains about experiencing shortness of breath. The nurse knows that this complaint can be explained as the:

Fetus is needing more oxygen now that his/her size is larger.
Fundus of the uterus is high and pushing the diaphragm upwards.
Woman is experiencing an allergic reaction because of high histamine levels.
Oxygen partial pressure concentration is lower in the third trimester.
A

Fundus of the uterus is high and pushing the diaphragm upwards

172
Q

Which of the following fish should be limited in a pregnant woman’s diet because of the high mercury content?

Salmon
Cod
Shrimp
Sword fish
A

Sword Fish

NRSG 206: OB (42 decks)

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