Expected Physiological Changes in Pregnancy Flashcards
how long does pregnancy span?
9 months
- 10 lunar months of 28 days
- 40 weeks
- 280 days
first trimester
week 1 - week 12 and 6 days
where is the uterus during the first trimester?
behind the pubic symphysis
initial visit
Questions about pregnancy, symptoms, feelings about pregnancy, and hopes for pregnancy LMP Medication supplements Educate and avoid drugs Limit caffeine to 2 cups or less Cramping? Bleeding? Planned pregnancy? Social supports?
second trimester
week 13 - week 26 and 6 days
third trimester
week 27 - week 40
up to how many weeks is it considered an abortion?
20 weeks
after how many weeks is the fetus viable?
27 weeks
preterm
prior to 37 weeks gestational age
term
pregnancy between 37-42 weeks
post term
after 42 weeks of pregnancy
striae gravidum
stretch marks which are common on the breasts, lungs, thighs, and abdomen
may appear dark or red then become pale or silvery over time
linea nigra
dark line from the pubic symphysis to the fundus is more often with women with darker skin and disappears after pregnancy
chloasma
the mask of pregnancy that darkens with sun exposure and disappears after pregnancy
thrombocytopenia
low platelets
when pregnant, what level of RBCs in the CBC is considered anemia?
below 10.7
urinary frequence or incontinence remedies
Kegels, empty bladder often, decrease caffeine
fatigue remedies
eat healthy diet, take naps, feeling tired? Rest, stay away from caffeine
nausea and vomiting remedies
avoid empty stomach, crackers prn, avoid greasy food, fried food, strong odors
backache remedies
heating pad on low setting, support with pillows, attention to posture and back exercises
leg cramp remedies
elevate legs and when they cramp, straighten legs and felt feet to head
varicosities remedies
walk daily, elevate legs, avoid standing, don’t cross legs, support stockings
hemorrhoid remedies
BM daily, fiber rich foods, exercise daily, witch hazel compresses
constipation remedies
Increase fluids, exercise daily, decrease cheese, ground flax seeds 1 TBS/day
heartburn remedies
Avoid spicy or greasy foods, eat sm. Frequent meals, avoid caffeine, sleep on pillows, sips of water, few antacids
Kelly is having her 4th pregnancy. She has had 1 miscarriage and one term baby who is 4 years old and a set of preterm twins who are now 2 years old. What is her GTPAL?
G4 1113
During the 1st prenatal exam, Sally had laboratory tests done by drawing blood. Which tests will be obtained?
A. CBC B. Rh factor C. Rubella titer D. Group B Strep E. Maternal serum alpha-fetoprotein
A, B, C
why is Rh factor important?
It indicates whether the blood of two different people is compatible when mixed – such as the blood of a mother and her baby at birth
Baby is Rh pos and the mom is Rh neg
Second baby is the one that is at risk
what would a rubella infection or vaccination do to the fetus?
blind, birth defects, and cognitive disabilities
Kelly’s LMP (1st day of last menses) it is estimated the pregnancy is approximately 6 weeks gestation. At this gestational age, which findings on a sonogram would confirm the pregnancy? (choose all that apply) A. Fetal pole B. Cardiac activity C. Gestational sac D. Biparietal diameter E. Placental location
A, B, C
If a pregnant woman’s LMP was (9/20), What would her due date be?
A. May 27
B. June 13
C. June 27
D. July 20
C
Tanya’s next prenatal appointment is in 4 weeks. She is instructed to call the provider’s office if which of the following signs and symptoms occur before the next visit? (Select all that apply)
A. Vaginal bleeding B. Abdominal cramping C. Dysuria D. Temperature >100.4 E. Change in fetal activity?
A, B, ??
when will the uterus be at the umbilicus?
at 20 weeks
presumptive signs
changes that a client experiences that makes them think they might be pregnant but it could be other factors
Amenorrhea
Breast tenderness
Nausea
Urinary frequency
probable signs
changes that would make an examiner expect that the person is pregnant
Braxton Hicks contractions
Positive pregnancy test
Softening of the cervix (Goodell’s sign)
Bluish discoloration of the female genitalia (Chadwick’s sign)
positive signs of pregnancy
signs that can only be explained by pregnancy
Fetal heartbeat obtained
Fetus visualized on ultrasound
Fetus movements
Goodell’s sign
A positive Goodell sign is characterized by softening of the cervix, typically noticed in the first 4 to 8 weeks of pregnancy
Chadwick’s sign
dark bluish or purplish discoloration of the vaginal tissue, vulva, or cervix, which is caused by an increase in venous (from the veins) blood flow to the area
naagles rule
calculates when the due date is
add seven days to the first day of your last menstrual period and subtract three months
What is the most accurate way to know what the correct due date is?
Ultrasound measurement of the embryo/fetus size in the first trimester
GTPAL
G = Gravida = number of pregnancies in lifetime
T= Term- Number of pregnancies that ended at term >37 wks
P = Preterm – Number of pregnancies that ended preterm (20 – 36.6 weeks)
A = Abortions – Number of pregnancies that end spontaneously before 20 wk
elective ITOP (intentional termination of pregnancy/spontaneous)
L = Living Childrengravity
number of times pregnant
parity
number of times pregnancy ended in birth
how do you confirm a woman is pregnant?
Blood and urine tests to confirm the presence of hCG
Presence is after days 10/11
Can detect it 7-8 days prior to menses
what do high levels of hcg mean?
can indicate multifetal, ectopic, hydatidiform mole, or a genetic abnormality
what do low levels of hcg mean?
can be miscarriage, late, or an ectopic pregnancy
what part of blood volume increases the most?
plasma
when does diastolic bp change?
decreases around 24 to 32 weeks but returns to normal at the end
what happens to respiratory rate especially after the third trimester?
it increases as lung capacity decreases
what happens to cardiac output?
Cardiac output increases by 30-50%
10-15 bpm above pre-pregnancy rate
what labs are done in early pregnancy?
CBC Blood type and Rh Rubella status STIs Genetic testing Diabetic glucose control (HgbA1C) TB status (PPD) Lead levels
small for gestational age
less than 10% on growth chart
large for gestational age
above 90% on a growth chart
