Expected Physiological Changes in Pregnancy

Question 1

how long does pregnancy span?

Answer 1

9 months

• 10 lunar months of 28 days
• 40 weeks
• 280 days

Question 2

first trimester

Answer 2

week 1 - week 12 and 6 days

Question 3

where is the uterus during the first trimester?

Answer 3

behind the pubic symphysis

Question 4

initial visit

Answer 4

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?

Question 5

second trimester

Answer 5

week 13 - week 26 and 6 days

Question 6

third trimester

Answer 6

week 27 - week 40

Question 7

up to how many weeks is it considered an abortion?

Answer 7

20 weeks

Question 8

after how many weeks is the fetus viable?

Answer 8

27 weeks

Question 9

preterm

Answer 9

prior to 37 weeks gestational age

Question 10

term

Answer 10

pregnancy between 37-42 weeks

Question 11

post term

Answer 11

after 42 weeks of pregnancy

Question 12

striae gravidum

Answer 12

stretch marks which are common on the breasts, lungs, thighs, and abdomen

may appear dark or red then become pale or silvery over time

Question 13

linea nigra

Answer 13

dark line from the pubic symphysis to the fundus is more often with women with darker skin and disappears after pregnancy

Question 14

chloasma

Answer 14

the mask of pregnancy that darkens with sun exposure and disappears after pregnancy

Question 15

thrombocytopenia

Answer 15

low platelets

Question 16

when pregnant, what level of RBCs in the CBC is considered anemia?

Answer 16

below 10.7

Question 17

urinary frequence or incontinence remedies

Answer 17

Kegels, empty bladder often, decrease caffeine

Question 18

fatigue remedies

Answer 18

eat healthy diet, take naps, feeling tired? Rest, stay away from caffeine

Question 19

nausea and vomiting remedies

Answer 19

avoid empty stomach, crackers prn, avoid greasy food, fried food, strong odors

Question 20

backache remedies

Answer 20

heating pad on low setting, support with pillows, attention to posture and back exercises

Question 21

leg cramp remedies

Answer 21

elevate legs and when they cramp, straighten legs and felt feet to head

Question 22

varicosities remedies

Answer 22

walk daily, elevate legs, avoid standing, don’t cross legs, support stockings

Question 23

hemorrhoid remedies

Answer 23

BM daily, fiber rich foods, exercise daily, witch hazel compresses

Question 24

constipation remedies

Answer 24

Increase fluids, exercise daily, decrease cheese, ground flax seeds 1 TBS/day

Question 25

heartburn remedies

Answer 25

Avoid spicy or greasy foods, eat sm. Frequent meals, avoid caffeine, sleep on pillows, sips of water, few antacids

Question 26

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?

Answer 26

G4 1113

Question 27

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 ```

Answer 27

A, B, C

Question 28

why is Rh factor important?

Answer 28

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

Question 29

what would a rubella infection or vaccination do to the fetus?

Answer 29

blind, birth defects, and cognitive disabilities

Question 30

``` 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 ```

Answer 30

A, B, C

Question 31

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

Answer 31

C

Question 32

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? ```

Answer 32

A, B, ??

Question 33

when will the uterus be at the umbilicus?

Answer 33

at 20 weeks

Question 34

presumptive signs

Answer 34

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

Question 35

probable signs

Answer 35

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)

Question 36

positive signs of pregnancy

Answer 36

signs that can only be explained by pregnancy ­Fetal heartbeat obtained ­Fetus visualized on ultrasound Fetus movements

Question 37

Goodell's sign

Answer 37

A positive Goodell sign is characterized by softening of the cervix, typically noticed in the first 4 to 8 weeks of pregnancy

Question 38

Chadwick's sign

Answer 38

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

Question 39

naagles rule

Answer 39

calculates when the due date is add seven days to the first day of your last menstrual period and subtract three months

Question 40

What is the most accurate way to know what the correct due date is?

Answer 40

Ultrasound measurement of the embryo/fetus size in the first trimester

Question 41

GTPAL

Answer 41

``` 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 Children ```

Question 42

gravity

Answer 42

number of times pregnant

Question 43

parity

Answer 43

number of times pregnancy ended in birth

Question 44

how do you confirm a woman is pregnant?

Answer 44

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

Question 45

what do high levels of hcg mean?

Answer 45

can indicate multifetal, ectopic, hydatidiform mole, or a genetic abnormality

Question 46

what do low levels of hcg mean?

Answer 46

can be miscarriage, late, or an ectopic pregnancy

Question 47

what part of blood volume increases the most?

Answer 47

plasma

Question 48

when does diastolic bp change?

Answer 48

decreases around 24 to 32 weeks but returns to normal at the end

Question 49

what happens to respiratory rate especially after the third trimester?

Answer 49

it increases as lung capacity decreases

Question 50

what happens to cardiac output?

Answer 50

Cardiac output increases by 30-50% 10-15 bpm above pre-pregnancy rate

Question 51

what labs are done in early pregnancy?

Answer 51

``` CBC Blood type and Rh Rubella status STIs Genetic testing Diabetic glucose control (HgbA1C) TB status (PPD) Lead levels ```

Question 52

small for gestational age

Answer 52

less than 10% on growth chart

Question 53

large for gestational age

Answer 53

above 90% on a growth chart