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MCN FINALS > MCN 1F > Flashcards

MCN 1F Flashcards

1
Q

Confined to reproductive organs

A

Local Changes

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2
Q

Length or the height of the uterus increases 6.5-32cm

Landmark symphysis pubis to the top of uterine fundus to measure height of uterus

Depth: 2.5-22cm

Width: 4-24cm

Weight: 50-1000grams

End of Pregnancy: muscle fibers come 2-7 times longer

Volume: 2 to more than 1000mL (can hold a 7lbs fetus plus the amniotic fluid

End of 12 Weeks: Uterus is large enough to be palpated above the symphysis pubis

End of 20/22 Weeks: Palpated at the level of Umbilicus

End of 36 Weeks: Touches xiphoid proces (depresses diaphragm)

2 Weeks before Term:Uterus returns to 36 Week height

Amenorrhea

Uterine Wall Thickness:

Early Pregnancy: 1-2cm

End Pregnancy: 0.5cm thick

A

Uterine Changes

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3
Q

Becomes more vascular and edematous (Goodell’s Sign)

Presence and formation of mucus plug (Operculum - helps prevent infection of the fetus and its membrane)

A

Cervix

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4
Q

Increased size of vagina

Increased vascularity (Chadwick’s Sign)

Change in Vaginal Secretion

pH now 4/5 = acidic

Acidity make vagina resistant to bacterial invasion

Acidity happens because of action of Lactobacillus acidophilus that grows freely in increased glycogen environment which increases lactic acid content of secretions

pH changes favors the growth of Candida albicans a yeast like fungi

A

Vagina

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5
Q

Ovulation stops because of the active feedback of estrogen and progesterone produced by corpus luteum

Later part of Pregnancy: Stopping of ovulation is caused by the placenta. Causes pituitary gland to halt production of FSH and LH

A

Ovaries

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6
Q

Feeling of fullness, timgling,or tenderness

Increased size (+73 to growth of mammary alveoli

Areola darkens and increases the diameter to 5-7.5cm

Blue veins become prominent

Nipples are more erectile

Some women for secondary areola, additional darkening of the skin

A

Breast

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7
Q

T/F: In the 20th Century Pregnancy was considered a 9 month long illness

A

TRUE

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8
Q

Best shared with supportive partner and family

Choose level of pain management they want for labor and delivery

A

Modern Social Influence on Pregnant Woman

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9
Q

Cultural background influence active role in pregnancy

Myths & Taboos may affect behavior and activities

A

Cultural Influence on Pregnancy

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10
Q

People love as they have loved

How pregnant woman was raised will affect her pregnancy

Pregnant woman won’t believe if all she hears is excruciating pain.

A

Family Influence on Pregnancy

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11
Q

How pregnant woman copes with their situation along the stresses they are facing

Woman should feel secure in relationship with others esp the father of her child.

A

Individual Differences

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12
Q

Second Trimester: Accepting the Fetus

A

As soon as fetal movements are felt, psychological responses change

Narcissism & Introversion

Role playing and Increased dreaming

Start to imagine themselves as parents

Refers to child as he or she

Measure the level of acceptance of the coming baby by how well she follows her prenatal schedule and instructions

Since the focus is on the baby; Partner feels left alone to compensate for this feeling

Partner becomes overly absorbed in work to produce something concrete to show that not only woman is capable of creating something

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13
Q

Emotional Responses that Cause Concerns in Pregnancy: NICEBEDSG

A

Narcissism

Introversion

Couvade Syndrome

Extroversion

Body Image & Boundary

Emotional Lability

Depression

Stress

Grief

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14
Q

Partner experiences physical symptoms at same degree or even more intensely than pregnant mother

A

Couvade Syndrome

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15
Q

Changes in Sexual Desire

A

1st Trimester: decrease in libido due to nausea, fatigue, and breast tenderness that accompany early pregnancy

2nd Trimester: as blood flows to pelvic area increases to supply the placenta, libido, and sexual enjoyment will rise

3rd Trimester: Sexual desire remains high or it may decrease due to difficulty in finding a comfortable position

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16
Q

Experienced by woman and cannot be documented by the examiner; Subjective Symptoms

A

Presumptive Symptoms

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17
Q

First Trimester: Accepting the Pregnancy

A

Ambivalence

Partner and Mother still recovering from the surprise of learning that they are pregnant

Mixed emotions

49% of pregnancy is unintended, unwanted, or mistimed; Accept reality of pregnancy

Ambivalence toward pregnancy refers to interwoven feelings of wanting and not wanting

Partner feels proud and happy about the pregnancy, ambivalent more than the woman

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18
Q

Third Trimester: Preparing for the Baby and End of Pregnancy or Preparing for Parenthood

A

Begin nesting activities

Preparing clothing and sleeping arrangements

Name of baby

Ensure safe passage by attending prenatal classes

Grow impatient as they ready themselves for the delivery of the baby

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19
Q

Presumptive Symptoms

A

a. Breast Changes - tenderness, fullness, tingling, and enlargement felt by the mother, darkening of areola

b. Nausea & Vomiting

c. Amenorrhea (cessation of menstruation)

d. Increase urination

e. Fatigue

f. Uterine Enlargement

g. Quickening - fetal movement felt by the woman

h. Linea Nigra - dark pigmentations on abdomen

i. Melasma - dark pigmentations on face

j. Striae Gravidarum - red streaks formed in the abdomen

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20
Q

Confirm Pregnancy

A

Positive Signs

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21
Q

Objective Symptoms

A

Probable Signs

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22
Q

Older children should be well prepared and informed of the baby and assure that it will not replace them or change their parents’ affection toward them

A

Changes in Expectant Family

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23
Q

Partner plays a great part in her situation

The closer the partner is to the pregnant woman, the closer it is to the child

A

Partner’s Adaptation

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24
Q

Positive Signs

A

a. Sonographic Evidence of Fetal Outline

b. Audible Fetal Heart Tone

c. Fetal Movement Felt by Examiner

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25
Q

Probable Signs

A

a. Positive Maternal Serum Test - presence of hCG

b. Chadwick’s Sign - Pink to Bluish or Violet

c. Goodell’s Sign - Softening of the Cervix

d. Hegar’s Sign - Softening of the lower segment of the uterus

e. Sonography Evidence of Gestational Sac - characteristic ring is evident

f. Ballottement - fetus can be felt to rise against abdominal walls

g. Braxton Hick’s Contraction - Uterine Tightening

h. Fetal outline that is already felt by examiner - examiner can palpitate through abdomen

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26
Q

Mood changes occur frequently in a pregnant woman as a manifestation of narcissism

A

Emotional Lability

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27
Q

Additional gland of Pregnancy

Produces Estrogen causes breast and uterine enlargement

Produces progesterone maintains endometrium lining

inhibits contractility and aids breast lactation

Presence of hCG & hPL
hCG - stimulates progesterone and estrogen
hPL - serves as antagonists to insulin

Relaxin and Prostaglandins
relaxin - inhibits uterine activity to soften cervix
prostaglandins - initiate labor

A

Endocrine: Placenta

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28
Q

FSH and LH production stops due to high level of estrogen and progesterone produced by placenta

Increased production of Growth Hormone and Melanocytes stimulating hormone - causes skin pigmentation

Prolactin and Labor Induction - occurs in late pregnancy; helps breast prepare lactation and aid in labor progress

A

Endocrine: Pituitary Gland

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29
Q

Increase size which increases hormone production

Metabolic Rate increases to 20% or increase Basal Metabolic Rate

A

Endocrine: Thyroid and Parathyroid Gland

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30
Q

Double production of corticosteroids and aldosterone - help reduce probability of woman to reject foreign protein of the fetus

A

Endocrine: Adrenal Glands

31
Q

Increased production of Insulin

A

Endocrine: Pancreas

32
Q

Decreased production of Immunoglobin G - to reduce immunologic competency; prevents rejection of fetus

A

Immune System

33
Q

Presence of Striae Gravidarum

Presence of Linea Nigra

Presence of Melasma

Presence of Vascular spiders seen on the body

Presence of protrusion of umbilicus

A

Integumentary System

34
Q

Shortness of Breath

A

Respiratory System

35
Q

Increased circulatory blood volume and plasma - results to pseudoanemia

Increased RBC production - reason why additional iron is needed

Increased cardiac output - 25-50%

Decreased peripheral blood floor during 3rd Trimester

Increased level of fibrinogen and leukocyte

Blood Pressure:
2ND TRIMESTER: slightly decrease due to expanding placenta which causes peripheral resistance to circulation to lower

3RD TRIMESTER: BP rises to 1st Trimester Level

A

Cardiovascular System

36
Q

Decrease stomach acidity

Slowed intestinal peristalsis

Slowed emptying time

A

Digestive System

37
Q

Increased aldosterone production and sodium reabsorption

Increased GFR and renal plasma flow by 30-50% - leads to filtration of glucose

Increased urinary frequency- due to pressure from growing uterus to bladder

Increased ureter diameter and bladder capacity

A

Urinary System

38
Q

Gradual softening of a woman’s pelvic ligament and joints - to create pliability and facilitate passage; influenced by relaxin and progesterone

Wide separation of symphysis pubis

Pride of Pregnancy - to change center of gravity

A

Musculoskeletal System

39
Q

Bathing

A

Daily tub baths or showers should be strictly followed

Not bathe in hot water for too long

40
Q

Breast Care

A

Wear a firm supportive brassiere or brazier with wide straps

avoid soap - causes nipple cracking

Washing should be done daily esp when colostrum secretions begin

drying with soft towel in patting manner

if colostrum is profuse, use gauze squares/breast pads change frequently

41
Q

Dental Care

A

Avoid sweets

encourage regular dental visits

brush teeth arising, after meals, bedtime

42
Q

Discomforts: Breast Tenderness

A

wear bra/brassier

dress warmly

avoid soap on nipples and areola to prevent skin drying

43
Q

Discomforts: Palmar Erythema

A

apply calamine lotion on her hands

palmar erythema is normal

44
Q

Discomforts: Nausea & Vomiting

A

Morning sickness

First Trimester and subsides by the third month

Eat dry crackers

Avoid brushing teeth immediately after arising

Eat small frequent, low fat meals during the day

Drink liquids between meals rather than at meals

Avoid fried and spicy foods

45
Q

Discomforts: Constipation

A

Drink no less than 2000mL per day

Regular exercise

Eat fiber foods such as whole grains, fruits, and vegetables

46
Q

Discomforts: Pyrosis

A

Eat small frequent meals

Sit upright for 30 minutes after a meal

Drinking milk between meals

Avoid fatty and spicy foods

Perform tailor sitting exercises

47
Q

Fatigue

A

Frequent rest periods

Correct postures

Regular Exercise

Muscle relaxation and strengthening exercises

48
Q

Muscle Cramps

A

Increase calcium intake

Regular exercise

lie on back momentarily and extend the involved leg while keeping knees straight and dorsiflexing foot

49
Q

Hypotension

A

Always rest and sleep on their side not on their back

insert a small firm pillow under right hip

50
Q

Varicosities

A

Sim’s position/ elevated foot stool for 15-20 minutes twice a day

Avoid cross legs or constrictive knee-high hose or garters

Avoid long standing

Move while standing

51
Q

Hemorrhoids

A

Daily bowel evacuation

Adequate fluid intake

Eating high fiber food

Sitting on soft pillow

Soaking in a warm sitz bath

Exercising regularly

52
Q

Heart Palpitations

A

move slowly and gradually

53
Q

Frequent Urination

A

Void as necessary

Avoid restricting fluid intake and reduce caffeine and cola

Limit fluid intake only in the evening before sleeping

Sleep side lying at night

Performing Kegel exercises

54
Q

Leukorrhea

A

Daily baths

Wearing cotton under pads

Sleeping at night without underwear

Avoid douching

55
Q

Backache

A

Move slowly

Wear low heeled comfy and supportive shoes

Apply local heat on the area

Squatting when picking up objects than bending over

Pelvic Rocking and Tilting

Lift objects by holding them close to the body

56
Q

Headache

A

Avoid eye strains or tension

Rest with ice pack on forehead

Change position

57
Q

Dyspnea

A

Advise to sleep with her head and chest elevated

Use two or more pillows

58
Q

Ankle Edema

A

Left side lying position and

Elevate legs

Avoid constricting clothes

Avoid sitting or standing in one position for a long time

59
Q

Why is Positive Maternal Serum Test considered Probable?

A

Because there is also a disease that causes the release of this hormone

60
Q

Discoloration of the Vagina from Pink to Bluish/Violet

A

Chadwick’s Sign

61
Q

Softening of the Cervix

A

Goodell’s Sign

62
Q

Softening of the lower segment of the Uterus

A

Hegar’s Sign

63
Q

Characteristic ring is evident

A

Sonographic Evidence of Gestational Sac

64
Q

Tapping of the lower uterine segment on a bimanual examination

A

Ballottement

65
Q

Periodic uterine tightening

A

Braxton Hick’s Contraction

66
Q

Red Streaks that is formed on the abdomen

A

Striae Gravidarum

67
Q

Dark pigmentations on face

A

Melasma

68
Q

Dark line pigmentations on abdomen

A

Linea Nigra

69
Q

Fetal movement felt again by the woman

A

Quickening

70
Q

Mother can palpated the uterus over the symphysis pubis

A

Uterine Enlargement

71
Q

Fetal outline can be seen and measure by a sonogram

A

Sonographic Evidence of Fetal Outline

72
Q

when estrogen and progesterone increases, what hormones decrease in production?

A

FSH & LH

73
Q

Because of the increasing level of estrogen occurring during pregnancy

A

Palmar Erythema

74
Q

Results from increased in progesterone production, decreased intestinal motility, displacement of intestines, pressure of uterus

A

Constipation

MCN FINALS (4 decks)

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