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N133 > Module 4: pregnancy > Flashcards

Module 4: pregnancy Flashcards

1
Q

Gravida:

A

A woman who is pregnant

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2
Q

Gravidity

A

Pregnancy

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3
Q

Parity

A

of pregnancies

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4
Q

Multigravida

A

Woman who has had 2 or more pregnancies

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5
Q

Nulligravida

A

Woman who has never been pregnant and is not currently pregnant

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6
Q

Nullipara

A

Woman who has not completed a pregnancy with a fetus or fetuses beyond 20 weeks of gestation

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7
Q

Parity

A
  • # of pregnancies in which the fetus or fetuses have reached 20 weeks of gestation, not the # of fetuses (eg. Twins) born
  • Not affected by whether the fetus is born alive or is stillborn (showing no signs of life at birth)
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8
Q

Primigravida

A

Woman who is pregnant for the first time

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9
Q

Primipara

A

Woman who has completed one pregnancy with a fetus or fetuses who have reached 20 weeks of gestation

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10
Q

Viability

A

Capacity to live outside the uterus, occurring about 22-25 weeks

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11
Q

Term pregnancy

A

Pregnancy from beginning of week 37 of gestation to end of week 40 +6 days of gestation

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12
Q

Preterm

A

Pregnancy that has reached 20 weeks of gestation but prior to completion of 36 weeks of gestation

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13
Q

Early term

A

Pregnancy between 37 and 38 weeks 6 days

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14
Q

Full term

A

Pregnancy between 39 and 40 weeks 6 days

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15
Q

Late term

A

Pregnancy in 41st week

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16
Q

Post term

A

Pregnancy after 42 weeks

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17
Q

What is Amenorrhea and what causes it?

A
  • absence of menstruation for more than three cycles
    • Caused by the feedback of estrogen and progesterone leading to the cessation of secretion of follicle-stimulating hormone
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18
Q

What physiological symptoms occur in first semester?

A
  • Amenorrhea
  • tingling, tender breasts
  • frequent urination
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19
Q

How many weeks is the first trimester?

A

wks 1-16

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20
Q

What physiological events occur in wks 1-2?

A
  • Implantation of the blastocyst

- Human chorionic gonadotropin secreted.

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21
Q

What physiological events occur in wk6?

A
  • Nausea and vomiting
  • Increased cardiac output
  • Hegar’s sign - a softening of cervix.
  • Hyperemesis gravidarum
  • Chadwick’s sign
  • Hegar’s sign
  • Goodell’s sign
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22
Q

what is Chadwick’s sign?

A

colour change of the vaginal wall from the pre-pregnancy pink to deep violet.

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23
Q

What is hyperemesis gravidarum?

A

A more severe form of nausea and vomiting that lasts beyond the third month or imposes serious health effects.

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24
Q

What is Hegar’s sign?

A

The lower uterine segment just above the cervix becomes extremely soft

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25
Q

what is Goodell’s sign?

A

• increased fluid between the cells causing the cervix to soften; a significant sign
o A non-pregnant cervix feels like the tip of the nose, a pregnant cervix feels like an earlobe

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26
Q

What physiological events occur in wk8?

A
  • Estrogen causes breast and uterine enlargement
  • fetal outline can be visible on ultrasound
  • Progesterone helps maintain the endometrium, inhibits uterine contractility, and aids in breast development
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27
Q

What physiological events occur in wks 10-12?

A
  • Uterine contractions start and last for the duration of gestation; they become stronger as the pregnancy advances
  • Fundus of the uterus is palpable at just above the pubis symphysis
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28
Q

What physiological events occur in wk 16?

A
  • changes in skin pigmentation (Linea nigra, Chloasma, stria gravidarum)
  • possible expression of colostrum
29
Q

What is linea nigra?

A

a dark line from just under the sternum to the pubis, separating the abdomen vertically into two hemispheres

30
Q

What is Chloasma?

A
  • darkened areas on the face, primarily over the nose and cheeks; referred to as the ‘mask of pregnancy’
31
Q

What is Striae gravidarum?

A
  • small ruptures in the connective tissue layer of the skin resulting from the stretched skin around the growing abdomen; may also appear on the breasts, or other areas with large weight gain
    o Tend to fade following the birth of the baby, but do not ever disappear completely
32
Q

What physiological symptoms occur in the 2nd semester?

A
  • Glomerular filtration increases
  • Renal plasma flow increases
  • Physiological anemia of pregnancy – the increase of RBC volume is relatively less than the increase of plasma
    • A daily iron supplement of 16-20mg is recommended for healthy pregnant women and is effective in reducing iron deficiency anemia that results from the increased circulating RBC mass
  • Heartburn because of stomach displacement
  • Constipation
  • Operculum
33
Q

What physiological events occur in wks 18-20?

A
  • Quickening

- fetal heartbeat audible on otoscope

34
Q

What is quickening?

A
  • the first perception of fetal movements
35
Q

What physiological events occur in wk20?

A
  • fetal outline palpable through abdominal wall; human placental lactogen
  • Human Placental Lacotgen secreted
36
Q

How many weeks is the 2nd trimester?

A

16 -22wks (??)

37
Q

How many weeks is the 3rd trimester?

A

27- end of pregnancy

38
Q

What physiological symptoms occur in the 3rd trimester?

A
  • Braxton-Hicks
  • increased resp. effort and dyspnea
  • Diastasis
39
Q

What are braxton hicks?

A
  • waves across the uterus in the early part of the third trimester; palpable and visible on monitor strips
    • Most women are taught about Braxton-Hicks contractions with the expectation that they will be able to distinguish them from labour contractions
40
Q

What is diastasis?

A
  • stretching of the rectus muscle to the point that it separates
    • The client should refrain from doing sit-ups and avoid lifting anything heavy until the gap reduces
    (These may exacerbate the separation and may lead to the development of a hernia)
41
Q

What physiological events occur in wk27?

A
  • Increased blood volume, cardiac output, and pulse
  • Uterine enlargement leading to supine postural hypotension
  • Shortness of breath
  • Edema
  • Hemorrhoids
  • Lordosis
42
Q

What is lordosis?

A

• an abnormal forward curvature of the spine in the lumbar region as the woman attempts to maintain a centre of gravity
(May experience chronic backache)

43
Q

What physiological events occur in wk38?

A
  • Lightening
  • increased urinary frequency because of baby’s head on bladder
  • Relief from dyspnea
44
Q

What is lightening?

A

-movement of the presenting part of the fetus into the pelvis. causing urinary frequency

45
Q

What reproductive systems are involved in the physiological changes that occur?

A

Involves the uterus, ovaries, vagina, and breasts

46
Q

How does the uterus change?

A
  • is a presumptive sign

- the myometrium changes in length, depth, weight, wall thickness, and volume

47
Q

How is uterine height measured?

A
  • from the top of symphysis pubis to over the top of the uterine fundus
48
Q

Why is measuring blood volume and velocity so important?

A
  • Measuring blood volume and velocity is one of the most important measures of fetal health
49
Q

How does the cervix change?

A
  • more vascular
  • softer
  • operculum
50
Q

What is operculum?

A
  • Mucus plug of cervix serves as a barrier to prevent bacteria from entering the vagina
51
Q

What vaginal changes occur?

A
  • increased vaginal discharge due to estrogen
  • increased vascularity
  • pH becomes more acidic
52
Q

What ovarian changes occur?

A
  • Corpus Luteum produces estrogen and progesterone until wk 16 when the placenta takes over
53
Q

How do breasts change?

A
  • areola darkens and increased diameter
  • increased vascularity
  • enlarged montgomery glands
  • colostrum at wk 16
54
Q

How does the integumentary system change?

A

Striae, diastasis, linea nigra, melasma, vascular spiders, increased perspiration, hair growth increased

55
Q

How does the respiratory system change?

A
  • congestion or stuffiness from increased estrogen
  • pressure on lungs and diaphragm resulting in shortness of breath until lightening occurs,
  • vital capacity doesn’t decrease
  • residual volume decreases,
  • tidal volume increase,
  • total O2 consumption increases, polyuria occurs
56
Q

What psychological changes occur in the 1st trimester?

A

ACCEPTING THE PREGNANCY

  • emphasize that ambivalence is normal (partners also experiences this)
  • Seeing the beating heart or fetal outline on a monitor can promote acceptance
  • All partners are important and should be encouraged to play an emotional role in pregnancy
  • Partners can go through the same psychological changes as the woman
  • For partners it also means accepting the woman in her changed state
57
Q

What psychological changes occur in the 2nd trimester?

A

ACCEPTING THE BABY

  • As soon as fetal movements are felt (also called quickening), psychological responses of both partners are apt to change
  • Stage of anticipatory role-playing
  • Knowing when they wanted their child can come at anytime during pregnancy or immediately after
  • A good way to measure the level of a woman’s acceptance of the coming baby is to measure how well she follows prenatal instructions
  • Partners can become preoccupied during this time and less emotionally availability
58
Q

What psychological changes occur in the 3rd trimester?

A

PREPARING FOR THE BABY AND END OF PREGNANCY

  • “Nest-building” occurs (buying clothes, naming, sleeping arrangements, ensuring safe passage by learning about birth)
  • Prenatal classes
  • A multidisciplinary approach is needed to help resolve the multifaceted problems that could arise in this stage
59
Q

What emotional to pregnancy can occur?

A
  • Grief, narcissism (self-centeredness and need to protect her body and baby), intro or extroversion, body image or boundary (zone of separation between you and the objects or ppl around you) concerns, stress, mood swings, change in sexual desire
  • Convade syndrome (somatic experiences of father during pregnancy simulating the pregnant mother)
60
Q

What social influences can occur in pregnancy?

A
  • How well a woman and partner feel during pregnancy and childbirth is related to their cultural background, their personal experiences, and the experiences of friends and relatives and childbirth educators.
  • Stigma around adolescent pregnancy, late in life pregnancy and LGBTQ2+ pregnancies.
61
Q

How does culture influence pregnancy?

A
  • Cultural background can influence how active a role she wants to take in pregnancy
  • Supporting beliefs shows respect
  • Beliefs and taboos may place restrictions
62
Q

How does the family influence pregnancy?

A
  • The family that the woman was raised in can influence pregnancy beliefs because it’s part of her cultural environment
  • A woman’s upbringing will influence whether she see’s pregnancy positive or negative “ppl love as they have been loved”
  • A mother who views mothering as positive activity is more likely to be pleased when she becomes pregnant vs the opposite.
63
Q

How does culture influence pregnancy?

A
  • Cultural background can influence how active a role she wants to take in pregnancy
  • Supporting beliefs shows respect
  • Beliefs and taboos may place restrictions
  • The degree of affiliation with her cultural group.
  • Cultural beliefs and practices.
  • Pattern of decision making.
  • Language, and communication.
  • The family’s parenting style and role.
  • Dietary practices.
  • Culturally influenced expectations of the healthcare system.
64
Q

How does the individual influence pregnancy?

A
  • Ability to cope with or adapt to stress vs conflict resolution
  • Mothering/pregnancy depends on basic temperament
  • How she adapts to new situations
  • Security in relationships vs acceptance of pregnancy
  • Young brides/old mothers = robbed of youth
  • Children time-consuming = robbed of freedom
  • post- Pregnancy body = robbed of looks
  • Robbed of financially or job promotion
  • The father has the same influential factors as the mother (social, cultural and individual)
65
Q

How is pregnancy diagnosed and what 3 classifications are used?

A
  • on the symptoms reported by the woman and signs elicited by the HCW
  • Presumption (subjective), probable (objective), and positive (documented)
66
Q

What are the presumptive (subjective) signs of pregnancy?

A
  • Those that are least indicative of pregnancy (could easily indicate other conditions)
  • Cannot be documented by examiner
  • Uterine changes
  • Breast changes, nausea, vomiting, amenorrhea = 2wks
  • Frequent urination = 3wks
  • Fatigue, uterine enlargement = 12wks
  • Quickening = 18wks
  • Linea nigra, melasma (drk pigment on face), striae = 24wks
67
Q

What are the probable (objective) signs of pregnancy?

A
  • Can be documented by examiner but are still not reliable or true diagnostic findings
  • Serum lab test can be preformed = 1wk
  • Chadwicks sign (vaginal color change), Goodell’s sign (cervix softening), Hegar’s sign (softening of lower uterine segment), gestational sac evidence = 6wks
  • Ballottement (fetus can be felt to rise against abdominal wall) = 16wks
  • Braxton Hicks, fetal outline felt = 20wks
68
Q

What are the positive signs of pregnancy?

A

There are only 3 documented or positive signs of pregnancy:

  • Fetal heart beat (5-7wks), or fetal heart sounds (10-12wk), or auscultation (18-20wk)
  • Fetal movement felt by examiner (20-24wks), (felt by woman at 16-20 not counted as reliable)
  • Fetus on ultrasound (4-6wks) (gives information on sight of implantation or multple pregnancy exists. Fetal outline can be measured by 8th wk
69
Q

what is the purpose of prenatal care?

A

Establish a baseline of present health
Determine the gestational age of the fetus
Monitor fetal development and maternal well being
Identify women at risk for complications
Minimize the risk of possible complications by anticipating the preventing problems before they occur
Provide time for education about pregnancy, lactation, and newborn care

N133 (8 decks)

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