NORMAL CHANGES IN PREGNANCY Flashcards
1
Q
acceptance of pregnancy
A
ambivalence
2
Q
mood swings, changes in body image
A
introversion
3
Q
what trimester?
anxiety, fears, signs and symptoms
A
1st trimester
4
Q
what trimester?
self-conscious on weight gain, can husband support? overwhelming changes
A
2nd trimester
5
Q
what trimester?
anxiety on labor and delivery, after giving birth?
A
3rd trimester
6
Q
seeking of commitment and acceptance of self as mother to the infant
A
binding in
7
Q
subjective signs of pregnancy
A
presumptive
8
Q
objective sings of pregnancy
A
probable
9
Q
diagnostic signs of pregnancy
A
positive
10
Q
true or false: presumptive signs are definite in that they indicate a baby is growing in the uterus
A
false - they are NOT definitive
11
Q
absence of menses, is the earliest symptom of pregnancy
A
amenorrhea
12
Q
A narrow, brown line may form, running from the umbilicus to the symphysis pubis and separating the abdomen into right and left hemispheres
A
linea nigra
13
Q
a skin condition characterized by brown or blue-gray patches or freckle-like spots
A
melasma
14
Q
main cause of melasma during pregnancy
A
excess estrogen and progesterone
15
Q
- stretch marks in pregnancy
- are primarily due to the rapid rate at which the skin is being stretched, combined with the influence of hormones
A
striae gravidarum
16
Q
mothers perception of fetal movement
A
quickening
17
Q
when does quickening usually occur
A
18-20 weeks after LMP;
16 weeks for multigravida
18
Q
flexing of the body of the uterus against the cervix
A
mcdonald’s sign
19
Q
A soft blowing murmur heard in auscultating a pregnant uterus. It is caused by the increased vascularity of pregnancy
A
uterine souffle
20
Q
- prodromal or false labor pains,
- contractions of the uterus that typically are not felt until the second or third trimester of the pregnancy
A
braxton hicks contracttions
21
Q
true or false: BH contractions feel like mild mestrual cramps
A
true
22
Q
passive fetal movement when the examiner inserts two gloved fingers into the vagina and pushes against the cervix
A
ballotement
23
Q
softening and compressibility of the lower segment of the uterus; 6 weeks AOG
A
hegar’s sign
24
Q
softening of the cervix
A
goodell’s sign
25
cervix and vaginal mucosa becomes violet-bluish color
chadwick's sign
26
when can fetal heart tone be heard?
10-12 weeks
27
fetal movement can be felt when?
20th week
28
during UTZ the parts and movement of fetus can be detected when?
8 weeks
29
- earliest structure seen during pregnancy (2-3 weeks after conception / 4-5 weeks gestation age)
- a fluid-filled structure surrounding an embryo during the first few weeks of embryonic development
gestational sac
30
Uterine growth is stimulated by high levels of ___ and ___
estrogen and progesterone
31
uterine growth:
___ becomes thicker, richer and more vascular
dedicua
32
uterine growth:
Hyper___ and hyper___ of uterine muscle fibers
-trophy and -plasia (increase in cell number and size)
33
during the 1st trimester, the uterus is in the ___
pelvic cavity
34
during the 2nd-3rd trimester the uterus is in the ___
abdominal cavity
35
Uterus changes to a ___ shape in early pregnancy to accommodate increasing amounts of fluid and fetal tissue
globular
36
uterus weight increases from 50 to ___
1000 g
37
uterus:
Length increases from 6.5 to ___; Depth increases from 2.5 to ___; Width expands from 4 to ___
32 cm
22 cm
24 cm
38
uterine wall during early pregnancy thickens to
1cm to 2 cm
39
uterine wall by the end of pregnancy becomes ___ at about ___ thick
thinner; 0.5 cm
40
Uterine volume increases from 2 mL to more than ___ and can hold a ___ fetus plus ___ of amniotic fluid
1 liter
7 lbs
1 liter
41
Between 38-40 weeks, fundal height drops as the fetus begins to descend and engage in the pelvis known as
lightening
42
After ___ of pregnancy, uterine contractions can be felt through abdominal wall known as Braxton Hick Sign (Contractions)
4 months
43
braxton hicks facilitates ___ and promote ___ delivery to the fetus
uterine blood flow
oxygen
44
true or false: Blood flow decreases rapidly as uterine size increases
false: it increases
45
mucus plug that acts to seal out bacteria
operculum
46
white mucoid discharge due to cervical stimulation by estrogen and progesterone
leukorrhea
47
Vaginal pH is more acidic due to increased ___
lactic acid
48
during pregnancy the ovaries stop production of ___
ova
49
Hypertrophy of sebaceous glands called ___ around nipples
montgomery tubercles
50
___ is inhibited until decrease of estrogen occurs after birth
lactation
51
creamy, white-to-yellowish premilk-fluid maybe expressed as early as 16 weeks AOG
colostrum
52
true or false: colostrum may leak or be expressed from the breasts during the last trimester
true
53
- the “mask of pregnancy"
- these increases in pigmentation are caused by melanocyte-stimulating hormone, which is secreted by the pituitary
facial chloasma
54
pink or reddish streaks appearing on the sides of the abdominal wall and sometimes on the thigh
striae gravidarum
55
swollen veins that are visible just under the surface of the skin
spider veins / telangiectases
56
abdominis muscle separate and stretched
diastasis
57
Vascular spiders or telangiectases result from the increase level of ___
estrogen
58
spider veins commonly appear on the ___ because they have to work against gravity and are a great distance from the heart
legs
59
during pregnancy Blood volume increases by approximately ___
1500 ml
60
- occurs as a result of hemodilution of the blood
- there is a 45%-50% increase in blood volume expansion (75% plasma and 25% RBCs)
physiologic anemia
61
During pregnancy, a woman's blood ___ more easily to lessen blood loss during labor and delivery
clots
62
true or false: Increase in blood volume during pregnancy is a protective mechanism
true
63
increased cardiac output by ___
25-50%
64
increased cardiac work would happen during the ___
2nd trimester
65
pulse rate increases ___ bpm
10-15
66
impaired blood flow to lower extremities during ___
3rd trimester
67
blood pressure ___ during 2nd trimester but ___ near delivery
decreases
increases
68
true or false: blood hypercoagulates up to 50% during pregnancy
true
69
true or false: there is slight decrease of WBC
false - increase
70
total protein of blood ___
decreases
71
true or false: the subcostalnangle and ap diameter increases
true
72
chest circumference increases up to ___
6 cm
73
tidal volume increased to ___;
residual volume decreased to ___
40%
20%
74
what kind of breathing does pregnant women do?
abdominal to thoracic breathing
75
pyrosis means
heartburn
76
___ gastric emptying / peristalsis
decreased
77
excessive flow of saliva
hyptertyalism
78
true or false: gums may soften and bleed easily
true
79
true or false: there is increased tendency to form kidney stones
false - gallstones
80
total body water increases to ___
7.5 Liter
81
by the 2nd trimester, both the GFR and the renal plasma flow have increased by ___
30-50%
82
urinary frequency happens during
1st and 3rd trimester
83
bladder capacity increases to ___
1500 ml
84
pride of pregnancy
waddling gait and lordosis
85
separation of the rectus abdominis muscle
diastasis recti
86
wide separation of symphysis pubis ___
3-4 mm
87
average weight gain on 1st trimester?
3.5-5 lbs
88
average weight gain on the 2nd and 3rd trimester
12-15 lbs
89
weight gain throughout the whole pregnancy goes up to
23-35 lbs / 11-15 kg
90
Increased water retention, intracapillary pressure & permeability
water metabolism
91
Increased protein & fat demands and CHO
nutrient metabolism
92
placenta
Stimulates uterine development; helps develop the ductal system of the breast for lactation
estrogen
93
placenta
Maintains endometrium, inhibits uterine contractility & aids in the development of the breasts for lactation
progesterone
94
placenta
inhibits uterine activity & soften cervix & collagen in joints
relaxin
95
placenta
antagonist to insulin
human placental lactogen
96
placenta
Affects smooth muscle contractility
prostaglandin
97
adrenals
Regulates carbohydrate & protein metabolism
increase cortisol
98
adrenals
Protective response to increased sodium excretion
increased aldosterone
99
thyroid and parathyroid gland
- Increased basal metabolism
rate by 20%
- Increased oxygen consumption
slight enlargement
increased thyroid hormone production
100
pancreas
signs of gestational diabetes
increased insulin needs
101
pituitary gland
- anovulation
- breast prepared for lactation
- increased BP
- letdown reflex
- FSH and LH decreased
-prolactin increased
- secrete vasopressin
- secretes oxytocin
102
danger sign of:
Miscarriage, abruptio placenta, placenta previa
vaginal bleeding
103
danger sign of:
Hyperemesis gravidarum
persistent vomitting
104
danger sign of:
Intrauterine infection,
gastroenteritis
chills and fever (>38 C)
105
danger sign of:
Premature rupture of membranes (PROM)
sudden gush/escape of fluid from vagina
106
danger sign of:
Ectopic pregnancy, premature labor, abruptio placenta, Appendicitis, ulcer, pancreatitis
abdominal pain
107
danger sign of:
Pulmonary embolus
chest pain / SOB
108
danger sign of:
Gestational hypertension, mild & severe preeclampsia
dizziness, blurring of vision, flashes of light, headache, edema of face and hands, oliguria
109
danger sign of:
Eclampsia
muscular irritability, seizure
110
danger sign of:
fetal distress
increase/decrease fetal movement
111
danger sign of:
UTI
dysuria
112
danger sign of:
preterm labor
uterine contractions, cramps, constant/irregular low backache, pelvic pressure
