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