PCM Reproduction:

Question 1

During pregnancy Vaginal pH becomes more acidic due to the action vf?

Answer 1

Lactobacillus acidophilus on the increased levels of glycogen stored in the vaginal epithelium.

Question 2

This change in pH during pregnancy helps protect the woman against some vaginal infections, but?

Answer 2

increased glycogen may contribute to higher rates of vaginal candidiasis

Question 3

Hegar’s sign:

Answer 3

The uterus early in pregnancy loses the firmness & resistance of the nonpregnant organ with palpable
softening at the isthmus.

Question 4

Over the course of 9 months of pregnancy, the uterus

Answer 4

Increases in both weight and size:
- Weight 2 ounces to 2 pounds chiefly due to larger muscle cells more extensive fibrous & elastic tissue, & the considerable increase in the
size& number of blood vessels and lymphatics.
- size of the uterus increases 500- to 1000-fold,
- capacity approximately 10 liters by the end of the pregnancy.

Question 5

The nongravid uterus may be?

Answer 5

anteverted, retroverted, or retroflexed.

Question 6

Up to 12 weeks of gestation, the gravid uterus is?

Answer 6

still a pelvic organ.

Question 7

Regardless of its initial positioning, the enlarging uterus becomes?

Answer 7

Anteverted and quickly fills space usually occupied by the bladder, triggering frequent voiding.

Question 8

By 12 weeks’ gestation, the uterus?

Answer 8

Straightens & rises out of the pelvis & can be felt when palpating the abdomen.

Question 9

Chadwick’s sign:

Answer 9

The cervix pronounced softening & cyanosis appear very early after conception & continue throughout pregnancy.

Question 10

Common Concerns Time in Pregnancy: No menses (amenorrhea)

Answer 10

Throughout
Continued high levels of estrogen, progesterone, & human chorionic gonadotropin following fertilization of the ovum build up the endometrium to support the developing pregnancy, averting menses & shedding of the endometrial lining.

Question 11

Common Concerns Time in Pregnancy: Nausea with or without vomiting

Answer 11

1st trimester
Possible causes include hormonal changes of pregnancy leading to slowed peristalsis throughout the GI tract, changes in taste and smell, the growing uterus, or emotional factors. Women may have a modest (2–5 lb) weight loss in the first trimester.

Question 12

Common Concerns Time in Pregnancy: Breast tenderness, tingling

Answer 12

1st trimester
The hormones of pregnancy stimulate the growth of breast tissue. As the breasts enlarge throughout pregnancy, women may experience upper backache from their increased weight. There is also increased blood flow throughout the breasts, increasing pressure on the tissue.

Question 13

Common Concerns Time in Pregnancy: Weight loss

Answer 13

1st trimester

If a woman experiences nausea & vomiting, she may not be eating normally in early pregnancy

Question 14

Common Concerns Time in Pregnancy: Groin/lower

abdominal pain

Answer 14

2nd trimester: 14–20 weeks
Rapid uterine growth early in second trimester causes tension & stretching of round ligaments, causing spasm with sudden movement or change of position.

Question 15

Common Concerns Time in Pregnancy: Urinary frequency (nonpathologic)

Answer 15

1st/3rd trimesters
There is increased blood volume & increased filtration rate in the kidneys with increased urine production. Due to less space for the bladder from pressure from the growing uterus (first trimester) or from the descent of the fetal head (third trimester), the woman needs to empty her bladder more frequently

Question 16

Common Concerns Time in Pregnancy: Fatigue

Answer 16

1st/3rd trimesters
Rapid change in energy requirements; hormonal changes (progesterone has a sedative effect); in third trimester, weight gain, changes in mechanics of movement, & sleep disturbances contribute.

Question 17

Common Concerns Time in Pregnancy: Edema

Answer 17

3rd trimester
There is increased venous pressure in the legs, obstruction of lymphatic flow, & reduced plasma colloid osmotic pressure.

Question 18

Common Concerns Time in Pregnancy: Heartburn,

constipation

Answer 18

Throughout
Relaxation of the lower esophageal sphincter allows stomach contents to back up into the lower esophagus. The decreased GI motility caused by pregnancy hormones slows peristalsis & causes constipation. Constipation may cause or aggravate existing hemorrhoids.

Question 19

Common Concerns Time in Pregnancy: Backache

nonpathologic

Answer 19

Throughout
Hormonally induced relaxation of joints & ligaments & the minor lordosis required to balance the growing uterus sometimes result in a lower backache. Pathologic causes must be ruled out.

Question 20

Common Concerns Time in Pregnancy Leukorrhea

Answer 20

Throughout
Increased secretions from the cervix and the vaginal epithelium, due to the hormones & vasocongestion of pregnancy, result in an asymptomatic milky white vaginal discharge.

Question 21

Early in pregnancy, the corpus luteum, the ovarian follicle that has discharged its ovum, may be?

Answer 21

Sufficiently prominent to be felt on the affected ovary as a small nodule, but it disappears by midpregnancy. It is important to examine the fallopian tubes to rule out a tubal pregnancy.

Question 22

Evaluate the nutritional status of the woman at

the first prenatal visit, including?

Answer 22

A diet history, measurement of height & weight, & screening for anemia by checking the hematocrit.

Question 23

Be sure there is a balanced increase in calories & protein, since?

Answer 23

protein will be used for energy, rather than growth, unless sufficient calories are consumed.

Question 24

Prepregnancy
Recommended Total Gain
Weight-for-Height Category
Low (BMI <19.8)

Answer 24

28–40 lbs

12.5–18 kgs

Question 25

Prepregnancy Recommended Total Gain Weight-for-Height Category Normal (BMI 19.8 to 26.0)

Answer 25

25–35 lbs | 11.5–16 kgs

Question 26

Prepregnancy Recommended Total Gain Weight-for-Height Category High (BMI 26.0 to 29.0)

Answer 26

15–25 lbs | 7.0–11.5 kgs

Question 27

Prepregnancy Recommended Total Gain Weight-for-Height Category Obese (BMI >29.0)

Answer 27

≥15 lbs | ≥7.0 kgs

Question 28

After the first trimester, women should avoid exercise in the?

Answer 28

Supine position, which can compress the inferior vena cava & decrease blood flow to the placenta.

Question 29

Because violence survivors often disclose their experiences to their health care provider before confiding in their family, clergy, or friends, many experts consider?

Answer 29

Universal screening an ethical imperative.

Question 30

Prolonged periods of lying on the back should be | avoided?

Answer 30

Because the uterus then lies directly on the woman’s vertebral column & may compress the descending aorta and inferior vena cava, interfering with return of venous blood from the lower extremities & the pelvic vessels.

Question 31

Chloasma define:

Answer 31

The mask of pregnancy, chloasma, is normal. It consists of irregular brownish patches around the eyes or across the bridge of the nose.

Question 32

During pregnancy, breasts are?

Answer 32

tender & nodular

Question 33

Purplish striae and linea nigra are?

Answer 33

normal in pregnancy.

Question 34

Measure the fundal height?

Answer 34

With a tape measure if the woman is more than 20 weeks’ pregnant. Holding the tape as illustrated & following the midline of the abdomen, measure from the top of the symphysis pubis to the top of the uterine fundus.

Question 35

fetal heart:

Answer 35

The rate is usually in the 160s during early pregnancy, and then slows to the 120s to 140s near term.

Question 36

Rhythm becomes important in the third trimester?

Answer 36

Expect a variance of 10 to 15 beats per minute (BPM) over 1 to 2 minutes.

Question 37

Leopold's Maneuvers are a common & systematic way to determine?

Answer 37

the position of a fetus inside the woman's uterus;

Question 38

Sexual dysfunction disorders may be classified into four categories:

Answer 38

sexual desire disorders arousal disorders orgasm disorders pain disorders