Physiologic Adaptation Flashcards
confined to the reproductive organs
Local
Affecting the entire body
Systemic
Local changes
- Uterine changes
- Cervical changes
3.Vaginal changes
4.Ovarian changes - Breast changes
Systemic changes
- Respiratory system
- Cardiovascular system
3.Gastrointestinal system - Urinary System
- Integumentary system
- Skeletal system
7.Endocrine system
in uterine changes length increases to?
6.5 to 32 cm
in uterine changes width increases to?
4 to 24cm
in uterine changes depth increases to?
2.5 to 22cm
in uterine changes weight increases to?
50-1,000 grams
early in pregnancy, the uterine wall thicken from about?
1cm to about 2cm
Toward the end of pregnancy, the wall thins to becomes supple and?
only about 0.5 cm thick
The volume of uterus increases about?
2ml to more than 1000ml
The uterus can hold?
7lbs (3175g) fetus plus 1000ml of amniotic fluid for total of about 4000g
Uterine growth occurs as a result of?
- hyperplasia- proliferation of myometrial cell
- hypertrophy- stretching of muscle
Irregular contraction
Braxton Hicks contraction
During the 3rd trimester contraction occur more frequently/ and mistaken for the onset of early labor
frequent painless uterine contraction
False labor
softening of the lower uterine segment.
Hegar’s sign
one finger of the examiner placed in the vagina, the other hand on the abdomen demonstrate that with preg., the uterus is more anteflexed, larger, and softer to touch than usual.
Bimanual examination
softening of the cervix. ( consistency of a nonpregnant cervix -nose, pregnant - earlobe)
Goodell’s sign
The glands of the endocervix undergo both hyperplasia and hyperthropy as they increases in number and distend mucus.
This mucus plug called?
-seals the endocervical canal and prevents contamination of the uterus by bacteria and other substances. Expelled just before the onset of labor.
Operculum
The resulting increase in circulation/ vascularization changes the color of the vaginal walls from normal light pink to deep violet called
Chadwick’s sign
Cervical:
causes the cervix to soften in consistency
increased fluid between cells (edematous)
Cervical:
causes it to darken more a pale pink to violet hue.
increased vascularity
bacteria that grow freely in the increase glycogen environment, this change in ph unfortunately, favors the growth of candida albicans,
lactobacillus acidophilus
species of yeast like fungi manifested by an itching, burning sensation in addition to a creamcheese like discharge.
candida albicans
why Ovaries do not produce ova during pregnancy?
because of high amount of progesterone and estrogen
feeling of fullness,tingling or tenderness in the breast are due to?
increase stimulation of the breast tissue by the high estrogen level in the body
nipple and areola darken diameter increases from?
3.5 cm to 7.5cm
sebaceous glands enlarge and become proturbent called?
tubercles of montgometry
By the 16th week of pregnancy, the thin watery, high protein fluid that is the precursor of breast milk, can be expelled from the nipple.
Colostrum
Respiratory changes
diaphragm elevates
substernal angel increases (^estrogen)
breathing more deeply increases the efficiency of gas exchange
rr increase 2 bpm
congestion or stuffiness of nasopharynx
Cardiovascular system
heart is shifted to more transverse position
blood volume increases 30-50%
Pr 10-15bpms
cardiac output 25-50-%
nursing management for vena caval syndrome
turn on her side/left lateral recumbent position to enhance blood flow to the vena cava
excessive production of saliva due to stimulation of the salivary gland.
Ptyalism
brownish patches in the forehead,cheeks and bridge of the nose.
• Facial Chloasma (mask of pregnancy)
dark line of pigmentation from the umbilicus to the symphysis pubis.
Linea Nigra
pink or reddish streak appearing on the sides of the abdominal wall and sometimes on the thighs may develop in late pregnancy.
Striae gravidarum-
Weeks after birth it lightens to a silvery white
striae Albicantes or atrophicae.
Skeletal changes
Symphisis pubis may separate slightly due to hormone relaxin.
• Lumbodorsal spinal curve increased during 3rd trimester.
Skeletal changes
Symphisis pubis may separate slightly due to hormone relaxin.
• Lumbodorsal spinal curve increased during 3rd trimester.
only hormone in the APG that increases which prepares the breast to produce milk.
Prolactin
PPG secretes ____\ , second hormone involve in lactation.
Stimulate the milk ejection reflex (let down) after birth.
•also stimulate contraction of the uterus
Oxytocin
two types of oxytocin
natural-produce by pppg
artificial/synthetic- iv meds
are those that are least indicative of pregnancy; taken as single entities, they could easily indicate other condition.
-subjective data
Presumptive signs of pregnancy
Presumptive signs of pregnancy
Breast changes ( early as 4 wks.)
• Nausea and vomiting (8-12 wks.)
• Amenorrhea
• Frequency in urination
• Fatigue
• Uterine enlargement -
• Quickening
• Linea nigra
• Melasma
• Striae gravidarum
INDICATIONS OF PREGNANCY ARE OBJECTIVE FINDINGS THAT CAN BE DOCUMENTED BY AN EXAMINER.
probable signs of pregnancy
probable signs of pregnancy
• Chadwick’s sign (7-8 wks.)
• Hegar’s sign ( 7-8 wks.)
• Goodell’s sign ( 5-6 wks)
•Sonographic evidence of gestational sac
Ballottement- rebounding of the floating fetus against the examiners finger. (4-5 mos.) -
• Abdominal enlargement -
• Palpation of fetal outline
• Preg. Test The Commonly used faboratory test for preanany
are based on detecting the presence of HCG. The test are performed by radioimmunoassay(RIA), enzyme- linked immunosorbent assay(ELISA), or radioreceptor assay(RRA)
techniques. Trace amounts of hCG appear in the serum as early 24 to 48 hrs. after implantation.
• POSITIVE SIGN OF PREGNANCY
• Sonographic evidence of fetal outline
• Auscultation of fetal heart tones
• Fetal movement
Common psychological changes that occur with pregnancy
-1st trimester- accepting pregnancy
( ambivalence)
2nd trimester- accepting the baby
(narcissism and introversion)
3rd trimester- preparing for the baby and end of pregnancy
(resting behavior)
-it refers to the interwoven feelings of wanting and not wanting that can exist at high levels.
AMBIVALENCE
before a woman can take a mothering role, she has to give up or alter her present roles. She will never be a daughter in exactly the same way again. She must incorporate her new role as a mother into her other roles as a daughter, wife or friend.
GRIEF
selfcenteredness A woman may manifest this by a change in her activity level. She does things to unconsciously protect her body and thus her baby. e.g. She may stop playing tennis, even though her physician tells her it will do no harm in moderation.
NARCISSISM
turning inward to concentrate on oneself and one’s body.
INTROVERSION
the way your body appears to yourself.
BODY IMAGE
zone of separation you perceive between yourself and objects of other people.
BODY BOUNDARY
many men experience physical symptoms such as nausea, vomiting and backache to the same degree or even more intensely than their partners do during pregnancy. These symptoms apparently result from stress anxiety and empathy for the pregnant woman.
CAUVADE SYNDROME
Mood changes occur frequently in a pregnant woman, partly as a manifestation of narcissism and partly because of hormonal changes, particularly the sustained increase in estrogen and progesterone.
EMOTIONAL LABILITY
Changes in sexual desire
1st trimester- decrease in libido because of the nausea, fatigue, and breast tenderness.
2nd trimester-libido and sexual enjoyment rise markedly.
3rd trimester- sexual desire may remain high or it may decrease because of difficulty finding a comfortable position and increasing abdominal size.
preschool and school- age children may need to be reassured periodically during pregnancy that a new baby will be an addition to the family and will not replace them in their parent’s affection.
CHANGES IN EXPECTANT FAMILY
Sexualy activity are generally no contraindication except in the presence of;
•Threatened abortion
• Partner with sexually transmitted infection
• Maternal history of miscarriage following orgasm
• Premature rupture of membranes
• Premature labor
• History of abortion, bleeding
• Incompetent cervix
appear on face, neck,chest,arms and thighs. these are tiny red evaluation yhat branch in all direction
Vascular spider, spider nevi,telangectasis
appear on face, neck,chest,arms and thighs. these are tiny red evaluation yhat branch in all direction
Vascular spider, spider nevi,telangectasis
redness and itching that occur on palms or sole of the feet from increase level of estrogen
Palmar erythema
characterized by RBCs that are larger than normal. There also aren’t enough of them. When RBCs aren’t produced properly, it results in blank. Because the blood cells are too large, they may not be able to exit the bone marrow to enter the bloodstream and deliver oxygen.
megaloblastic anemia.
is a serious birth defect in which a baby is born without parts of the brain and skull. It is a type of neural tube defect (NTD). As the neural tube forms and closes, it helps form the baby’s brain and skull (upper part of the neural tube), spinal cord, and back bones (lower part of the neural tube).
Anencephaly
congenital defect of the spine in which part of the spinal cord and its meninges are exposed through a gap in the backbone. It often causes paralysis of the lower limbs, and sometimes mental handicap.
Spina bifida
strengthen the pubococcygeus nuscle and increase its elasticity
perineal muscle tightening (kegel exercises)
tailor-sitting
inner thigh exercises
exercises that helps prevent or reduce back strain as it strenghtens abdominal muscles.
pelvic tilt or pelvic rocking
easential nutrients during pregnancy
Iron: 30-60mg
Calcium: 1200mg
Carbohydrates: 2300-2700 kcal
Protein: 60-80mg
preg/lactation
A- 800 ug/1300
D- 10 ug/12
E-10/12
K- 65/65
b1thiamine- 1.5mg/1.6mg
b2riboflavin-1.6mg/1.8mg
b6pyridoxine- 2.2mg/2.1mg
b12cyanocobalamin-2.2mg/2.6mg
