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N416 > Physiologic Changes in Pregnancy > Flashcards

Physiologic Changes in Pregnancy Flashcards

1
Q

Uterus

A

Enlargement of existing myometrial cells

Increase in wt, strength, elasticity, and vascularity

Volume capacity increases from 10 mL to 5000 mL

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2
Q

When should you measure fundal height?

A

Starting at 20 weeks gestation

Public symphysis to top of fungus = # weeks gestation in centimeters

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3
Q

Cervix

A

Glandular tissues secretes thick sticky mucus to form mucous plug (from progesterone)

Increased vascularity

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4
Q

What does the mucous plug in the cervix do?

A

Prevents organisms from entering uterus

Increase in vaginal discharge - mucorrhea

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5
Q

Vagina

A

“Tunnel”

Increased thickness of mucosa

Increased vaginal secretions to prevent bacterial infections

Increased blood flow - can cause painful pelvic varicosities

Connective tissue relaxes

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6
Q

Breasts

A

Mammary glands increase in number and size

Superficial veins more prominent

Nipples more erect and areoles darken

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7
Q

When is colostrum produced?

A

During the third trimester

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8
Q

Respiratory System

A

Increased volume of air breathed each minute, from 30-40%

Abdominal breathing moves to thoracic breathing

Increase in nose bleeds and nasal stuffiness from estrogen-related edema

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9
Q

Cardiovascular System

A

Blood volume increased by 40-50%

CO increases 30-50%

Pulse increases by 10-15

Hyper-coagulable state

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10
Q

The size of an increased uterus interferes with what?

A

With blood return from lower extremities, leading to supine hypotensive syndrome, edema and varicose veins

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11
Q

Dilutional Anemia

A

RBC increase about 18% while plasma increase about 50% causing more fatigue

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12
Q

Supine Hypotensive Syndrome

A

Vena Caval Syndrome

When laying flat, the uterus puts pressure on the inferior vena cava and causes a relative hypotension

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13
Q

Supine Hypotensive Syndrome Interventions

A

Turn pt to side or to sitting position

Put pillow under hip

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14
Q

When Does Supine Hypotensive Syndrome start?

A

About 18 weeks due to weight of uterus, fetus, placenta, amniotic fluid

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15
Q

GI System

A

N/V - thick hCG and blood sugar instability

Increase of progesterone levels cause smooth muscle relaxation

Decreased peristalsis leading to bloating and/or constipation

Relaxation of cardiac sphincter may cause heart burn

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16
Q

GU System

A

Increased urinary frequency 1st & 3rd trimesters from pressure on bladder

Ureters elongate and dilate d/t progesterone - Pyelonephritis

Increased GFR resulting in glycosuria

17
Q

Linea Nigra

A

Dark line on the abdomen that starts at the pubic symphonies and up to the belly button and can somtimes be higher

18
Q

Skin

A

Linea Nigra

Facial chloasma or melasma gravidarum

Striae/Stretch marks

19
Q

Musculoskeletal

A

Joints of pelvis relax - can be painful

Lumbar spinal curve becomes accentuated

Abdominal muscle may separate - Diastasis Recti

20
Q

What happens when the lumbar spinal curve becomes accentuated?

A

Center of gravity changes

Compensates fro increase uterine weight in anterior aspect

21
Q

Weight Gain

A

Increased demand only 300 kcal/day in 2nd & 3rd trimesters

22
Q

Weight Gain: BMI <18.5

A

28-40 pounds

23
Q

Weight Gain: BMI 18.5-24.9

A

25-35 pounds

24
Q

Weight Gain: BMI 25-29.9

A

15-25 pounds

25
Q

Weight Gain: BMI >30

A

11-20 pounds

26
Q

Thyroid

A

Enlarges d/t estrogen and increased vascularity

Basal metabolic rate increase up to 20-25%

27
Q

What happens with mother’s who have thyroid issues?

A

Hyper or Hypothyroid increases the chance of complications including miscarriage

So check for people w/ thyroid issues

28
Q

Anterior Pituitary Gland

A

Prolactin for lactation

29
Q

Posterior Pituitary Gland

A

Vasopressin - vasoconstriction, regulate water balance

Oxytocin - contractions and lactation

30
Q

Pancreas

A

Increased insulin needs in 2nd/3rd trimester may lead to gestational diabetes

31
Q

Pregnancy Hormones

A

Human Chorionic Gonadotropin (hCG)

Estrogen

Progesterone

Relaxin

32
Q

Human Chorionic Gonadotropin (hCG)

A

Stimulates corpus luteum to make progesterone and estrogen

May cause N/V if levels go up

33
Q

Estrogen

A

Placenta makes this about week 7

Stimulates uterine myometrial cell enlargement

Stimulates mammary gland development

34
Q

Progesterone

A

Prevents uterine contractions

Stimulates mammary gland development

35
Q

Relaxin

A

Decreases strength of uterine contractions

Softens cervix and ligaments in pelvis

36
Q

Partner’s Psychologic Changes

A

1st trimester - disbelief, left out

2nd trimester - choosing parenting style

3rd trimester - anxiety about labor and birth/safety of partner

37
Q

Couvade

A

Partner develops physical symptoms of pregnancy

Fatigue, ache, increased appetite, depression

N416 (9 decks)

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