Physiological changes during pregnancy

Question 1

breasts changes

Answer 1

• enlargement
• tender, full, tingling
• striae fr stretching
• prominent veins fr incr BF

Question 2

prolactin is produced by ____ + causes ____

Answer 2

• ant. pituitary
• productn of COLOSTRUM
• incr growth of mammary glands
• incr in lactiferous ducts

Question 3

colostrum

Answer 3

• first milk
• yellow secretion rich in antibodies
• begins as early as 16 wk

Question 4

goodell’s sign

Answer 4

softening of cervix

Question 5

hegar’s sign

Answer 5

softening of lower uterine segment

Question 6

chadwick’s sign

Answer 6

bluish coloration of cervix, vaginal mucosa, + vulva

Question 7

braxton hicks

Answer 7

contractions caused by increased estrogen

Question 8

incr leukorrhea

Answer 8

increaed discharge fr increased vascularity _ hypertrophy of vagina + glands
-caused by P + E

Question 9

pH of vagina

Answer 9

more acidic

• means less bacteria
• but more prone to yeast

Question 10

decr in BP

Answer 10

-decr in peripheral vasc resistance

Question 11

cardiac

Answer 11

• incr in blood vol 40-45%
• incr in CO 40%
• incr HR
• incr stroke vol 25-30%
• sys murmur, maybe S3
• incr in size

Question 12

plasma incr by ___ and RBC incr by ___

Answer 12

50%

30%

Question 13

risk for DVT

Answer 13

• bc hypercoag
• incr in plasma fibrin, incr in fibrinogen, decr in coag inhibitors
• to protect mom fr blood loss in birth

Question 14

incr venous pressure + decr BF to extremeties due to ________ causes ________

Answer 14

due to COMPRESSION of ILIAC VEINS + INFR VENA CAVA

|&raquo_space;edema in lower, varicosities, hemorrhoids

Question 15

changes in respiratory

Answer 15

• slight hypervent
• slight alkalosis
• incr tidal vol

Question 16

E + P + prostaglandins on resp

Answer 16

incr vascular engorement + smooth muscle relaxatn

|&raquo_space;causes congestion, nosebleeds, + dyspnea

Question 17

incr BF to kidneys causes…

Answer 17

• frequency + incontinence
• risk for UTI
• incr GFR> incr UO
• glucosuria + proteinuria

Question 18

renal in third trimester

Answer 18

-decr renal flow» dependent edema

Question 19

n/v in early preg is due to

Answer 19

incr hCG + altered carb metabolism

Question 20

bloating, flatulence, + constipation is caused by

Answer 20

incr progesterone levels

|&raquo_space;>relaxes smooth muscles

Question 21

gallstone + cholestasiis is caused by

Answer 21

incr progesterone levels
»>decr muscle tone of gallbladder
»>prolonged emptying time

Question 22

estrogen on GI

Answer 22

-vascular congestion

|&raquo_space; gingivitis, bleeding gums, incr peridontal disease

Question 23

progesterone + relaxin on skeletal

Answer 23

• soft joints> incr mobility
• waddle gait
• lower back/pelvic discomfort
• incr risk for falls fr shift in center of gravity + change in gait

Question 24

estrogen on ligaments

Answer 24

incr elasticity

Question 25

incr adrenocorticosteroids on muscles

Answer 25

leads to cutaneous elastic tissue becoming fragile | >>>incr striae

Question 26

low fsh

Answer 26

amenorrhea

Question 27

estrogen causes..

Answer 27

- uterine + breast enlargement - incr vascularity - hyperpigmentation - alters metab processes + fluid electrolyte imbalance

Question 28

incr oxytocin causes

Answer 28

- UC | - milk let down + ejection

Question 29

incr hCG

Answer 29

- maintains corpus luteum until placenta becomes fully functional - N/V

Question 30

breasts tenderness + leaking | nursing care

Answer 30

- good posture - supportive bra - breast pads for leaking *all normal**

Question 31

braxton hicks nursing care

Answer 31

- occasional contractions are normal - wear uterus girdle - adeqt fluid intake - call hcp if becomes regular + persists before 37 wk

Question 32

yeast infection nursing care

Answer 32

- panty liner - cotton underwear - avoid douching/ femme hygiene products - contact HCP if discharge is foul or pruritus

Question 33

dependent lower extremities or varicosities nursing care

Answer 33

- loose clothing - maternal girdle - avoid prolonged sitting/standing - dorsiflex feet often - elevate legs when sitting - position on side when lying down for varicosities, wear a support hose or raise her legs on the wall

Question 34

hyperventilation + dyspnea nursing care

Answer 34

- reassure normalcy - slow down resp rate + depth - good posture - stand + stretch, take deep breath often - sleep w lots of pillows semi sitting up

Question 35

nasal/sinus congestion nursing care

Answer 35

- cool air humidifier - avoid decongestants + sprays - -use normal saline drops instead

Question 36

frequency + urgency

Answer 36

- normal + more commin in 1st + 3rd tri - empty bladder frequently - wipe front to back - maintain adequate hydration - pee after sex - exercise kegel *notify hcp if blood in urine

Question 37

N/V nursing care

Answer 37

- small freq meals - fluid BW meals not during - crackers/toast in AM - wear P6 acupressure wristbands - B6 25 mg 3x oral - ginger 250 mg 4x/day

Question 38

flatulence nursing care

Answer 38

- reg bowel habits - reg exercise - avoid gassy foods - chew foods slowly + thoroughly - knee to chest positions

Question 39

hemorrhoids (late pregnancy) nursing care

Answer 39

- avoid constipation - avoid bearing down - comfort measures (ice pack, warm bath, witch hazel compress) - elevate hips + lower extremities during rest - gently reinsert hemorrhoids when doing kegels

Question 40

diastasis recti

Answer 40

separation of rectus abdomen during pregnancy from being stretched

Question 41

diastasis recti nursing care

Answer 41

- ab strengthening like crunches | - to sit up: roll to side, lift torso up using arms until in sitting position

Question 42

round ligament spasms and pain | nursing care

Answer 42

- lie on side + flex knees up to abdomen - bend toward pain - pelvic rocking exercise - warm baths or compress - sim's position

Question 43

leg cramp | nursing care

Answer 43

- dorsiflex foot - warm bath/compress - change positions slowly - massage affected area - regularly exercise

Question 44

striae nursing care

Answer 44

- no way to prevent them - lotions, oatmeal baths, nonbinding clothing for comfort - good wt control

Question 45

folic acid intake

Answer 45

600 micrograms