Pregnancy

Question 1

Presumptive

(Subjective) signs of pregnancy

Answer 1

Amenorrhea
N/V
Fatigue 
Urinary frequency
Changes in breast 
Quickening

Question 2

Probable
(Objective) signs of pregnancy

SIGNS

Answer 2

Goodell’s Sign- soft cervix

Chadwick’s Sign- blue color to cervix

Hegar’s Sign- softening of uterus

McDonald’s Sign- flexibility of uterus

Positive Pregnancy Test

Ballottement-feeling the rebound of the fetus following a quick digital tap on the wall of the uterus

Enlargement of Abdomen / Uterus
Changes in skin
Uterine Souffle

Braxton Hicks Contractions- false contractions

Question 3

Positive (Diagnostic) of pregnancy

Answer 3

Heart beat
Movement
Visualization

Question 4

Due date - nageles rule

Answer 4

1st day of LMP, subtract 3 months and add 7 days

Question 5

Due date - fundal height

Answer 5

Measure size of uterus from Pubic symphysis is to fundas in cm

Most accurate between 22-34 wk

Question 6

Quickening

Answer 6

First moment normally around 20 wk

Question 7

Auscultation- due date

Answer 7

Doppler ultrasound- heart beat 8-12 wk

Stethoscope- 20 wk

Ultrasound

• confirm pregnancy
• 6-7 wk see activity
• most accurate 14-26 wk

Question 8

Pregnancy test- urine

Answer 8

• should be done on 1st early morning voiding
• detects hCG levels
• positive as early a 10-14 days after first missed period
  
  • encouraged to wait to perform until missed period
  • Repeat in one week if continue to have pregnancy symptoms and no menstrual cycle

Question 9

Pregnancy test - serum

Answer 9

Detects hCG

More accurate

Question 10

GTPAL

Answer 10

1) GRAVIDITY
Number of pregnancies including the present (twin count as ONE)
2) TERM
Number of term infant after 37 weeks gestation ( twin count as ONE)
3) PRETERM
Number of preterm infants after 20 weeks but before 37 weeks gestation
4) ABORTION
Number of pregnancies ending before 20 weeks
5) LIVING
Number of currently living children

Question 11

Due date- Estimated wheel

Answer 11

• put arrow in LMP and other will point to due date

Question 12

Physical findings

Answer 12

1) spider nevi
abnormal collection of blood vessels near the surface of the skin

2) linea nigra
dark vertical line that runs down the middle of the abdomen

3) striae gravidarum
Stretch marks

4) melasma
brown patches appear on the face.

Question 13

Follow up visits

Answer 13

1) every 4wk up to 28wk
2) every 2wk from 29 to 36 wk
3) every week from 37 week until birth

Question 14

11 Self care considerations

Answer 14

1) breast- supportive bra, avoid soap on Breast if breast feeding (dry skin)
2) clothes - comfort, NO constrictive, no heels (center of gravity off)
3) bathing- safety, mate, bars, chair
4) employment- can work if no risk, what type? Look for teratogens
5) travel- car to stop and stretch q2h and walk 10 min, use lap and shoulder belt, hydrate
6) dental - gingivitis common
7) immunization- yes except live like MMR
8) activity/ rest- can continue if no risk, allow rest, avoid contact sports, high risk of falls
9) preparation exercises- pelvic tilt (decrease strain on back & strenth abd muscles)
10) sex- alternate positions, STOP if bleeding
11) teratogens - life style changes ( hot tub, alcohol, drugs)

Question 15

Goodells signs

Chadwick’s sign

Hegars signs

McDonald’s sign

Answer 15

Goodell’s Sign- soft cervix

Chadwick’s Sign- blue color to cervix

Hegar’s Sign- softening of uterus

McDonald’s Sign- flexibility of uterus