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Patient Assessment > Pregnancy > Flashcards

Pregnancy Flashcards

1
Q

enlarged uterus initially caused by

A

elevated estrogen and progesterone

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2
Q

enlarged uterus later caused by

A

mechanical pressure after first trimetser

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3
Q

by what point does the uterus reach the abdominal cavity

A

12 weeks

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4
Q

uterine weight increases by

A

10 fold

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5
Q

uterine capacity increases by

A

500-1000 x

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6
Q

cardiovascular changes seen by

A

5 weeks

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7
Q

what happens to heart? 7 things

A

enlarges, shifts upward and to left; axis changes; increase HR; increase CO; decreased vascular resistance; splitting 1st heart sound(systolic murmur)

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8
Q

upper respiratory changes? five things

A

SOB, increased secretions, swollen mucus membranes, increased epistaxis, chronic cold symptoms

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9
Q

what impact does progesterone have in GI system?

A

relaxes sphincters, leads to GERD

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10
Q

bowel changes

A

slower transit time leads to constipation

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11
Q

N/V treatmetn

A

B6 and unisom

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12
Q

zofran SE

A

heart defects and cleft palate

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13
Q

kidney changes

A

enlarge

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14
Q

ureter changes

A

dilate

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15
Q

what’s not uncommon to see with kidneys?

A

hydronephrosis (just watch for infection)

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16
Q

bladder changes

A

increases vascularity and decreases capcity

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17
Q

UA changes

A

proteinuria (not concerning unless seen with HTN)

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18
Q

breast changes

A

increased vascularity; heaviness and pain (6 weeks)

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19
Q

nipple and areola changes

A

hyperpigmented, erectile, Montogomery tubercle more prominent and raised (8-20 weeks)

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20
Q

when does colostrum secretion begin?

A

16 weeks

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21
Q

derm changes

A

linea nigra; chloasma; striae

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22
Q

mask of pregnancy

A

cholasma

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23
Q

MSK changes

A

increased lumbar lordosis; widening of pubic symphysis; loosening of SI and pubic joints

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24
Q

triglyceride changes

A

increase

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25
Q

total cholesterol changes

A

increase

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26
Q

LDL changes

A

increase

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27
Q

pancreas changes

A

fasting hypoglycemia; postprandial hyperglycemia

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28
Q

thyroid changes

A

increase in size; slight decrease in TSH

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29
Q

fetus dependent on maternal thyroid hormone until

A

12 weeks

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30
Q

adrenal changes

A

increased cortisol; increased aldosterone; ACTH

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31
Q

pituitary changes

A

increase in size; susceptible to bleeding; prolactin and oxytocin increase

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32
Q

dental changes

A

tooth sensitivity; bleeding gums; increased susceptibility to bacteria

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33
Q

severe gum disease is linked to

A

preterm labor and LBW

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34
Q

diagnose pregnancy with

A

serume or urine assay for beta-human chorionic gonadotropin

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35
Q

may detect pregnancy as early as X from missed period

A

4-7 days

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36
Q

US can confirm pregnancy as early as

A

5 weeks

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37
Q

Fetal heart rate at

A

6 weeks

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38
Q

GTPAL stands for

A

gravidity, parity (term, preterm, abortions, living children)

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39
Q

term pregnancy

A

37-42

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40
Q

preterm pregnancy

A

20-36

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41
Q

abortions

A

spontaneous or induced; before 20 weeks

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42
Q

no delivery

A

nulliparous

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43
Q

first delivery

A

primaparous

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44
Q

previously delivered

A

multiparous

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45
Q

EDD

A

Add 1 year year to first day of last menstrual period, subtract three months; add 7 days

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46
Q

average duration

A

280 days or 40 weeks

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47
Q

x cm per week in fundal height

A

1 cm

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48
Q

just above pubic symphysis

A

12 weeks

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49
Q

midway between pubis and umbilicus

A

14-16 weeks

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50
Q

level of umbilicus

A

20-22 weeks

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51
Q

height equal to gestation age in weeks by

A

22-38 weeks

52
Q

2-3 cm below xiphoid process

A

38-40 weeks

53
Q

Chadwick sign

A

cervix, vagina, and vulva bluish color due to increased vascularity

54
Q

Goodell’s sign

A

softening and cyanosis of cervix after 4 weeks

55
Q

effacement

A

thinning of cervix

56
Q

cervix will gradually thin to

A

only a few mm

57
Q

which comes first in the primavera? effacement or dilation

A

effacement

58
Q

dilation

A

opening of the cervical canal

59
Q

Fetal heart rate at

A

11-12 weeks

60
Q

fetal movement appreciated by mother at

A

16-20 weeks

61
Q

fetal movement times per hour

A

10 times in 1 hour to 10 times per 12 hours

62
Q

start monitoring fetal movement at

A

34-36 weeks

63
Q

Leopold Maneuvers: A

A

fetal pole–fetal lie; longitudinal or transverse

64
Q

Leopold Maneuvers: B

A

umbilical pole–small parts/big parts; which ways is back facing

65
Q

Leopold Maneuvers: C

A

Pawlicks Grim–confirms cephalic

66
Q

Leopold Maneuvers: D

A

pelvic group–attiude (what is presenting and how); attitude; head flexed or extended

67
Q

station

A

relationship of the presenting part of the ischial spines of the mother’s pelvis

68
Q

Braxton Hicks begin as early as the

A

third month

69
Q

how does the uterus position change?

A

more anteflexed during the first three months

70
Q

bleeding in early pregnancy can mean

A

ectopic pregnancy

71
Q

bleeding in late pregnancy can mean

A

abruptio placentae: separation of placenta from the site of uterine implantation before delivery

72
Q

Initial pregnant visit at

A

6-8 weeks

73
Q

no brush after

A

10 weeks

74
Q

test for gestational diabetes at

A

24-28 weeks

75
Q

initial glucose test

A

drink glucose; one hour later; test. <130-140 is normal

76
Q

Follow-up glucose testing

A

fast overnight, then test blood sugar level. Then drink another higher concentration glucose drink. Check every hour for three hours. If at least two are higher, then you have gestational diabetes.

77
Q

A prior child weighing over x pounds then you might consider earlier glucose testing?

A

9 lbs

78
Q

Rectus abdominal muscles separate

A

diastasis recti

79
Q

umbilicus changes

A

flattens or protrudes

80
Q

gallbladder changes

A

becomes distended, decreased emptying time and change in tone

81
Q

what type of stones are you higher risk for?

A

gallstones (second and third trimesters)

82
Q

dilation of the ureter is greater on the?

A

right side

83
Q

ureter changes in shape

A

elongate and form single and double curves which can lead to urinary statis

84
Q

renal function is most efficient if the individual

A

lies in the lateral recumbent position

85
Q

renal changes can last up to

A

3-4 months after delivery

86
Q

trigone changes

A

deepening and widening which may lead to microhematuria

87
Q

colon location changes

A

displaced laterally upward and posterior

88
Q

colon changes

A

peristaltic activity decreases; water absorption increases –> bowel sounds diminished, constipation and flatus common

89
Q

appendix position changes

A

upward and laterally

90
Q

immediately after delivery, the uterus is approximately the size of a

A

20 week pregnancy (palpable at umbilicus)

91
Q

by end of first week post-partum, uterus is approximately size of

A

12 week pregnancy (palpable at pubic symphysis)

92
Q

muscles of pelvic floor take how long to recover

A

6-7 weeks

93
Q

protrusion of naval can indicate

A

umbilical hernia

94
Q

ectopic pregnancy pain

A

lower quadrant, refers to shoulder; with rupture, agonizing

95
Q

symptoms of ectopic pregnancy

A

hypogastric tenderness, symptoms of pregnancy, spotting, irregular menses, soft abdominal wall, mass on bimanual pelvic examination

96
Q

symptoms of rupture ectopic pregnancy

A

shock, rigid abdominal wall, distension, Kehr, Cullen

97
Q

Kehr sign

A

abdominal pain radiating to left shoulder

98
Q

Cullen sign

A

ecchymosis around umbilicus

99
Q

two signs of ectopic pregnancy

A

Kehr and Cullen

100
Q

four pelvic joints

A

symphysis pubis; sacrococcygeal; two sacrioiliac joints

101
Q

what hormones are responsible for softening of the pelvic cartilage and strengthening of the pelvic ligaments

A

relaxin and progesterone

102
Q

pelvic joints separate and lead to what type of gait

A

waddle

103
Q

symphysis pubis returns to prepregnancy state within

A

3-5 months

104
Q

the cervical canal is obstructed with what after conception?

A

thick mucus protecting the infant from infection

105
Q

what dislodges at beginning of labor?

A

“bloody show”

106
Q

pH of vaginal secretions

A

acidic due to lactic acid

107
Q

acidic vaginal pH can lead to

A

candida infection

108
Q

cervix is located

A

midline

109
Q

cervix consistency

A

softer

110
Q

painful cervical movements can mean

A

ruptured tubal pregnancy

111
Q

trimester length

A

slightly more than 13 weeks (3 months)

112
Q

is early uterine enlargement symmetric?

A

maybe not

113
Q

a variation of fundal height of x cm should be evaluated

A

2 cm

114
Q

if uterus is smaller than expected, think:

A

intrauterine growth restriction

115
Q

goodell occurs around

A

4-6 weeks

116
Q

hegar

A

softening of the uterine isthmus

117
Q

goodell

A

softening of the cervix

118
Q

hegar at

A

6-8 weeks

119
Q

mcdonald

A

fundus flexes easily on the cervix

120
Q

mcdonald at

A

7-8 weeks

121
Q

braun von fernwald

A

fullness and softening of teh fundus near the site of implantation

122
Q

braun von fernwald at

A

7-8 weeks

123
Q

piskacek

A

palpable lateral bulge or soft prominence of one uterine cornu

124
Q

piskacek at

A

7-8 weeks

125
Q

chadwich

A

bluish color of cervix, vagina, and vulva

126
Q

chadwich at

A

8-12 weeks

127
Q

shortening of the cervix (less than 29 mm midpregnancy) can mean

A

risk for preterm delivery

Patient Assessment (3 decks)

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