PSYCHOLOGIC/EMOTIONAL ADAPTATIONS OF PREGNANCY Flashcards
- Circulatory/Cardiovascular
1.1 Beginning the end of the first trimester there is a gradual increase of about
30% - 50%
gradual increase of about 30% - 50% in the total cardiac volume, reaching its peak during the 6th month. This causes a drop in
hemoglobin and hematocrit values
1.1.3 Systolic murmurs are common due to
lowered blood viscosity
1.1.1 Easily fatigability and shortness of breath because of
increased workload of the heart
1.1.2 Slight hypertrophy of the heart, causing it to be displaced to the left, resulting in torsion on the great vessels
(the aorta and pulmonary artery).
1.1.4 Nosebleeds may occur because of marked
congestion of the nasopharynx as pregnancy progresses.
1.2.2 Increased pressure of uterus against the diaphragm during
second half of pregnancy
1.3.1. Edema of the lower extremities occurs. Management:
legs above hip level.
1.3.2. Varicosities of the lower extremities can also occur Management:
Use/wear support hose or elastic stockings to promote venous flow, thus preventing stasis in lower extremities
Apply elastic bandage
Avoid use of constricting garters
1.4 Because of poor circulation in the blood vessels of the genitalia due to the pressure of the gravid uterus, varicosities of the vulva and rectum can occur Management
side-lying position with hips elevated on pillow and modified knee-chest position.
- Gastrointestinal changes
2.1 Morning sickness – nausea and vomiting during the first trimester is due to increased human chorionic gonadotropin (HCG). It may also be due to increased acidity or even to emotional factors. Management:
Eat dry toast or crackers 30 minutes before arising in the morning (or dry, high carbohydrate, low fat, and low spices in the diet).
2.2 Hyperemesis gravidarum = excessive nausea and vomiting which persists beyond 3 months; results in dehydration, starvation, and acidosis.
Management: D10NSS 300 ml in 24 hours is the priority treatment; complete bed rest is also important
2.3 Constipation and flatulence are due to displacement of the stomach and intestines, thus slowing peristalsis and gastric emptying time. May also be due to increased progesterone during pregnancy. Management:
2.3.1 Increase fluids and roughage in the diet
2.3.2 Establish regular elimination time
2.3.3 Increase exercise
2.3.4 Avoid enemas
2.3.5 Avoid harsh laxatives like Dulcolax; stool softeners, e.g. Colace, are better
2.3.6 Mineral oil should not be taken because it interferes with absorption of fat-soluble vitamins
2.4 Hemorrhoids are due to pressure of enlarged uterus Management:
cold compress with witch hazel or Epsom salts.
2.5 Heartburn management
2.5.1 Pats or butter before meals
2.5.2 Avoid fried, fatty foods
2.5.3 Sips of milk at frequent intervals
2.5.4 Small, frequent meals taken slowly
2.5.5 Bend at the knees, not at the waist
2.5.6 Take antacids (e.g. milk of Magnesia) but never sodium bicarbonate (e.g. Alka Seltzer or baking soda) because it promotes fluid retention.
3.1.1 Increased oxygen consumption and production of carbon dioxide during the
first trimester
3.1.1 Increased oxygen consumption and production of carbon dioxide during the first trimester.
3.1.2 Increased uterine size causes diaphragm to be pushed or displaced, thus crowding the chest cavity.
Management:
Lateral expansion of the chest to compensate for shortness of breath increases oxygen supply and vital lung capacity.
slight increase in basal temperature due to
increased progesterone, but the body adapts after the 4th month
8.1 During the first trimester, weight gain of
1.5-3 lbs. is normal
8.2 On 2nd and 3rd trimesters, weight gain of
10-11 lbs.
8.3 Total allowable weight gain during entire period of pregnancy, therefore, is
20-25 pounds (10-12 kgs).
weight:
Fetus Placenta
Amniotic fluid
Increased weight of uterus Increased weight of the breasts Weight of additional fluid
Fat and fluid accumulation
7lbs. 1 lb.
1 ½ lbs.
2 lbs.
1/1 – 3 lbs. 2 lbs.
4-6 lbs.
