Psychological and Physiologic Changes of Pregnancy

Question 1

Para

Answer 1

of pregnancies that reached 20 weeks or beyond (born alive or not)

Question 2

Gravida

Answer 2

A woman who is or has been pregnant (how many times)

Question 3

Primigravida

Answer 3

A woman who is pregnant for the first time

Question 4

Primipara

Answer 4

A woman who has given birth to one child passed age of viability (first delivery)

Question 5

Multigravida

Answer 5

A woman who has been pregnant previously

Question 6

Multipara

Answer 6

Delivered more than once

Question 7

Nulligravida

Answer 7

A woman who has never been and is not currently pregnant

Question 8

Post term/post dates

Answer 8

Pregnancy goes beyond 42 weeks + 6 days

Question 9

Preterm

Answer 9

Pregnancy beyond 20 weeks, but not completed the full 37 weeks + 6 days = <38 weeks

Question 10

Term

Answer 10

beginning of 38 weeks and went to the end of the 42nd week

Question 11

Viability

Answer 11

Capable of living outside the uterus (22-25 weeks)

Question 12

Placental Function

Lungs:

Answer 12

O2 and C02 exchange

Question 13

Placental Function

Digestive:

Answer 13

Absorption of nutrients

Question 14

Placental Function

Liver:

Answer 14

Processes moms blood for iron

Question 15

Placental Function

*Endocrine:

Answer 15

Maintains pregnancy, prevents another pregnancy, prepares breasts for lactation

Question 16

Placental Function

Thermal control:

Answer 16

Cools/warms fetal blood

Question 17

Placental Function

Immune:

Answer 17

Barrier against infection (cannot protect against viruses)

Question 18

Fetal Surveillance
Goals:
Hx:

Answer 18

Goals: prevent prenatal mortality, compromise

Hx: Diabetes, renal problems -> htn? etc. This determines how often you see mother.

Question 19

What is a NST?

Answer 19

Shows fetus is getting oxygen

Shows fetus well being (accelerations)

Question 20

NST
Reactive:
Non reactive:

Answer 20

Reactive: 2 accelerations in 20 min period. 15 sec long, 15 bpm high

Non reactive: Poor blood supply (worrisome)

(want an active baby. Wake if necessary!)

Question 21

Tone

Answer 21

Body position of fetus

Question 22

CST

Answer 22

Contraction stress test

Causes contractions (to see how baby responds)

Done if NST is non reactive

Question 23

Biophysical Profile (BPP)

Answer 23

This is a physical exam on fetus

Looking at breathing, gross body movement, tone, fluid in uterus.

Question 24

Presumptive signs of pregnancy

Answer 24

Amenorrhea
Breast changes
n/v
Frequency
fatigue
Uterine enlargement
Quickening (Feel baby move)
Linea negra, melasma, striae gravidarum

(These dont always mean you’re pregnant, could be endocrine problem)

Question 25

Probable signs of pregnancy

Answer 25

Lab tests 95-98% reliable
Home pregnancy test (if neg repeat in week)
Physical signs

Question 26

Goodell

Answer 26

Soft cervix

Question 27

Chadwicks sign

Answer 27

Everything turns blue

Question 28

Braxton Hicks

Answer 28

Helps uterus grow

Helps circulation

Question 29

Positive signs of pregnancy

Answer 29

outline of fetus on U/S
Fetal heart separate from mother
Fetal movements
Visualization of fetus

Question 30

Couvade syndrome

Answer 30

Dad has s/s of pregnancy

Question 31

Cardiovascular

- Blood volume

Answer 31

• increased plasma and rbc (pseudo anemia)
• increased iron need
• increased clotting factor
• increased lipids

Question 32

Cardiovascular

- Cardiac output

Answer 32

• slight increase in BP
• blood sugar elevated
• progesterone effect (vasodilator)

Question 33

Supine hypotension syndrome

Answer 33

Vena cava/aorta compression by growing uterus

-Hypotension, dizziness, pallor

Question 34

Respiratory changes during pregnancy?

Answer 34

Increased vascularity d/t increased estrogen*

Question 35

Respiratory

-Upper

Answer 35

• stuffy nose
• increased mucus, epistaxis (bloody nose)
• sensitive to odors

Question 36

Respiratory

-Lower

Answer 36

• increased O2 consumption (hyperventilation)
• enlarged circumference of chest
• elevated diaphram

Question 37

Integumentary

Answer 37

• hyper pigmentation
• increased oil production (oily hair, sweat)
• decreased elasticity
• angiomas (tiny red mole)
• palmer erythema (red hands)
• PUPP (cool shower can help)

Question 38

Neurological

Answer 38

• brain shrinkage
• carpal tunnel syndrome (d/t swelling)
• blurred vision
• emotional liability

Question 39

Musculoskelatal

Answer 39

• softening of joints (waddling gait)
• postural changes
  
  • butt sticks out (back pain)
  • pressure on nerves
  • dec. serum calcium (leg cramps)

Question 40

Endocrine

Answer 40

• double metabolism: fatigue
• thyroid enlarged (T4 increased)
• parathyroid enlarged
• pituitary (refer to pp)
• adrenal (increased aldosterone and cortisol)
• pancreas cells increase in size (increased insulin prod.)

Question 41

Endocrine (placental hormones)

Answer 41

-hCG