Quiz #4 Module 4 (Pregnancy) Flashcards
what does gravida mean?
pregnant
what does parity mean?
number of pregnancies
what does multi and primi mean?
multi- more than one
primi- first time/one
what does the term nulli mean?
none
what does the term viability mean?
capacity to live outside uterus (can live 22-25 weeks)
what does GTPAL stand for?
gravida (# of all pregnancies youve had), term (# of term births-37weeks), pre-term abortions (miscarried as well-before 37 weeks), any living children who you have
what is really important for nurses to do with pregnant women?
always teach about health promotion, ensure they know its a huge learning curve and a major life event
how do you calculate Naegele’s rule and what is it?
it calculates estimated due date. You count back 3 months from first menstrual period and then add 7 days plus a year
list changes that occur during pregnancy?
- nose congestion
- nausea and vomiting
- palpitations
- breast tenderness
- shortness of breath
- back ache
- urinary frequency
- abdominal discomfort
- constipation
- braxton hicks
- hemorrhoids
- muscles cramps
- ankle edema
what is supine hypotension?
when pregnant women line in supine position, their belly pushes on aorta and cuts off some circulation
what does the term para refer to?
pregnancies
what is hCG and how does it reveal that you’re pregnant?
its human chorionic gonadotopin and its the earliest biological marker for pregnancy. it is the cause of the pink line, it depends on the hCG levels
what are presumptive signs?
those subjective changes felt by women (breast changes, fatigue)
what are probable signs?
those objective changes (hegar sign, pregnancy tests)
what are positive signs?
signs attributed only to the presence of the fetus (hearing fetal heart tones, visualizing the fetus, palpating fetal movements)
what hormones stimulate vast growth of uterus during first trimesteR?
high levels of progesterone and estrogen
what are braxton hicks?
irregular and painless. these contractions facilitate uterine blood flow and promote oxygen delivery to the fetus
what is leukorrhea?
white or slightly grey discharge with a faint musty odour
vagina secretions are more acidic or basic?
they are more acidic
why are external structures of perineum enlarged during pregnancy?
due to increase in vasculature, hypertrophy of perineal body and disposition of fat
what happens to breasts during pregnancy?
they enlarge, but nipples and areolae become more pigmented
what are montgomery tubercles?
sebaceous oil glands embedded in the primary areolae that secrete lubricating and anti-infective substances to protect nipples/areolae during breastfeeding
what is primigravida?
someone who is pregnant for the first time
what accounts for the progressive breast enlargement?
growth of mammary glands
what happens to pulse for pregnant women?
between weeks 14 and 20 pulse increases about 10-15BPM
what happens to systolic and diastolic pressure?
- systolic usually remains the same as the pre-pregnancy level but may decrease slightly as pregnancy advances
- diastolic begins to decrease in first tri. until 24-32 weeks and gradually increases and returns to pre pregnancy levels by term
how much does blood volume increase by?
1500mL when pregnant
as you get further along in pregnancy, what happens to breathing?
chest breathing takes over abdominal breathing
what infection are women more susceptible to when pregnant? why?
UTI’s due to more basic pH
what changes occur in the mouth?
- gums become hyperemic, spongy, swollen
- gums bleed more easily due to increased levels of estrogen
what changes can occur in the abdominal region?
pelvic heaviness, round ligament tension, flatulence, bowel cramping
list some hormonal changes
increased sensitivity, increased irritability, tears, great joy, cheerfulness
what does it mean to have feelings of ambivalence
having conflicting feelings of being pregnant as well as wanting to be pregnant
what are the three phases of the mother-child relationship?
- women accepts biological fact of pregnancy
- women accepts the growing fetus as distinct from herself and as person to nurture
- women prepares realistically for the birth and parenting of child
list barriers to obtaining health care during pregnancy
• Inadequate numbers of HCP • Unpleasant clinic facilities or procedures • Inconvenient clinic hours • Distance from health care facilities • Lack of transportation • Fragmentation of services • Inadequate finances -Conflicting personal attitudes
what bp suggests hypertension
140/90
define term
beginning 37 weeks to end 40 weeks +6 days
what are the pre term weeks
20-36 weeks
what is early term?
37-38 weeks
what is full term?
39-40 +6 days
late term?
41 weeks
post term?
42+ weeks
describe the normal pattern of hCG for pregnancy
hCG rises till 60-70 days then decreases for 80 days. then stabilizes till 30 weeks and then increases till end of term
what are factors that cause a false positive result?
blood in urine, protein in urine, or certain medications
what can cause a false negative?
if the pregnancy test is taken too early
describe what happens during uterine growth
due to increased vascularity, dilation of blood vessels, development of decidua, hyperplasia, hypertrophy and increased pressure
what is the fundus height at 12-14 weeks gestation?
can be palpated above the symphysis pubis
what is the fundus height at 20-22 weeks gestation?
can be palpated at the level of the umbilicus
what is the fundus height at term?
can be palpated near the xiphoid process
what is the fundus height at 38-40 weeks?
fundus (top of the uterus) gradually begins to descend
what can altar the examination of the fundal height?
- the amount of amniotic fluid
- more than 1 fetus
- maternal obesity
- variation of examiner
when can contractions be first felt and what kind of contractions?
first at 4 months and it can indicate pre labour (braxton hicks)
how much blood flow goes through uterus?
450-650mL
what does the goodell sign show?
softening of cervix (which is a sign of pregnancy) and its due to an increase in vascularity and slight hypertrophy
how do a multi para and nulli para cervix differentiate?
nulli- rounded
multi-has a slit, more oval and horizontal
what happens when there’s an increase in mucosa in vagina and vulva?
- connective tissue loosens
- smooth hypertrophy muscle
- vagina vault lengthens
- violet blue mucosa
- leukorrhea
-and a mucous plug can occur called a operculum
what is the pH of mucosa?
more acidic due to lactic acid
what is pre colostrum and colostrum?
clear, thin for pre colostrum
orangey/white and its pre milk for colostrum
what is it called when the partner experiences several of the same symptoms that the mother is feeling?
couvade syndrome
what happens with pulse?
increases 10-15 BPM
what happens with blood volume?
1500ml or 40-50% increase
what happens with cardiac output?
increases by 30-50% by 32 weeks
what contributes to the development of hemorrhoids in the later stage of pregnancy?
compression of the iliac veins and inferior vena cava by the uterus
what is chadwicks sign?
violet blue mucosa and cervix due to increase vascularity
what happens when there is an increase in vascularity of upper respiratory tract?
- nasal congestion
- epistaxis
- voice changes and strong inflammatory response to URTI’s
for respiratory, what happens with pH?
pH slightly increases (basic)
describe the term angiomas and when do they occur?
tiny star shaped blood vessels on neck, face and arms. occur 2-5 months along pregnancy
what is epulis?
red bumps on gums that bleed easily
what is hirsutism?
excessive hair in unusual places
what can persist after pregnancy?
diastasis recti abdominis (splitting of the abs)
what is syncopal episodes and when does this typically occur?
fainting or passing out. usually occur in early stage of pregnancy
what is ptyalism?
excessive salivation
what is pyrosis?
heart burn
what is the normal weight gain for someone who has a normal BMI?
11.5-16kg
what does hCG do?
maintains corpus luteum production of estrogen and progesterone until placenta takes over
what does estrogen do?
- fat deposit (butt, hips)
- body enlargement
- increase vascularity
- relaxes pelvic ligaments
- increase retention of sodium and water (this is a reason for constipation)
what does progesterone do?
- relaxes smooth muscle
- decreases uterine contractibility
- decreases mothers ability to use insulin
prolactin?
prepares breasts for lactation
oxytocin?
- stimulates uterine contractions
- stimulates lactation
what confirms pregnancy?
- last menstrual period
- intercourse
- basal body temp
what does a mother need for maternal adaptation?
Accepting pregnancy: reflected in relation to emotional response and mood swings (engagement and awareness of the presence of infant). Normal response.
Identifying w/ mother role: begins early in life when she is being mothered as child. Ambivalence continues into 3rd trimester
Personal relationship: with other pregnant women, promote good relationships with people around her.
Relationship w/ fetus: emotional attachment, fantasize and daydream about child (3rd trimester)
Preparing for childbirth: anxious about process of birth (3rd trimester)
what are the phases of the mother relationship?
phase 1: they’re accepting biological fact that they’re pregnant (“i am pregnant”- you wanna hear)
phase 2: the growing fetus is distinct from herself, you want her to say “i’m going to have a baby”
phase 3: prepares realistically for birthing and parenting (‘i’m going to be a mother!”)
what are parental adaptations?
- accepting pregnancy
- couvade symptom
what are the phases of developmental tasks by accepting fathers
- announcement phase (them knowing and accepting that they’re pregnant)
- moratorium phase (related to the man’s perception of his own readiness for pregnancy)
- focusing phase (fathers active involvement with child and pregnancy)
identifying of the father role
- child care that the dad received as a child
- father memories
- his perception of males and fathers
- this guides his tasks and responsibilities that he will assume when he becomes as dad
the fathers role is? (paternal adaptation)
- accepting: same as for mother
- identifying: the father as a child
- reordering personal relationships: involvement with baby. quality of relationship with partner (only spouse where as the other one has a relationship with spouse and mother)
- relationship with fetus: the father prepares in many of the same ways that the mother does (imagining life with a new born etc and emotional attachment)
- preparing for childbirth: anxiety and anticipation. Many fathers channel energy into productive activity
grandparent adaptation?
- evidence they’re getting older
- there maybe negative comments toward new mother
sibling adaptation?
- jealousy cause of sharing
- parent’s attitudes
- fathers role
- length of separation of mom
- hospital visitation policy
- how child has been prepared for change
