week 2 lecture Flashcards
define gravidity
number of pregnancies
define parity
number of births
GTPAL
gravida
term
pre-term
abortion
living
pre-term
20 weeks - 37 weeks
late pre-term
32 weeks - 36 weeks and 6 days
early term
37 weeks - 38 weeks and 6 days
full term
39 weeks - 40 weeks and 6 days
late term
41 weeks - 41 weeks and 6 days
post term
42 weeks - 42 weeks and 6 days
viability
how viable to fetus is during 22-25 weeks
Nagele’s rule
estimates due date (date of delivery)
LMP (last mensuration) - 3 months + 7 days
what is the most definitive way of calculating due dates?
ultrasound
characteristics of pregnancy tests
measure HCG
alisa-assay test is the most common type of at-home pregnancy test
how to HCG produced
production is stimulated from the placenta by estrogen and HPL
what is a presumptive sign of pregnancy
signs and symptoms the mother perceives
why the mother thinks they are pregnant
subjective
examples of presumptive signs
breast enlargement
frequent urination
missed period (amenorrhea)
nausea and vomiting
fatigue
quickening - perceived fetal movement
spotting
define amenorrhea
missed period
absence of mensuration
define quickening
perceived fetal movement
what is a probable sign of pregnancy
physical signs
more objective
examples of probable signs of pregnancy
goodell sign
chadwich sign
hegar sign
positive serum pregnancy test
positive urine pregnancy test
braxton hicks contractions
ballottement
define goodell sign
softening of cervix
define chadwich sign
bluish mucosa membranes of the vagina, cervix, and vulva
define hegar sign
the softening of the isthmus of the uterus
define braxton hicks contractions
mild painless contractions
define ballottement
passive fetal movement in response to tapping of the lower portion of the uterus or cervix
what are positive signs of pregnancy
definite signs
confirms that the pt is pregnancy
attributes of the fetus
examples of positive positive signs of pregnancy
visualization of a fetus by real-time ultrasound examination
fetal heat tones detected by ultrasounds
visualization of the fetus by radiographic study
fetal heart tones detected by a doppler ultrasound stethoscope or fetal stethoscope
fetal movement palpated by the examiner
fetal movement visible by the examiner
priority lab tests
HCG trends
trend should be rising
low trend can indicate the fetus is not viable
very high trends can indicate twins
reproductive adaptations to pregnancy
uterus gets bigger and becomes more vascular in response to hormonal changes
relaxin causes cartilage in the pelvis to relax so the pelvis can widen as the fetus grows
what does a boggy fundus indicate?
hemorrhage
when does the “baby bump” develop
around 14 weeks
braxton hicks vs real contractions
braxton hicks - random, no pattern
real contractions - regular, increasing in intensity, decreasing in duration
way to alleviate braxton hicks contractions
drink water
pee
rest
put feet up
cardiovascular adaptations to pregnancy
hemodilution - increased blood volume caused by increased plasma levels
blood volume increased by 1200-1500 CCs
decreased H+H causes anemia
5-6x increased risk for developing blood clots because of slower blood circulation
heart is anatomically elevated and pushed to the left
HR increases by 15-20 BPM initially, but then returns to normal
mostly no change in BP
increased cardiac output of 30-50%
supine hypotension
edema
increased venous pressure leads to varicose veins and hemorrhoids
characteristics of anemia pregnancy
S+S - fatigue, dizziness, SOB
need to ensure the baby is getting enough iron
iron supplements can increase constipation
treatments for constipation
increase fiber
increase fluids
keep active
major indicator for preeclampsia
hypertension (140/90)
characteristics of supine hypotension
uterus presses down on aorta and vena cava when pt is supine
never take a BP when pt is lying down
slowly go from supine to sitting up to prevent balance issues and dizziness
prevent by having pt lie left lateral recumbent
concerns with edema
edema is a concern is there is sudden onset in the face or hands
unilateral edema could be caused by a blood clot. it is important to compare both sides during inspection/assessment
what conditions are caused by increased venous pressure
hemorrhoids
varicose veins
respiratory adaptations to pregnancy
SOB could indicate PE
capillaries in respiratory system becomes engorged and causes edema
increase immune response causes inflammation
common to get bronchitis, URI, and sinus congestion
helps to sleep with a humidifier
uterus presses on diaphragm and causes SOB
more chest breathing
“blow out a candle” engages the diaphragm
define linea nigra
vertical line down the middle of the pt’s abdomen
define striae
stretch marks
seen on the abdomen, hips, breast, and thighs
define chloasma
mask of pregnancy
hyperpigmentation in cheeks, forehead, and nose
can cause impaired self-esteem
changes in hair and nails
during pregnancy hair and nails grow long and thick
post-partum hair falls out
define palms erythema
palms get red
musculoskeletal adaptation to pregnancy
relaxin relaxes cartilage and ligaments
lordosis (causes lower back pain)
different center of gravity causes fall risk
promote yoga and stretches
define diastasis recti
separation of the rectus abdominal muscle, leading to flaccidity of the abdominal area after birth
GI adaptations to pregnancy
slowed motility and gastric emptying
acid reflux and constipation are common
food eversion
hyperemesis gravida
pica
encourage eating small frequent meals
define food eversion
avoiding certain foods
define hyperemesis gravida
can’t keep any food down
pt might be hospitalized
define pica
cravings for things that aren’t foods
usually means there is something nutritionally missing
renal adaptations to pregnancy
increase urine output
relaxin dilates ureters
increased GFR but slower flow
high risk for UTIs
pyelonephritis
nocturia
increased urination frequency
uterus presses on bladder which prevents bladder expansion
define pyelonephritis
high risk for kidney infection
