Week 2: Physiological Changes in Pregnancy Flashcards
What are the cardiovascular changes during pregnancy?
Slight hypertrophy, heart changes position, heart rate increases, blood volume increases, RBC increase, hemoglobin and hematocrit decrease, more WBC from 2nd trimester onwards, cardiac output increases, slight decrease in systolic and diastolic blood pressure, edema, increased risk for blood clots.
Where and why does the heart move in pregnancy?
Enlarged uterus displaces the diaphragm which elevates the heart and rotates it to the left.
How much does heart rate increase during pregnancy?
10-15 BPM.
How much does blood volume increase during pregnancy?
1500 ml or 40-50%.
What happens when hemoglobin and hematocrit decrease during pregnancy?
State of demodulation which results in physiological anemia.
When do WBC peak in pregnancy?
Third trimester.
How much does cardiac output increase by during pregnancy?
30-50%.
Why do patients present with swollen ankles and edema in pregnancy?
Compression of the iliac vein and inferior vena cava, which also leads to varicose veins and hemorrhoids.
Why is there an increased risk for blood clots in pregnancy?
Increase in clotting factors circulating in blood.
What is Supine Hypotensive Syndrome?
In the second half of pregnancy, clients lying on their back will compress the vena cava, decreasing systolic blood pressure and leading to reflex bradycardia and cardiac output decrease.
What symptoms are associated with Supine Hypotensive Syndrome?
Pallor, dizziness, faintness, breathlessness, tachycardia, nausea, clamminess, and diaphoresis.
How does one treat Supine Hypotensive Syndrome?
Position client on their left side until signs and symptoms subside and vitals stabilize.
How does oxygen consumption change during pregnancy?
Increases by 20-40%.
When do we see a slight increase in respiratory rate during pregnancy?
Third trimester.
What happens with chest expansion during pregnancy?
Increases, with a 30-40% increase in tidal volume due to estrogen loosening ligaments.
What are some common respiratory symptoms during pregnancy?
Increased congestion, vascularity, nasal stiffness, nosebleeds, and a sense of fullness in the ears.
Why is there an increase in urine output of pregnant women?
Increased progesterone leading to vasodilation which increases GFR, along with enlargement of the ureters and kidneys.
Why is there an increased risk for UTIs in pregnancy?
Urinary stasis or stagnation.
Why are we concerned if a mother has a UTI and it goes untreated?
Increased risk for preterm birth due to amniotic sac rupture or if caused by an STI.
Why do pregnant women have high urinary frequency?
Increased bladder sensitivity and later compression of the bladder, with decreased bladder tone.
What is caused by decreased renal flow and GFR at the end of pregnancy?
Physiological or dependent edema.
What gets darker in pregnancy?
Nipples, areola, axillae, and vulva.
What is chloasma?
Also called the mask of pregnancy, it is blotchy brown hyperpigmentation in the cheeks, nose, and forehead.
What is Linea Nigra?
Pigmented line extending from the symphysis pubis to the top of the fundus.
What happens to gums in pregnancy?
Hypertrophy.
What hormones contribute to an increase in fullness and sensitivity of breasts during pregnancy?
Estrogen and progesterone.
What are Montgomery Tubercles?
Sebaceous glands that secrete lubricant and anti-infection substances to protect nipples and areola during breastfeeding.
When is the uterus palpable above the pubic symphysis?
12-14 weeks.
When does the uterus rise to the level of the umbilicus?
20-22 weeks.
What is Hegar’s sign?
Softening of the lower uterine segment.
What happens to the internal os following birth?
It becomes more transverse and horizontal rather than round as seen in nullipara.
How much blood is lost in a vaginal birth?
500 ml.
How much blood is lost in a C-section birth?
1000 ml.
Why do we have Braxton Hicks contractions?
Increase in blood flow; these are not painful and do not lead to changes in the cervix.
What is Goodell’s sign?
Softening of the cervical tip.
What is Chadwick’s sign?
Increased vascularity resulting in violet-blue color of vaginal mucosa and cervix.
What is leukorrhea?
White or grey discharge with faint musty odor in response to an increase in estrogen or progesterone.
Why is there an increase in nausea and vomiting in early pregnancy?
Increase in hCG and altered carbohydrate metabolism.
Why do pregnant women sometimes experience carpal tunnel syndrome?
Edema which compresses the median nerve.
