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46 Cards in this Set
- Front
- Back
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Presumptive/Subjective Signs |
Signs that the subject describes to you: fatigue, breast tenderness, N/V, amenorrhea, urinary frequency, quickening, hyperpigmentation, uterine enlargement, breast enlargement. |
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Probable/Objective Signs |
Signs that an examiner could see or palpate: Braxton Hicks contractions, pos test, abd enlargement-- Ballottement, Goodel's Sign, Chadwicks sign, Hegars sign. |
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Ballottment |
16-28 weeks, "baby bounce". The baby moving freely within the amniotic fluid. |
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Goodell's Sign |
5 weeks- Cervical softening. Felt upon examination of the cervix |
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Chadwick's Sign |
6-8 weeks, Vaginal mucosa turns a more purple color d/t increased vascularity and blood flow to the area. |
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Hegar's sign |
6-12 weeks, the ability to palpate the uterus as it begins to move out of the pelvis. |
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Positive Signs/ Diagnostic Signs |
Ultrasound of embryo or fetus 4-6 weeks Fetal movement palpated by physician 20 weeks Auscultation of fetal heart tones 10-20 weeks |
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Reproductive System Changes: Uterus |
Increase in overall capacity Positive Hegar's Sign Increased contractility Ascent into abd Increased fundal height (20wks=20cm above belly button) |
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Reproductive System Changes: Cervix |
Begins to soften formation of mucus plug to protect from infection Increased vascularity ripening before birth |
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Reproductive System Changes: Vagina |
Increased vascularity Lengthening of vaginal vault Leukorrhea formation- white/yellowish vaginal discharge. (Acidic to help protect from infection) |
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Reproductive System Changes: Ovaries |
Cessation of ovulation enlargement until 12-14 wks |
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Reproductive System Changes: Breasts |
Increase in blood flow(doubles) and overall size, Increase in nipple size, darker pigmentation, nipple erection to prepare for lactation Production of colostrum begins Increase in milk ducts |
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GI System Changes |
Hypereremic, swollen, and friable gums Ptyalism decreased peristalsis, increased constipation increased risk for hemorrhoids slowed gastric emptying prolonged gallbladder emptying increased N/V |
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CV system changes |
50% increase in BV INCREASED: CO, venous return, and HR Slight decrease in BP by midpregnancy increase in RBC and Plasma result in Anemia Increased hypercoagulable state d/t increased demand for iron and fibrin levels |
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Resp system Changes |
Breathing becomes more diaphragmatic (breathing from diaphragm) Increased lung capacity and tidal volume d/t increased size in chest circumference. |
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Renal system changes |
dilation of the renal pelvis increased GFR d/t increased BV |
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MS system changes |
softening and stretching of round ligaments sway back and upper spine curvature changes forward shifting of center of gravity lordosis waddle gait --no heels during pregnancy, fall prevention, increase ligament flexibilty |
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Integ system changes |
Hyperpigmentation- facial melasma linea negra striae gravidarum varicosities vascular spiders palmar erythema decline in hair loss |
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Endocrine System Changes
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Thyroid: increased activity, slight enlargement, increased metabolic rate Pituitary gland: increase in prolactin, gradual increase in oxcytocin Pancreas: insulin resistance -- can result in gestational diabetes; inc. risk if already overweight Adrenal glands: increase production of cortisol and aldosterone |
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Endocrine System Change: Placenta |
Placenta considered a organ: releases (hCG) Human chorionic gonadatropin, (hPL) Human placental lactogen, relaxin, estrogen, and progesterone Only exhists during pregnancy, expelled during child birth |
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Nutrition : Calorie Intake |
1st trimester: No increase in calories 2nd: +340 cals 3rd: +450 cals If breastfeeding: +500 cals |
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Weight Gain |
25-30lbs total: 2-4 lbs 1st trimester 1lb/week 2nd an 3rd trimester |
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Couvade Syndrome |
sympathy weight, N/V, subjective symptoms..ect. |
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Contraindications for Sexual Activity |
vaginal bleeding Placenta previa r/f preterm labor cervical insufficiency premature membrane rupture active labor **Problems that increase risk for preterm labor or hemorage** |
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Preconception Care |
Complete a total assessment and then educate to make adjustments: full H&P, head to toe, Nutrition & lifestyle, support system, ect. |
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Risk Factors for Adverse Pregnancy Reactions |
Isotretinoins (certain facewashes), alcohol misuses, anti-epileptic drugs, diabetes, folic acid deficiency, HIV/AIDS, hypothyroidism, Maternal phenylketonurea (PKU- increase in phenylalanine), |
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1st Prenatal visit |
Goals: establish a trusting relationship full H&P Menstrual history Establish pt baselines Estimated due date |
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Nagele's Rule |
1. Use first day of LMP 2. Subtract 3 months 3. Add 7 days 4. Add 1 year = Due Date |
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Gavidity |
Number of pregnancies: Nulligravida- never been pregnant Primigravida-1st pregnancy Multigravida- 2+ pregnancies |
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Parity |
Number of pregnancies reaching 20wks Nullipara- no pregnancy reaching 20wks Primipara- 1st to reach 20 wks Multipara- 2+ reaching 20 wks |
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GTPAL |
G: gravida T: term births P: preterm births A: abortions L: living children ex: G2T1P0A1L1 |
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Preterm |
babies born before 37wks (lungs are fully developed) |
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Pelvic Exam |
Bimanual internal and external exam determine pelvic shape (gynecoid, android, anthropoid, platypelloid) Take pelvic measurements (diagonal conjugate, true conjegate, ischial tuberosity) |
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lab tests |
UA
blood type rH factor CBC, HgB, HcT Rubella titer Hep B HIV VDRL RPR Vag/Cervical culture |
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Scheduling follow up visits |
Q4 wks: until 28 wks Q2 wks: 29-36 Q1 wks: 37-birth |
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Kick Counting |
start at 16-20wks 2-3 times a day 4+ movements an hr good Drink water/LLP before calling physician |
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Pt Edu: Danger Signs |
vaginal bleeding abd pain/cramps persistent n/v leaking fluid decreased fetal movements fever HA/Blurry vision/Swelling/Epigastric pain Dysuria s/s hyper/hypoglycemia |
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Doppler flow study |
assess velocity of bloodflow |
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Alpha-fetoprotein analysis |
increased # can mean fetal neural tube defects |
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Marker screening tests |
check for down syndrome |
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Nuchal translucency screening |
sono detection of abnormality |
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Amniocentesis |
Analysis and confirmation of abnormality |
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Chorionic Villlus Sampling |
Chromosomal disorders |
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Lamaze |
Psychopropholactic methods: focus on breathing and relaxation |
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Bradley Method |
partner-coached birthing: focus on exercises and slow controlled abd breathing |
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Dick-Read Method |
natural childbirth: focus on fear reduction via education and slow breathing |
