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30 Cards in this Set
- Front
- Back
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Changes experienced in pregnant woman: Cervix
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Goodell's sign
Increased vascularity- friability (spotting after exam) Increased mucous production |
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Changes experienced in pregnant woman: Vagina
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Mycoid vaginal discharge
Ruga(e)- ridge/fold of tissue Chadwick's sign |
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Changes experienced in pregnant woman: Breasts
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Nipples darker & larger
Increased circulation, blood vessels dilate Montgomery's tubercles (sebaceous glands around areola, become secretory later in pregnancy) |
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Changes experienced in pregnant woman: Cardiovascular Changes
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Heart displaced upward and to the left
Increased size of heart Increased HR Increased work of heart Increased circ. volume Increased Cardiac Output |
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True or False: Total blood volume increases by 30-50 % in pregnancy
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True
Book says 30-50 Lecture says 40-50 |
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The increase in plasma volume is more pronounced and occurs earlier than the increase in RBC volume. The resulting dilution of RBC mass causes a decline in maternal ______ and _____.
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hemoglobin and hematocrit.
Condition known as physiologicanemia or pseudoanemia of pregnancy |
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_________________occurs when HGB is less than 11 g/dL in 1st and 3rd trimesters or less than 10.5g/dL in the second trimester.
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Iron deficiency anemia
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True or False: Because of the increase in blood volume during pregnancy, blood pressure usually increases throughout pregnancy.
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False. As a result of decreased peripheral vascular resistance, blood pressure remains stable during pregnancy despite the increase in blood volume. (Systolic pressure remains unchanged or decreases slightly and diastolic pressure may decrease by about 10-15mm Hg by 24-42 weeks gestation. By 3rd trimester, BP returns to normal.)
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A hemoglobin of ___ g /dL and a hematocrit of ___% or higher give most women an adequate margin of safety for blood loss associated with normal birth.
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11
33 |
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Heart Rate changes in pregnancy
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1st semester:increase by 8-10 from baseline
3rd semester: increase by 15 beats at term (Within 4-6 weeks postpartum HR should go back to baseline as she gets rid of excess circulatory volume) |
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Normal blood loss for C section is _____ ml and for vaginal _____ ml
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1000, 500
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How do you diagnose PIH?
What if you don't have a baseline BP? |
Increase of Sys by 30 and Dias by 15 above baseline BP in 2 subsequent readings. If baseline unknown, 140/90 is diagnostic for PIH.
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______ reduces vascular tone. It can cause venous dilation which leads to stasis in the legs-- edema, vericosities.
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Progesterone
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Changes experienced in pregnant woman: Respiratory System
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Increased oxygen consumption: 15-20%.
Breathing becomes more thoracic rather than abdominal, may cause dyspnea. Compromised during colds, URIs, |
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Changes experienced in pregnant woman: GI
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nausea & vomitting: hormonal changes, iron may cause, also increased pressure in abdominal cavity, stomach and intestines displaced.
Constipation- may be due to progesterone, decreased peristalsis, may be due to iron intake, less exercise Heartburn- may be due to progesterone Gums- swollen, bleed easily due to estrogen PICA- odd food cravings |
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Ptyalism (hyerptyalsim)
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difficulty swallowing, due to excess saliva
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Changes experienced in pregnant woman: Urinary System
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Ureters elongate
Renal Pelvises enlarge due to loss of tone Urinary stasis & reflux- can lead to UTI Dependent edema in daytime- pooling, stasis Nocturia- esp. at night Frequency urination |
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look up neurological and rest in PP
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look at rest of powerpoint no more time!!!
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Classic Signs of Preterm Labor
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lower abdominal cramping
diarrhea intermittent lower back pain painful menstrual-like cramps suprapubic pain/pressure rupture of amniotic membrane urinary frequency |
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Changes experienced in pregnant woman: Neurologic System
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Compression of pelvic nerves
dorsolumbar lordosis Carpal tunnel syndrom hypocalcemia lightheadedness/ faintness (volume excess, quick postural changes, also may be related to hypoglycemia) |
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How is hypocalcemia manifested?
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muscle cramps in lower extremities
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Tinil's Sign
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?
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Phalen's sign
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?
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Changes experienced in pregnant woman: Musculoskeltal System
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increased weight and change of center of gravity
decreased abdominal muscle tone- sometimes there is separation of rectus abdominus at times, usually returns to normal postpartum Waddling gait Exaggerated lumbrosacral curve (relaxin relaxes pelvic joints) Ligaments and muscles of mid and lower spine stressed |
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Changes experienced in pregnant woman: Integumentary
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Increase in hair/nail growth
Increased sweat & sebaceous gland activity Acne- esp. early pregnancy Striae gravidarum Increased pigmentation: -cholasma (mask of pregnancy) -may have darkening of skin linea nigra- pigmented line from symphysis pubis to top of fundus photosensitivity |
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Progesterone
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small muscle relaxer
increase BMR warm sensations increase perspirations |
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Relaxin
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Relaxes pelvic joints
difficult, difficulty walking |
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Thyroid
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slight enlargement of thyroid gland at about 3rd months,
6 weeks post- returns to normal compare this one with girls... |
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Adrenals
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Increase aldosterone
slight need for more sodium, but we get enough of that with the American diet |
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Danger Signs
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Escape of fluid from vagina
bleeding from vagina abdominal pain, cramps, contractions (Braxton Hicks vs. true contractions) Dizziness Visual disturbance -PIH (silver, flashing lights) Chills and elevated temperature (infection) Persistent and severe vomiting - hyperemesis gravidarum Epigastric pain- heartburn persistent, pounding headaches- PIH rapid weight gain over several days- retaining fluid Decreased, scanty, or painful urine ouput- UTI Decreased urine output Absence of fetal movement after quickening Any time there's fluid flowing, not just a discharge, call MD Put fluid on a slide, look under microscope... Ferning- lacy appearancy pH will change from white-yellow-blue |
