Women's Health Exam 1

Front 1

Expected Total Weight Gain for average BMI

What factors change the recommendations?

Back 1

Total = 25-35 lbs

-reduced for overweight, obese
-increased for underweight, multifetal, adolescents

Front 2

recommended caloric increases for each trimester

Back 2

1st: no increase
2nd: 340 per day
3rd: 452 per day

Front 3

Folic Acid

Back 3

-prevents neural tube defects and cleft lip/palate
-recommended intake of 600 mcg per day

Front 4

Iron

Back 4

helps with metabolism and formation of hemoglobic
-pregnancy: 27 mg per day

Front 5

Fat-soluble vitamins

Back 5

-A, D, E, K
-stored in fat cells
-toxicity can result from over-supplementation

Front 6

recommended protein intake during pregnancy

Back 6

71 mg
(an increase of 25 mg!)

Front 7

definition of pica

Back 7

eating substances not usually considered part of a normal diet

Front 8

Groups at risk for nutritional problems during pregnancy

Back 8

abnormal prepregnancy weight, amenia, eating disorders, pica, more than 5 pregnancies, closely spaced pregnancies, multifetal pregnancies

Front 9

increased caloric need during lactation/ breastfeeding

Back 9

330 calories during first 6 mos

400 calories during the 2nd 6 mos

Front 10

definition of couvade

Back 10

pregnancy-related rituals or a cluster of symptoms experienced by some prospective fathers during pregnancy and childbirth

Front 11

1st trimester psychosocial characteristics

Back 11

uncertainty
ambivalence
primary focus = self
"i am pregnant"

Front 12

2nd trimester psychosocial characteristics

Back 12

psychical evidence of pregnancy
primary focus = fetus
narcissism and introversion
change in body image
change in sexuality
"i am going to have a baby"

Front 13

3rd psychosocial characteristics

Back 13

vulnerability
increasing dependence
preparation for birth
"i am going to be a mother"

Front 14

Rubin's Steps of Maternal Role Taking

Back 14

Mimicry
Role Play
Fantasy
Search for Role Fit
Grief Work

Front 15

Maternal Tasks of Pregnancy

Back 15

1. seeking safe passage through labor
2. securing acceptance from partner and family
3. learning to give
4. attachment to baby

Front 16

Paternal "reality boosters"

Back 16

hearing the fetal heart beat
feeling the fetus move
viewing the fetus on the sonogram

Front 17

Braxton Hicks

Back 17

irregular, usually mild uterine contractions that occur throughout pregnancy and become stronger in the last trimester

Front 18

Chadwick's Sign

Back 18

bluish purple discoloration of the cervix, vagina, and labia during pregnancy as a result of increased vascularization

Front 19

colostrum

Back 19

breast fluid secreted during pregnancy and the first week after childbirth

Front 20

diastasis recti

Back 20

separation of the longitudinal muscles of the abdomen (rectus abdominis) during pregnancy

Front 21

Goodell's sign

Back 21

softening of the cervix during pregnancy

Front 22

GTPAL

Back 22

G = gravida
T = term births
P = preterm births
A = abortions
L = living children

Front 23

Gravida

Back 23

a woman who is or has been pregnant, regardless of duration or outcome

Front 24

Para

Back 24

number of pregnancies that have progressed past 20 weeks (delivered alive or stillborn, refers to pregnancies not fetuses)

Front 25

striae gravidarum

Back 25

irregular pink to purple streaks on the woman's abdomen, breasts, or buttocks resulting from tears in connective tissue

Front 26

Nägele's Rule

Back 26

from date of LNMP (last normal menstrual period):
-subtract 3 months
-add 7 days
-correct year

Front 27

uterine souffle

Back 27

a soft, blowing, sound heard over the uterus. the sound of the blood circulating through the placenta
-should correspond with maternal pulse

Front 28

Funic souffle

Back 28

the soft, purring sould heard over the umbilical cord that corresponds with the fetal HR

Front 29

mucus plug

Back 29

in the cervix; blocks the ascent of bacteria from the vagina

Front 30

"bloody show"

Back 30

-an early sign of labor
-consists of the cervical mucous plug and blood (produced by disruption of the cervical capillaries during cervical thinning and dilation)

Front 31

supine hypotension

Back 31

the weight of the pregnant uterus compresses the aorta and vena cava, reducing cardiac return.
-lightheadedness, dizziness, nausea, agitation, or syncope can result
-side-lying or a pillow under 1 hip can resolve this

Front 32

5 major changes to Blood Flow during Pregnancy

Back 32

1. perfusion of placenta and uterus
2.increased renal flow to remove fetal waste
3. increased skin perfusion to dissipate maternal body heat
4. increased breast perfusion
5. stasis of blood flow in lower extremeties from obstruction- hemorrhoids, varicose veins

Front 33

3 benefits of increased blood volume during pregnancy

Back 33

1. transport nutrients and oxygen to fetus
2. meets the demands of increased maternal tissue
3. protects mother from blood loss during childbirth

Front 34

physiologic/ pseudoanemia of pregnancy

Back 34

decreased hemoglobin and hematocrit in the mother due to dilution by increased plasma volume. (no actual decreased in RBC's)

Front 35

GI Changes during pregnancy

Back 35

-increased appetite
-gingivitis/ bleeding gums
-excessive salivation
-reduced esophageal sphincter tone leading to GERD
-decreased GI tone and motility
-prolonged emptying time of gall bladder leading to gallstones

Front 36

kidney changes during pregnancy

Back 36

-increased glomerular filtration rate (by 50%)
-increased glucose excretion, contributing to increased UTI's
-increased urine output

Front 37

Skin changes during pregnancy

Back 37

-increased circulation to dissipate heat
-increased sebaceous gland activity
-hyperpigmentation / melasma
-linea nigra on the abdomen
-striae gravidarum
-increased hair growth and nails become brittle

Front 38

effects of relaxin on the mother's body

Back 38

-softening of the pelvic cartilage
-inhibits uterine activity
-softens connective tissue of cervix
-softens ligaments around the ribs

Front 39

pituitary gland

Back 39

-increased secretion of prolactin
-decreased secretion of FSH and LH
-secretion of oxytocin at birth

Front 40

thyroid gland

Back 40

-secretes T3 and T4 which are both important to development of fetal CNS

Front 41

pancreatic changes during pregnancy

Back 41

-decreased cellular sensitivity to insulin which makes more glucose available to the growing fetus
-in healthy mothers, insulin production should be increased

Front 42

gestational diabetes

Back 42

when insulin production cannot be increased during pregnancy, resulting in periodic hyperglycemia

Front 43

hCG

Back 43

Human Chorionic Gonadotropin: produced by the embryo- prevents deterioration of the corpus luteum which is secreting progesterone and estrogen.
-this is what a pregnancy test looks for

Front 44

functions of estrogen during pregnancy

Back 44

-stimulates uterine growth
-increased blood supply to uterus
-increased uterine contractions near term
-development of glands and ducts in the breasts
-hyperpigmentation and vascular changes

Front 45

functions of progesterone during pregnancy

Back 45

-maintains endometrium for implantation
-prevent spontaneous abortion
-smooth muscle relaxation in uterus, bowels, etc
-prevents tissue rejection of fetus
-development of lobes in breasts
-maternal fat deposits
-stimulates ventilation
-immunosuppression

Front 46

hPL

Back 46

human placental lactogen:
-increases the glucose availability for the fetus
-decreases maternal insulin sensitivity and metabolism of glucose

Front 47

changes in the eye during pregnancy

Back 47

corneal edema, resulting in contact lens discomfort
-do not get new prescription until 6 weeks postpartum

Front 48

PRESUMPTIVE indications of pregnancy

Back 48

amenorrhea
nausea and vomiting
fatigue
urinary frequency
breast growth and tenderness
increased pigmentation of the skin
vaginal/ cervical changes
fetal movements felt by mother

Front 49

PROBABLE indications of pregnancy

Back 49

abdominal enlargement
cervical softening
changes in uterine consistency
ballottement
braxton hicks contractions
palpation of fetal outline
uterine souffle
pregnancy tests

Front 50

POSITIVE indications of pregnancy

Back 50

auscultation of fetal heart sounds
fetal movements felt by examiner
visualization of fetus (US)

Front 51

antepartum care schedule (for uncomplicated pregnancy)

Back 51

conception to 28 weeks - every 4 weeks
29 to 36 weeks - every 2-3 weeks
37 wks to birth- every week

Front 52

PRESUMPTIVE indications of pregnancy

Back 52

amenorrhea
nausea and vomiting
fatigue
urinary frequency
breast growth and tenderness
increased pigmentation of the skin
vaginal/ cervical changes
fetal movements felt by mother

Front 53

PROBABLE indications of pregnancy

Back 53

abdominal enlargement
cervical softening
changes in uterine consistency
ballottement
braxton hicks contractions
palpation of fetal outline
uterine souffle
pregnancy tests

Front 54

POSITIVE indications of pregnancy

Back 54

auscultation of fetal heart sounds
fetal movements felt by examiner
visualization of fetus (US)

Front 55

antepartum care schedule (for uncomplicated pregnancy)

Back 55

conception to 28 weeks - every 4 weeks
29 to 36 weeks - every 2-3 weeks
37 wks to birth- every week

Front 56

what causes morning sickness?

Back 56

increased levels of hCG and estrogen, along with relaxation of the smooth muscle of the stomach