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88 Cards in this Set
- Front
- Back
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Name the presumptive indicators of pregnancy
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* S/S noticed by the pt
Amenorrhea N/V Fatigue Urinary Frequency Breast & Skin Changes |
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Name the Probable indicators of pregnancy
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* S/S noticed by the Dr
Goodells Sign Hegars Sign Ballottement Positive Urine Test Braxton Hicks UC Abdominal enlargement Palpation of fetal outline Uterine Souffle |
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Name the positive indications of pregnancy
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Auscultation of FHT
Fetal movements felt by examiner Visualization of embryo or fetus |
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Gravida
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number of times a woman has or is pregnant
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Para
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Number of pregnancies lasting >20 weeks
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Term
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Number of pregnancies reaching 37-40 weeks
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Preterm
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Number of pregnancies lasting <37weeks
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Abortions
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Number of pregnancies lasting <20 weeks
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How long is pregnancy?
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40 weeks or 280 days
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Nagele's Rule
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Due Date
LNMP - 3 months + 7 days |
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What does a woman's age put a pregnancy at risk for?
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<16 and >35
Inc preterm birth Preeclampsia Congenital anomalies |
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What does a woman's race put a pregnancy at risk for?
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African Americans
Inc preterm babies LBW Infant and Maternal death |
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What does a woman's SES put a pregnancy at risk for?
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Low SES
Inc Preterm birth LBW |
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What does parity (>4 pregnancies) put a woman's pregnancy at risk for?
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Inc pregnancy loss
postpardum hemorrhage c/s |
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What are underweight and over weight women at risk for?
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Underweight: LBW
Overweight: Preeclampsia, GDM, c/s, wound infections, endometritis, thromoembolism |
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What does being under 5ft put pregnancy at risk for?
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c/s
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How does smoking affect the pregnancy?
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Inc spontaneous abortion
Placenta abruption Placenta LBW preterm babies SIDS |
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How does ETOH affect the pregnancy?
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MR
fetal alcohol syndrome |
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How do street drugs affect the pregnancy?
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congenital anomalies
neonatal withdrawl syndrome |
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What are the risks for a woman who has had a previous child weighing over 8.8lbs?
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GDM
infant birth injury c/s neonatal hypoglycemia |
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If a mother has had a previous preterm baby what are the risks of the next pregnancy?
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inc repeated preterm baby
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Name the risks if the mother has DM
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preeclampsia
SGA or LGA neonatal hypoglycemia congenital anomalies fetal or neonatal death |
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Name the risks if the mother has hypothyroidism
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SAB
congenital hypothyroidism |
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Name the risks if the mother has hyperthyroidism
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preeclampsia
thyroid storm neonatal risk for thyrtoxosis |
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What are the risks if the mother has CVD
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maternal risk for cardiac decompensation and death
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What are the risks if the mother has renal disease?
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maternal renal failure
PTB Intrauterine growth retardation |
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Name the hormones produced by the placenta
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hCG
E/P hPL |
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What is hCG's function in pregnancy?
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1. Maintains CL until 10-12 weeks gestation
- CL produces e/p 2. Causes a +UPT |
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What are estrogen's functions during pregnancy?
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stimulate uterine growth
inc vascularization Breast changes Inc salivary glands (pytalism Hyperemia of gums & nasal mucus membranes |
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What are the functions of progesterone in pregnancy?
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maintain endometrium
relaxes smooth muscle - uterine, GI, bladder Breast Changes Maternal Fat storage Inc CO sensitivity Dec immune system |
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What are the causes of uterine growth in each trimester?
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1st: estrogen and growth factors
2nd and 3rd: growing fetus |
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What is the holding capacity of the uterus?
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Non pregnant: 50-70g, capacity 10mL
Pregnant: 800-1200g, capacity 5000 mL |
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Where is the uterus located at 12 and 20 weeks?
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12 weeks: above the symphysis pubis
20 weeks: at level of umbilicus >20weeks:fundal hight = cm |
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When do Braxton Hicks UC occur?
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as the uterine grows, consistent in character
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What is the blood flow rate
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3rd trimester: 750 ml per min
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What are the changes in the Cervix during pregnancy?
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Estrogen causes:
Chadwicks Sign Goodells Sign Hegar's sign Mucal Plug forms |
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What are the changes to the vagina during pregnancy?
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Turns blue
Softening Leukorrhea (thick white discharge) Glycogen Inc: Lactobacillus acidophilus - inc pH (3.5-6) |
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What are the changes in the Pituitary gland during pregnancy?
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increase in size
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What are the changes in the anterior pituitary gland?
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Prolactin secreted: milk production, insulin antagonist
Melanocyte Stimulating Hormone: causing hyperpigmentation |
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What are the changes to the posterior pituitary gland during pregnancy?
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Oxytocin is secreted which stimulates UC and milk ejection
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What are the changes to the Thyroid gland during pregnancy?
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Slight enlargement
Inc Basal Metabolic Rate by 25% Inc in T3 and T4 |
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What are the changes to the Pancreas during pregnancy?
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1st T: dec in glucose levels (less insulin needed)
2nd T: Inc insulin sensitivity due to hPL, prolactin, e/p, and cortisol (inc in insulin) |
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What are the changes to HR and BP during pregnancy?
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*Changes greatest at 24-32wks
Inc HR by 15-20 bpm Inc in volume Inc CO Inc vasodilation Dec PVR Dec BP |
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What position should you take the BP in?
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lowest lateral position
or higher sitting |
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What is supine hypertension syndrome?
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occurs during 2nd and 3rd trimester
Heavy gravid uterus compresses vena cava, reducing cardiac return, dec BP, causing lightheadedness, dizziness, nausea, clammy, agitation |
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What are the changes to the RBCs during pregnancy?
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Inc 250-450mL but still less than plasma causing hemodilution (28 weeks)
this is a protective effect- dec viscosity and blood clots check hct and hgb <11 give iron |
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What changes in the respiratory system during pregnancy?
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inc O2
* Progesterone Hyperventilation Dec resistance Respiratory center sensitivity (c/o air hunger) * estrogen Inc vascularity - congestion - nose bleeds - ears full/ aches |
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What are the changes of the physical respiratory system?
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Relaxin inc chest expansion (2-2.5in)
Uterus puts pressure on diaphragm (lifts 1.6in) Thoracic breathing SOB in 3rd T |
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What changes occur in the mouth during pregnancy?
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hyperemia (red swollen gums bleed easily)
ptyalism n/v resolved in 12 weeks |
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What changes occur in the esophagus and stomach during pregnancy?
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esophageal sphincter relaxed inc reflux (heart burn)
Gastric acidity inc 3rd T |
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What changes occur in the Large intestine and small intestine during pregnancy?
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because of relaxation theres slower emptying
- inc in nutrient absorption - inc bloating, constipation, gas |
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What changes occur in the liver and gallbladder during pregnancy?
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prolonged emptying time
inc risk for gallstones inc bile salts - intense generalized itching |
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What changes occur in the bladder during pregnancy?
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relaxed muscles - incontinence
compression in 1st and 3rd T inc frequency |
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What changes occur in the kidneys and ureters during pregnancy?
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dilation of renal pelves, calyces, and ureters
partially obstructed inc dilation (esp on R side) Urinary Stasis - inc UTI Inc renal blood flow Inc glucose excretion |
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What changes occur in skin during pregnancy?
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Inc circulation and metabolism
Inc perspiration Inc acne Hyperpigmentation in darker complexes Cholasma Linea Nigra Striae Gravidarum - butt,boobs, thigh |
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What hormones cause hyperpigmentation?
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e/p
melanocyte-stimulating hormone |
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What changes occur in the hair and nails during pregnancy?
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grows more rapidly
after delivery: rapid hairloss resolves 6-12months after |
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What are the changes in the muscular system?
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Progesterone causes softening in the: pelvic cartilage, connective tissue, sacroilliac joints, symphus pubis
waddling of gait Lordosis of spine Diastasis recti |
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What is the immunological balancing act?
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protect mom from infection
prevent rejection of fetus results in: successful pregnancy inc risk for maternal infections improved auto-immune disorders (RA, lupus) |
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How does the placenta play a role in immunity during pregnancy?
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IgG
Separates maternal and fetal blood and lymphatic system |
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What is round ligament pain?
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pain in inguinal area relieved by knee to chest position and heat
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What occurs during the first phase of maternal acceptance?
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Phase 1:
Uncertainty Ambivalence Self primary focus Fetus vague and unreal mood swings |
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What occurs in the second phase of maternal acceptance?
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5 months: women accept growing fetus as separate from self
begins the mother child relationship |
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What occurs in the third phase of maternal acceptance?
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Attachment: woman prepares for child and accepts parenting responsibilities
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Couvade Syndrome
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when the male feels same n/v, kicks, etc as pregnant female
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What are the phases of paternal acceptance?
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1. Announcement Phase: accept biological fact of pregnancy
2. Moratorium Phase: Adjust to reality of pregnancy (become introspective) 3. Focusing Phase: actively involved in pregnancy/relationship with child |
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What are the siblings adaptation during pregnancy at different ages?
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Toddlers: like to be told own story
School Age Children: jealous, curious about clinical aspects Adolescents: confused about own sexuality |
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What does ETHNIC stand for?
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Explanation
Treatments Healers Negotiate Interventions Collaboration |
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What should you note when assessing for intimate partner violence?
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Nonverbal - flat affect
Injuries - document Vague Somatic complaints - anxiety, panic attacks Discrepancy between history and types of injury |
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What does the intrauterine environment set the stage for future risk of?
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Obesity
Metabolic syndrome T2DM CVD |
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How much should a woman gain in the first trimester?
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1-4.4lbs
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How much weight should a woman gain if she is under weight?
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BMI <18.5
28-40lbs |
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How much weight should a woman gain if she is normal weight?
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BMI 18.5-24.9
25-35lbs |
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How much weight should a woman gain if she is overweight?
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BMI 25-29
15-25lbs |
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How much weight should a woman gain if she is obese?
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BMI >30
11-20lbs |
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What is the increase in calories during the 1st,2nd,and 3rd trimester?
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1st: none
2nd: 340 3rd: 452 |
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What determines the pregnancy calorie needs?
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age
activity level BMI 2200-2900 |
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What is the nutritional intake for Grains, veges, proteins, milk, and oils?
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Grains: 6-8oz (1/2 from whole grains)
Veges: 2.5C Fruits: 2C Proteins: 3-5.5oz Milk: 3C Oils: (unsaturated fats or oils, polyunsaturated contain some essential fatty acids): 2servings (1T) |
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What should you avoid in your fluid intake?
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juices
soft drinks sweet tea coffee (<200mg/day) |
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What nutrients are needed to be added to the diet?
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Folic acid >600mg - prevents neural tube defects
Iron 27mg DHA Omega 3 & 6 essential fatty acids Don't use supplements to replace a healthy diet |
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What are some food poisonings found during pregnancy?
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Listeriosis
Mercury in fish Toxoplasmosis |
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What foods is listeriosis found in?
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Hot dogs (heat to steaming)
Pate Meat spreads Smoked seafood Stored Ham, chicken, egg, or tuna salad Soft unpasteurized cheese: feta, brie, queso fresco, blue-viened Raw Unpasturized milk |
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What are Listeriosis symptoms?
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flu like sx causing SAB, premature birth, still birth
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Why is mercury harmful to pregnant women?
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causes harm to nervous system development
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What fish should a pregnant woman stay away from?
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Shark
Sword fish king maceral Tilefish |
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What fish are ok to eat?
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those high in omega 3,6,DHA because they are good for neurological and vision development
may eat 12oz/week (2 meals) of: shrimp, canned tuna, pollock, catfish |
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What is toxoplasmosis?
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a parasite
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How can you prevent toxoplasmosis?
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wash hands after gardening, food prep
wash utensils after food prep cook meat completely wash and or peel fruits and veges avoid changing the litter box |
