Study with the several resources on Docsity
Earn points by helping other students or get them with a premium plan
Prepare for your exams
Study with the several resources on Docsity
Earn points to download
Earn points by helping other students or get them with a premium plan
A comprehensive overview of the various physiological changes that occur during pregnancy, covering topics such as changes in the cardiovascular, renal, integumentary, musculoskeletal, and endocrine systems. It also discusses the signs and symptoms of pregnancy, the stages of pregnancy (antepartum, intrapartum, and postpartum), and the essential components of prenatal history. Additionally, the document covers various diagnostic tests and procedures used during pregnancy, including ultrasound, doppler blood flow studies, non-stress tests, biophysical profiles, and amniocentesis. This information is valuable for healthcare professionals, students, and individuals interested in understanding the complex physiological adaptations that occur during the gestational period.
Typology: Exams
1 / 19
This page cannot be seen from the preview
Don't miss anything!
Doula - Answer-Specialized person to assist in labor obesity - Answer-BMI> IUGR - Answer-intrauterine growth retardation Pregnancy - Answer-3 trimesters= 13 weeks each EDC, EDB, EDD - Answer-estimated date of confinement estimated date of birth estimated date of delivery Gestation - Answer-# of weeks since first day of last menstrual cycle Stillborn - Answer-born dead after 20 weeks
Abortion - Answer-birth that occurs before the end of 20 weeks gestation Term Pregnancy - Answer-38-40 weeks Preterm Pregnancy - Answer-20-37 weeks Postterm Pregnancy - Answer-after 42 weeks (40-42 weeks usually included in this category) Gravida - Answer-Any pregnancy Primigravida - Answer-First time pregnant Multigravida - Answer-Second or any subsequent pregnancy Para - Answer-birth after 20 weeks gestation; multiples count as one FYI: You should start taking Folic acid when you begin planning to become pregnant or as soon as you find out you are pregnant - Answer-... FYI: You should stop taking contraception and have 2-3 normal periods before becoming pregnant - Answer-... FYI: A pregnant woman should take 0.4 mg of folic acid daily - Answer-... Birth Plans - Answer-birth plans are organized with the understanding that safety of the mom and baby are of the utmost priority
Braxton Hicks - Answer-irregular painless contractions rxn of uterus being stretched and enlarged; usually doesn't hurt Cervix in Prego - Answer-secretes mucus that forms a plug prevents bacteria from travelling up into the uterus Goodell's Sign - Answer-Softening of the cervix hard like nose to soft like lips Chadwick's sign - Answer-bluish color of the cervix during preganancy Ovaries in Prego - Answer-ovulation stops corpus luteum (fertilized ovum) produces hormones until 6-8 wks after 6-8 wks the placenta produces the hormones Vagina in Prego - Answer-mucosa thickens connective tissue relaxes pH acidity favors yeast Breast in Prego - Answer-increase in size and # of glands can start producing milk @ 12 wks Colostrum - Answer-thin yellow secretion high in protein and immune properties (Abs)
Respiratory Changes in Prego - Answer-growing uterus elevates diaphragm increased oxygen needs chest enlarges to allow increased lung expansion increased resp rate and decreased lung capacity nasal stuffiness (increased edema in nasal sinuses) epistaxis (nose bleeds) Cardiovascular Changes in Prego - Answer-cardiac output and blood volume increase 45-50% pulse increases 10-15 bpm BP- decreases in the 1st and 2nd trimester; 3rd trimester increases to preprego lvls RBCs increase 18-30% plasma volume increases 50% WBCs increase fibrin and plasma fibrinogen increases to prevent postpartum hemorrhage (predisposes to DVT) Vena Cava Syndrome - Answer-uterus compresses the vena cave s/s: pallor, dizzy, lightheadedness, clammy skin want mom in L side lying position for best placental blood flow Physiologic Anemia - Answer-H&H go down b/c of increased serum lvl GI in Prego - Answer-1st Trimester- increased HCG= N/V Bleeding gums (increased vasculature)- oral hygiene important to prevent preterm labor Increased progesterone lvls- decreased peristalsis (reflux and constipation) Hemorrhoids- constipation and increased pressure on vessels in rectum
Water- increases water retention from increased levels of steroid hormones Nutrient- increased protein utilization of fetus, CHO needs increase, fats more completely absorbed Endocrine in Prego - Answer-increase in protein bound iodine BMR increases 20-25% Pituitary= prolactin, vasopressin, oxytocin Adrenal= increased cortisol producing changes in protein and CHO metabolism Pancreas= increased insulin production Prolactin - Answer-for lactation Vasopressin - Answer-increases BP Oxytocin - Answer-promotes uterine contractility FYI: Oxytocin is secreted when the baby breast feeds; natural way to prevent post partum hemorrhage; usually worst with each child - Answer-... Placenta becomes an endocrine organ producing large amounts of hormones - Answer-hCG hPL estrogen progesterone relaxin prostaglandins
Human Chorionic Gonadotropin- hCG - Answer-used to determine if prego and how far along; released by corpus luteum then after 6 wks produced by the placenta Human Placental Lactogen- hPL - Answer-antagonist to insulin cause of gestational DM Estrogen - Answer-uterine and breast duct developement Progesterone - Answer-most important inhibits contractility of the uterus Relaxin - Answer-detected in serum by 1st missed menses relaxes cartilage also inhibits contractility of uterus Prostaglandins - Answer-help with placental vascular resistance S/S of Prego - Answer-Presumptive Probable Positive Presumptive- woman reports - Answer-amenorrhea N/V fatigue urinary frequency breast changes
Rubin's Maternal Task - Answer-ensuring safe passage for fetus seeking acceptance of the fetus by others assumption of mother role learning to give oneself on behalf of one's child Couvades - Answer-where the father takes on some of the roles and experiences the same as the mom Antepartum - Answer-from conception to the onset of labor Intrapartum - Answer-from the onset of labor to the first 1-4 hours after delivery of newborn and placenta Postpartum - Answer-refers to the 6 wks after delivery of the newborn and placenta Essential Components of Prenatal Hx - Answer-basis of prenatal care OB Hx Gynecologic Hx Medical Hx Family Medical Hx Religious, spiritual, and cultural Hx Occupation Hx Personal info about the woman comprehensive psychosocial assessment depression assessment (required) Comprehensive OB Hx Acronym - Answer-TPAL
T- term births (twins or more count as 1) P- birth from 20-37 wks A- abortion either spontaneous or therapuetic L- living children (multiples count here) Negele's Rule - Answer-TO DETERMINE THE DUE DATE first day of last menstrual period subtract 3 months add 7 days McDonald Method - Answer-Fundal Height correlates with wks gestation Quickening - Answer-fetal movement felt by mom; 16-22 wks Fetal Heartbeat - Answer-Doppler 10-12 wks and 17-20 wks with fetoscope Ultrasound - Answer-most accurate way to determine expected birth date Initial Prenatal Assessment - Answer-8-12 wks gestation baseline weight and VS head to toe physical assessment pelvic exam initial labs Initial Labs - Answer-CBC
22-34 wks fundal height correlates with wks gestation too small or too large needs to be evaluated FYI: 10-12 wks fundus slightly above symphysis pubis 16 wks fundus halfway between symphysis and umbilicus 20-22 wks fundus at umbilicus 28 wks fundus about 3 fingers above umbilicus 36 wks fundus just below xiphoid process - Answer-... Sebsequent Prenatal Visits - Answer-Every 4 wks until 28 wks Every 2 wks until 36 wks Every week until delivery Subsequent Prenatal Assessment - Answer-CBC at 7 months AFP at 15-20 wks indirect coombs for Rh negative moms at 28 wks glucose screen (I hr GTT) 24-28 wks GBS vag culture 35-37 wks FFN positive result= woman @ higher risk for preterm labor Leopold manuevers for presentation and position RhoGAM IM @ 28 wks for RH negative mom GBS - Answer-Group B Strep
FFN - Answer-Fetal Fibronectin glue-like substances; holds together membranes Leopold Manuevers - Answer-in 3rd trimester can feel outline of baby Self Care Measures - Answer-tylenol is safe know teratogens have immunizations (can have flu shot while prego) exercise unless contraindicated avoid hot tubs and saunas drink 2-3 liters of water per day fetal activity monitoring after 28 wks breast care and prep for breast feeding prenatal classes and exercises clothing- allow for expansion bathing- more frequently employment- may have to alter Travel- need to walk frequently and seat belts dental care- infection can cause prelabor Danger Signs - Answer-vaginal bleeding N/V that last more than 24 Hrs fever 100. dizziness- sudden & extreme, associated with pelvic or uterine pain preterm labor sxms
Ankle Edema- prop up feet, rest frequently, avoid garters Varicose Veins- elevate legs, support hose, avoid crossing legs, avoid constrictive clothing Flatulence- avoid constipation and gas producing foods Hemorrhoids- avoid constipation, warm sitz bath Constipation- increase fluids, increase fiber, exercise, stool softeners Back Ache- use proper body mechanics, pelvic tilt exercise Leg cramps- dorsiflexion of feet,avoid uncomfortable working heights, high heels, lifting heavy loads, and fatigue, apply heat, arise slowly form resting position Faintness- avoid prolonged standing in warm/stuffy environments, evaluate H&H Dyspnea- proper posture, sleep propped up Carpal Tunnel Syndrome- avoid aggravating movements, use splint as prescribed, elevated affected arm Sexual Activity in Prego - Answer-talk to Dr Safety of Fetus is # High Risk Indicators - Answer-Maternal age <16 or > Chronic Disease- HTN, DM, cardiovascular or renal disease, thyroid disorder Preeclampsia RH Isoimmunization Hx of stillbirth IUGR Postterm Pregnancy Multiple gestation (twins+) Hx of preterm labor previous cervical incompetence (treated with cerclage: holds cervix closed)
Maternal Assessment of Fetal Activity - Answer-vigorous activity is reassuring decreased activity requires immediate follow-up factors: sound, drugs, sleep, smoking, glucose lvl Ultrasound - Answer-High frequency sound waves Advantages: early detection of fetal anomalies, accurate determination of gestation, noninvasive, painless, no known harmful effects, use at any time during pregnancy types: transabdominal and endovaginal Ultrasound- Indications - Answer-early identification of prego observation of FHR and breathing movements Measurements(parietal and femur) detection of anomalies identification of amniotic fluid index location of placenta and grading detection of fetal death determination of fetal position and presentation accompanying procedure Doppler Blood Flow Studies - Answer-Evaluates blood flow in fetus and mother assess placental function Nonstress Test - Answer-evaluate FHR with fetal activity reassuring if accelerations occur with fetal movement Reactive- 2 or more FHR accelerations of at least 15 bpm with a duration of at least 15 seconds in a 20 minute interval
multiple gestation Amniocentesis - Answer-amniotic fluid obtained by inserting a needle through the abd and uterine walls purpose- genetics, fetal lung capacity risk- infection and pregnancy loss test- AFP, hCG, UE3; L/S ratio (assess fetal lung maturity based on lung surfactant level) Amniocentesis Complications - Answer-Amniotic fluid emboli maternal or fetal hemorrhage fetomaternal hemorrhage with Rh isoimmunization inadvertant fetal damage or anomalies involving limbs maternal intestinal or bladder damage fetal death miscarriage premature rupture of membranes leakage of amniotic fluid Other Fetal Diagnostic Test - Answer-Chorionic Villus Sampling @ 10-12 wks Percutaneous Umbilical blood Sampling CT MRI Fetal Echocardiography
