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Flashcards in Antepartal Care Deck (73):
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Definition of Gravidity

State of pregnancy

1

Definition of gravida

Woman who is pregnant

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Multigravida

Woman who has had two or more pregnancies

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Parity

Number of pregnancies where the fetus reached 20-24 weeks- not the number of children

4

Definition of A.B.

Abortion

5

Definition of S.A.B.

Spontaneous abortion

6

Definition of viability

Ability to live outside of the uterus, usually 20-24 weeks or 500grams or more

7

Multipara

Women who had 2 or more pregnancies that were viable

8

Definition of stillborn

Fetus that shows no life after birth

9

Definition of preterm

A fetus that has reached 20 weeks but not older than 37 weeks

10

Duration of pregnancy in days and weeks

About 280 days or 40-42 weeks

11

Determining due date- Nagel's Rule

1st day of last period minus 3 months plus 7 days

12

Changes with pregnancy- 1st trimester uterus

Braxton hicks contractions start but are not usually felt
Endometrium changes to deciduous

13

Changes with pregnancy- 2nd trimester uterus

Enlarges, uterus walls thin and soften
20-22 weeks can be palpated at umbilicus
Braxton hicks contractions felt at this point

14

Braxton hicks contractions

Physiologic flexion of the uterus

15

Mcdonalds sign

Ability of the uterus to become easily flexed at the site of where the uterus and cervix join

16

Changes with pregnancy- 3rd trimester- uterus

Becomes it's greatest size
Braxton hicks contractions increase in frequency
38-40 weeks fundus is located at the tip of the xyphiod process

17

Changes with pregnancy- 1st trimester cervix

Softening occurs
Hegers and Goodell signs
Increased vascularity
Chadwick's sign
Increased blood flow
Mucous plug forms in endocervical canal

18

Hagers sign

The isthmus of the uterus widens to where it can be felt on a bimanual exam

19

Goodells sign

Softening of the cervix related to vasocongestion and hyper trophy of the cervical glands

20

Chadwick's sign

Increased blood flow that causes the cervix to turn bluish purple

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Changes with pregnancy- 2nd trimester cervix

No new changes just ones from 1st

22

Changes with pregnancy- 3rd trimester cervix

Bloody show occurs from mucous plug dislodging

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Changes with pregnancy- 1st trimester vagina

Vascularity increases
Ph becomes acidic due to increase of lactic acid production from glycogen (helps keep it free of pathogenic organisms)

24

Changes with pregnancy- 2nd trimester vagina

Tissues loosen
Small muscle cells hyper trophy
Changes allow for distention and move ability to allow passage of baby

25

Changes with pregnancy- 3rd trimester vagina

Increase vaginal secretions

26

Changes with pregnancy- 1st & 2nd trimester- Fallopian tubes

Few structural changes, site of fertilization

27

Changes with pregnancy- 3rd trimester Fallopian tubes

Tubes are high in the abdomen

28

Changes with pregnancy- ovaries

Ovulation stops while pregnant
Corpus luteum secretes pregnancy hormones

29

What hormones does the corpus luteum secrete

Progesterone estrogen and relaxin

30

Changes with pregnancy- 1st trimester breasts

Increase in size and tenderness from progesterone
Increased blood flow
Nipples and areola darken

31

Changes with pregnancy- 2nd & 3rd trimester breasts

Colostrum can be expressed from 5th month to birth

32

Changes with pregnancy- pituitary gland

Increase in prolactin which prepares breast for lactation.
Hypothalamus inhibits LH & FSH (FSH makes egg, LH releases it)

33

Changes with pregnancy- thyroid gland

Mild enlargement

34

Changes with pregnancy- pancreas

Insulin requirements and production changes in response to fetal demand for glucose

35

Changes with pregnancy- placenta

Once developed at 12 weeks takes over production of pregnancy hormones

36

What does relaxin do

Helps the pelvic girdle to relax

37

Changes with pregnancy- 1st trimester cardiovascular system

Blood volume, cardiac output, and resting pulse increases

38

Changes with pregnancy- cardiovascular 2nd trimester

Cardiac output reaches peak of 30-50% over norm
HR is over 10 bpm norm
Blood volume expands rapidly- increase in plasma then RBC, slight decrease in hgb

39

What is the rational for the increase in blood volume?

Supply placenta and fetus and also to compensate for loss of blood during delivery

40

Changes with pregnancy- cardiovascular 3rd trimester

High cardiac output, high blood volume, heart is pushed up and to the left, HR 15 bpm above normal
s3 sound may occur and is normal bc of the increases blood flow

41

Changes with pregnancy- respiratory system 1st trimester

Increases tidal volume, total oxygen carrying capacity of RBC increase, woman breathes more deeply, nasal stuffiness, nose bleeds, congestion because of vasocongestion

42

Changes with pregnancy- respiratory system 2nd trimester

Diaphragm is displaces bc of uterus, rib cage expands, SOB may occur

43

Changes with pregnancy- respiratory 3rd trimester

Diaphragm rises higher in chest
Chest diameters increase
Need for more oxygen

44

Changes with pregnancy- kidneys 1st trimester

Increase in size and weight
Gfr increases
Prone to uti
Uterus press against bladder and causes urination frequency

45

Changes with pregnancy- kidneys 2nd trimester

Urinary frequency increases
Gfr rises 50%
Glucose, electrolytes, h2o vitamins may be expelled

46

Changes with pregnancy- 3rd trimester kidneys

Fetus puts pressure on bladder

47

Changes with pregnancy- integumentary system 1st trimester

Hair seems thicker, linea nigra appears, warm feeling from blood flow, nails soften and grow thicker

48

Changes with pregnancy- integumentary system 2nd trimester

Skin darkens around areola, nipples and vulva, melasma may occur

49

What is linea nigra

Dark line of pigment from top of pubis synthesis to fundus

50

Changes with pregnancy- integumentary system 3rd trimester

Striae, increased sweat, spider vein

51

Changes with pregnancy- musculoskeletal 1st trimester

Minimal changes

52

Changes with pregnancy- musculoskeletal 2nd trimester

Hip joints relax, center of gravity changes, gait changes lower ab and inguinal pain

53

Changes with pregnancy- 3rd trimester musculoskeletal

Pelvic girdle joints relax, walking is difficult

54

Changes with pregnancy- GI 1st trimester

Gums are sensitive
Constipation
Time to absorb nutrients increases
Nausea and vomiting
Taste and smell altered

55

Changes with pregnancy- GI 2nd trimester

Stomach capacity seems less
Gastric reflux

56

Changes with pregnancy- GI 3rd trimester

Everything just continues

57

Presumptive symptoms of pregnancy

Amenorrhea (no period)
N/V
Breast tenderness
Urinary frequency
Fatigue
Quickening

58

Presumptive Signs

Increase temperature
Linea nigra
Melasma
Striae
Secondary breast tissue enlargement
Colostrum

59

Probable signs of pregnancy

Chadwick's sign
Goodell sign
Hegars sign
Uterine englargement
Braxton hicks
Ballottement of uterus
Uterine soufflé
Positive pregnancy test

60

Positive signs of pregnancy

Fetal heartbeat heard
Fetal movements felt
Fetal outline seen on ultrasound

61

Ballottement of uterus

Examiner can feel fetus move away and back

62

Uterine souffle

Sound of blood rushing through placenta

63

Maternal tasks of pregnancy

Accept fact of pregnancy
Accept fetus as different from themselves
Prepare for active parenting

64

Prenatal care- definition

Care delivers by a combo of professionals throughout pregnancy and post Parton

65

Sequence of dr visits when pregnant

1st trimester- one visit a month
2nd- one visit every 2 weeks
3rd- one visit a week

66

1st Prenatal visit

Health hx, PE, preg test, blood type, rh factor, rubella titer, culture of cervix, hep b, HIV syphilis test, hcg level

67

Alpha fetoprotein study

Done 14-20 weeks in. Detects neural tube defects (spina bifida)

68

Red flags during pregnancy

Gestational diabetes, high BP, malaise, fever, headache, abnormal edema, sudden vaginal bleeding, spontaneous rupture or leakage, lack of fetal movement

69

Common discomforts of pregnancy

Urinary frequency
N/v,
Heartburn
Constipation
Backache
Hemorrhoid a

70

Nutrition during pregnancy

Healthy diet before conception is the best way to ensure adequTe nutrition,

71

Weight gain during pregnancy

Gain 25-30 lbs
3-4lbs 1st trimester
1lb per week after

72

Recommend vitamin intake

300+ calories than normal
1300mg of calcium
27 mg of iron
60 g of protein
400mcg of folic acid