Chapter 13 & 15 Flashcards Preview

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Flashcards in Chapter 13 & 15 Deck (27):

changes in the reproductive system: uterus

gets bigger, muscle tissue strengthens, gets firmer and muscle tissues gets thicker in upper uterus
purple - vascular increases blood supply
rise of pelvis, close to term can drop back down (lightning)
engagement - drops to level of iscial spine, baby can't move, is stationed (may or may not happen with lightning)


changes in the reproductive system: breast

get larger, alevoli gets darker with dark skin people


GI adaptations

decrease peristalsis, more likely to become constipated


respiratory adaptations

less expansion of lungs (A-P diameter); relaxent hormone that relaxes the joints and cartilage and allows expansion


renal adaptations

dilation of uterus, problems with stasis, higher risk of UTIs


other system adaptations

center of gravity changes, lower extremity edema (occurs in later mnths, edema above wast not normal), stai (stretch marks pulling of connective tissues), morning sickness (hormonal changes)


endocrine system

Pituitary, thyroid, adrenals and pancreas


placental hormones

Human Chorionic Gonadotropin (HCG)
Estrogen/ Progesterone
Human Placental Lactogen (HPL)



timing is important


oxytocin -

from posterior pituitary - stimulates contractions, stimulates nipples to release oxytocin in body, let down reflex


prolactin -

stimulates milk production in breast - anterior pituitary


thyroxin -

released by thyroid


adrenal glands -

aldesterone, rise to retain Na


pancreas -

control glucose (carbohydrate metabolism);
glucose will cross placenta but insulin does not, baby releases its own insulin - why fat baby if mom has high blood glucose
hyperglycemia - 2nd and 3rd trimester when 1st trimester hypoglycemia


5-8 wks

urinary frequency


9-12 wks

morning sickness, gets better by 12th wk, growing uterus may start to show


13-16 wks

may feel fetal movement around 16 wks (quickening) urinary frequency decreases


5 months

examiner can feel movement, pigmentation stages, fondus at level of umbilicus


6 months

distinct relaxation and dilation of vessels, more likely UTI


7 months

rapid growth of uterine size (back pain)


8 months

heart burn (bc uterus pressed on stomach), delayed GI emptying, brackstan hicks contractions


9-10 months

lightening, SOB, veriscosities, edema more pronounced uterine efaces and dilates, urinary frequency again


supine position

compromises blood flow to mom and baby, if have to be on back use wedge


confirming pregnancy

The establishment of pregnancy includes both symptoms and complaints related to of pregnancy and signs that are observed by the examiner

Theses signs and symptoms are grouped under three areas-
Presumptive, Probable and Positive


presumptive indications (All can be caused by other conditions)

Amenorrhea - no period (problem bc might not have period bc of other reasons)
Nausea and vomiting - bc of hormonal changes, more frequently in morning
Fatigue - hypoglycemia, possibly dehydration
Urinary frequency - pressure on bladder
Breast and skin changes- Chloasma, Linea Nigra
Fetal movement- Quickening - mom feels it
Vaginal and cervical color changes- Chadwick’s Sign


probable indications (Can be documented by the examiner, primarily related to changes in reproductive organs)

Abdominal enlargement- McDonald’s Technique - measure fondus height in CM (with 22 cm should be 22 mg
Cervical softening (bc of increase of vasolarity)- Goodell’s Sign (softening of cervix), Hegar Sign (softening of uterus)
Uterine changes- Ballottement (presenting part), Braxton-Hicks Contractions, Palpation of Fetal Outline, Uterine Souffle (when listen when doppler hear a blowing murmur, blood in large uterine vessels, will match mothers pulse) if funic souffle blood rushing through umbilical cord, more rapid than pulse
Pregnancy tests- HCG


positive indications (Nothing can mimic these findings)

Auscultation of fetal heart sounds (pick up 18-20 wks, ultrasound can pick up early, between 110-160 bpm before born, after born 120)
Fetal movements by the examiner
Visualization of the fetus- by ultrasound