pregnancy adaptations (systems) chapter 13

Question 1

when do we start measuring fundal height ?

Answer 1

20 weeks
-measures if baby is growing appropriately

Question 2

when does pregnancy start to “show”?

Answer 2

14 wks

Question 3

fundal height measurement

Answer 3

symphysis pubis to fundus (top part of uterus)

Question 4

fundal height

Answer 4

should coincide with gestation week
we’ll allow +/- 2 cm
(ex. 20 weeks = 20 cm)

Question 5

where will fundus be at 12 wks ?

Answer 5

above symphysis pubis

Question 6

where will fundus be at 20 wks ?

Answer 6

close to umbilicus

Question 7

Braxton Hick’s

Answer 7

tightening sensation, painless, uncomfy, not a true contraction

Question 8

what makes a true contraction different from Braxton Hick’s ?

Answer 8

true contractions make cervical changes

Question 9

Hegar’s sign

Answer 9

softening of the lower part of the uterus
-6 weeks gestation

Question 10

uroplacental blood flow

Answer 10

whooshing sound heard over the placenta
-400 to 500 mL of blood flow through the uterus

Question 11

quickening

Answer 11

first fetal movements

Question 12

Ballottement

Answer 12

examiner pushes against cervix, feels baby bounce up and down

Question 13

lightening

Answer 13

baby starts to descend into the pelvis to get ready for delivery
-wk 38-40
-fundal height may go down

Question 14

leukorrhea

Answer 14

increase in vaginal discharge
normal change

Question 15

Chadwick sign

Answer 15

cervix has a bluish hugh
d/t increase in vascularity

Question 16

operculum

Answer 16

mucus plug
barrier that sticks in the cervix
stops germs from advancing

Question 17

normal vaginal pH

Answer 17

4.5

Question 18

pregnancy vaginal pH

Answer 18

3.5-4
puts at risk for yeast infection

Question 19

Goodell sign

Answer 19

softening of cervix
-6 wks gestation

Question 20

friability

Answer 20

tissue bleeds easier

Question 21

dilation

Answer 21

size of hole measured in cm

Question 22

effacement

Answer 22

cervix thinning out measured in 0-100%

Question 23

when do we typically check woman’s cervix ?

Answer 23

36 wks
GBS swab

Question 24

changes in breasts

Answer 24

get larger
areola pigmentation darkens

Question 25

colostrum

Answer 25

produced in 2nd trimester

Question 26

why don't we pump before giving birth ?

Answer 26

it'll stimulate oxytocin and contractions

Question 27

blood volume

Answer 27

multiplies by 30 to 45%, even 50% almost doubles

Question 28

cardiovascular related changes

Answer 28

nose bleeds bleeding gums more headaches

Question 29

coagulation

Answer 29

hypercoagulable state

Question 30

at risk for blood clots

Answer 30

at higher risk for blood clots until 6 wks postpartum

Question 31

D-dimer is not a good test to see if clot is present during pregnancy

Answer 31

TRUE

Question 32

supine hypotension

Answer 32

if woman is laying flat, there's pressure on vena cava -sweaty, diaphoretic, nauseous

Question 33

nursing interventions for supine hypotension

Answer 33

raise her HOB to at least 30

Question 34

gestational hypertension

Answer 34

BP is elevated over 20 wks gestation w/ no protein in urine

Question 35

acid base balance

Answer 35

respiratory alkalosis

Question 36

breathing patterns

Answer 36

more shallow breathing, higher RR, abdominal breathing

Question 37

at risk for ___ (regarding renal function)

Answer 37

kidney stones UTIs - asymptomatic ones

Question 38

infection puts at risk for ___

Answer 38

miscarriage preterm labor

Question 39

melasma

Answer 39

pregnancy mask darker pigmentation around cheeks and forehead

Question 40

linea nigra

Answer 40

dark line that goes up and down on belly

Question 41

striae gravidarum

Answer 41

stretch marks

Question 42

palmar erythema

Answer 42

red palms

Question 43

PUPPP

Answer 43

RASH! super itchy, over abdomen -oatmeal baths, hydrocortisone

Question 44

muscles

Answer 44

relax and may become weaker

Question 45

diastasis recti

Answer 45

separation of abdominal muscles

Question 46

neurologic system

Answer 46

increase in carpal tunnel syndrome

Question 47

lordosis

Answer 47

occurs in 3rd trimester tummy out, shoulders back

Question 48

hyperemesis gravidarum

Answer 48

electrolyte imbalance d/t excessive emesis

Question 49

normal weight gain

Answer 49

25-35 lbs

Question 50

underweight weight gain

Answer 50

35-45 lbs

Question 51

overweight weight gain

Answer 51

not much

Question 52

pyrosis

Answer 52

heartburn d/t pushing up of stomach acids

Question 53

ptyalism

Answer 53

excessive salivation

Question 54

appendicitis

Answer 54

difficult to diagnose appendix is displaced

Question 55

pancreas

Answer 55

decreased tissue sensitivity to insulin -insulin needs increase

Question 56

thyroid gland

Answer 56

watch TSH and T4 if hx of hypothyroidism

Question 57

Naegele's Rule for EDD/EDB

Answer 57

determine first day of LMP subtract 3 calendar months add 7 days