Flashcards in Test 1 Blueprint (3) Deck (81):
What causes morning sickness?
- often unknown
- hormonal changes, possibly hCG
What causes fatigue?
- often unexplained
- increased estrogen, progesterone, and hCG
- elevated body temp
- psychologic response to pregnancy
- physical adaptations
What causes urinary frequency?
1) vascular enlargement and altered bladder function from hormones
2) pressure on bladder from enlarged uterus
What causes pyrosis (heartburn)?
progesterone slows GI tract motility and digestion, reverse peristalsis, relaxes cardiac sphincter, enlarged uterus presses upward on stomach
What causes hemorrhoids and varicosities?
pressure from enlarged uterus, gravity, and bearing down
What causes backache?
lumbar lordosis, change in center of gravity, relaxation of symphyseal and sacroiliac joints from hormones (relaxin)
What causes insomnia?
What causes leg cramps?
Compression of nerves to lower extremities b/c of enlarging uterus
Too little calcium, too much phosphorus
Fatigue, poor peripheral circulation, pointing toes
Drinking too much milk
What causes supine hypotensive syndrome?
uterus pressing on vena cava when woman supine, decreasing perfusion to uterus and placenta, baby can become hypoxic
Other pregnancy discomforts:
What signs/symptoms should be reported to doctor immediately?
What can result from frequent UTI's?
What do UTI's include?
- asymptomatic bacteriuria
Asymptomatic bacteriuria is diagnosed when:
All women screened for asymptomatic bacteriuria when?
first prenatal visit
What problems are associated with asymptomatic bacteriuria?
low birth weight
What is a bladder infection called?
S/S of cystitis:
lower abdominal/suprapubic pain
Pathogens in urine
What is a kidney infection called?
What is the leading cause of septic shock during pregnancy?
Complications of pyelonephritis?
transient renal dysfunction
What can pyelonephritis cause?
intrauterine growth restriction
S/S of pyelonephritis?
aching of lumbar area/costovertebral angels tender
Pregnancy induced hypertension (PIH) is a precursor to ____.
PIH can lead to:
- acute kidney injury
- heart failure
- placental abruption
Fetal risks associated with PIH:
S/S of PIH:
fluid volume deficit
Who is more at risk for preeclampsia?
pregnant women with PIH
What occurs with the liver in preeclampsia?
HIGH liver enzymes
What med is given to women with PIH or preeclampsia?
What is the purpose of mag sulfate?
HELLP syndrome is:
EL: elevated liver enzymes
LP: low platelets
What are the 5 cardinal signs of preeclampsia?
4) HA, dizziness
5) blurred vision
Signs of ECCLAMPSIA:
severe epigastric pain (RUQ)
altered mental status
Amniotic fluid is slightly ____ (pH).
What color does amniotic fluid turn litmus (nitrazine) paper?
What is ballottement? What type of pregnancy sign is it?
gentle tapping on cervix, fetus bounces away then back
What is the first recognition of fetal movements called? When does it occur?
16-20 wks (14-16 wks for multips)
What is a concern when the membranes rupture?
umbilical cord prolapse
cuts off baby's blood and oxygen
What is the purpose of the mucus plug?
prevent bacteria from entering the uterus
Why is measuring fundal height important?
assesses fetal well being and determines age
When the fundal height is stable or decreased, this could indicate...
intrauterine growth restriction (IUGR)
Excessive increase in fundal height could indicate...
What lab values are important to know in pregnancy:
RPR and VDRL (syphilis)
1 hr and 3 hr glucose tolerance
What lab values indicate anemia?
Hgb less than 10 g/dL
Hct less than 30%
What does ABO typing test for? Rh typing?
ABO = blood type (A,B,AB,O)
Rh = antigen (-,+)
If the rubella titer is negative it will read as ____. What does this mean?
lower than 1:10 dil
means susceptible to rubella
When can a pregnant woman get the rubella vaccine?
Never! Wait until postpartum.
If canker sore is present, test for syphilis with which tests?
RPR or VDRL
When must the mother be treated to avoid spreading syphilis to the fetus?
by 18-20 weeks
All women take which glucose tolerance test? When?
24-28 wks gestation
Who must take a 3 hr glucose tolerance test?
At risk pts
If failed 1 hr
Glycosuria is ___ in the urine.
What causes glycosuria?
decreased renal threshhold
What may glycosuria indicate?
What can proteinuria be a sign of?
infection or preeclampsia
Proteinuria is seen with a value of:
2+ to 4+ on dipstick
Ketonuria may result from insufficient ____ intake or ____.
WBCs in urine may indicate ____.
What are Braxton Hicks contractions?
irregular uterine contractions
no cervical change
- increases blood flow to uterus
- strengthens muscles for birth process
Education for Braxton Hicks contractions:
drink water to help with BP and amount of amniotic fluid
mom needs to gain:
- gain in entire 1st Tri: 2.2-4.4 lb
- gain in 2nd, 3rd Tri: 1-1.3 lbs/wk
- total during pregnancy: 28-40 lbs
mom needs to gain:
- gain in entire 1st Tri: 2.2-4.4 lbs
- gain in 2nd, 3rd Tri: 0.8-1 lb/wk
- total during pregnancy: 25-35 lb
mom needs to gain:
- gain in entire 1st Tri: 1.1-4.4 lbs
- gain in 2nd, 3rd Tri: 0.5-0.7 lbs/wk
- total during pregnancy: 15-25 lb
mom needs to gain:
- gain in 1st Tri: 1.1-4.4 lbs
- gain in 2nd, 3rd Tri: 0.4-0.6 lb/wk
- total during pregnancy: 11-20 lb
How to determine EDC using Naegles Rule:
subtract 3 months from FIRST DAY OF LAST PERIOD
add 7 days
Agents that cause birth defects are called:
During the first 2 weeks of development the embryo is not usually susceptible to ____.
Teratogens in 3-8 weeks can result in:
major congenital anomalies
Teratogens in 9-38 weeks can result in:
functional defects and minor anomalies
Severity of exposure to teratogens related to:
1) timing of exposure
2) different susceptibility or organ system
3) strength of teratogen
What areas are the most vulnerable to malformation upon teratogen exposure?
developing areas with rapid cell division
Caffeine can cause:
Drug use can cause:
How far before pregancy should rubella vaccine be given?
at least 3 months prior
Why should pregnant women avoid changing the litter box?
risk of toxoplasmosis
How should a pregnant woman lay to increase venous flow?
on her side
How may a pregnant woman have pseudoanemia?
increase in vascular anemia --> increase in RBCs --> hemodilution --> Hgb & Hct levels decrease --> pseudoanemia of pregnancy
Education for diaphragm use:
- insert into vagina up to 6 hours before sex
- use with spermicidal jelly/cream
- leave in place 6-8 hours after sex
- increases risk of UTI
- may need new size if weight fluctuates
- does not prevent STD
- must be washed with mild soap and water, dried, kept away from heat
What nutritional concerns with vegetarian pregnant woman?
- risk for B12 deficiency; need supplement
- sources of B12: milk, eggs, meat (liver)
- Deficient B12 may result in neurologic deficits: maternal-infant megaloblastic anemia; infant-neuron-development delays