WEEK 2 Flashcards
(16 cards)
What are the main hormones in pregnancy?
estrogen (fetal dev, suppress ovulation by decreasing FSH and LH)
progesterone (maintain pregnancy)
hCG (comes first from ovary, then from placenta)
What are changes to CVS in pregnancy?
heart elevated and rotated to the left,
HR increase 10-15bpm
blood volume increase by 1500ml
RBC mass increase
Hg and hematocrit DECREASE
WBC increase in second trimester, peak in third
CO increase 30-50%
sys BP slight to no decrease
dia BP slight decrease mid preg
increased risk for blood clots due to increase clotting factors.
What is Supine Hypotensive Syndrome?
at second half of pregnancy, client lay on back will compress vena cava and feel unwell.
fetal decel because blood decrease to them
decrease in sys pressure
reflex bradycardia
decrease Co
S&S: pallor, dizziness, faintness, breathlessness, tachycardia, nausea, clammy and diaphoretic
Intervention for Supine Hypotensive Syndrome
put client on left side until vitals and symptoms get better.
ensure they lay at 30 degree with pillow behind them.
What are changes to resp system in pregnancy?
O2 consumption increase 20-40%
RR unchanged, or slight increase
Tidal volume increase
Increase congestion and vascularity to upper resp tract.
Uterus expands and pushes on diaphragm = short of breath
More prone to infections
What are changes to renal system in pregnancy?
Renal pelvis and ureters dilate.
Urinary stasis (more UTI risk/ kidney stones)
Urinary frequency
Bladder tone decrease
GFR and renal plasma flow increase in early pregnancy
edema from decreased renal blood flow and GFR near end of pregnancy
What are changes to the integumentary system in pregnancy?
nipple, areola, vulva, axillae darken
chloasma (brown pigmentation on face)
linea nigra (line from symphysis pubis to top of fundus)
stretch marks
gum hypertrophy
increased nail and hair growth
What are changes to the breast in pregnancy?
increase fullness and sensitivity
blood vessels more visible
nipples more erect and dark
montgomery tubercles secrete lube to protect nips during breastfeeding
increased proliferation of ducts for breastfeeding
colostrum (creamy, premilk from nips)
What are changes to the uterus and cervix?
uterus changes shape and size, palpable above symphysis pubic (12-14wks)
uterus rise to umbilicus level (20-24 wks)
internal os: never preg before (pinpoint), preg (horizonal slit)
4 months in, braxton hicks contractions
all the probable signs
leukorrhea (white/grey discharge)
What are changes to the GI system in pregnancy?
nausea/vomiting early on
gums more swollen –> more saliva
gingivitis –> LBW, preterm birth, preeclampsia
heartburn
constipation
hemorrhoids
appetite/intake fluctuations
What are changes to the neuro system in pregnancy?
carpal tunnel because edema compress median nerve
acroesthesia (numb hands)
tension headaches
faintness or syncope
What is fundal height?
the distance from the symphysis pubic bone to the top of the uterus in cm
start at 18-20 wks
indicator of fetal growth
from wk 18, fundal height should = gest age (+/-2cm)
client should void before assessment
decrease in wk 36-40 as baby descends into pelvis
When is fundal height not accurate?
more or less amniotic fluid
pregnancy has multiple babies
differences in examiner technique
if uterus is flexed on one side
baby is transverse
individuals with higher BMI
position of the fundus
How to listen for FHR?
doppler stethoscope, fetoscope to hear
best place between baby scapula (leopold maeuvers)
check maternal HR first
count for one full minute for quality and rhythm
100-160bpm
How to assess for fetal movements?
fluttering at 13-16wks
24wks baby movement more predictable
kick counts (daily for high risk)
count movement for 2 hours, for minimum of 6 movements
