Help
Options
Question
Physiological Anemia
click to flip
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't know
Question
Blood Volume during pregnancy
Remaining cards (146)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Antepartum
BC3 Maternity
| Question | Answer |
|---|---|
| Physiological Anemia | normal due to increase blood volume |
| Blood Volume during pregnancy | up 30-50% |
| Pseudoanemia | HGB 11, HCT 37% |
| True Anemia during pregnancy | HGB under 10, HCT under 35% |
| Leukocytes during pregnancy | above 10,000 - reflects increased blood volume and increased protection against infection for mother |
| Pregnancy is a hypercoagulable state therefore what happens .... | increased risk of thrombophlebitis or venous thrombosis (Increased circulating fibrinogen & fibrin |
| GI system changes during pregnancy | intestines and stomach are displaced by increasing uterus - appendix can be as high as the right flank |
| What is the cause of n/v during pregnancy | primarily result of high HCG levels and progesterone/estrogen levels; can occur 1-2 weeks after conception |
| Treatment for n/v | dry crackers prior to sitting up (CHO foods) - eat small meals throughout the day - limit fluids with meals - avoid fatty foods - take prenatal vits at night |
| Relaxin | hormone secreted by corpus luteum and stimulated by progesterone - softens the cervix and relaxes the uterus; also relaxes the cardiac sphincter and stomach leading to reflux and heartburn |
| Constipation is caused by | decreased motility of the intestines and prolonged emptying and absorption time r/t the relaxin - may also be the result of increased pressure from the uterus |
| Tx of constipation during pregnancy | fiber, increase fluids and activity (eat lots of fruits and veggies - walk regularly) |
| Gall bladder function and tone during pregnancy | decreased; gall bladder may also become distended which can lead to gallstones and disease - decreased emptying of bile from the gallbladder leads to reabsorption of bilirubin which causes dry itching skin |
| Gums & teeth during pregnancy | can be swollen - increase blood supply to teeth, increased acid content of mouth and increased eating can lead to tooth decay |
| Urinary system during pregnancy | progesterone & relaxin cause relaxation of smooth muscle through the urinary system especially in 1st & 3rd trimester |
| Urinary stasis during pregnancy | common - important to drink lots of water |
| What causes pressure on the bladder | the enlarging uterus - especially during 3rd trimester can cause frequency |
| Lab changes during pregnancy | decrease is specific gravity, BUN and creatinine, tendency to spill dextrose in urine (1+) |
| Pica | craving for non-food items such as starch, dirt, chalk, ice |
| Skeletal system changes during pregnancy | relaxin causes gradual softening of pelvic ligaments leading to excess mobility of the joints |
| Pelvic instability | puts more strain on the back muscles and thighs |
| Endocrine changes during pregnancy | Thyroid & pituitary slighly enlarges; Adrenals also slightly enlarge and their activity increases |
| What is the major endocrine gland during pregnancy | the placenta |
| Anterior lobe responsible for | gonadotropins suppressed to stop ovulation & menstruation; Prolactin secreted - responsible for initial lactation |
| Posterior lobe responsible for | secretes Oxytocin which promotes uterine contracitility during pregnancy and stimulates the ejection of breast milk |
| HCG | All blood and urine pregnancy tests are based on the presence of this hormone |
| What excretes HCG | chorionic villi of implanted ovum |
| What does HCG do | prolongs the life of the corpus luteum, which leads to continued production of estrogen and progesterone until the placenta takes over after the second month of pregnancy |
| Chronic villi | produce Human Placental Lactogen (HPL) - this influences cell growth of the fetus and stimulates breast changes for lactation and is present in maternal serum by the 6th week |
| Aldosterone | increases and is responsible for the retention of sodium by the kidneys. Any imbalance here can lead to Na retention and edema |
| Neurologic changes during pregnancy | sensory changes in legs, back pain r/t lumbar lordosis, carpal tunnel syndrome, acrothesia, tension HA, light headedness, stuffy nose |
| Lumbar lordosis | the overexaggerated curve of the lumbar spine |
| Acrothesia | ?? |
| Danger signs of pregnancy | PROM, vaginal bleeding, severe HA/blurred vision, abdominal pain, temp 101.9/chills, swelling of lower legs, hands and face, absence of fetal movement |
| PROM | Premature Rupture of Membranes - sudden gush of clear fluid from vagina |
| What are the risks r/t PROM | infection and premature labor |
| Assessment of vaginal bleeding | depends on timing |
| Light spotting | early is normal |
| Bright red bleeding early | could indicate a spontaneous abortion |
| Brigh red bleeding later | could indicate a placental problem |
| Assessment of abdominal pain | depends on time - sharp cramping indicates danger sign |
| Oral temp above 101.9 F | could indicate infection |
| Swelling of lower legs, hands and face | not uncommon, but if peri-orbital or increased weight gain it could indicate pre-eclampsia |
| When is the first fetal movement felt | usually 18-20 weeks for first time moms; second time moms may feel earlier b/c they know what they are feeling |
| What is one component of amniotic fluid | fetal urine |
| Hyperemesis gravidum | persistent vomitting - every day for 1st trimester |
| Tx of Hyperemesis gravidum | hospitalized with central line for weeks - TPN; mom is worse off than baby |
| When can an US detect gestational sac | 5-6 weeks |
| When can an US show fetal heart beating | 11 weeks |
| When can an US detect fetal breathing | 11 weeks |
| When can an US show fetal movement | 12 weeks |
| When should mom report n/v | if she shows signs of dehydration and concentrated urine |
| What should mom do in regards to urinary frequency | good cleanliness - reports signs of UTI - drink 2000 mL/day (bladder spasms can lead to uterine contractions) |
| What should a mom do about heartburn | Avoid baking soda - may take Maalox (give her a measurable amount) |
| How can a mom decrease edema and varicosities | keep legs elevated as much as possible |
| What can a mom do about a backache | good posture is important |
| What should a mom do about faintness | moderate exercise, deep breathing, avoid sudden changes in position and warm crowded areas (usually happens in 1st trimester) |
| What can a mom do regarding Vena Caval Syndrome | teach to lie on side - not back |
| Breast Care during pregnancy | wide straps, bras large enough, good cleanliness, check if nipples are inverted - use nipple shield |
| Nipple stimulation | may stimulate uterine activity - should be avoided during last trimester if there is any danger of pre-term labor |
| Exercise | moderate exercise is important to strengthen muscles for childbirth (no full sit-ups); Kegel exercises and Pelvic tilt |
| Sexual activity | only limited if woman prone to pre-term labor, bleeding or ROM |
| Teratogens | subsatnce that harm the growth and development of fetus -can be alcohol, cocaine, caffein, etc., |
| Overall weight gain during pregnancy | 25-35 pounds |
| Caloric intake | should only increase by 300 Kcal/day above usual allowance (Approx 18Kcal/lb of mom's ideal body weight) |
| Weight gain during the first trimester | 2-4 pounds |
| Weight gein during the 2nd and 3rd trimester | 0.8-1 pound / week |
| A sharp weight gain after the 20th week may indicate | increased water retention and the beginning of PIH |
| What do CHO provide | Protective substances (vitamins & minerals), bulk (fiber), and energy |
| CHO promote | weight gain and growth of the fetus, placenta and other maternal tissues |
| Sources of CHO | milk, fruit, veggies & whole-grain cereals & bread |
| Fats provide | essential fatty acidsq |
| Function of protein | build and repair all body cells - preferably not to be used as an energy source |
| Increased amount of protein is needed during pregnancy for | growth & development of maternal and fetal tissue |
| Vitamins | organic substances essential to life |
| Fat-soluable vitamins | ADEK - stored by body, it is possible to overdose with large supplements |
| Water soluable vitamins | all B's & C's - not stored in the body, need replenishing - excreted in urine |
| Dairy needs for pregnant woman | 2 servings |
| Grain needs for pregnant woman | 6-11 servings |
| Fat needs for pregnant woman | 2 servings |
| Veggie needs for pregnant woman | 3-5 servings |
| Fruit needs for pregnant woman | 2-4 servings |
| Meat needs for pregnant woman | 2-3 servings |
| Antiflexed | uterus bends forward |
| Dextrorotate | uterus turns to the right |
| Size changes of the uterus | Normal 60-70g goes to 1100-1200g; Capacity 10ml (2tsp) - greater than gallon |
| The growth of the uterus is principally r/t | enlargement of pre-existing muscle fibers |
| The effect of estrogen on uterine muscle | increase fibroelastic tissue between the muscle bands |
| Braxton - Hicks | painless, irregular, beginning of 4th month, prepare the uterus for labor |
| Fundal height is important to assess to determine | fetal well-being |
| Fundal height is first palpable | above symphysis at 12 weeks at umbilicus by 20 wks |
| How is fundal height measured & when | with a paper tape from the symphysis to fundus of uterus at prenatal visits |
| Fundal Height # of weeks gestation = | # of centimeters measured until 3rd trimester (17wks gest = 17cm) |
| McDonald's Rule (wks) | # of cm x 8/7 = wks gestation |
| McDonald's Rule (months) | # of cm x 2/7 = duration of pregnancy in months |
| If the fundal height is low for gestation | IUGR due to problems with placenta or other disorders |
| If fundal height is greater than it should be for gestational age | twins, hydraminios, hydatidiform mole, internal hemorrhage |
| Goodell's Sign | Cervix softens with pregnancy |
| Normal cervix feels like | the tip of the nose |
| The pregnant cervis feels like | an earlobe |
| The cervix is bluish discoloration is due to | increased vascularity |
| operculum | mucous plug |
| Why is the mucous plug formed | due to increased excretion of endocervical glands |
| Chadwick's sign | vagina has increased vascularity which leads to blue discoloration |
| If mom gets yeast infections, newborn can get? | thrush |
| Vaginal pH | acidic during pregnancy to discourage bacteria - but can encourage yeast infections |
| Breast changes in pregnancy r/t | increased circulation and increased endocrine activity |
| What are the breast changes | larger, firmer, tender; areola enlarges & darkens; colostrum can be expressed during last trimester |
| Abdominal wall changes | stretches to accommodate uterus; stretch marks on abd., thighs, breasts; Diastasis recti |
| Striae Gravidarum | Stretch marks (younger women tend to have less) |
| Diastasis Recti | separation of the rectus muscle of the abdomen; May leave a blue groove on the abdomen |
| Skin Changes | Linea Nigra; Cloasma; Spidernevi; Glowing |
| Linea Nigra | Black line from mons veneris to umbilicus; r/t increased hormones; will lighten 6-12 wks post partum |
| Cloasma | Mask of pregnancy; r/t hormones; sunburn like |
| Spidernevi | Vascular, spider-like red blemishes on the skin with branching legs; do disappear |
| Glowing | increased activity of sebaceous & sweat glands |
| Metabolic changes (BMR) | BMR increased 15-20% |
| Metabolic changes (CHO) | pregnancy mimics a subclinical diabetes; glucose excreted in urine - don't test urine for glucose it won't be accurate |
| Metabolic changes (weight gain) | r/t presence of grownig fetus, placenta, fetal membranes, and amniotic fluid more than to a change in metabolism; Increased water retention r/t increased aldosterone |
| Respiratory changes | O2 consumption inc. by 20%; mom's need for O2 inc.; Inc resp effort, dec. PCO2 d/t progesterone; mucous mem engorged > stuffiness & epistaxis; level of diaphragm displaced as much as 4cm upward; mild hyperventilation >resp alk>Inc urinary output |
| If mom has a stuffy nose | do not take OTC meds for congestion |
| Circulatory changes (blood vol) | Inc. 30-50%; Inc begins by the end of the 1st trimester & peaks by 24-30th wks |
| Circulatory changes (pulse) | Inc. 10-15 bpm |
| Circulatory changes (BP) | slightly inc 1st trimester; drops 2nd trimester - r/t lower peripheral resistance; returns to normal during 3rd trimester |
| Circulatory changes (placement of heart) | gets displaced to a transverse position to the right by 2 degrees |
| Postural hypotension can occur r/t | increased blood volume in lower legs |
| During last trimester, blood flow to lower extremities may be impaired by | pressure of the uterus on veins and arteries - leads to edema, varicosities of the vulva, rectum & legs |
| Vena Caval Syndrome | the enlarging uterus presses on the vena cava when the pregnant woman lies supine - it decreases blood to the right atrium |
| S/S of vena caval syndrome | dizziness, rapid pulse, diaphoretic |
| LMP | The date of the first day of the Last Menstrual Period |
| EDC | Naegles rule to determine the estimated date of confinement |
| Gestation | Literally "pregnancy" |
| Gestational age | # of weeks since LMP |
| Gravida | A pregnant woman |
| Primigravida | Woman pregnant for the first time |
| Multigravida | Woman pregnant for 2 or more times |
| Para | A woman who has delivered offspring who reached the age of viability |
| Nullipara | Woman who has never delivered her 1st baby over 20 weeks |
| Primipara | Woman who has delivered her 1st baby over 20 weeks gestation (primip) |
| Multipara | Woman has delivered more than one neonate after the age of viability |
| Abortion | Delivery of a fetus at 20 weeks gestation or less (can be spontaneous - miscarriage or elective) |
| age of viability | over 20 weeks |
| GTPAL | Gravida/Term/Preterm/Abortion/Living |
| Term | 38-42 weeks |
| Preterm | 20-37 weeks |
| Abortion | under 20 weeks |
| Naegles Rule | LMP - 3 months + 7 days = EDC |
Created by:
okrecota
Popular Nursing sets