Young Pregnant Adult

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AngelGoosie
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291783
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Young Pregnant Adult
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2014-12-16 20:46:47
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Young Pregnant Adult
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Module III, Unit D
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  1. Where is the fundus height at

    At 12, 16, 20, 26, and 37-40 weeks?
    • 12 weeks - (just above) pubic symphysis
    • 16 weeks - between public symphysis & umbilicus
    • 20 weeks - umbilicus
    • 26 weeks - xiphoid process

    37-40 weeks - Regression in fundal height (dropping)
  2. Chadwick’s Sign

    • Discoloration (blue to purple) of the vagina & labia
    • Earliest signs of pregnancy
    • Due to increased blood flow to area

    A presumptive sign of pregnancy
  3. Why are pregnant women more prone to yeast infections?
    Vagina cells increase in glycogen

    • This causes an increased discharge
    • But prevents growth of harmful bacteria
  4. Early pregnancy stages are maintained with
    progesterone secreted from the _____ for first ______ in pregnancy

    After the ______ is developed, it take over the progesterone production
    • corpus luteum
    • 6-7 weeks
    • placenta
  5. Progesterone is the considered _____
    the “hormone of pregnancy”
  6. During pregnancy, the breasts & nipples become larger because of
    Increased vascularity
  7. Colostrum
    Thick yellowish fluid secreted from nipples rich in antibodies

    Begin at 12-16 weeks of pregnancy

    Can be readily expressed from 3rd trimester
  8. Medical term for stretch marks
    What are they?
    Straie Gravidarium

    Lineal tears in connective tissue
  9. Total blood volume during pregnancy increases ____ %

    Why?
    40-60%

    • Transports nutrients & oxygen to placenta
    • Demands of expanded maternal tissues

    Functions as a reserve to protect women from effects of blood loss during birth
  10. Physiologic Anemia aka Pseudo-anemia of
    Pregnancy
    Dilution of in RBC concentration in plasma

    Due to pronounced plasma volume increase NOT decrease in RBC

    Hematocrit Levels

    Normal non-pregnant female is 12-15 g/dL

    2nd trimester is less than 10.5 g/dL

    1st & 3rd trimester is less than 11 g/dL
  11. Cardiac Output Increases in pregnancy because

    Why does the BP stay the same?
    Increase is mostly based on amount of blood

    • Placenta gives blood more room to go
    • Heat from fetus causes vasodilatation
    • Progesterone relaxes smooth muscle
    • Prostaglandins decrease angiotensins ability to constrict vessels
  12. Five Major Changes in Blood Flow during pregnancy
    Altered to include the uterus & placenta

    More blood circulates thru kidneys (more waste generated by mother & fetus)

    Skin requires increased circulation to dissipate

    Blood flow to breasts increases causing engorgement & dilated veins

    Varicose Veins of legs, vulva, or rectum (hemorrhoids)
  13. Supine Hypotension aka Vena Cava Syndrome
    Decrease in BP when lying flat on back

    Due to extra weight pushing down on vena cava & descending aorta

    Mother feels light headed & faint

    Turn mother on lateral recumbent position
  14. Excessive salivation experienced by some during pregnancy
    Ptyalism
  15. Gallbladder changes during pregnancy
    Becomes hypotonic causing emptying time to prolong

    Becomes thicker bile

    Increases chances of gallstones
  16. Linea Nigra
    Dark vertical line appearing on abdomen of pregnant women

    Line runs vertically down midline

    Caused by increased production of melanocyte stimulating hormone by placenta

    More common in women with darker complexions

    Disappears within few months after delivery

    Latin “black line”
  17. What happens to the thyroid gland during pregnancy
    • Thyroid Gland Enlarges
    • Increases in activity 25%                       
    • Increase in pulse & heat intolerance
  18. Parathyroid Gland is Important for ______ during pregnancy
    Calcium Homeostasis
  19. Explain quickly how Gestational
    Diabetes happens
    • In the 2nd half of pregnancy
    • Maternal tissue sensitivity to insulin declines
    • Mother uses fat stores to meet energy needs

    The higher amounts of glucose in blood is for fetal energy

    These higher glucose levels stimulates the pancreas to make more insulin

    Gestational Diabetes is due to inadequate insulin production
  20. Human Chorionic Somatomammotropin (hCS) aka
    Human Placental Lactogen (hPL)
    An insulin antagonist (reduces sensitivity of maternal cells to insulin)

    Thus decreases maternal metabolism of glucose

    This frees glucose for fetus
  21. As maternal body water increases
    List some outcomes
    Edema (in the feet &legs) especially at end of the day

    Carpal Tunnel due to fluid retention
  22. List guidelines for weight gain during pregnancy and loss after pregnancy
    • 1st trimester
    • 2-4 pounds
    • (1-1.5 lbs stated in lecture)

    • 2nd & 3rd trimester
    • 1 pound per week
    • (0.88 lbs stated in lecture)

    • Total Gain
    • 25-35 pounds for women at normal BMI

    • Weight Loss
    • Usually lose 12 lbs immediately after birth
    • 9 lbs after two weeks
    • 5 lbs more in six months
  23. During pregnancy resistance to infection _____

    But autoimmune diseases  during pregnancy

    Why is this?
    decreases

    improve

    allowing foreign object (fetus) grow
  24. List out presumptive, the probable, and the positive signs of pregnancy
    • Presumptive
    • Nausea & Vomiting
    • Fatigue & Drowsiness
    • Urinary Frequency
    • Breast & Skin Changes
    • Chadwick’s Sign 
    • Fetal Movement (not felt until 2nd trimester)
    • Amenorrhea



    Probable


    • Abdominal
    • Enlargement

    • Cervical
    • Softening (found during pelvic exam)

    • Probable
    • Change in Uterus (Hagar’s Sign, Ballottment)  Braxton Hicks Contractions
    • Pregnancy Tests

    • Postive
    • Auscultation of Fetal Heart Sounds (16-20 weeks)
    • Fetal Movements Felt by Examiner
    • Visualization of Fetus via ultra-sound
  25. Uterine Soufflé
    • Soft blowing sound auscultated over uterus Sound of blood circulating thru dilated uterine vessels
    • Heard late in pregnancy
  26. The absence of menstruation
    Amenorrhea
  27. Subtle fetal movements between 16-20 weeks

    Movements increase in intensity with progression
    Quickening
  28. Hagar’s Sign
    • Uterus so soft can be flexed against cervix
    • 6-8 weeks after menses
  29. Ballottement
    • Rising of fetus in amniotic fluid & rebounding to same position
    • Takes place when pushing up cervix during exam
    • You can feel the rebound
  30. Tightening in the abdomen that comes and goes
    Feels like mild menstrual cramps

    Braxton Hicks Contractions
  31. Characteristics that make Braxton Hicks unlike true labor
    • Usually not painful
    • Don’t happen at regular intervals
    • Don’t get closer together
    • Don’t increase when you walk
    • Don’t last longer as they go on
    • Don’t feel stronger over time
    • Occur throughout pregnancy
  32. False Labor
    3rd trimester Braxton Hicks Contractions that are mistaken as early labor

    They become more frequent in 3rd trimester, causing discomfort for mother
  33. Gravida

    Number of times pregnant regardless of duration

    • Primagravida – Pregnant for 1st time 
    •                       
    • Multigravida – Pregnant more than once
  34. Parity (Para)
    Number of pregnancies that have ended at 20 weeks or more

    Regardless of infant being alive or dead

    Nullipara (none), primipara (1), multipara (more than 2)
  35. Acronym that gives complete description of all pregnancy outcomes
    GTPAL

    • Gravida
    • Term Births
    • Pre-Term Births
    • Abortions (Terminations, Spontaneous)
    • Living Children
  36. Fetal Heart Rate
    110-160 bpm
  37. Treatments for Morning Sickness (as discussed in lecture)
    • Have a little protein before going to bed
    • Eat saltines in morning before your feet hit the ground
    • Small meals
    • Drink liquids separately from meals
    • Some advice taking vitamin B (talk to doc about that)
  38. Complication of pregnancy characterized by severe nausea, vomiting, weight loss, and electrolyte imbalance
    Hyperemesis Gravidarum

    NOT the same thing as morning sickness
  39. What causes heartburn during pregnancy?

    Ways to treat it
    • Diminished gastric motility
    • Compression of stomach
    • Esophageal sphincter relaxes

    • Treatments
    • Antacids (liquids are better)
    • Avoid high salt content food
    • Sit up for meals
    • Ditch the coffee
  40. Men exhibiting pregnancy symptoms (fatigue, nausea, vomiting)
    Related to stress, anxiety, & empathy
    Couvade
  41. Practice of eating nonfood or some food components not part of normal diet
    • Pica

  42. Caffeine Intake during pregnancy
    less than 200 mg/day

    6 oz coffee = 100 mg caffeine
  43. What happens to iron supplement intake after pregnancy?
    Continue taking them for 2-3months to replenish stores depleted during pregnancy
  44. What are the 3 phases of a Contraction
    Cycle


    • Increment
    • Begins in fundus & spreads thru uterus

    • Peak (Acme)
    • Contraction most intense

    • Decrement
    • Decreasing intensity as uterus relaxes
  45. Contractions can be described in terms of
    • Frequency
    • Measured in “minutes apart”
    • Frequency = Duration + Interval

    • Duration
    • How long contractions last

    • Interval
    • In between time / uterine relaxation occurs
    • Period between end of one contraction & beginning of next
    • Fetal exchange of oxygen, nutrients & waste occur

    • Intensity
    • (mild, moderate, strong)

  46. Effacement
    Thinning & shortening of cervix

    Starts a cylindrical structure but merges with lower uterus as it thins

    Measured as a percentage (100% effaced)
  47. Dilation
    • Opening of the cervix
    • Expressed in cm (10 cm is full dilation)
  48. During labor & birth, mother should be in a position other than _____ in order to let blood return to heart
    Supine
  49. Changing shape of fetal head to adapt to size &
    shape of pelvis
    Molding
  50. List premonitory (warning) signs of labor
    Braxton Hicks Contractions increase in frequency & become

    Vaginal Secretions increase of clear, nonirritating secretions

    • Lightening (Dropping)
    • Bloody Show
    • Nesting

    • Small Weight Loss
    • 2.2 -6.6 kg (1-3 pounds)
  51. Lightening
    • aka Dropping
    • Fetus descends toward pelvic inlet
    • Most noticeable in nulliparas

    Usually occurs 2-3 weeks before onset of labor
  52. Bloody Shoe
    Mixture of thick mucus with pink or brown blood

    • Caused due to cervix beginning to soften,
    • dilate, & efface slightly (Ripening)

    This change in cervix causes mucus plug to come out

    Blood comes from vessels in cervix as it changes
  53. Lochia
    vaginal discharge after giving birth (puerperium) containing blood, mucus, and uterine tissue

    • Lochia Rubra
    • Discharge is red
    • Containing lots of blood
    • Lasts up to day 5

    • Lochia Serosa
    • Brownish or pink in color
    • Contains contains serous exudate, erythrocytes, leukocytes, and cervical mucus
    • Lasts up to 10th day

    • Lochia Alba
    • Whitish or yellowish-white
    • Contains leukocytes, epithelial cells, cholesterol, fat, and mucus
    • Weeks 2-7 after birth
  54. Medical Terms for the "mask of pregnancy"
    Chloasma or Melasma

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