What are some risk factors for pregnancy?

 Complete blood count (CBC)

● Age Serum cholesterol & glucose

● Gravida (# of preg) / para (# of deliveries)
● race/ethnicity, religion, mariatal/family Urinalysis
status, occupaion, education
HIV
2
Why is it important to take a family history before
STD: syphilis, gonorrhea, Chlamydia
pregnancy?
11
To determine both modifiable & non modifiable risk
What are Presumptive Signs of pregnancy and
factors related to family & genetic history to initiate
what are some examples of them?
actions to minimize risk
3 Subjective signs can be caused by causes outside
What is a healthy BMI Range? of pregnancy (Physiological changes perceived by
the woman)
8.5 – 24.9
4 Amenorrhea
What BMI classifies being "over weight"?
Breast changes and tenderness
25-29.9
5 Discoloration of vaginal mucosa
What BMI classifies one as "obese"?
30+ Increased skin pigmentation and striae

6 Nausea and Vomiting, Urinary Frequency

What BMI Classifies one as underweight?
BMI < 18.5 Quickening,  Fatigue

7 12
What are the different levels of Maslow's hierachy What are objective signs?
of needs? Pregnancy signs that can be perceived by the
healthcare provider
8 13
What is preconception counseling and why is it What are some examples of objective pregnancy
done? signs?
Assessing a woman’s relevant health hx, and
physical exam for risk factors & implementing ● Chadwick’s
interventions when needed can positively impact
her current & future health – resulting in better ● Goodell’s
health outcomes for women and families
● Hegar’s
9
What are the components of a pre-conception ● Ballottement
physical exam?
● pregnancy
Height & weight to calculate BMI
● Skin changes
Comprehensive physical exam
14
Breast exam What is Chadwick's sign, where does it occur, and
how many weeks after conception does it appear?
Pelvic exam
● The vigina, cervix, vulva turns blue/purple
10 in color
What are the Components of a pre-conception lab ● Occurs after 6-8 weeks from conception
exam?
15
Pap smear What is Goodell's sign, where does it occur, and
how many weeks after conception does it appear?
Blood type & Rh Factor
 ● It is a Softening & > leukorrhea of the cervix ● Subtract 3 months: August 21
and vagina ● Add 7 days: August 28
● Occurs after 8 weeks
24
16 What does the term "gravida" mean?
What is Hegar's sign, where does it occur, and how
Study These Flashcards
many weeks after conception does it appear?

● It is a Softening of lower uterus total # of times a woman has been pregnant –

● Occurs after 6 weeks
without reference to # fetuses, including a current
17 pregnancy
What are some positive signs of pregnancy? 25
     Fetal Heart Tone What does the term "para" mean?
Study These Flashcards
● -What: fetal heart beat (doppler) total # of births after 20 weeks whether alive or still
● -Where: near symphysis pubis over birth
shoulder
● -When: 10-12 weeks <20 wks = abortion (spontaneous or elective)
> # fetuses’ = one birth
     Fetal movement 26
What does each leter of the GTPAL system
● -What:actual movement represent?
● -Where: below umbilicus
Study These Flashcards
● -When: 20 weeks
G  Number of pregnancies (gravidity)
      Cardiac Visualization

● What: fetal heart by ultrasound T   Term infants (>37 weeks)

● Where: below symphysis pubis
● When: 4-8 weeks P   Preterm Infants (<37 weeks)

18 A   Abortions (spontaneous or therapeutic)

How do you determine pregnancy?
L   Living Children
It is 1st day of the last normal menstrual period
(LMP) to onset of labor
 
19
When does the 1st trimester begin? Abortions = < 20 weeks
1st day LMP through 14 completed weeks 27
What does Nulli-para or gravid mean?
20
When does the 2nd trimester begin? Study These Flashcards
Never pregnant or given birth
15 weeks through 28 completed weeks
28
21
What does primigravida mean?
How long does the 3rd trimester last?
Study These Flashcards
29 weeks through 40 completed weeks
Pregnant for 1st time
22
29
How many days long is a normal pregnancy?
What does multigravida mean?
280
Study These Flashcards
23 Pregnant for at least a second time
What is nagele's rule for gestional age?
30
What does grand multigravida mean?
–First day of LMP
Study These Flashcards
–Subtract 3 months Pregnant 5 or more times
31
–Add 7 days What is the function of the corpus luteum?

–Example: LMP Nov 21 Study These Flashcards

The main function of HCG is to maintain the corpus Diaphragm elevates 4 cm
luteum in early pregnancy by producing
progesterone. HCG generally is detectable in the Transverse diameter increases 2 cm
maternal serum about 7 days after conception
32 AP diameter increases 2cm
What is goodell's sign?
Oxygen consumption increases 15-25%
Study These Flashcards
Softening of the cervix. Feels like an earlobe. Tidal volume increases 50%
33
What is chadwick's sign? Respiratory rate increases slightly
Study These Flashcards
Increased vascularity entire upper tract
cyanosis of the cervix due to increase vascularity 
and edema 37
What are some changes in the renal system during
Mucus plug is the cork at the opening of a bottle an
pregnancy?
obstructs the cervical canal due to proliferation of
the mucus glands. Mucus forms within the cervix Study These Flashcards
and serves to protect the fetus from ascending
infectious bacteria ● Renal plasma blood flow increases 50%
34 ● GFR increases
What are some changes in the cardiovascular ● Increased excretion:
o Bicarbonate
system during pregnancy?
o Creatinine
Study These Flashcards ● Dilation of renal pelves and ureters
● Relaxation of bladder smooth muscle
● Blood Volume increases by 1600 ml (stasis)
● Heart Rate increases 15-20 bpm ● If glucose >160 – may spill in urine.
● Body water increases 6-8 liters ● Protein in urine may indicate
● Heart sounds: systolic ejection murmur preeclampsia.
● Vascular changes:
38
–SVR decreases 20% What are some changes in the gastrointestinal
system with pregnancy?
–PVR down 34%
Study These Flashcards
● Arterial blood pressure:
● Salivary glands more active
● Increased vascularity in gums and mucus
–decreased 2nd trimester
membranes
● Teeth – loss of minerals
–back to normal by term ● Decreased motility and tone in stomach
and intestines
35 o Contributes to reflux and heartburn
What is supine hypotension syndrome? o Constipation & hemorrhoids
Study These Flashcards ● Function of gallbladder and liver slower
Occurs when woman is lying on her back. o Increased risk of gallstones
Enlarged, heavy uterus presses on the inferior vena ● Functional Changes:
cava causing reduced blood flow back to the right o N/V (esp 1st trimester)
atrium. This results in: o Hyperemesis gravidarum
▪ May require hospitalization
–Hypotension o Altered tastes & cravings
–Fainting o Increased appetite (esp 2nd
–Dizziness trimester)
 
Keep woman on her side or upright 39
BP changes of concern: What is Hyperemesis Gravidarum?
–Systolic 30 mmHG
–Diastolic 15 mmHG Study These Flashcards
–>140/90 excessive vomiting and weight loss with
dehydration. Not a frequent occurrence, and occurs
36
after 15 weeks from conception.  She will also
What are some respiratory system changes seen in
complain of severe dehydration
the respiratory system with pregnancy?
40
Study These Flashcards
What are some changes in the Musculoskeleteal o Fibrinolysis (prone to clots)
system during pregnancy?  
● Increases:
Study These Flashcards
o Fibrinogen (30-50%)
o Coagulation Factors (VII-X)
● Posture changes: o WBC
o Lordosis
o Center of gravity shift
44
● Relaxin
What are some neurological system changes
● Rectus abdominous
during pregnancy?
● Low back pain
● Side pain Study These Flashcards
● Leg cramps
Sensory changes/compression of nerves
41
What are some integumentary system changes Carpal tunnel syndrome due to edema
during pregnancy?
Study These Flashcards Tension headaches

● Striae gravidarum - strech marks Numbness and tingling related to postural changes
● Chloasma
45
● Darkening of areola, vulva, & linea nigra
What are some hormonal changes seen in
● Increased:
pregnancy?
o Vascular markings
o Oily skin Study These Flashcards
o Acne
● Softening of fingernails ● Chorionic villi produce hCG
● hCG maintains corpus luteum
42 o Indicator for positive test
What are some endocrine system changes during ● Corpus luteum continues to produce
pregnancy? estrogen and progesterone for 8-10 wks
● Placenta takes over about 10 weeks
Study These Flashcards
● Estrogen & progesterone stay up
● FSH and LH stay down
Thyroid hypertrophy & increased BMR o No follicles mature

Increased need for glucose and insulin 46

Describe fatigue during pregnancy and how would
Decreased tissue sensitivity to insulin you treat it?
Study These Flashcards
Placental hormones present
Usually starts very early in pregnancy.
Decreased LH and FSH
May be due to hormonal changes.
Adrenal glands
Most women are “Super Woman”.
–increased aldosterone
 
–sodium regulation in urine
Remedy:
 
–Rest and sleep more.
NOTE: human placental lactogen jacks up
insulin sensitivity
–Exercise regularly (walking, swimming, etc.)
43
What are some hematologic changes during –Usually corrects itself during 2nd trimester.
pregnancy?
Study These Flashcards –Check blood count, eat healthy foods.
47
● Decreases: What are some weight gain changes seen with
o Hemoglobin (<10 – anemia) pregnancy?
o Hematocrit (31.9 to 36.5% are ok)
Study These Flashcards
–BMI = 18.5 – 24.9 Total gain of 25-35lb . •Antibody screen for Rh – negative women
 
–1st trimester gain of 3-4.4 lbs
52
–2nd and 3rd trimester 1lb./wk What kind of assessment will be conducted during
the 3rd trimester?
48
What is the "fundal height?" Study These Flashcards

Study These Flashcards

•Focused assessment
The height of the belly measured from the top of
the symphysis pubis to the top of the uterine
•Assessment of fetal well-being
fundus.  Findings may differ if the women is obese,
has uterine fibroids, or has poly/oligohydramnios
•Pelvic examination
49
What is leopold's maneuvers? •Leopold’s maneuver
Study These Flashcards
•Nutritional follow-up
Abdominal palpation that shows the degree of:
•Screening for group B streptococcus --> can
● uterine irritability lead to respiratory stress syndrome
● tone
● tenderness •Laboratory tests    
● current contractility
● and fetal movement •Patient education and anticipatory guidance          

50 •
What are some changes seen in the women during
the 2nd trimester? 53
What are the maternal tasks of pregnancy?
Study These Flashcards
Study These Flashcards
•BP may slightly decrease during 2nd trimester
•Ensuring safe passage for herself and her child
•Urine dip stick for glucose, albumin & ketones
•Ensuring social acceptance of the child by
significant others
•FHR (110 – 160 bpm)

•Attaching or “binding-in” to the child refers to the

•Fetal movement = quickening
development of maternal-fetal attachment
•Fundal height = cm = wk gestation
•Giving of oneself to the demands of being a
mother
•Edema lower extremities
54
•Ultra sound = 18 – 20 wks to confirm EDD & What are the 7 dimenstions of maternal role
anatomy development?

51 Study These Flashcards

What are some laboratory & diagnositc tests done
during the 2nd trimester?
Study These Flashcards
•Triple or quad screen (15 – 20 wks) *> =
chromosome  & < = NTD
•1 hr GTT (24 – 28 wks) if > = 3 hr GTT
1. Acceptance of pregnancy
2. Identification with the motherhood role
3. Relationship to her mother
4. Reordering relationship with her husband
or partner
5. Preparation for labor
6. Prenatal fear of control in labor
7. Prenatal fear of loss of self-esteem in labor

•Hgb & HCT (24 – 28 wks)  because blood volume 55

increases What is Couvade Syndrome?
Study These Flashcards
•Syphilis serology PRN, syphilis can’t pass to baby
prior to 18 weeks
a condition in which men may experience
pregnancy symptoms and discomforts similar to
their pregnant partner.
56
What are some father's worries with pregnancy?
Study These Flashcards

•Financial

•Changing relationship/wife and friends

•Sexual responsiveness of wife

•Safety of wife and infant

•Role in L&D

•Ability to father

•Disturbed feelings toward the baby

57
What are the 3 phases of developmental tasks of
fathers?
Study These Flashcards

1. Announcement phase

  –May react with joy, distress or combined

emotions

2. Moratorium phase Thought of PG put aside:

  –Fear of hurting baby with sex, Feelings of rivalry

  –Task = accepting the PG (wife and fetus)

3.Focusing phase – active involvement with fetus

  –Task – role in L&D and parenting