NR EXAM REVIEW WELL GRADED SOLUTION

NR EXAM REVIEW WELL GRADED SOLUTIONS Presumptive signs of pregnancy - Subjective signs. Amenorrhea, nausea, vomiting, increased urinary frequency, excessive fatigue, breast tenderness, quickening at 18-20 weeks. Probable signs of pregnancy - Objective Signs. Goodell sign (softening of cervix), Chadwick sign (cervix is blue/purple), Hegar's sign (softening of lower uterine segment), uterine enlargement, Braxton Hicks contractions (may be plapated by 28 weeks), uterine souffle (soft blowing sound due to blood pulsating through the placenta), integumentary pigment changes, ballottement, fetal outline definable, positive pregnancy test (could be hydatidiform mole, choriocarcinoma, increased pituitary gonadotropins at menopause). Positive signs of pregnancy - Diagnostic. Fetal heart rate auscultated by fetoscope at 17-20 weeks or by Doppler at 10-12 weeks, Palpable fetal movement after 20 weeks, visualization of fetus with cardiac activity by ultrasound (fetal parts visible by 8 weeks). Pregnancy and fundal height measurement - As pregnancy progresses, the fundus rises out of the pelvis. At 12 weeks gestation, the fundus is located at the level of the symphysis pubis and the umbilicus. By 20 weeks gestation, the fundus is at the same height as the umbilicus. Until term, the fundus enlarges 1 cm per week. As the time for birth approaches, the fundal height drops slightly. This process is called lighting and occurs mostly for primigravida and may not occur for woman who are multigravida until she goes into labor. Naegele's rule - The EDB for women with 28 day cycles - Nagele's rule - Add 7 days to LMP then subtract 3 months. Example: 4/23 LMP of April 23 + 7 days = 4/30 (April 30th) - 3 months = January 30th (following year) Hematological changes during pregnancy - During pregnancy, the heart is displaced upward and to the with withing the chest cavity by the gravid uterus's pressure on the diaphragm. As pregnancy progresses, the risk for inferior vena cava and aortic compression leading to supine hypotension increases when the woman lies in a supine position. Advice pregnant women to lie left lateral position. Cardiac output in pregnancy increases by 30-50%. Peaks