MIDTERM EXAM-NURS 326
What is prenatal period? - ANSWERSPeriod of physical and psychological preparation
for birth and parenthood that offers opportunities for:
-health of the expectant mother and infant- diagnosis and treatment of maternal
disorders
-education and support for self-care and parenting
*monitoring and teaching the mother
What does pregnancy tests indicate? - ANSWERS-human chorionic gonadotropion
(hCG) is earliest biochemical marker for pregnancy
-production begins as early as day of implantation (7-10 DAYS!!!!)
What is Gravida? - ANSWERSrefers to the number of times a woman has been
pregnant, regardless of the outcome
When do you take a pregnancy test? - ANSWERSthe first voided urine in the morning
What is Para/TPAL? - ANSWERSrefers to the number of deliveries (not children) that
have occurred after 20 weeks of gestation (TWINS COUNT AS 1 PARA)
-when calculating parity, multiple births count as only one
-a fetus born dead after 20 weeks is added to the parity count
-TPAL (term births, preterm births, abortions, and living children) may be calculated
What is Primipara? - ANSWERSwoman who has completed 1 pregnancy with a fetus
or fetuses who have reached stage of fetal viability
What is Term? - ANSWERSpregnancy from the beginning of week 38 to end of week
42 of gestation
What is Viability? - ANSWERScapacity to live outside the uterus
What is Multiparous? - ANSWERSwoman who has completed multiple (more than 1)
pregnancy
What is TPAL? - ANSWERST - TERM BIRTHS
P - PRETERM BIRTHS
A - Abortions (Spontaneous or Elective)
L - Living Children
Spontaneous Abortion (Miscarriage)
Elective Abortion (Elected)
,What does the reproductive system consist of? - ANSWERSuterus, cervix, vagina,
ovaries, breasts
Uterus growth/size? - ANSWERStremendous growth
-non pregnant vs size @ 36 weeks (size of a pear to be able to hold 5000 mL)
-muscle fibers increase in length and width
Sizes/weeks of the uterus at symphis, 1/2 way to umbilicus, umbilicus, and xyphoid
process? - ANSWERS12 weeks at symphsis
16 weeks 1/2 way to umbilicus
20 weeks at umbilicus
36 weeks at xyphoid process
*lightening/engagement (2 weeks before labor)
Cervix: What signs are included? - ANSWERS-Leukorrhea discharge: soften,
increased contraction mucous
-Chadwick's sign: bluish color of vagina
-Goodell's sign: softening of the cervix
-Mucous plug: thick mucous covers canal to protect fetus from infection
What is Chadwick's sign? - ANSWERSbluish color of the vagina due to increased
vascularization caused by estrogen
What is Goodell's sign? - ANSWERSsoftening of the cervix
Does the vagina have increased vascularity/secretions? - ANSWERSYes
When does the ovaries enlarge and what hormone does the ovaries secrete until
weeks 6-7? - ANSWERSenlarge until 12-14 weeks
also secretes progesterone until weeks 6-7 when placenta takes over then
progesterone levels will drop
Reproductive system: Breasts? - ANSWERS-becomes more full
-more tender, tingling sensation
-increased vascularization
-nipples larger & more erectile
-colostrum expressed beginning week 12 in 1st trimester (first milk produced)
-Striae (stretch marks)
Cardiovascular changes (BLOOD VOLUME) during pregnancy? -
ANSWERS**Increased blood volume!
-plasma volume increases 40-60%
-RBC volume increases 20-30% and total volume increases
, Does anemia happen during pregnancy? - ANSWERSYes! physiological anemia of
pregnancy is due to hemodilution (Hgb 10.5g to 11g) b/c plasma volume increases
more than RBC volume
What is hemodilution? - ANSWERSduring pregnancy, RBC's increase, but so does the
amount of plasma in the body. This causes less RBC's to remain in the system
Patient may have to take oral iron supplements for this
● Taken w/ vitamin C/orange juice
● Can cause constipation → increase fiber
● If stool changes color → this is b/c of iron
Cardiovascular changes (Cardiac Output) during pregnancy? - ANSWERS-stroke
volume & heart rate = cardiac output
-increases 50% by week 20
HR
-increases 10-20 bpm
-slight cardiac enlargement during pregnancy
-heart works harder to provide oxygen for mom
Cardiovascular changes (Blood Components) during pregnancy? -
ANSWERSHypercoagulable
-Fibrin and Fibrinogen increase by 50%
-protective mechanism to prevent postpartum hemorrhage
-venous stasis/long periods of standing or sitting
-increased risk of DVT (using Bubble-Dep Assessment)
Are pregnant women more hyper coagulable? - ANSWERSYes, it's the body way of
protecting itself from postpartum hemorrhage
What is the Vena Caval Syndrome (Supine Hypotensive Syndrome)? - ANSWERS-
weight of uterus on vena cava
-pts feel faint, dizzy, fetal bradycardia
-pt's should not lay straight on their back, the left side is a good side
What eases the symptoms of Venal Caval Syndrome? - ANSWERSleft lateral or right
lateral (side lying)
Respiratory system during pregnancy? - ANSWERS-oxygen consumption increases
20% (respiratory remains unchanged!)
-baby takes up more space and presses against diaphragm
Respiratory: What are the hormonal changes during pregnancy (Progesterone &
Estrogen)? - ANSWERS-progesterone relaxes smooth muscle but high progesterone
can cause a pregnant woman to breathe faster
, -estrogen leads to increased vascularity & congestion (nasal & sinus stuffiness,
Epistaxis (nosebleeds))
-estrogen increases more gallstones due to cholesterol
GI system during pregnancy? - ANSWERS-Pytalism (increased salivation) - PICA,
more craving for foods/weird dislikes
Smooth muscle relaxation (progesterone)
-constipation
-slower emptying, reflux, pyrosis (heartburn)
-increased risk of gallstones
-N/V (50-80% pregnant women)
How to prevent N/V during pregnancy? - ANSWERSdry crackers, small frequent meals,
ginger ale, salty or tart foods (lemonade, pretzels)
Renal/Urinary System during pregnancy? - ANSWERS-increased workload/increased
blood volume (30-60% increase blood flow)
-increased GFR: pressure of the baby on the bladder = urinary frequency
-MORE PRONE TO UTI!!!
Why are pregnant women more prone to UTIs? - ANSWERSprogesterone = smooth
muscle relaxer and increased GFR = increased "spilling" of glucose in urine causes it to
be more alkaline - UTI is caused/urinary frequency
-UTIs can cause preterm labor
Integumentary System during pregnancy? - ANSWERS-Hyperpigmentation (estrogen,
progesterone & melanocyte - stimulating hormone)
-Hyperpigmentation especially around breasts (areola) and face (brownish patches:
melasma, chloasma, mask of pregnancy, linea nigra)
-changes to connective tissue (striae gravidarum)
-cutaneous vascular changes (spider veins, sometimes palmar erythema)
Should pregnant women bend over when picking something up? - ANSWERSNo,
squat!
Musculoskeletal system during pregnancy? - ANSWERS-changes are progressive
-joint softening beginning weeks 10-12 (due to progesterone relaxing muscles)
-Lordosis (swayback posture)
-Hormone - "Relaxin": relaxation of pelvic joints (pregnancy waddles)
What is it called when a pregnant woman has a swayback posture? -
ANSWERSLordosis - the center of gravity of pregnant women moves towards the
abdomen
What relieves Lordosis pain? - ANSWERScat arch and pelvic tilt to relieve pain
What is prenatal period? - ANSWERSPeriod of physical and psychological preparation
for birth and parenthood that offers opportunities for:
-health of the expectant mother and infant- diagnosis and treatment of maternal
disorders
-education and support for self-care and parenting
*monitoring and teaching the mother
What does pregnancy tests indicate? - ANSWERS-human chorionic gonadotropion
(hCG) is earliest biochemical marker for pregnancy
-production begins as early as day of implantation (7-10 DAYS!!!!)
What is Gravida? - ANSWERSrefers to the number of times a woman has been
pregnant, regardless of the outcome
When do you take a pregnancy test? - ANSWERSthe first voided urine in the morning
What is Para/TPAL? - ANSWERSrefers to the number of deliveries (not children) that
have occurred after 20 weeks of gestation (TWINS COUNT AS 1 PARA)
-when calculating parity, multiple births count as only one
-a fetus born dead after 20 weeks is added to the parity count
-TPAL (term births, preterm births, abortions, and living children) may be calculated
What is Primipara? - ANSWERSwoman who has completed 1 pregnancy with a fetus
or fetuses who have reached stage of fetal viability
What is Term? - ANSWERSpregnancy from the beginning of week 38 to end of week
42 of gestation
What is Viability? - ANSWERScapacity to live outside the uterus
What is Multiparous? - ANSWERSwoman who has completed multiple (more than 1)
pregnancy
What is TPAL? - ANSWERST - TERM BIRTHS
P - PRETERM BIRTHS
A - Abortions (Spontaneous or Elective)
L - Living Children
Spontaneous Abortion (Miscarriage)
Elective Abortion (Elected)
,What does the reproductive system consist of? - ANSWERSuterus, cervix, vagina,
ovaries, breasts
Uterus growth/size? - ANSWERStremendous growth
-non pregnant vs size @ 36 weeks (size of a pear to be able to hold 5000 mL)
-muscle fibers increase in length and width
Sizes/weeks of the uterus at symphis, 1/2 way to umbilicus, umbilicus, and xyphoid
process? - ANSWERS12 weeks at symphsis
16 weeks 1/2 way to umbilicus
20 weeks at umbilicus
36 weeks at xyphoid process
*lightening/engagement (2 weeks before labor)
Cervix: What signs are included? - ANSWERS-Leukorrhea discharge: soften,
increased contraction mucous
-Chadwick's sign: bluish color of vagina
-Goodell's sign: softening of the cervix
-Mucous plug: thick mucous covers canal to protect fetus from infection
What is Chadwick's sign? - ANSWERSbluish color of the vagina due to increased
vascularization caused by estrogen
What is Goodell's sign? - ANSWERSsoftening of the cervix
Does the vagina have increased vascularity/secretions? - ANSWERSYes
When does the ovaries enlarge and what hormone does the ovaries secrete until
weeks 6-7? - ANSWERSenlarge until 12-14 weeks
also secretes progesterone until weeks 6-7 when placenta takes over then
progesterone levels will drop
Reproductive system: Breasts? - ANSWERS-becomes more full
-more tender, tingling sensation
-increased vascularization
-nipples larger & more erectile
-colostrum expressed beginning week 12 in 1st trimester (first milk produced)
-Striae (stretch marks)
Cardiovascular changes (BLOOD VOLUME) during pregnancy? -
ANSWERS**Increased blood volume!
-plasma volume increases 40-60%
-RBC volume increases 20-30% and total volume increases
, Does anemia happen during pregnancy? - ANSWERSYes! physiological anemia of
pregnancy is due to hemodilution (Hgb 10.5g to 11g) b/c plasma volume increases
more than RBC volume
What is hemodilution? - ANSWERSduring pregnancy, RBC's increase, but so does the
amount of plasma in the body. This causes less RBC's to remain in the system
Patient may have to take oral iron supplements for this
● Taken w/ vitamin C/orange juice
● Can cause constipation → increase fiber
● If stool changes color → this is b/c of iron
Cardiovascular changes (Cardiac Output) during pregnancy? - ANSWERS-stroke
volume & heart rate = cardiac output
-increases 50% by week 20
HR
-increases 10-20 bpm
-slight cardiac enlargement during pregnancy
-heart works harder to provide oxygen for mom
Cardiovascular changes (Blood Components) during pregnancy? -
ANSWERSHypercoagulable
-Fibrin and Fibrinogen increase by 50%
-protective mechanism to prevent postpartum hemorrhage
-venous stasis/long periods of standing or sitting
-increased risk of DVT (using Bubble-Dep Assessment)
Are pregnant women more hyper coagulable? - ANSWERSYes, it's the body way of
protecting itself from postpartum hemorrhage
What is the Vena Caval Syndrome (Supine Hypotensive Syndrome)? - ANSWERS-
weight of uterus on vena cava
-pts feel faint, dizzy, fetal bradycardia
-pt's should not lay straight on their back, the left side is a good side
What eases the symptoms of Venal Caval Syndrome? - ANSWERSleft lateral or right
lateral (side lying)
Respiratory system during pregnancy? - ANSWERS-oxygen consumption increases
20% (respiratory remains unchanged!)
-baby takes up more space and presses against diaphragm
Respiratory: What are the hormonal changes during pregnancy (Progesterone &
Estrogen)? - ANSWERS-progesterone relaxes smooth muscle but high progesterone
can cause a pregnant woman to breathe faster
, -estrogen leads to increased vascularity & congestion (nasal & sinus stuffiness,
Epistaxis (nosebleeds))
-estrogen increases more gallstones due to cholesterol
GI system during pregnancy? - ANSWERS-Pytalism (increased salivation) - PICA,
more craving for foods/weird dislikes
Smooth muscle relaxation (progesterone)
-constipation
-slower emptying, reflux, pyrosis (heartburn)
-increased risk of gallstones
-N/V (50-80% pregnant women)
How to prevent N/V during pregnancy? - ANSWERSdry crackers, small frequent meals,
ginger ale, salty or tart foods (lemonade, pretzels)
Renal/Urinary System during pregnancy? - ANSWERS-increased workload/increased
blood volume (30-60% increase blood flow)
-increased GFR: pressure of the baby on the bladder = urinary frequency
-MORE PRONE TO UTI!!!
Why are pregnant women more prone to UTIs? - ANSWERSprogesterone = smooth
muscle relaxer and increased GFR = increased "spilling" of glucose in urine causes it to
be more alkaline - UTI is caused/urinary frequency
-UTIs can cause preterm labor
Integumentary System during pregnancy? - ANSWERS-Hyperpigmentation (estrogen,
progesterone & melanocyte - stimulating hormone)
-Hyperpigmentation especially around breasts (areola) and face (brownish patches:
melasma, chloasma, mask of pregnancy, linea nigra)
-changes to connective tissue (striae gravidarum)
-cutaneous vascular changes (spider veins, sometimes palmar erythema)
Should pregnant women bend over when picking something up? - ANSWERSNo,
squat!
Musculoskeletal system during pregnancy? - ANSWERS-changes are progressive
-joint softening beginning weeks 10-12 (due to progesterone relaxing muscles)
-Lordosis (swayback posture)
-Hormone - "Relaxin": relaxation of pelvic joints (pregnancy waddles)
What is it called when a pregnant woman has a swayback posture? -
ANSWERSLordosis - the center of gravity of pregnant women moves towards the
abdomen
What relieves Lordosis pain? - ANSWERScat arch and pelvic tilt to relieve pain
