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What does the acronym GTPAL stand for?
- Gravida
- Term
- Preterm
- Abortion
- Living Children
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What is the earliest biologic marker for pregnancy?
Human Chorionic Gonadotropin (hCG)
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When performing a urine pregnancy test, when is the best time to do so?
In the morning.
(hCG levels are nearly the same as serum level.)
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What is the most popular method of testing?
Urine testing with ELISA
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What kind of medications can cause false positive results in a pregnancy test?
Anticonvulsants and Tranquilizers
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What kind of medications can cause false negative results in a pregnancy test?
Diuretics and Promethazine
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What are the 3 categories of the signs and symptoms of pregnancy?
Define:
Examples:
- Presumptive - changes felt by the woman
- EX: Amenorrhea, fatigue, breast changes, N&V
- Probable - changes observed by the examiner
- EX: Hegar sign, ballottement, pregnancy test
- Positive - signs attributed only to the presence of the fetus
- EX: Hearing fetal heart tones, visualizing the fetus, palpating fetal movements
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What is Hegar sign?
Softening and compressing of the lower uterine segment at 6 weeks
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Passive movement of the unengaged fetus is called?
Ballottement
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What is Chadwick's sign?
Increased vascularity of the vagina resulting in a violet-bluish color by the 6th week
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Why do vaginal secretions become more acidic during pregnancy?
Lactic acid production increases
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When can you palpate the fundus at the umbilical level?
20 weeks
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What are the 3 parts that move the pelvis?
- Sacroiliac joint
- Coccyx
- Symphyseal joint
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What are the 2 main pregnancy hormones?
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What do the montgomery tubercles do for the breasts?
Produce lubrication for the nipple
(esp. for breastfeeding)
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Breasts
What hormone stimulates growth?
They grow rapidly until how many weeks gestation?
Estrogen
20 weeks
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How is milk production made in breasts?
Estrogen and progesterone drop after the delivery of the placenta
Causing prolactin levels to increase and produce milk
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What ABG readings increase or decrease in pregnancy?
PCO2
HCO3
pH
What is the acid-base balance called?
- PCO2 - decrease
- HCO3 - decrease
- pH - increase
Respiratory alkalosis compensated by metabolic acidosis
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Nose bleeds, gingival hyperplasia, labial edema and nasal congestion are caused by?
Increased vascularity of the mucous membrane
(increased vascularity = increased sexual arousal)
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True or False
It is common for a pregnant woman to complain of shortness of breath?
True
The fetus is pushing on the diaphragm and oxygen consumption increases
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Why is the right side of the renal system dilated?
Heavy uterus is displaced to the right by the sigmoid colon
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What is Goodell's sign?
Softening of the cervical tip at the beginning of week 6
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System changes during pregnancy:
Cardiovascular
Blood volume/output/heart size/pulse/circulation/clotting
- Increased blood volume (RBC, WBC, Plt)
- Increased cardiac output
- Enlarged heart
- Pulse increase by 15 beats
- Decreased circulation
- Increased clotting time
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System changes during pregnancy:
Respiratory
O2/Chest expansion/diaphragm/upper tract/BMR
- Increase O2
- Increase chest expansion (estrogen relaxes ribs)
- Displaced diaphragm
- Vascular upper respiratory tract = epistaxis
- BMR increases
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System changes during pregnancy:
Renal
Structures/urine volume/GFR
- Ureter/renal pelvis dilation
- More urine held (may lead to UTI)
- Increased GFR
- Increase tubular resorption
- Polydipsia
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System changes during pregnancy:
Integumentary
Color/marks/gums/nails
- Hyperpigmentation
- Darkened areolas
- Linea nigra appear
- Stretch marks
- Angiomas
- Gum hypertrophy
- Nail growth
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System changes during pregnancy:
Gastrointestinal
Appetite/stomach pH and motility
- Appetite fluctuates
- Stomach hernias possibly
- Acid reflux (progesteron decreases motility)
- Decreased ulcers (estrogen decreases HCl)
- Constipation
- Distended gallbladder
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System changes during pregnancy:
Thyroid
Glands size
Enlarged gland
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