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Postpartum these reduce in size...
uterus, fundus (1 cm per day), cervix, vagina
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When doing Head to Toe Health Hx add in...
OB info!
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Fundus
- Measure from top to bottom
- 12 wks symphysis pubis
- 16 wks halfway umbillicus/ symphysis pubis
- 20 wks umbillicus
- 36 wks xiphoid process
- After 36 wks may be lower... if bigger find out why
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Uterus increases to hold...
15-20 liters of fluid
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Uterine Blood flow
- Increases during preg.
- Trauma to pelvis is SERIOUS
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Goodell's sign..
cervical softening
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Chadwick's sign
vag turns blue
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Mucous Plug
- protects baby from vag. bacteria
- decreases vag. pathogenic bacteria
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Ovaries
- hCG production maintains corpus luteum until 6-7 wks
- secretes progesterone until placenta takes over
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Contractility
suppressed by progesterone (spr) which decreases closer to term
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Breasts
- ^ in size and modularity
- colostrum (12 wks)
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Respiratory
- More thoracic breathing
- decreased CO2 threshold (b.c. of progesterone)
- ^ tendency to hyperventilate
- Stuffiness & epitaxis (nose bleed common)
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Heart
- Apex- 4th ICS, lateral to MCL (apical pulse)
- Increased size
- Systolic murmur
- S3 common
- Decreased T waves (norm)
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Cardiac Output
- ^ @ 10 wks
- Peaks @ 20-24 wks
- HR ^ 20beats/min
- C.O. @ term 6l/min 20% to uterus
- slows after delivery x7 days
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Blood pressure
Decreases during 1st trimester/ is lowest during 2nd trimester
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Venal Caval Syndrome (supine hypotension)
- Vena cava compressed by fundus
- = decreased C.O., thrombosis
- Nursing Intervention= Suggest lying on either side instead of back
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Hematologic Sys.
- Blood vol. ^ 1200-1500 mL
- WBC ^ ( could increase to 25-30,000)
- Platelets, fibrin, fibrinogen & coagulation factors ^
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Can lose 30% of fluid vol. w/o vitals changing....
b/c body will pull blood from uterus/baby causing baby to experience blood loss
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GI tract
- Decreased motility, emptying, & esophageal regurgitation
- ^ gallbladder emptying time = gallstones
- Hemorrhoids
- Nausea/Vomiting
- weight gain 25-35 lbs
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Renal Sys
- ^ in weight & size
- physiologic hydronephrosis (H2O backed up into kidney)
- ^ in infection
- ^ in kidney stones
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Bladder
- tone decreases
- capacity x2 (> 1 liter)
- Infection can cause contractions
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Chloasma
- Mask of pregnancy (light brown spots on skin/face)
- butterfly shaped area of pigmentation
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linea nigra
line from umbillicus to pubis area
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sudden gush of fluid from vagina could mean...
premature rupture of membranes
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Vaginal Bleeding could mean....
lesions of cervix or vagina "bloody show"
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Abdominal pain could mean...
premature labor, abruption of placentae
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Temp above 101 deg. f & chills could mean...
Infection
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Dizziness, blurring of vision, 2x vision, spots before eyes could mean...
hypertension, preeclampsia
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Persistent vomiting could mean...
Hyperemesis gravidarum
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Severe headache could mean...
hypertension, preeclampsia
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Edema of hands, face, legs & feet could mean...
preeclampsia
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Muscular irritability, convulsions could mean...
preeclampsia, eclampsia
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Epigastric pain could mean...
preeclampsia-ischemia in mj. abd vessels
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Oliguria could mean...
Renal impairment, decreased fluid intake
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Dysuria could mean...
UTI
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Abscence of fetal movement could mean...
maternal medication, obesity, fetal death
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