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Questions and Answers
What anatomical change occurs to the uterus during pregnancy?
What anatomical change occurs to the uterus during pregnancy?
Which part of the uterus is referred to as the upper part?
Which part of the uterus is referred to as the upper part?
Which of the following is NOT a physiological change of pregnancy?
Which of the following is NOT a physiological change of pregnancy?
What is one of the common discomforts experienced during pregnancy due to physiological changes?
What is one of the common discomforts experienced during pregnancy due to physiological changes?
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What is an important intervention for relieving discomforts in the antepartum setting?
What is an important intervention for relieving discomforts in the antepartum setting?
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What is the main reason for the cessation of menses during pregnancy?
What is the main reason for the cessation of menses during pregnancy?
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What signifies Chadwick's sign during pregnancy?
What signifies Chadwick's sign during pregnancy?
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What occurs by mid-pregnancy with the height of the fundus?
What occurs by mid-pregnancy with the height of the fundus?
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What major function does the corpus luteum serve in early pregnancy?
What major function does the corpus luteum serve in early pregnancy?
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How does the vagina change during pregnancy?
How does the vagina change during pregnancy?
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Which of the following describes Braxton Hicks contractions?
Which of the following describes Braxton Hicks contractions?
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What characterizes the mucus plug in the cervix during pregnancy?
What characterizes the mucus plug in the cervix during pregnancy?
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What is a common risk associated with the increase in vaginal acidity during pregnancy?
What is a common risk associated with the increase in vaginal acidity during pregnancy?
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What physiological change increases the risk of urinary tract infections during pregnancy?
What physiological change increases the risk of urinary tract infections during pregnancy?
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Which hormone is primarily responsible for the shift from abdominal to thoracic breathing during pregnancy?
Which hormone is primarily responsible for the shift from abdominal to thoracic breathing during pregnancy?
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What is a common gastrointestinal change experienced in pregnant individuals due to hormonal fluctuations?
What is a common gastrointestinal change experienced in pregnant individuals due to hormonal fluctuations?
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Which condition can occur due to the increase in venous pressure during pregnancy?
Which condition can occur due to the increase in venous pressure during pregnancy?
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What is a potential risk associated with the craving for non-food substances during pregnancy, known as PICA?
What is a potential risk associated with the craving for non-food substances during pregnancy, known as PICA?
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Which of the following changes in skin pigmentation often occurs during pregnancy?
Which of the following changes in skin pigmentation often occurs during pregnancy?
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What physiological effect does increased progesterone have on digestive function during pregnancy?
What physiological effect does increased progesterone have on digestive function during pregnancy?
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Which type of skin change is characterized by brownish pigmentation on the face during pregnancy?
Which type of skin change is characterized by brownish pigmentation on the face during pregnancy?
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What is the minimum requirement for fetal movement as indicated by fetal kick counts?
What is the minimum requirement for fetal movement as indicated by fetal kick counts?
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Which condition indicates a positive Contraction Stress Test (CST)?
Which condition indicates a positive Contraction Stress Test (CST)?
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What is the typical monitoring duration for a NonStress Test (NST)?
What is the typical monitoring duration for a NonStress Test (NST)?
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At what gestational age should fetal kick counts begin?
At what gestational age should fetal kick counts begin?
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What is typically used to initiate uterine contractions during a Contraction Stress Test?
What is typically used to initiate uterine contractions during a Contraction Stress Test?
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Which of the following is NOT a normal finding during a NonStress Test?
Which of the following is NOT a normal finding during a NonStress Test?
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Which scenario qualifies a pregnancy as high-risk for conducting an NST?
Which scenario qualifies a pregnancy as high-risk for conducting an NST?
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What is the characteristic of a non-reactive NST?
What is the characteristic of a non-reactive NST?
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What are striae gravidarum commonly associated with during pregnancy?
What are striae gravidarum commonly associated with during pregnancy?
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What physiological change can occur in the musculoskeletal system during pregnancy?
What physiological change can occur in the musculoskeletal system during pregnancy?
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Which hormone is NOT typically increased during pregnancy?
Which hormone is NOT typically increased during pregnancy?
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What is a common nutritional risk factor during pregnancy?
What is a common nutritional risk factor during pregnancy?
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Which sign of pregnancy is classified as a positive sign?
Which sign of pregnancy is classified as a positive sign?
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What condition describes the split of the rectus abdominus muscles during pregnancy?
What condition describes the split of the rectus abdominus muscles during pregnancy?
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What is a consequence of increased hormone levels during pregnancy in the endocrine system?
What is a consequence of increased hormone levels during pregnancy in the endocrine system?
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What is the primary effect of the abdominal distension during pregnancy?
What is the primary effect of the abdominal distension during pregnancy?
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What term describes the anticipated outcome of a pregnancy using an acronym?
What term describes the anticipated outcome of a pregnancy using an acronym?
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Which test is used to assess fetal well-being if preliminary tests have failed?
Which test is used to assess fetal well-being if preliminary tests have failed?
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What hormonal changes occur in the breasts during pregnancy?
What hormonal changes occur in the breasts during pregnancy?
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How much does the plasma volume increase during pregnancy?
How much does the plasma volume increase during pregnancy?
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What cardiovascular change is NOT typically seen during pregnancy?
What cardiovascular change is NOT typically seen during pregnancy?
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Which respiratory change occurs during pregnancy?
Which respiratory change occurs during pregnancy?
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What effect does the enlarged uterus have on the diaphragm during pregnancy?
What effect does the enlarged uterus have on the diaphragm during pregnancy?
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What symptom might occur due to compression of the iliac veins and inferior vena cava during pregnancy?
What symptom might occur due to compression of the iliac veins and inferior vena cava during pregnancy?
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What is the likely cause of slight respiratory alkalosis during pregnancy?
What is the likely cause of slight respiratory alkalosis during pregnancy?
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What happens to the total number of red blood cells during pregnancy?
What happens to the total number of red blood cells during pregnancy?
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What physical change occurs to the areola during pregnancy?
What physical change occurs to the areola during pregnancy?
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Which cardiovascular change associated with pregnancy may lead to anemia?
Which cardiovascular change associated with pregnancy may lead to anemia?
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Study Notes
Module 1: Pregnancy
- This module covers the anatomical and physiological changes during pregnancy.
- It links these changes to common signs, symptoms, and discomforts.
- It describes appropriate interventions to relieve common discomforts in the antepartum setting.
- It identifies critical assessment and nursing care elements during initial and subsequent prenatal visits.
- It describes elements of patient education and anticipatory guidance in the antepartum setting.
Pregnancy Changes: Summary
- Blood Volume: Rises
- Breathing: Becomes shallow
- Urinary Output: Increases
- Mood: Changes
- Ligaments: Become looser
- Nausea/Taste: Changes
- Breasts: Change
- Skin: Darkens
Physiological Changes of Pregnancy
- Respiratory: Increased tidal volume, oxygen consumption, diaphragm elevation, nasal stuffiness, epistaxis, and increased breast size.
- Breasts: Increased size, heaviness, darkening of nipple.
- Gastrointestinal: Nausea and vomiting, changes in motility, hemorrhoids, constipation, and gallbladder emptying
- Cardiovascular: Increased blood volume, heart rate, cardiac palpitations, murmurs, pseudonemia. Increased frequency of urination in 1st & 3rd trimester, enlarged bladder.
- Musculoskeletal: Lumbosacral curve increases, altered center of gravity, waddling gait, and Braxton Hicks contractions.
- Integumentary: Increased skin pigmentation, facial mask appearance, acne, and stretch marks.
- Urinary-Renal: Enlarged bladder, increased glomerular filtration, increased blood volume and frequency, increase in need for water and elevated BP.
- Endocrine: Increase in basal metabolic rate and parathyroid activity, elevated hormone levels facilitate breast and uterine growth.
- Reproductive: Uterus increases in size, weight, and capacity. Cervix softens and vagian secretions increase.
Reproductive System - Uterus
- Uterus has three parts: fundus, isthmus, and cervix.
- Before pregnancy, the uterus is small, resembling a pear.
- Pregnancy causes significant enlargement and weight increases.
- Uterine wall thickens and vascularity increases.
- Menstrual cycle stops.
Reproductive System - Cervix & Vagina
- Cervix shortens, becomes more elastic and increases in diameter.
- Endocervical glands secrete a thick mucus plug that is expelled during dilation.
- Increased vascularization and estrogen increase causes cervix to soften and discolor (Chadwick's sign).
- Vaginal muscle hypertrophy and thickening, and vaginal secretions increase in thickness, turn white and acidic.
Reproductive System - Ovaries
- High levels of hCG maintain the corpus luteum for the first couple months of pregnancy.
- Corpus luteum produces progesterone, which is critical for implantation.
- By weeks 6-7 the placenta takes over progesterone production from the corpus luteum.
- Ovulation ceases.
Reproductive System - Breasts
- Estrogen and progesterone increase.
- Breasts become tender, fuller, enlarge, and areola darken in color and increase in size.
- Mammary gland/ducts increase, allowing colostrum production.
- Superficial veins become prominent.
- Colostrum may leak from breasts.
Cardiovascular System
- Blood volume increases by 30-50%.
- Cardiac output increases by 30-50%.
- Heart rate increases to 10-15 beats per minute.
- Decrease in peripheral vascular resistance may lead to decreased blood pressure, but this is not the norm.
- Some women may also experience high blood pressure.
Respiratory System
- Increased oxygen demand and uptake.
- Lung capacity increases, tidal volume increases by 30-40%, and slight respiratory alkalosis occurs.
- Diaphragm shifts upwards.
Renal System
- Increased frequency of urination in the first and third trimesters due to pressure from the enlarged bladder.
- Glomerular filtration rate increases.
- Fluid and electrolyte balance changes.
- Ureters elongate.
- Bladder tone decreases
- Risk of UTIs and pyelonephritis may increase.
- Renal ability to metabolize glucose may also slightly increase.
Gastrointestinal System
- Nausea and vomiting are common, but typically subside by the third month.
- Decreased appetite, alterations in taste and smell, and constipation may occur due to increased progesterone levels
- Heartburn and hemorrhoids may also occur.
- Increased estrogen levels can also cause gum tissue sensitivity.
- Consumption of non-food substances (PICA) may occur.
Integumentary System
- Linea nigra, chloasma, pregnancy acne, and striae gravidarum (stretch marks) may be present.
Musculoskeletal System
- Pelvic joints relax.
- Posture adjusts to accommodate weight gain.
- Lordosis increases.
- Round ligament pain may occur.
- Diastasis recti (separation of abdominal muscles) may occur in the third trimester.
Endocrine System
- hCG, progesterone, estrogen, lactogen, and prostaglandins levels increase.
- Smooth muscle relaxes, decreasing gastrointestinal motility.
- Hormone levels support breast and uterine development and lactation.
- Thyroid may enlarge.
- Heat intolerance and fatigue may be experienced.
- Water retention increases.
Immune System
- Immune system changes in pregnancy to support both mother and child.
Preconception Health Care
- Risks identification (medical, behavioral, social, environmental)
- Preconception health care
- Routine physical examination
- Health screening
- Education
- Nutrition
Nutrition in Pregnancy
- Caloric intake increases, with specific focus on protein, folic acid, iron, calcium, fluids and caffeine restriction.
Pregnancy Weight Gain
- Average weight gain is 25-35 pounds during pregnancy
Diagnosis and signs of Pregnancy
- Positive pregnancy tests
- Presumptive signs (subjective)
- Probable signs (objective findings)
- Positive signs (definitive evidence)
Tests for Fetal Status and Well-Being
- Ultrasonography
- Biophysical Profile (BPP)
- Non-stress test (NST)
- Amniotic Fluid Index (AFI)
- Maternal/Fetal tests
- Fetal heart monitoring
Calculating Due Date
- Nagele's rule is used
Prenatal Assessment Terminology
- Gravida/gravidity
- Parity
- Nulligravida
- Primigravida
- Multigravida
- Nullipara
- Primipara
- Multipara
- GTPAL
Fetal Kick Counts
- Performed at 28 weeks
- Done twice per day
- Record kick times
Contraction Stress Test (CST)
- Baseline FHM for 20 min
- CST performed to observe for late decelerations
- Assess for uterine contractions and resulting fetal decelerations.
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Description
This quiz explores the anatomical and physiological changes that occur in the uterus during pregnancy. It covers important topics such as the specific parts of the uterus, common discomforts, and interventions for alleviating discomforts in the antepartum setting. Test your knowledge on these vital aspects of prenatal care!
