Anatomy and Physiology of Pregnancy
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Questions and Answers

What anatomical change occurs to the uterus during pregnancy?

  • It becomes denser in structure.
  • It retains its original vascularity.
  • It changes in weight. (correct)
  • It decreases in size.

Which part of the uterus is referred to as the upper part?

  • Body
  • Fundus (correct)
  • Cervix
  • Isthmus

Which of the following is NOT a physiological change of pregnancy?

  • Increased vascularity
  • Weight gain in the uterus
  • Resumption of menstrual cycles (correct)
  • Size enlargement of the uterus

What is one of the common discomforts experienced during pregnancy due to physiological changes?

<p>Back pain (B)</p> Signup and view all the answers

What is an important intervention for relieving discomforts in the antepartum setting?

<p>Offering education on coping strategies (B)</p> Signup and view all the answers

What is the main reason for the cessation of menses during pregnancy?

<p>High levels of progesterone produced by the corpus luteum (D)</p> Signup and view all the answers

What signifies Chadwick's sign during pregnancy?

<p>Violet discoloration of the cervix (B)</p> Signup and view all the answers

What occurs by mid-pregnancy with the height of the fundus?

<p>It reaches the level of the umbilicus (A)</p> Signup and view all the answers

What major function does the corpus luteum serve in early pregnancy?

<p>It allows implantation by producing progesterone. (A)</p> Signup and view all the answers

How does the vagina change during pregnancy?

<p>There is hypertrophy and thickening of the muscle. (A)</p> Signup and view all the answers

Which of the following describes Braxton Hicks contractions?

<p>Irregular contractions that begin around 16 weeks (B)</p> Signup and view all the answers

What characterizes the mucus plug in the cervix during pregnancy?

<p>It acts as a barrier against infections. (D)</p> Signup and view all the answers

What is a common risk associated with the increase in vaginal acidity during pregnancy?

<p>Candidiasis (yeast infection) (C)</p> Signup and view all the answers

What physiological change increases the risk of urinary tract infections during pregnancy?

<p>Renal stasis (A)</p> Signup and view all the answers

Which hormone is primarily responsible for the shift from abdominal to thoracic breathing during pregnancy?

<p>Progesterone (D)</p> Signup and view all the answers

What is a common gastrointestinal change experienced in pregnant individuals due to hormonal fluctuations?

<p>Decreased appetite (A)</p> Signup and view all the answers

Which condition can occur due to the increase in venous pressure during pregnancy?

<p>Hemorrhoids (B)</p> Signup and view all the answers

What is a potential risk associated with the craving for non-food substances during pregnancy, known as PICA?

<p>It might result in nutrient deficiencies (D)</p> Signup and view all the answers

Which of the following changes in skin pigmentation often occurs during pregnancy?

<p>Striae Gravidarum (D)</p> Signup and view all the answers

What physiological effect does increased progesterone have on digestive function during pregnancy?

<p>Decreased gastric motility (B)</p> Signup and view all the answers

Which type of skin change is characterized by brownish pigmentation on the face during pregnancy?

<p>Chloasma (A)</p> Signup and view all the answers

What is the minimum requirement for fetal movement as indicated by fetal kick counts?

<p>10 movements in 2 hours (C)</p> Signup and view all the answers

Which condition indicates a positive Contraction Stress Test (CST)?

<p>Late decelerations with at least 50% of uterine contractions (D)</p> Signup and view all the answers

What is the typical monitoring duration for a NonStress Test (NST)?

<p>20-40 minutes (A)</p> Signup and view all the answers

At what gestational age should fetal kick counts begin?

<p>28 weeks (A)</p> Signup and view all the answers

What is typically used to initiate uterine contractions during a Contraction Stress Test?

<p>Nipple stimulation or intravenous oxytocin (C)</p> Signup and view all the answers

Which of the following is NOT a normal finding during a NonStress Test?

<p>Presence of contractions (A)</p> Signup and view all the answers

Which scenario qualifies a pregnancy as high-risk for conducting an NST?

<p>Gestational diabetes (D)</p> Signup and view all the answers

What is the characteristic of a non-reactive NST?

<p>No accelerations present in fetal heart rate (B)</p> Signup and view all the answers

What are striae gravidarum commonly associated with during pregnancy?

<p>Atrophic linear scars (C)</p> Signup and view all the answers

What physiological change can occur in the musculoskeletal system during pregnancy?

<p>Pelvic joint relaxation (D)</p> Signup and view all the answers

Which hormone is NOT typically increased during pregnancy?

<p>Insulin (C)</p> Signup and view all the answers

What is a common nutritional risk factor during pregnancy?

<p>High caffeine consumption (D)</p> Signup and view all the answers

Which sign of pregnancy is classified as a positive sign?

<p>Fetal heartbeat (A)</p> Signup and view all the answers

What condition describes the split of the rectus abdominus muscles during pregnancy?

<p>Diastasis recti (D)</p> Signup and view all the answers

What is a consequence of increased hormone levels during pregnancy in the endocrine system?

<p>Relaxation of smooth muscle (C)</p> Signup and view all the answers

What is the primary effect of the abdominal distension during pregnancy?

<p>Spasms and pain in round ligaments (A)</p> Signup and view all the answers

What term describes the anticipated outcome of a pregnancy using an acronym?

<p>GTPAL (A)</p> Signup and view all the answers

Which test is used to assess fetal well-being if preliminary tests have failed?

<p>Contraction stress test (B)</p> Signup and view all the answers

What hormonal changes occur in the breasts during pregnancy?

<p>Increased estrogen and progesterone (D)</p> Signup and view all the answers

How much does the plasma volume increase during pregnancy?

<p>40-60% (C)</p> Signup and view all the answers

What cardiovascular change is NOT typically seen during pregnancy?

<p>Decrease in cardiac output (D)</p> Signup and view all the answers

Which respiratory change occurs during pregnancy?

<p>Increased tidal volume (D)</p> Signup and view all the answers

What effect does the enlarged uterus have on the diaphragm during pregnancy?

<p>It moves upward approximately 4 cm (A)</p> Signup and view all the answers

What symptom might occur due to compression of the iliac veins and inferior vena cava during pregnancy?

<p>Hypotension and edema (B)</p> Signup and view all the answers

What is the likely cause of slight respiratory alkalosis during pregnancy?

<p>Increased oxygenation consumption (B)</p> Signup and view all the answers

What happens to the total number of red blood cells during pregnancy?

<p>Increases by 30% (A)</p> Signup and view all the answers

What physical change occurs to the areola during pregnancy?

<p>Darkening and growth in circumference (B)</p> Signup and view all the answers

Which cardiovascular change associated with pregnancy may lead to anemia?

<p>Increased plasma volume exceeding RBC production (C)</p> Signup and view all the answers

Flashcards

Fundus of the Uterus

The upper portion of the uterus.

Isthmus of the Uterus

The lower segment of the uterus, connecting the body to the cervix.

Cervix of the Uterus

Lower, narrow part or neck of the uterus.

Uterine Size and Weight Changes

The uterus increases in size and weight throughout pregnancy.

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Uterine Vascularity Changes

The uterus becomes more vascular meaning it has increased blood flow.

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Uterine Changes in Pregnancy

The uterus significantly enlarges in size, increasing its capacity from 10mL to 5000mL. This enlargement is accompanied by a thickening of the uterine wall and increased blood flow.

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Cessation of Menstruation

Regular menstrual cycles cease during pregnancy due to hormonal changes.

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Braxton Hicks Contractions

Irregular contractions, known as Braxton Hicks contractions, start around 16 weeks of pregnancy and help prepare the uterus for labor.

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Fundal Height

By the middle of pregnancy, the top of the uterus, called the fundus, reaches the level of the belly button.

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Cervical Changes in Pregnancy

The cervix softens, shortens, and widens during pregnancy to prepare for labor.

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Mucus Plug

The cervix produces a thick mucus plug that seals the opening of the uterus, protecting the baby from infections.

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Chadwick's Sign

Increased estrogen levels cause the cervix to become softer and take on a purplish hue, known as Chadwick's sign.

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Vaginal Changes in Pregnancy

The vagina thickens and produces more secretions, which are thick, white, and acidic.

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Breast changes in pregnancy

The breast size and shape increase due to estrogen and progesterone. The areola also darkens and grows in circumference, and colostrum may leak.

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Blood volume changes during pregnancy

The total blood volume increases during pregnancy, with a significant increase in plasma volume. This leads to a higher demand for iron to support fetal development.

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Heart rate changes during pregnancy

The heart rate slightly increases during the second trimester, reaching a peak around 32 weeks, and then stays elevated until after delivery due to increased blood volume and cardiac output.

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Respiratory changes during pregnancy

The volume of air inhaled with each breath (tidal volume) increases, and the respiratory rate also increases to support the increased oxygen demands of the pregnancy.

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Uterine size and weight changes in pregnancy

The uterus increases in size and weight due to the growth of the baby.

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Uterine vascularity changes in pregnancy

The uterus becomes more vascular during pregnancy as blood flow increases to supply nutrients and oxygen to the baby.

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Ovulatory changes in pregnancy

Hormonal changes in pregnancy, primarily increased estrogen and progesterone, lead to the cessation of ovulation and the prevention of new follicle maturation.

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Fluid retention during pregnancy

During pregnancy, the body retains more water and sodium, which can contribute to edema (swelling) in the lower extremities, particularly as the growing uterus presses on the veins.

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Anemia during pregnancy

The increase in plasma volume during pregnancy often surpasses the rate of red blood cell production, leading to anemia, a condition where the blood has a lower than normal concentration of red blood cells.

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Diaphragm changes during pregnancy

The enlarged uterus during pregnancy pushes the diaphragm upwards, resulting in a decreased lung capacity. However, the body compensates by increasing the chest circumference.

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Breathing Changes in Pregnancy

A shift in breathing pattern from abdominal to thoracic breathing that occurs as pregnancy progresses because of the growing uterus putting pressure on the diaphragm.

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Urination Frequency in Pregnancy

Increased frequency of urination during the first and third trimesters, caused by hormonal changes and pressure on the bladder.

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Increased GFR in Pregnancy

An increase in glomerular filtration rate (GFR) during pregnancy, which is the rate at which blood is filtered by the kidneys.

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Ureteral Changes in Pregnancy

A condition where the ureters become elongated and dilated, a common occurrence during pregnancy, which can lead to an increased risk of urinary tract infections (UTIs) and pyelonephritis.

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Decreased Bladder Tone in Pregnancy

A decrease in bladder tone due to the increase of progesterone and estrogen during pregnancy, which can lead to increased urinary frequency and urge incontinence.

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Morning Sickness in Pregnancy

Morning sickness, which is characterized by nausea and vomiting, commonly experienced during the first trimester due to elevated hCG levels, usually subsiding by the third month.

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Decreased Gastric Mobility in Pregnancy

A decrease in gastric mobility during pregnancy, which can lead to poor appetite and indigestion.

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Constipation in Pregnancy

Constipation, a common issue during pregnancy, often caused by increased progesterone levels, a hormone that can slow down bowel movements.

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Striae Gravidarum

Stretch marks that appear on the abdomen and thighs, resulting from the skin stretching to accommodate the growing fetus.

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Thyroid Enlargement in Pregnancy

Enlargement of the thyroid gland during pregnancy, often caused by increased hormone levels.

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Areola Pigmentation

Increased pigmentation of the areolas (the area around the nipples) during pregnancy due to hormonal changes.

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Diastasis Recti

A separation of the rectus abdominus muscles (the 'six-pack' muscles) in the third trimester of pregnancy, caused by the stretching of the abdominal wall.

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Lordosis in Pregnancy

Abnormal anterior curvature of the spine during pregnancy, often due to the shifting center of gravity.

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Round Ligament Pain

Pain in the round ligaments (which support the uterus) caused by their stretching during pregnancy.

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Waddling Gait

A waddling gait during pregnancy, caused by the shifting center of gravity and relaxation of pelvic joints.

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Presumptive Signs of Pregnancy

A group of signs that may indicate pregnancy, but aren't conclusive on their own.

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What is a Non-Stress Test (NST)?

A non-stress test (NST) involves external monitoring of the fetal heart rate (FHR) to assess fetal well-being. It's typically done in high-risk pregnancies.

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When is a Non-Stress Test (NST) used?

A Non-Stress Test (NST) involves external monitoring of the fetal heart rate (FHR) to assess fetal well-being. It's typically done in high-risk pregnancies.

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How long does a Non-Stress Test (NST) usually last?

A Non-Stress Test (NST) typically involves 20-40 minutes of monitoring. The baby's heart rate should be within the normal range, and there should be at least two contractions within 10 minutes.

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What are Fetal Kick Counts?

Fetal kick counts are a simple way for moms to monitor their baby's movement in the womb. It starts at 28 weeks and involves counting the number of kicks in a set period of time.

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How do you do Fetal Kick Counts?

Start fetal kick counts at 28 weeks and count them twice a day or more. Choose the same time, and record the first kick time. Count until the 10th kick and record the time. You should feel 10 movements in 2 hours or less.

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What is a Contraction Stress Test (CST)?

A Contraction Stress Test (CST) is used to assess how well the baby is tolerating contractions. It involves measuring the baby's heart rate response to contractions.

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What are the results of a Contraction Stress Test (CST)?

A Contraction Stress Test (CST) can be considered positive or negative. A positive CST indicates there are late decelerations (drops in the baby's heart rate) occurring with at least 50% of the contractions. A negative CST means there are no decelerations occurring during uterine contractions.

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How are contractions induced during a Contraction Stress Test (CST)?

Contractions are initiated during a Contraction Stress Test (CST) either through nipple stimulation or by administering oxytocin intravenously.

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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!

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