Antepartum Nursing Assessment
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Questions and Answers

What is the typical duration of a woman's menstrual cycle?

  • 28 days (correct)
  • 42 days
  • 35 days
  • 21 days

Which factor is NOT typically assessed to evaluate a woman's pregnancy status?

  • Her opinion about conception timing
  • Her dietary preferences (correct)
  • Woman’s cramping history
  • Her menstrual cycle regularity

What could indicate potential complications in early pregnancy?

  • Positive attitude toward the pregnancy
  • Absence of cramping or spotting
  • Presence of cramping, bleeding, or spotting since the last menstrual period (correct)
  • Regular menstrual cycles

Which factor might inform the expected due date for a pregnancy?

<p>The woman's menstrual cycle length (A)</p> Signup and view all the answers

What is an important consideration regarding a woman's view of her pregnancy?

<p>Whether the pregnancy was planned (D)</p> Signup and view all the answers

Which of the following is NOT considered a prenatal risk factor screening criteria?

<p>Father's educational level (D)</p> Signup and view all the answers

What aspect of occupational history may impact prenatal health?

<p>Exposure to physical stress and harmful substances (C)</p> Signup and view all the answers

Which personal history factor could indicate a higher risk for mental health issues during pregnancy?

<p>History of emotional or physical deprivation (C)</p> Signup and view all the answers

Why is the father's blood type and Rh factor significant in prenatal assessments?

<p>It poses a risk for Rh incompatibility in the baby (C)</p> Signup and view all the answers

What type of support systems are particularly important for prenatal health?

<p>Emotional and practical support from family and friends (B)</p> Signup and view all the answers

At what point in pregnancy can a gestational sac typically be identified using ultrasound?

<p>5 weeks after the LMP (D)</p> Signup and view all the answers

Which ultrasound method is preferred for early pregnancy assessment?

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

When can fetal heart activity typically be detected during pregnancy?

<p>6 to 7 weeks (C)</p> Signup and view all the answers

What fetal movement is typically observed by 10 to 11 weeks of pregnancy?

<p>Fetal breathing movements (D)</p> Signup and view all the answers

After approximately how many weeks of pregnancy is transabdominal ultrasound used for measurement?

<p>10 weeks (A)</p> Signup and view all the answers

What does the term 'Nullipara' refer to in obstetrics?

<p>A woman who has not had any births at more than 20 weeks' gestation (C)</p> Signup and view all the answers

What is indicated by the 'P' in the TPAL system?

<p>Number of preterm births, between 20 and 37 weeks' gestation (B)</p> Signup and view all the answers

Which definition accurately describes a 'Multipara'?

<p>A woman who has had two or more births at more than 20 weeks' gestation (A)</p> Signup and view all the answers

When assessing prenatal history, which important date is often considered first?

<p>First day of last normal menstrual period (LMP) (B)</p> Signup and view all the answers

Which of the following is NOT considered when calculating the TPAL score?

<p>Number of pregnancies resulting in twins or multiples (B)</p> Signup and view all the answers

What is the estimated date of birth (EDB) if the first day of the last menstrual period (LMP) is November 21?

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

Which factor is NOT necessary for Nägele’s rule to accurately determine the estimated date of birth?

<p>Having regular exercise habits (B)</p> Signup and view all the answers

What does fundal height measurement correlate well with between 22 and 34 weeks of gestation?

<p>Weeks of gestation (A)</p> Signup and view all the answers

What is one aspect that is being considered if breastfeeding is discussed?

<p>Duration of breastfeeding (C)</p> Signup and view all the answers

Which event related to child loss is mentioned in the context of breastfeeding?

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

At what gestational age might quickening first be felt by the mother?

<p>16 to 22 weeks (D)</p> Signup and view all the answers

In the context provided, what type of child loss is discussed aside from miscarriage?

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

What is the typical fetal heartbeat range detected by an ultrasonic Doppler device at 8 to 12 weeks of gestation?

<p>110 to 160 beats/min (D)</p> Signup and view all the answers

What factor can affect the accuracy of fundal height measurements during the third trimester?

<p>Variations in fetal weight (A)</p> Signup and view all the answers

What are common types of losses referred to when considering the duration of breastfeeding?

<p>Stillbirth and neonatal death (C)</p> Signup and view all the answers

What implication could breastfeeding duration have in situations involving loss of a child?

<p>It can affect maternal emotional health (D)</p> Signup and view all the answers

Which of the following is a requirement for measuring fundal height reliably?

<p>The same examiner should measure each time (B)</p> Signup and view all the answers

Which statement is inaccurate concerning ovulation and menstrual cycle timing?

<p>Ovulation happens immediately after the previous menses (D)</p> Signup and view all the answers

What is a common musculoskeletal adaptation during pregnancy?

<p>Increased flexibility of tendons and ligaments (A)</p> Signup and view all the answers

Which alteration in the gastrointestinal system is typically observed during pregnancy?

<p>Increased incidence of heartburn (C)</p> Signup and view all the answers

What urinary tract modification is expected during pregnancy?

<p>Increased glomerular filtration rate (B)</p> Signup and view all the answers

What cardiovascular change is commonly seen in pregnant women?

<p>Increased heart rate (D)</p> Signup and view all the answers

Which skin and hair change is frequently reported during pregnancy?

<p>Color change of moles or skin lesions (D)</p> Signup and view all the answers

What condition may result from the pressure of the uterus on abdominal muscles during pregnancy?

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

What skin condition is characterized by a darkening of the skin over the forehead and around the eyes during pregnancy?

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

Which of the following describes the lumbar spinal curve that typically occurs during pregnancy?

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

Which anatomical change in pregnant women results from the relaxation of pelvic joints due to hormonal changes?

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

What is a common postural change in pregnant women that can lead to discomfort?

<p>Increased lumbar lordosis (A)</p> Signup and view all the answers

How can low backache during pregnancy be commonly explained?

<p>Pressure on the lumbar region due to the uterus (D)</p> Signup and view all the answers

What is the appearance characterized by bright-red elevations of the skin radiating from a central body during pregnancy?

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

Which of the following describes the pigmented line that extends from the pubic area to the umbilicus during pregnancy?

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

Which adaptation in a pregnant woman's body can affect the alignment of her spine?

<p>Weight gain and forward shifting of the center of gravity (D)</p> Signup and view all the answers

What is the primary hormonal influence causing increased skin pigmentation during pregnancy?

<p>Combined estrogen and progesterone (B)</p> Signup and view all the answers

What physiological change is associated with an enlarged uterus during pregnancy?

<p>Elevated diaphragm positioning (B)</p> Signup and view all the answers

Which of the following best describes the effect of progesterone during pregnancy?

<p>Increased O2 consumption (D)</p> Signup and view all the answers

What change does the cardiovascular system undergo during pregnancy as a result of increased blood volume?

<p>Rapid increase in blood volume particularly around 30-34 weeks (A)</p> Signup and view all the answers

What symptom can occur due to estrogen-induced edema during pregnancy?

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

How does the breathing pattern change as pregnancy progresses?

<p>From abdominal to thoracic breathing (C)</p> Signup and view all the answers

What physiological change in the gastrointestinal system is primarily associated with increased progesterone levels during pregnancy?

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

During pregnancy, what causes the urinary patterns observed in the first and third trimesters?

<p>Enlarging uterus exerting pressure (A)</p> Signup and view all the answers

What condition might result from the inability of the kidneys to reabsorb all the glucose filtered by the glomeruli during pregnancy?

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

What is a possible consequence of decreased peristalsis and prolonged gallbladder emptying during pregnancy?

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

Which of the following gastrointestinal symptoms is commonly associated with upward displacement of the stomach by the enlarging uterus during pregnancy?

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

Which of the following signs is associated with physical changes in pelvic organs during pregnancy?

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

What condition might be indicated by excessively soft walls of a nonpregnant uterus?

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

Which of these skin changes is attributed to melanocyte hormonal stimulation during pregnancy?

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

What is a likely cause for a positive pregnancy test result besides normal pregnancy?

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

What might enlarged abdominal size in a woman indicate aside from pregnancy?

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

Which of the following conditions is linked to increased uterine blood flow during pregnancy?

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

Which abnormal finding could potentially be discovered through palpation for fetal outline?

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

At what gestational age can the fetal outline typically be identified by palpation?

<p>24 weeks (C)</p> Signup and view all the answers

What is ballottement in the context of fetal assessment?

<p>A passive fetal movement elicited by examiner pressure (B)</p> Signup and view all the answers

What technique does NOT allow for the identification of fetal movements?

<p>Using a stethoscope (C)</p> Signup and view all the answers

Which of the following statements about fetal movements is accurate?

<p>Fetal movements can be assessed via palpation after 24 weeks. (B)</p> Signup and view all the answers

What is one reason an examiner might perform the ballottement technique?

<p>To elicit fetal movement for assessment (B)</p> Signup and view all the answers

Which of the following is an indication of effective examination of fetal movement?

<p>Presence of ballottement indicating fetal activity (B)</p> Signup and view all the answers

Which statement about the identification of fetal outlines through palpation is false?

<p>It requires advanced medical technology. (B)</p> Signup and view all the answers

Which physical assessment method is specifically described as using the vagina and cervix?

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

What is Goodell's sign indicative of during early pregnancy?

<p>Significant softening of the vaginal portion of the cervix (B)</p> Signup and view all the answers

At what gestational age can Goodell's sign typically be observed?

<p>6 to 8 weeks (B)</p> Signup and view all the answers

What physiological change accompanies the presence of Goodell's sign?

<p>Increased vascularization of the cervix (C)</p> Signup and view all the answers

What type of sign is Goodell's sign classified as during the assessment of early pregnancy?

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

Which of the following correctly describes Goodell's sign?

<p>It represents a structural change in the vaginal cervix. (A)</p> Signup and view all the answers

What physiological change in the uterine blood supply is primarily attributed to the growing uterus during pregnancy?

<p>Hypertrophy and engorgement of vessels (A)</p> Signup and view all the answers

Which of the following statements accurately describes the role of the corpus luteum in early pregnancy?

<p>It maintains progesterone secretion until around seven weeks. (C)</p> Signup and view all the answers

In the context of pregnancy, what is the significance of the placenta's role after seven weeks?

<p>It assumes the function of supporting fetal life by secreting progesterone. (C)</p> Signup and view all the answers

What best explains the alteration in the ovaries during early pregnancy?

<p>They stop ovulation and support early pregnancy through hormonal secretion. (D)</p> Signup and view all the answers

What is an expected vascular change in the maternal body as a result of the growing uterus?

<p>Hypertrophy and engorgement of vessels below the uterus (B)</p> Signup and view all the answers

What physiological change occurs as the uterus enlarges during pregnancy?

<p>Transition from abdominal to thoracic breathing (A)</p> Signup and view all the answers

Which statement accurately reflects the impact of increased blood volume during pregnancy?

<p>Blood volume begins to increase rapidly from 30-34 weeks. (C)</p> Signup and view all the answers

What is a likely cause for nasal stuffiness and epistaxis during pregnancy?

<p>Estrogen-induced edema resulting in nasal passage swelling (B)</p> Signup and view all the answers

How does progesterone primarily affect airway resistance during pregnancy?

<p>Decreases airway resistance effectively (D)</p> Signup and view all the answers

Which change is NOT typically observed in the respiratory system due to the enlarging uterus?

<p>Breathing remains entirely abdominal (C)</p> Signup and view all the answers

What effect does estrogen have on nasal tissues during pregnancy?

<p>Causes increased mucus production and edema (C)</p> Signup and view all the answers

Which skin change is commonly noted during pregnancy that involves darkening of the skin in specific areas?

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

What is the term used to describe the dark line that may develop on a pregnant person's abdomen?

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

What skin condition associated with pregnancy is characterized by the darkening of the areolae?

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

Which pregnancy-related skin change might appear as streaks on the skin?

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

During pregnancy, which term is most closely associated with the appearance of dark patches on the face?

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

Which of the following changes is least likely to be associated with skin texture during pregnancy?

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

What condition is characterized by low blood pressure due to pressure on major blood vessels during pregnancy?

<p>Supine hypotension syndrome (B)</p> Signup and view all the answers

How is supine hypotension syndrome typically corrected in pregnant women?

<p>Lying on the left side (C)</p> Signup and view all the answers

What increase in iron intake is recommended for pregnant women?

<p>27 mg daily (C)</p> Signup and view all the answers

What physiological change is indicated by a decreased hematocrit during pregnancy?

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

What percentage increase in plasma volume is seen in pregnant women?

<p>50% (A)</p> Signup and view all the answers

Which of the following symptoms is considered a presumptive sign of pregnancy?

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

What makes subjective signs of pregnancy unreliable as proof of pregnancy?

<p>They are common in various health conditions (D)</p> Signup and view all the answers

Which statement is accurate regarding subjective changes experienced by a woman during early pregnancy?

<p>They cannot be independently verified through performance tests (D)</p> Signup and view all the answers

Which of the following is NOT considered a subjective change related to pregnancy?

<p>Positive hCG test (A)</p> Signup and view all the answers

In what context is amenorrhea typically observed as a symptom of pregnancy?

<p>As an early symptom experienced by women (D)</p> Signup and view all the answers

Which of the following is a possible endocrine factor contributing to amenorrhea?

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

What are some common physiological causes of nausea and vomiting during early pregnancy?

<p>All of the above (D)</p> Signup and view all the answers

Which one of the following is NOT a typical cause of urinary frequency?

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

What does breast tenderness during early pregnancy NOT typically indicate?

<p>Soothing hormonal changes (D)</p> Signup and view all the answers

Which phenomenon is incorrectly associated with quickening?

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

Which risk factor for amenorrhea is most related to systemic diseases?

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

Which of the following statements about the causes of nausea and vomiting is most accurate?

<p>Emotional disorders can trigger symptoms similar to gastrointestinal issues. (B)</p> Signup and view all the answers

What does the Hegar sign indicate in the context of pregnancy?

<p>Softening of the isthmus of the uterus (B)</p> Signup and view all the answers

When can enlargement and softening of the body of the uterus be typically detected?

<p>After 8 weeks of pregnancy (B)</p> Signup and view all the answers

What anatomical region does the Hegar sign specifically pertain to?

<p>Isthmus of the uterus (B)</p> Signup and view all the answers

How is the Hegar sign significant in the assessment of pregnancy?

<p>It helps confirm pregnancy by indicating uterine changes (D)</p> Signup and view all the answers

What is the relationship between Hegar sign and the isthmus of the uterus?

<p>The Hegar sign refers to softening of the isthmus (A)</p> Signup and view all the answers

What change in the uterus might occur after the 8th week of pregnancy?

<p>Enlargement and softening of the body of the uterus (B)</p> Signup and view all the answers

Flashcards

Nullipara

A woman who has had no births beyond 20 weeks gestation.

Primipara

A woman who has had one birth at more than 20 weeks' gestation.

Multipara

A woman who has had two or more births beyond 20 weeks gestation.

TPAL

A way to summarize a woman's reproductive history (terms, pregnancies, abortions, living children).

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LMP (Last Menstrual Period)

The first day of a woman's last normal menstrual cycle, used to estimate pregnancy duration.

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Menstrual cycle length

The typical duration of a woman's menstrual cycle, often around 28 days.

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Symptoms since LMP

Presence of cramping, bleeding, or spotting experienced by the woman since her last menstrual period.

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Conception timeframe

Woman's estimate of when conception occurred.

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Pregnancy plans

Whether the pregnancy is planned or unplanned.

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Attitude toward pregnancy

The woman's feelings and opinions about her pregnancy.

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Occupational History

Information about the pregnant woman's work, including physical demands, exposure to harmful substances, and opportunities for breaks and meals.

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Father's History

Details about the father's health, including age, significant health problems, genetic conditions, and lifestyle habits.

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Personal History

Information about the pregnant woman's personal life, such as age, education, living conditions, and emotional well-being.

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Prenatal Risk Factors

Conditions or factors that may increase the risk of negative outcomes for the pregnant woman or her unborn child.

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Support Systems

The people and resources available to the pregnant woman, such as family, friends, and healthcare professionals.

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Transvaginal Ultrasound

An ultrasound method used early in pregnancy (before 10 weeks) where a probe is inserted into the vagina for clearer images of the uterus and developing fetus.

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Transabdominal Ultrasound

A standard ultrasound method used after 10 weeks of pregnancy, where a probe is placed on the abdomen to visualize the growing fetus.

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Gestational Sac

A fluid-filled sac in the uterus that encloses the developing fetus, visible by ultrasound as early as 5 weeks after the last menstrual period (LMP).

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Fetal Heart Activity

The rhythmic beating of the fetal heart, detectable by ultrasound as early as 6 to 7 weeks after the LMP.

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Fetal Breathing Movements

Visible rhythmic movements of the fetus's chest while in the womb, observable by ultrasound around 10 to 11 weeks of pregnancy.

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Nägele's rule

A method to estimate the expected due date (EDB) by adding 9 months and 7 days to the first day of the last menstrual period (LMP).

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EDB

Estimated due date, a calculated date for a baby's birth.

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Fundal height

The measurement of the distance from the top of the symphysis pubis to the top of the uterine fundus, used to assess fetal growth during pregnancy.

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Quickening

Fetal movements felt by the mother, usually occurring between 16 and 22 weeks gestation.

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Fetal heartbeat

The sound of a baby's heart beating, detectable around 8 to 12 weeks gestation using a Doppler device.

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Why is Nägele's rule not always accurate?

Nägele's rule assumes a regular 28-day menstrual cycle, which is not typical for everyone. Other factors like ovulation timing and the woman's history also influence its accuracy.

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What's the significance of fundal height?

It's a good indicator of fetal growth, especially between 22 and 34 weeks, but may be less accurate in the third trimester.

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How long can a woman expect to feel quickening?

Quickening typically starts around 16 to 22 weeks of gestation, and continues throughout the remainder of the pregnancy.

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Breastfeeding Duration

The length of time a mother breastfeeds her infant. This information is important for assessing infant nutrition and overall well-being.

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Loss of a Child

Experiences like miscarriage, elective or medically indicated abortion, stillbirth, or neonatal death can have a significant impact on a woman's emotional and physical health.

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What is meant by 'Loss of a Child' in pregnancy history?

This refers to any pregnancy loss, regardless of the stage of gestation, including miscarriages, stillbirths, and neonatal deaths. It's important to record this information to understand a woman's reproductive history.

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How might loss of a child influence a woman's approach to pregnancy?

Past experiences with pregnancy loss can impact a woman's future pregnancy planning, emotions towards a current pregnancy, and overall well-being. It's important to be sensitive and provide adequate support.

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Why is breastfeeding duration important in pregnancy history?

Knowing how long a woman breastfed her previous child provides valuable insights into her breastfeeding capabilities, nutrition, and the baby's development. It can help anticipate potential needs and support during subsequent pregnancies.

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Skin Pigmentation Changes

During pregnancy, increased estrogen and progesterone levels can cause skin darkening, especially in areas exposed to the sun.

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Stretch Marks (Striae)

These appear as streaks on the abdomen, thighs, buttocks, and breasts due to skin stretching during pregnancy.

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Linea Nigra

A dark line that runs from the pubic area to the belly button, caused by hormonal changes.

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Spider Nevi

Tiny, red, spider-like markings on the skin, often found on the chest, face, and arms.

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Pregnancy Waddling

Hormones relax pelvic joints, causing a swaying or waddling walk during pregnancy.

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Pregnancy Metabolism

The body's metabolic rate increases during pregnancy to meet the demands of the growing fetus and the mother's changing needs. Processes like nutrient absorption and energy production are significantly boosted.

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Weight Gain in Pregnancy

Suggested weight gain varies based on pre-pregnancy Body Mass Index (BMI). Normal weight women should gain 11.5 to 16 kg, overweight women 6.8 to 11.5 kg, obese women 5 to 9 kg, and underweight women 12.7 to 18.1 kg.

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First Trimester Weight Gain

Expect to gain about 0.5 to 2.0 kg (1.1 to 4.4 lb) during the first trimester. This is mainly due to increased blood volume and tissue growth.

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Second & Third Trimester Weight Gain

Aim to gain about 0.45 kg (1 lb) per week during the second and third trimesters. This provides the nutrients and support for the growing fetus.

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Water Retention in Pregnancy

Pregnancy hormones like estrogen and progesterone contribute to water retention. This is necessary to support the growing fetus, placenta, and increased blood volume.

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Lumbar Spinal Curve (Lordosis)

The inward curve of the lower spine, also known as the 'lordotic curve', which is present during pregnancy due to hormonal changes and shifting weight.

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Diastasis Recti

A separation of the abdominal muscles (rectus abdominis) that can occur during pregnancy due to the growing uterus placing pressure on the abdomen.

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Low Back Pain during Pregnancy

A common discomfort in pregnancy caused by hormonal changes, weight gain, and the shifting center of gravity, putting strain on the lower back muscles.

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Postural Changes During Pregnancy

The body's natural adaptation to the growing fetus, including changes to the spine curvature, posture, and gait, to accommodate the shifting weight and balance.

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How does posture change during pregnancy?

The body's natural way to accommodate the growing fetus, including an increased lordotic curve (inward curve of the lower spine), shifting shoulders back, and a forward tilt of the pelvis.

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Progesterone's effect on airways

Progesterone relaxes the muscles surrounding the airways, leading to decreased resistance and easier breathing.

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How does pregnancy affect oxygen consumption?

The body's oxygen consumption increases by 15% to 20% during pregnancy to support the growing fetus and the mother's increased metabolic needs.

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Breathing changes during pregnancy

As the uterus expands, it pushes the diaphragm upwards, causing a shift from abdominal breathing to thoracic breathing.

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Why do nose stuffiness and nosebleeds happen during pregnancy?

Estrogen causes swelling in the nasal passages, leading to stuffy nose and sometimes nosebleeds.

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How does blood volume change during pregnancy ?

Blood volume starts increasing from the first trimester, peaking rapidly between 30-34 weeks to support the growing baby and placenta.

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Saliva Increase

During pregnancy, the secretion of saliva may increase due to hormonal changes.

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Delayed Gastric Emptying

Pregnancy hormones, especially progesterone, relax muscles, leading to a slower emptying of the stomach and intestines, causing discomfort like heartburn.

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Heartburn (Pyrosis)

A common symptom in pregnancy due to slowed gastric emptying and the uterus pressing on the stomach.

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Frequent Urination

Urinary frequency is common during the first trimester, decreases in the second, and returns in the third trimester due to the growing uterus pressing on the bladder.

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Glucoseuria

During pregnancy, kidneys may not reabsorb all glucose, leading to glucose levels high in urine. This doesn't always mean diabetes.

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Fetal Outline Palpation

Feeling the shape of the baby in the womb through the mother's abdomen, usually possible after 24 weeks of pregnancy.

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Ballottement

A technique where the examiner gently pushes on the cervix to see if the baby moves back and forth.

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What is the significance of fetal outline palpation?

It's a simple way to check if the baby is growing and in the right position, especially in the later stages of pregnancy.

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Why is ballottement important?

It helps determine how the baby is positioned within the uterus and whether it is developing normally.

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Goodell's Sign

Softening of the cervix, a sign of early pregnancy due to increased vascular congestion.

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Chadwick's Sign

Bluish discoloration of the cervix and vaginal walls due to increased blood flow.

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Hegar's Sign

Softening of the lower uterine segment, also caused by increased vascular congestion.

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Braxton Hicks Contractions

Irregular, painless uterine contractions that can be felt late in pregnancy, a practice run for labor.

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Uterine Souffle

A soft, blowing sound heard over the uterus during pregnancy, caused by increased blood flow.

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Chloasma (Melasma)

Pigmentation changes on the face, often appearing as brown patches, due to hormonal stimulation.

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Uterine Vascularization

Increased blood flow to the uterus during pregnancy, resulting from the enlargement of blood vessels due to the growing uterus.

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Corpus Luteum's Role

The corpus luteum produces progesterone until the seventh week of pregnancy, after which the placenta takes over this hormone production, ensuring the continuation of the pregnancy.

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Ovulation During Pregnancy

Ovulation ceases during pregnancy as the body focuses on sustaining the existing pregnancy.

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Placenta's Hormonal Role

The placenta takes over the production of progesterone after the seventh week of pregnancy, playing a vital role in maintaining the pregnancy.

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Pregnancy Hormones and Blood Vessels

Pregnancy hormones cause an increase in blood volume and the widening of blood vessels, especially in the uterus to support the growing fetus.

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Oxygen Consumption During Pregnancy

During pregnancy, your body needs to work harder to support the growing fetus, increasing oxygen consumption by 15% to 20%.

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Nose Stuffiness and Nosebleeds in Pregnancy

Estrogen, another pregnancy hormone, causes swelling in the nasal passages, leading to a stuffy nose and sometimes nosebleeds.

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Blood Volume Increase During Pregnancy

Starting in the first trimester, your blood volume increases rapidly, especially between 30-34 weeks, to supply enough blood for you and the baby.

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Why is blood volume increase important in pregnancy?

Increased blood volume is crucial to deliver oxygen and nutrients to the growing fetus and placenta, supporting their development.

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What causes nipple darkening?

Increased estrogen and progesterone levels during pregnancy lead to darkening of the nipples and areolae.

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Why might a pregnant woman experience waddling?

Hormones soften the pelvic joints, causing a swaying or waddling walk during pregnancy.

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Supine Hypotension Syndrome

A condition where a pregnant woman's blood pressure drops when she lies on her back due to the weight of the uterus compressing the vena cava and aorta, reducing blood flow to the heart.

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Iron Requirement During Pregnancy

Pregnant women require increased iron, around 27 mg daily, to support the growth of the fetus and the increased blood volume.

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Physiological Anemia in Pregnancy

A non-pathological condition where the hematocrit (ratio of red blood cells to plasma) drops due to the rapid increase in plasma volume during pregnancy.

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What causes the waddling gait in pregnancy?

Hormones like relaxin soften the ligaments around the pelvis, leading to a wider stance and a swaying or waddling walk.

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Why is breathing different during pregnancy?

The growing uterus pushes the diaphragm upward, causing a shift from abdominal breathing to thoracic breathing. This can lead to shortness of breath.

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Amenorrhea

Absence of menstruation, one of the earliest signs of pregnancy.

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Subjective (Presumptive) Changes

Signs and symptoms usually experienced by the woman but not considered proof of pregnancy.

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What is the corpus luteum's role in pregnancy?

The corpus luteum produces progesterone until the seventh week of pregnancy, after which the placenta takes over.

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Why does ovulation stop during pregnancy?

The body focuses on sustaining the existing pregnancy, preventing any further ovulations.

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What is the placenta's hormonal role?

It produces progesterone after the seventh week of pregnancy, maintaining the pregnancy.

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Enlargement and Softening of the Uterus

After the 8th week of pregnancy, the uterus starts to grow noticeably in size and becomes softer due to increased blood flow and hormonal changes.

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What causes Hegar's Sign?

Hegar's Sign is caused by increased vascular congestion, which is the increased blood flow to the uterus during pregnancy.

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Softening of the Cervix

The cervix, the lower part of the uterus, also softens during early pregnancy due to increased blood flow. This is known as Goodell's Sign.

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Bluish Discoloration of the Cervix

The cervix and vaginal walls turn a bluish color during pregnancy, called Chadwick's sign, due to increased blood flow.

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Why does the uterus soften during pregnancy?

The softening of the uterus during pregnancy is a result of hormonal changes and increased blood flow.

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Nausea and Vomiting

Common pregnancy symptom, often referred to as 'morning sickness', caused by hormonal changes and increased sensitivity to certain smells.

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Urinary Frequency

Frequent urination during pregnancy is caused by the growing uterus pressing on the bladder.

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Breast Tenderness

Pain or sensitivity in the breasts, often due to hormonal fluctuations and the preparation for breastfeeding.

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Increased Peristalsis

A possible cause of quickening, where the muscles in the digestive system contract more frequently, giving the feeling of fluttering.

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Flatus

Another possible cause of quickening, where gas bubbles in the intestines move around, creating a fluttering sensation.

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Study Notes

Antepartum Nursing Assessment

  • Antepartum: Time between conception and the start of labor; a prenatal period
  • Intrapartum: Time from the start of true labor until birth of the baby and placenta
  • Postpartum: Time from placenta and membrane delivery until the woman's body returns to a non-pregnant state (typically about 6 weeks)
  • Gestation: Number of weeks since the first day of the last menstrual period
  • Abortion: Birth before 20 weeks' gestation or birth of a fetus weighing less than 500g
  • Stillbirth: Baby born dead after 20 weeks' gestation
  • Term: Normal duration of pregnancy
  • Full-term: Births occurring between 39 weeks 0 days and 40 weeks 6 days
  • Postterm: Births occurring after 42 weeks

Additional Terms

  • Preterm labor: Labor occurring after 20 weeks but before completion of 36 weeks' gestation
  • Postterm labor: Labor occurring after 42 weeks' gestation
  • Gravida: Any pregnancy, including the current one (abbreviated as G)
  • Nulligravida: Woman who has never been pregnant
  • Primigravida: Woman pregnant for the first time
  • Multigravida: Woman pregnant for the second or subsequent time
  • Para: Birth after 20 weeks' gestation, regardless of whether the baby is alive or dead (abbreviated as P)
  • Nullipara: Woman who has never had a birth at or after 20 weeks
  • Primipara: Woman who has had one birth at or after 20 weeks
  • Multipara: Woman who has had two or more births at or after 20 weeks

TPAL

  • T: Number of early, full-term, or late-term births
  • P: Number of premature births (before 37 weeks), whether living or stillborn
  • A: Number of pregnancies ending in either spontaneous or therapeutic abortion (before 20 weeks)
  • L: Number of currently living children

Prenatal History

  • Details of Current Pregnancy:
    • First day of last menstrual period (LMP)
    • Cramping, bleeding, or spotting
    • Time of conception and estimated due date
    • Woman's attitude toward pregnancy (planned?)
    • Results of pregnancy tests
    • Any discomforts since LMP (e.g., nausea, vomiting)
  • History of Past Pregnancies:
    • Number of pregnancies
    • Number of abortions (spontaneous or induced)
    • Number of living children
    • History of previous pregnancies (length, type of birth, complications, anesthesia)
    • Neonatal status of previous children (Apgar scores, birth weight)
    • Loss of a child: (cause if known)
    • Blood type and Rh factor
    • Prenatal education classes and resources

Gynecologic History

  • Date of last Pap smear and result
  • Previous infections (vaginal, cervical, PID, STIs)
  • Previous surgeries (uterine, ovarian)
  • Age at menarche
  • Duration of menstrual flow, regularity, and frequency
  • History of dysmenorrhea
  • History of infertility
  • Contraceptive history
  • Issues related to infertility or fertility treatment

Current Medical History

  • Weight, height, BMI
  • General health (diet, allergies, intolerances)
  • Exercise program
  • Breast self-examination
  • Eye examination
  • Date of last dental examination
  • Meds currently taking
  • Use of alcohol, tobacco, or caffeine
  • Illicit drug use
  • Drug allergies
  • Potential teratogens
  • Chronic conditions
  • Illnesses since LMP
  • Immunizations (especially rubella)

Past Medical History

  • Childhood diseases
  • Past treatments (hospitalizations, injuries)
  • Surgical procedures
  • Bleeding disorders (blood transfusion history)
  • Family medical history (diabetes, heart disease, cancer, hypertension)
  • Multiple births
  • Congenital diseases
  • Cesarean birth history

Genetic History

  • Birth defects
  • Recurrent pregnancy loss
  • Stillbirth
  • Genetic disorders (e.g., cystic fibrosis, sickle cell disease, muscular dystrophy)
  • Religious, spiritual, and cultural history (beliefs influencing health care choices)

Current Medical History

  • Disease conditions (e.g., diabetes)
  • Immunizations
  • Uncommon symptoms

Occupational History

  • Physical demands
  • Exposure to chemicals/harmful substances
  • Opportunity for meals/breaks
  • Provision for maternity or family leave

Father's History

  • Age
  • Significant health problems
  • Blood type and Rh factor
  • Genetic conditions/diseases in family history
  • Occupation
  • Educational level
  • Tobacco, drug, and alcohol use
  • Thoughts/feelings about pregnancy

Personal History

  • Age
  • Educational level
  • Housing stability and neighborhood safety
  • Economic level
  • Emotional/physical deprivation history
  • Emotional/mental health issues (depression, anxiety)
  • Support systems
  • Personal preferences regarding the birth
  • Childfeeding preference

Prenatal Risk Factor Screening

  • Risk factors that suggest a negative outcome for the woman or her unborn child
  • Screening for these factors is an important part of prenatal assessments. Some factors are identified during initial assessment

Initial Prenatal Assessment

  • Physical, cultural, and psychosocial factors affecting the woman's health
  • Building nurse-client relationship
  • Discussing religious/spiritual, cultural, and socioeconomic factors
  • Preparing the woman for physical examination (vital signs, body, pelvic exams)
  • Obtaining urine sample

Determination of Due Date

  • Nägele's rule to estimate due date
  • Accurate if cycles are regular, LMP is known, and no contraceptives were used

Subsequent Prenatal Assessment

  • Regular visit schedule
  • Prenatal exam frequency
  • Tests during visits (vital signs, weight, edema, uterine size, fetal heartbeat, urinalysis, blood tests (AFP, glucose), vaginal swab for group B strep, psychological assessment

Normal Physiologic Changes in Pregnancy

  • Pulse, Respiration, Temperature, BP
  • Weight, nose, chest, lungs (diameter ratios), skin, mouth, neck
  • Breasts (size, pigmentation), abdomen (size, enlargement), extremities (edema), spine (curve)
  • Pelvic area, cervix, uterus, laboratory tests

Basic Screening Tests

  • Pap smear
  • Urinalysis
  • Complete blood count
  • Rubella titer
  • ABO and Rh typing
  • Hepatitis B screen
  • Syphilis and gonorrhea screening

Other Tests

  • Drug screen
  • HIV testing
  • Sickle cell screen
  • Cystic fibrosis screen
  • Chromosomal anomalies and neural tube defect screen
  • 1-hr 50g GTT
  • Group B strep test

Subsequent Client History

  • Family adjustments and preparations
  • Discomfort experiences
  • Physical changes related to pregnancy
  • Exposure to contagious illnesses
  • Treatment and therapy prescribed
  • Medications and herbal supplements use
  • Complementary and alternative therapies use
  • Identifying danger signs during pregnancy

Danger Signs of Pregnancy

  • Report these immediately to your care provider

Fetal Assessment

  • Quickening: fetal movements felt by the mother around 16-22 weeks' gestation
  • Fetal heartbeat: 8-12 weeks, using an ultrasound
  • Ultrasound: early-pregnancy uses transvaginal; otherwise transabdominal, typically after 10 weeks, gestational sac seen at 5 weeks

Pelvic Adequacy Assessment

  • Assess vaginal opening adequacy for natural birth
  • Measures pelvic inlet and outlet dimensions using various techniques/measurements (e.g., diagonal and obstetric conjugates, anteroposterior and transverse diameters)

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Description

This quiz covers essential concepts related to the antepartum period in nursing assessment. It includes definitions and terminologies regarding gestation, labor stages, and pregnancy classifications. Test your knowledge about prenatal nursing care and related terms.

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