Expected Physiological Changes During Pregnancy
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Expected Physiological Changes During Pregnancy

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Questions and Answers

Which of the following is not a presumptive sign of pregnancy?

  • Urinary frequency
  • Fatigue
  • Fetal heart sounds (correct)
  • Amenorrhea

    • What physiological changes can cause probable signs of pregnancy?

  • Hormonal fluctuations
  • Stress-induced changes
  • Menstrual irregularities
  • Pelvic congestion (correct)

    • When can hCG be detected following implantation?

  • At 3 weeks gestation
  • After the first missed period
  • 1 day after implantation
  • 7 to 8 days before expected menses (correct)

    • Which of the following groups includes positive signs of pregnancy?

    <p>Fetal movement palpated, Visualization of fetus by ultrasound, Fetal heart sounds</p> Signup and view all the answers

    Which group of patients would likely have higher levels of hCG?

    <p>A client with Down syndrome pregnancy</p> Signup and view all the answers

    Which method accurately estimates the due date of a pregnant client?

    <p>Subtract 3 months from the last menstrual period, then add 7 days</p> Signup and view all the answers

    Which statement correctly defines the term 'nulligravida'?

    <p>A client who has never been pregnant</p> Signup and view all the answers

    Which condition specifically refers to an increase of pigmentation on the face during pregnancy?

    <p>Chloasma</p> Signup and view all the answers

    What is the primary characteristic of striae gravidarum?

    <p>Stretch marks primarily located on the abdomen and thighs</p> Signup and view all the answers

    Which statement best describes linea nigra?

    <p>It is associated with hormonal changes during pregnancy.</p> Signup and view all the answers

    What is the definition of parity in relation to pregnancy?

    <p>Number of completed pregnancies that reached at least 20 weeks of gestation</p> Signup and view all the answers

    Which term describes a woman who has had no pregnancies beyond the stage of viability?

    <p>Nullipara</p> Signup and view all the answers

    Which skin change is most notably absent in non-pregnant individuals?

    <p>Striae gravidarum</p> Signup and view all the answers

    During which stage of pregnancy is linea nigra most likely to become prominent?

    <p>Third trimester</p> Signup and view all the answers

    What does the 'T' in the GTPAL acronym stand for?

    <p>Term births (37 weeks or more)</p> Signup and view all the answers

    In terms of structure, what does the linea nigra represent?

    <p>A concentration of melanin in the epidermis</p> Signup and view all the answers

    At what gestational age are infants considered to be on the threshold of viability?

    <p>22 to 25 weeks</p> Signup and view all the answers

    Which of the following is true regarding chloasma?

    <p>It may vary in intensity based on sun exposure.</p> Signup and view all the answers

    Which physiological change occurs in the reproductive system during pregnancy?

    <p>Cessation of ovulation and menstruation</p> Signup and view all the answers

    Which of the following best describes the term 'Multipara'?

    <p>A woman who has completed more than two pregnancies to at least 20 weeks</p> Signup and view all the answers

    What best distinguishes striae gravidarum from other skin changes?

    <p>It involves thinning of the skin.</p> Signup and view all the answers

    What triggers the development of skin changes like chloasma and linea nigra during pregnancy?

    <p>Hormonal fluctuations</p> Signup and view all the answers

    What occurs to the size and shape of the uterus during pregnancy?

    <p>It increases in size and changes shape and position</p> Signup and view all the answers

    Which skin change could be mistaken for a bruise if not recognized correctly?

    <p>Melasma</p> Signup and view all the answers

    What does the 'A' in the GTPAL acronym signify?

    <p>Abortions or miscarriages prior to viability</p> Signup and view all the answers

    What is the purpose of administering Rh(D) immune globulin IM around 28 weeks of gestation?

    <p>To prevent maternal-fetal blood incompatibility</p> Signup and view all the answers

    Which laboratory test specifically detects the presence of irregular antibodies in pregnant clients?

    <p>Indirect Coombs test</p> Signup and view all the answers

    At what gestational period is Group B Streptococcus (GBS) screening typically conducted?

    <p>36 to 37 weeks</p> Signup and view all the answers

    What does a positive result from the one-hour glucose tolerance test indicate?

    <p>Need for further testing for hyperglycemia</p> Signup and view all the answers

    Which of the following statements regarding CBC and differential tests is correct?

    <p>They help in detecting infection and anemia in the mother.</p> Signup and view all the answers

    During a gynecological examination, which action is taken to reduce discomfort for the client?

    <p>Recommending an empty bladder</p> Signup and view all the answers

    What is the purpose of the one-hour glucose tolerance test in pregnant clients?

    <p>To identify hyperglycemia</p> Signup and view all the answers

    What does a urinalysis reveal in pregnant clients?

    <p>Risk of diabetes, renal disease, and infection</p> Signup and view all the answers

    Which symptom indicates a potential infection during the first trimester?

    <p>Burning on urination</p> Signup and view all the answers

    What is a sign of hyperemesis gravidarum?

    <p>Severe vomiting</p> Signup and view all the answers

    Which of the following is assessed through Hgb electrophoresis?

    <p>Hemoglobinopathies such as sickle cell anemia</p> Signup and view all the answers

    Which condition should lead to immediate medical attention due to risk of miscarriage?

    <p>Severe abdominal cramping and/or vaginal bleeding</p> Signup and view all the answers

    Which of the following is true regarding pelvic measurements taken during a gynecological examination?

    <p>They help determine if the pelvis allows fetal passage.</p> Signup and view all the answers

    Which of the following positions is recommended for a client experiencing supine hypotension?

    <p>Side-lying or semi-sitting position with knees flexed</p> Signup and view all the answers

    What is a potential consequence of supine hypotension?

    <p>Reduced blood supply to the fetus</p> Signup and view all the answers

    Which sign is NOT associated with an infection during the first trimester?

    <p>Vaginal discharge</p> Signup and view all the answers

    When should a client report severe vomiting during the first trimester?

    <p>Regardless of severity</p> Signup and view all the answers

    Which of the following is a typical sign of dehydration in pregnant clients?

    <p>Dizziness or lightheadedness</p> Signup and view all the answers

    What should a pregnant client do if experiencing abdominal cramping and vaginal bleeding?

    <p>Consult a healthcare provider immediately</p> Signup and view all the answers

    Which statement correctly describes supine hypotension?

    <p>It results from compression of the vena cava.</p> Signup and view all the answers

    Study Notes

    Signs of Pregnancy

    • Presumptive Signs: Subjective changes indicating possible pregnancy, including:

      • Amenorrhea (missed period)
      • Fatigue
      • Nausea and vomiting
      • Increased urinary frequency
      • Breast changes: darkened areolae, engorged Montgomery glands
      • Quickening: fetal movement felt by the client (16-20 weeks)
      • Uterine enlargement

    • Probable Signs: Objective signs suspected by healthcare providers, including:

      • Abdominal enlargement due to uterine changes
      • Hegar's sign: softening of the lower uterus
      • Chadwick's sign: bluish color of cervix and vaginal mucosa
      • Goodell's sign: softening of the cervical tip

    • Positive Signs: Definitive indicators of pregnancy, including:

      • Fetal heart sounds
      • Visualization of the fetus via ultrasound
      • Fetal movement felt by an experienced examiner

    Verifying Pregnancy

    • Human chorionic gonadotropin (hCG) produced post-implantation can be detected in blood and urine, becoming detectable 7-8 days before expected menses.
    • hCG peaks at 60-70 days, declines, then remains lower throughout pregnancy.
    • Elevated hCG levels may indicate multifetal pregnancies, ectopic pregnancies, or genetic issues; low levels may suggest miscarriage or ectopic pregnancy.
    • Home tests are most accurate with first-morning urine samples.

    Calculating Delivery Date

    • Naegele's Rule: Calculate due date by taking the first day of the last menstrual period, subtracting 3 months, adding 7 days, and adjusting the year if necessary.
    • Fundal Height Measurement: Estimates gestational age between 18–30 weeks, allowing a variance of ±2 weeks.
    • Gravidity: Counts the number of pregnancies; terms defined include:
      • Nulligravida: never been pregnant
      • Primigravida: first pregnancy
      • Multigravida: two or more pregnancies

    Physiological Changes in Body Systems

    • Reproductive Changes: Uterus enlarges, ceasing ovulation and menstruation.

    Parity

    • Counts pregnancies reaching at least 20 weeks:
      • Nullipara: no viable pregnancies
      • Primipara: one viable pregnancy
      • Multipara: two or more viable pregnancies

    GTPAL Acronym

    • G: Gravidity
    • T: Term births (≥37 weeks)
    • P: Preterm births (20-37 weeks)
    • A: Abortions/miscarriages (before viability)
    • L: Living children

    Skin Changes During Pregnancy

    • Chloasma: Facial pigmentation increase
    • Linea Nigra: Dark line from umbilicus to pubic area
    • Striae Gravidarum: Stretch marks on abdomen and thighs

    Nursing Care and Routine Tests

    • Perform Leopold maneuvers to assess fetal position.
    • Routine laboratory tests include:
      • Blood type, Rh factor (assessing incompatibility risk)
      • CBC, Hgb, Hct (detect anemia/infection)
      • Rubella titer (immunity assessment)
      • Hepatitis B screen (carrier identification)
      • Group B Streptococcus screening at 36-37 weeks
      • Urinalysis for various conditions
      • Glucose tolerance tests for gestational diabetes

    Danger Signs During Pregnancy

    • First trimester symptoms needing immediate reporting:
      • Burning during urination
      • Severe vomiting
      • Diarrhea
      • Fever or chills
      • Abdominal cramping/vaginal bleeding

    Supine Hypotension

    • Results from the uterus compressing the vena cava when supine, causing lightheadedness.
    • Recommended to lie on one side or in a semi-sitting position with knees flexed.

    General Danger Signs

    • Gush of amniotic fluid before 37 weeks
    • Vaginal bleeding or abdominal pain
    • Decreased fetal activity
    • Persistent vomiting or severe headaches
    • Elevated temperature, dysuria, blurred vision
    • Facial and hand edema, epigastric pain

    Active Learning Scenarios

    • Encourage practices to prevent UTIs such as wiping front to back, avoiding bubble baths, maintaining hydration, and urinating post-intercourse.

    Application Exercises Overview

    • Initial laboratory testing includes CBC, Rubella titer, and blood type/Rh factor.
    • Common first trimester discomforts encompass breast tenderness and urinary frequency.
    • Measures to relieve backache include pelvic tilts and proper body mechanics.
    • Immediate reporting of vaginal bleeding is crucial; other symptoms can be more typical occurrences.

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    Description

    This quiz covers the expected physiological changes during pregnancy, including the classification of pregnancy signs into presumptive, probable, and positive categories. Understanding these changes is crucial for both healthcare providers and clients during prenatal visits.

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