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Why is the left lateral recumbent position recommended for pregnant women?
Why is the left lateral recumbent position recommended for pregnant women?
What is the primary cause of hemodilution during pregnancy?
What is the primary cause of hemodilution during pregnancy?
What is a significant respiratory change during pregnancy, and what causes it?
What is a significant respiratory change during pregnancy, and what causes it?
What renal change is typically observed during pregnancy?
What renal change is typically observed during pregnancy?
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Which integumentary system change is caused by increased melanocyte-stimulating hormone (MSH) during pregnancy?
Which integumentary system change is caused by increased melanocyte-stimulating hormone (MSH) during pregnancy?
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What musculoskeletal change contributes to balance issues in pregnant women?
What musculoskeletal change contributes to balance issues in pregnant women?
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What gastrointestinal change is primarily attributed to the effects of progesterone during pregnancy?
What gastrointestinal change is primarily attributed to the effects of progesterone during pregnancy?
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Which hematological change increases the risk of thrombosis during pregnancy?
Which hematological change increases the risk of thrombosis during pregnancy?
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What does 'Gravida' refer to in obstetric history?
What does 'Gravida' refer to in obstetric history?
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A client is currently pregnant. She had one previous pregnancy that resulted in a delivery at 39 weeks and another that ended in miscarriage at 10 weeks. What is her GTPAL?
A client is currently pregnant. She had one previous pregnancy that resulted in a delivery at 39 weeks and another that ended in miscarriage at 10 weeks. What is her GTPAL?
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What is indicated when a client is referred to as 'Primigravida'?
What is indicated when a client is referred to as 'Primigravida'?
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A woman is in her second pregnancy. Her first pregnancy ended at 35 weeks with the birth of a healthy baby. How would you classify her in terms of 'gravida' and 'para'?
A woman is in her second pregnancy. Her first pregnancy ended at 35 weeks with the birth of a healthy baby. How would you classify her in terms of 'gravida' and 'para'?
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What is the correct interpreation of 'P' in the TPAL acronym?
What is the correct interpreation of 'P' in the TPAL acronym?
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Which pregnancy is defined as a 'Term' delivery within the TPAL acronym?
Which pregnancy is defined as a 'Term' delivery within the TPAL acronym?
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A patient's obstetric history is documented as G4 P1112. What does this indicate about her pregnancies?
A patient's obstetric history is documented as G4 P1112. What does this indicate about her pregnancies?
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What is the correct definition of a 'Multigravida' client?
What is the correct definition of a 'Multigravida' client?
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Which of the following signs can ONLY be attributed to the presence of a fetus?
Which of the following signs can ONLY be attributed to the presence of a fetus?
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What physiological change occurs in the uterus during pregnancy?
What physiological change occurs in the uterus during pregnancy?
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What is the role of the corpus luteum during early pregnancy?
What is the role of the corpus luteum during early pregnancy?
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What change occurs in blood pressure during the first and second trimesters of pregnancy?
What change occurs in blood pressure during the first and second trimesters of pregnancy?
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What condition can result from the gravid uterus compressing the vena cava when a woman is supine?
What condition can result from the gravid uterus compressing the vena cava when a woman is supine?
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What happens to the ovaries during pregnancy?
What happens to the ovaries during pregnancy?
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Which statement about cardiovascular changes during pregnancy is true?
Which statement about cardiovascular changes during pregnancy is true?
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Which change occurs in the vagina during pregnancy?
Which change occurs in the vagina during pregnancy?
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Flashcards
Gravida
Gravida
Number of times a person has been pregnant, including the current pregnancy.
Para
Para
Number of pregnancies reaching 20 weeks or more, regardless of outcome.
GTPAL
GTPAL
A system to document obstetric history: Gravida, Term, Preterm, Abortions, Living.
Primigravida
Primigravida
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Multigravida
Multigravida
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Parity
Parity
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Presumptive signs of pregnancy
Presumptive signs of pregnancy
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Probable signs of pregnancy
Probable signs of pregnancy
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Positive signs of pregnancy
Positive signs of pregnancy
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Braxton Hicks contractions
Braxton Hicks contractions
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Myometrial hypertrophy
Myometrial hypertrophy
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Mucous plug
Mucous plug
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Supine hypotensive syndrome
Supine hypotensive syndrome
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Changes in blood flow during pregnancy
Changes in blood flow during pregnancy
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Corpus luteum's role during pregnancy
Corpus luteum's role during pregnancy
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Increased vascularity in the vagina
Increased vascularity in the vagina
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Left lateral recumbent position
Left lateral recumbent position
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Hematological changes in pregnancy
Hematological changes in pregnancy
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Increased WBCs
Increased WBCs
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Thrombosis risk
Thrombosis risk
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Urinary frequency
Urinary frequency
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Darkening of skin areas
Darkening of skin areas
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Diastasis recti
Diastasis recti
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Gastrointestinal changes
Gastrointestinal changes
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Study Notes
Maternal Adaptations to Pregnancy
- Gravida: The number of times a client has been pregnant, including the current pregnancy.
- Para: The number of pregnancies that have reached 20 weeks gestation, regardless of outcome. Twins/triplets are counted as one.
- GTPAL: A system used to document obstetric history.
- G: Gravida
- T: Term births (38-42 weeks)
- P: Preterm births (20-38 weeks)
- A: Abortions (before 20 weeks)
- L: Living children
- Example: A woman who has been pregnant three times, had two term births, no preterm births or abortions, and has two living children would be documented as G3 T2 P0 A0 L2.
- Primigravida: A client pregnant for the first time
- Multigravida: A client who has been pregnant more than once
- Primipara: A client who has not delivered a pregnancy past 20 weeks
- Multipara: A client who has delivered more than one pregnancy past 20 weeks
Signs of Pregnancy
- Presumptive Signs: Changes felt by the woman. Examples include amenorrhea, nausea, fatigue.
- Probable signs: Changes observed by the examiner. Examples include changes in pelvic organs or a positive HCG test
- Positive Signs: Changes that are definitively linked to the presence of a fetus. Examples include a fetal heartbeat, fetal movements, and ultrasound visualization of a fetus.
Reproductive System Changes
- Uterus:
- Hypertrophy and hyperplasia of myometrial cells
- Moves from being a pelvic organ to an abdominal organ
- By pregnancy's end, approximately 1/6 of the mother's total body mass.
- Cervix:
- Mucous plug forms
- Increased vascularity (blood vessels) and fragility.
- Vagina:
- Increased vascularity.
- Tissue loosens/vault lengthens.
- Increased secretions.
- Ovaries:
- Stop producing ova.
- Corpus luteum releases progesterone and estrogen until the placenta takes over.
- Breasts:
- Placenta releases estrogen and progesterone, increasing alveoli and ductal systems.
- Prolactin is needed for milk production, but is inhibited by estrogen & progesterone. Production of milk stops during pregnancy when the placenta produces the required hormones
Cardiovascular Changes
- Increased blood flow to the placenta, uterus & breasts
- Cardiac workload increases (increased cardiac output by 30-50%)
- Increased heart rate (by 10-15 bpm)
- Blood pressure may decrease during the first and second trimesters but returns to normal by term.
- Supine Hypotensive Syndrome: Gravid uterus compresses vena cava (especially when lying flat). Interferes with blood return to the heart—resulting in dependent edema, varicose veins, hemorrhoids, and thrombophlebitis
- Left lateral recumbent position is considered to be the best position for the expectant mother.
Hematological Changes
- Rapid increase in plasma volume (40-45% above non-pregnant levels, peaking at 32-34 weeks).
- Increased red blood cell production (RBC) (approximately 20-30% more).
- White blood cell (WBC) count increases in the 2nd trimester, peaking in the 3rd.
- Fibrin/fibrinogen and clotting factors (VII, VIII, IX, X) increase, increasing risk of thrombosis.
Respiratory Changes
- Increased oxygen requirements / lowered threshold for CO2.
- Ligaments relax, and the diaphragm is displaced, increasing chest expansion.
- Upper respiratory tract becomes more vascular with edema in the nose, pharynx, trachea and bronchi.
Renal System Changes
- Increased pressure from the uterus leads to increased urinary frequency in the first and third trimesters.
- Glomerular filtration rate (GFR) increases.
- Possible glycosuria.
- Proteinuria (trace amounts are normal; > 1 warrants close monitoring)
Integumentary System Changes
- Increased skin pigmentation (MSH) due to darkening of areola, nipples, axilla, and perianal area. This affects the complexion and creates chloasma.
- Linea nigra
- Striae gravidarum(stretch marks)
- Vascular spiders
- Palmar erythema
- Increased perspiration
- Gum hypertrophy
- Increased nail growth
- Decreased hair loss, and potential hirsutism
Musculoskeletal Changes
- Center of gravity shifts forward, leading to balance issues
- Joint relaxation due to relaxin hormone leads to waddling and back pain.
- Diastasis recti (separation of abdominal muscles)
Gastrointestinal Changes
- hCG and changes in carbohydrate metabolism may cause morning sickness.
- Progesterone (a smooth muscle relaxer) can lead to constipation, heartburn, and bloating.
- Gums soften and bleed easily. Saliva production may increase
- Delayed emptying of the gallbladder and potential stone formation.
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Description
This quiz explores key concepts related to maternal adaptations during pregnancy, including gravidity and para classifications. Understanding the GTPAL system and recognizing signs of pregnancy are essential for providing quality prenatal care. Test your knowledge on these important obstetric terms and their implications for maternal health.