Pregnancy and Childbirth Overview
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Questions and Answers

Which of the following is NOT part of the initial prenatal visit for a pregnant woman?

  • Fetal heart tones (correct)
  • Physical exam
  • Reproductive and sexual history
  • Mental health screening
  • What is the primary purpose of a 1-hour glucose tolerance test during pregnancy?

  • To evaluate kidney function
  • To detect potential gestational diabetes (correct)
  • To assess thyroid hormone levels
  • To screen for anemia
  • During pregnancy, a woman might experience conflicting emotions. What are these conflicting emotions often characterized as?

  • Excitement and disappointment
  • Excitement and fear (correct)
  • Joy and anger
  • Happiness and sadness
  • Which of these is NOT a stage in establishing a mother's relationship with the fetus?

    <p>Identifying with the mother role (A)</p> Signup and view all the answers

    What is the recommended timing for a Group B Strep screen during pregnancy?

    <p>36 weeks (C)</p> Signup and view all the answers

    What factor is considered to be evidence of gestational hypertension?

    <p>Systolic blood pressure greater than 140 mmHg or diastolic blood pressure greater than 90 mmHg on two or more occasions at least 2 hours apart after 20 weeks of gestation (C)</p> Signup and view all the answers

    Which of these is NOT a typical assessment performed during a follow-up prenatal visit?

    <p>Cervical dilation assessment (C)</p> Signup and view all the answers

    Which of the following is NOT a potential benefit of prenatal care for pregnant women?

    <p>Increased access to healthcare (C)</p> Signup and view all the answers

    What is the significance of the alpha fetal protein (AFP) test during pregnancy?

    <p>To identify potential neural tube defects (D)</p> Signup and view all the answers

    Which of these is NOT a stage in a father's adjustment to pregnancy?

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

    Which of these signs are considered probable signs of pregnancy?

    <p>Hegar's sign (A)</p> Signup and view all the answers

    During which trimester is a Hemoglobin level of 10.5 considered anemic in pregnancy?

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

    Which of the following hormones is primarily responsible for stimulating milk let-down?

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

    Which of the following hormonal changes is NOT associated with pregnancy?

    <p>Decreased levels of prolactin (D)</p> Signup and view all the answers

    Which of the following is the most accurate method for determining the estimated date of birth (EDB)?

    <p>Ultrasound measurement of the embryo in the first trimester (B)</p> Signup and view all the answers

    According to Naegele's rule, if a woman's last menstrual period (LMP) began on August 10th, what would her estimated due date be?

    <p>May 17th (C)</p> Signup and view all the answers

    What is the typical duration of a full-term pregnancy?

    <p>40 weeks (D)</p> Signup and view all the answers

    Which of these is a presumptive sign of pregnancy?

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

    Which of the following is a characteristic of the uterus during the second trimester of pregnancy?

    <p>The uterus is spherical. (C)</p> Signup and view all the answers

    What is the term for the noticeable bluish discoloration of the vaginal mucosa during pregnancy?

    <p>Chadwick's sign (C)</p> Signup and view all the answers

    Which of the following is NOT a symptom associated with supine hypotensive syndrome?

    <p>Decreased Blood Pressure (C)</p> Signup and view all the answers

    A pregnant woman complains of frequent nosebleeds. Which physiological change during pregnancy is most likely responsible for this?

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

    Which of the following is a normal change in the gastrointestinal system during pregnancy?

    <p>Increased absorption of iron (C)</p> Signup and view all the answers

    What is the name for the dark line that appears down the midline of the abdomen during pregnancy?

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

    Which term describes the separation of the abdominal muscles during pregnancy?

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

    A pregnant woman experiences frequent headaches and lightheadedness. Which of the following is a possible cause of this?

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

    Which of the following statements is true about the immune system during pregnancy?

    <p>The mother's immune system is suppressed to prevent rejection of the fetus. (C)</p> Signup and view all the answers

    Which of the following is a probable sign of pregnancy?

    <p>Positive pregnancy test (D)</p> Signup and view all the answers

    What is the name given to the pre-milk substance produced by the breasts during the first few days after birth?

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

    What is the term for the soft, easily damaged cervix during pregnancy?

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

    Which of the following is NOT a physiological change in the respiratory system during pregnancy?

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

    Which of the following is a symptom of supine hypotensive syndrome during pregnancy?

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

    Which of the following is a possible cause of pica during pregnancy?

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

    Which of the following is a presumptive sign of pregnancy?

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

    What is the recommended daily calorie increase for pregnant women in the second trimester?

    <p>350 calories (D)</p> Signup and view all the answers

    Which of the following is NOT a recommended strategy for managing heartburn during pregnancy?

    <p>Wearing tight clothing (A)</p> Signup and view all the answers

    What is the recommended approach for managing leg cramps during pregnancy?

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

    Which of the following is NOT a recognized sign or symptom of a potential pregnancy complication?

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

    What is the recommended approach to managing constipation during pregnancy?

    <p>Increasing fiber intake (B)</p> Signup and view all the answers

    Which of the following immunizations is generally safe for pregnant women?

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

    What is the recommended approach for managing ankle edema during pregnancy?

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

    Which of the following describes a common strategy for alleviating nausea and vomiting during pregnancy?

    <p>Eating a dry carbohydrate upon waking (D)</p> Signup and view all the answers

    What is the recommended approach for managing urinary frequency during pregnancy?

    <p>Performing Kegel exercises (D)</p> Signup and view all the answers

    Which of the following is a potential risk associated with smoking during pregnancy?

    <p>Increased risk of sudden infant death syndrome (SIDS) (A)</p> Signup and view all the answers

    What is the recommended weight gain for a woman who has a normal BMI during pregnancy?

    <p>25-35 lbs (C)</p> Signup and view all the answers

    Which of the following is NOT a risk associated with adolescent pregnancy?

    <p>Increased risk for gestational diabetes (D)</p> Signup and view all the answers

    What is the recommended weight gain per week for a woman who is obese during pregnancy?

    <p>0.4-0.6 lbs (A)</p> Signup and view all the answers

    Which of the following conditions is NOT typically associated with a multifetal pregnancy?

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

    Which of the following is NOT a risk associated with advanced maternal age in pregnancy?

    <p>Increased risk for twins (D)</p> Signup and view all the answers

    A patient presents with a history of one pregnancy resulting in a live birth at 38 weeks gestation. Using the GTPAL system, how would you document this patient's obstetrical history?

    <p>G1 T1 P0 A0 L1 (D)</p> Signup and view all the answers

    A patient presents to the clinic with a positive urine pregnancy test. Which of the following statements regarding this test is TRUE?

    <p>A false negative result can occur if the test is done too early. (B)</p> Signup and view all the answers

    A patient presents with a history of two pregnancies, both resulting in live births at 39 and 40 weeks gestation. Using the G/P system, how would you document this patient's obstetrical history?

    <p>G2P2 (C)</p> Signup and view all the answers

    A patient has a quantitative serum hCG level of 500 mIU/mL. Which of the following is a possible explanation for this elevated level?

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

    Which of the following is a FALSE statement regarding pregnancy-related physiological changes?

    <p>The glomerular filtration rate (GFR) decreases during pregnancy, leading to a decrease in urine output. (C)</p> Signup and view all the answers

    Flashcards

    Gravida

    The total number of pregnancies a patient has had.

    Para

    The number of pregnancies reaching at least 20 weeks.

    GTPAL

    An acronym to categorize pregnancies: Gravida, Term, Preterm, Abortions, Living children.

    hCG Testing

    Blood and urine tests for pregnancy; detects hCG hormones.

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    False Positives/Negatives

    Incorrect pregnancy test results due to external factors.

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    Adolescent Pregnancy Risks

    Increased risks include inadequate prenatal care, smoking, and preterm birth.

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    Advanced Maternal Age Risks

    Increased chance of genetic disorders, miscarriage, and low birth weight.

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    Multifetal Pregnancy Issues

    Higher risk of miscarriage, preterm birth, and maternal death; requires more prenatal visits.

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    Weight Gain Recommendations (Normal BMI)

    Gain 25-35 lbs; 2-4 lbs in first trimester, 1 lb/week thereafter.

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    Weight Gain for Obese Mothers

    Aim for 11-20 lbs total; gain 0.4-0.6 lbs/week in 2nd and 3rd trimesters.

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    Presumptive signs

    Changes felt by a woman that may indicate pregnancy, like missed period, nausea, tender breasts, and fatigue.

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    Probable signs

    Changes noted by a healthcare provider suggesting pregnancy, such as positive pregnancy tests and specific signs like Hegar's, Goodell's, and Chadwick's signs.

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    Positive signs

    Signs only detected when a fetus is present, e.g., ultrasound and Doppler heartbeat.

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    Physiologic anemia in pregnancy

    Increased red blood cell mass and blood volume leading to anemia; Hgb less than 11 and Hct less than 33% in 1st and 3rd trimesters.

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    Naegele's Rule

    A method to estimate due date: subtract 3 months from the first day of LMP and add 7 days, assuming a 28-day cycle.

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    Pituitary hormones in pregnancy

    Hormones like prolactin and oxytocin that facilitate lactation and uterine contractions during pregnancy.

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    Placental hormones

    Hormones such as estrogen and progesterone that help maintain pregnancy by enlarging reproductive organs and relaxing muscles.

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    Trimester Definitions

    Pregnancy is divided into three trimesters: 1st (0-13wks), 2nd (14-27wks), and 3rd (28-40wks).

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    Weight Gain During Pregnancy

    Expect to gain 25-35 lbs if you have a normal BMI during pregnancy.

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    Caloric Intake in Pregnancy

    Increase intake by 350 calories in the second trimester, 450 in the third, and 500 when breastfeeding.

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    Kegel Exercises

    Exercises that strengthen pelvic muscles around the vagina and urethra.

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    Oral Health in Pregnancy

    Gum infections during pregnancy can lead to preterm birth, preeclampsia, and gestational diabetes.

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    Moderate Physical Activity

    Aim for at least 30 minutes of moderate exercise daily during pregnancy.

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    Complications Recognition

    Signs of complications include severe vomiting, fever, vaginal bleeding, or changes in fetal movement.

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    Heartburn Relief

    Manage heartburn with small, frequent meals and avoiding tight clothing.

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    Constipation Solutions

    Stay hydrated, consume fiber, and maintain physical activity to alleviate constipation during pregnancy.

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    Urinary Frequency Management

    Practice Kegel exercises, limit fluids before bed, and avoid caffeine to manage frequent urination.

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    Travel Guidelines

    Low-risk pregnant women can fly domestically until 36 weeks, but should move regularly to prevent clots.

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    Maternal Acceptance of Pregnancy

    The process a mother undergoes to accept her pregnancy, which involves recognizing and confirming the biological fact, the fetus as separate, and preparing for birth.

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    Father's Role in Pregnancy

    Fathers also need to accept the pregnancy, identify with the parental role, and prepare for the child's arrival.

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    Benefits of Prenatal Care

    Prenatal care promotes health and well-being for pregnant women, fetuses, newborns, and families.

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    Initial Prenatal Visit Components

    Includes a prenatal interview, physical exam, and lab tests to assess health and history.

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    Gestational Hypertension

    Blood pressure greater than 140/90 occurring after 20 weeks gestation on two occasions.

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    Fetal Assessment Parameters

    Includes gestational age, fetal heart tones, health status (kick counts), and fundal height.

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    1-Hour Glucose Tolerance Test

    A test performed between 24-28 weeks to screen for gestational diabetes, positive if blood sugar ≥ 130-140.

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    Group B Strep Screening

    Screening at 36 weeks for bacterial infection; treated with antibiotics during labor if positive.

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    Alpha-Fetoprotein (AFP)

    A protein that helps identify neural tube defects; tested during pregnancy.

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    Genetic Screening in Pregnancy

    Includes quad screening and sequential screening during the second trimester to assess genetic conditions.

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    Uterine Position Changes

    The uterus moves from the pelvis to the abdominal cavity as pregnancy progresses.

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    Cervical Changes

    Transformation occurs including softening and the formation of a mucus plug (operculum).

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    Chadwick's Sign

    A sign of pregnancy characterized by a bluish color of the vaginal mucosa.

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    Montgomery Tubercles

    Small bumps on the areola that help with lubrication and protection.

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    Supine Hypotensive Syndrome

    Lower blood pressure caused by the uterus compressing the inferior vena cava while lying down.

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    Blood Volume Increase

    During pregnancy, blood volume can increase by 40-45%.

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    Chloasma

    A condition causing temporary hyperpigmentation on the cheeks during pregnancy.

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    Linea Nigra

    A dark line that appears down the midline of the abdomen during pregnancy.

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    Increased GFR

    During pregnancy, glomerular filtration rate increases by 50%.

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    Striae Gravidarum

    Commonly known as stretch marks occurring during pregnancy.

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    Respiratory Alkalosis

    A state during pregnancy where the mother experiences mild hyperventilation.

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    Musculoskeletal Changes

    Physical adaptations include forward center of gravity and lordosis during pregnancy.

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    False Contractions

    Contractions that do not lead to cervical dilation, indicating they are not true labor.

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    Hypercoagulable State

    In pregnancy, blood becomes more likely to clot, increasing the risk of clots.

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    Study Notes

    Pregnancy and Childbirth

    • Determining Gravida and Para: Gravida is the total number of pregnancies, Para is number of pregnancies reaching 20 weeks. GTPAL and G/P used for recording.
    • Pregnancy Tests: Quantitative serum testing (measures hCG in blood) is highly accurate. Qualitative hCG testing (measures hCG in urine) is less precise. hCG detectable in urine/blood 7-8 days before expected period, doubling every few days. High hCG linked to Down's syndrome, multiple gestations. Low hCG linked to ectopic pregnancy, miscarriage. False positives can occur with certain medications.
    • Uterus Changes: Uterus size, shape, and position change due to elevated estrogen and progesterone.
    • Uteroplacental Blood Flow: Blood flow through uterine arteries to the placenta increases as pregnancy progresses.

    Body System Changes

    • CV System: Blood volume increases 40-45%, Cardiac output 30-50% to compensate for blood loss during delivery and postpartum. Supine hypotensive syndrome is a possible effect in later stages- caused by baby position and pressure on vena cava.
    • Respiratory System: Maternal oxygen consumption increases, estrogen increases vascularity in upper respiratory tract causing congestion and nosebleeds. Mild hyperventilation normal in pregnancy.
    • GI System: Nausea/vomiting (N/V) peaks during early pregnancy (8-12 weeks). Pica occurs in pregnancy, meaning cravings for non-food items. Increased progesterone causes decreased smooth muscle motility leading to constipation.
    • Renal System: Increased glomerular filtration rate (GFR). Risk for UTIs increased during pregnancy.
    • Integumentary System: Hyperpigmentation (chloasma or melasma). Stretch marks (striae gravidarum). Spider veins (angiomas).
    • Musculoskeletal System: Center of gravity shifts forward, lordosis develops. Diastasis recti (separation of abdominal muscles).
    • Neurologic System: Headaches may be related to hormonal shifts. Carpal tunnel syndrome a possibility late in pregnancy due to swelling.
    • Immune System: Pregnancy has a complex relationship with the immune system to allow for the acceptance of a fetus which is genetically different, and mother's role in preventing infection while not rejecting the fetus.

    Screening

    • Prenatal Care: Screening tests for infectious diseases and metabolic conditions are common.
    • Follow up Visit: Physical exam (HTN) and lab work such as glucose tolerance tests to measure blood sugar levels. Detecting group B strep infection of which treatment can be provided during delivery. Various screenings including quad screens and ultrasounds.
    • Fetal Assesment: Include gestational age, fetal heart tones, and fundal height assessments

    Additional

    • Pregnancy Signs: Presumptive (felt by woman), Probable (observed by doctor), Positive (only detected by fetus).
    • Estimating Due Date: Naegele's rule calculates the estimated due date (EDD) based on the first day of the last menstrual period (LMP). Ultrasound measurements of the embryo's size can be more accurate.
    • Prenatal Care Strategies: The chapter also includes information on strategies for confirming pregnancy and discussing important considerations such as maternal weight gain. Women with low or high BMI need tailored weight gain recommendations to support healthy pregnancy outcome.

    Important considerations during pregnancy

    • Pregnancy hormones: Important hormones involved including Prolactin, Oxytocin, Estrogen and progesterone are briefly mentioned and their functions are touched upon..
    • Nutritional considerations: Important to consume nutritious foods and appropriate calories for the stages of pregnancy, including increased calorie consumption during the third trimesters as well as maintaining a healthy weight gain range for each BMI group.
    • Physical activities: Important to maintain healthy postural and physical activity routines during pregnancy.
    • Preventative care: Health professionals should perform necessary preventative care to mitigate risks during pregnancy.

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    Description

    Explore the essentials of pregnancy and childbirth, including key concepts like Gravida and Para, the accuracy of pregnancy tests, and the changes in the uterus and body systems during pregnancy. This quiz covers vital physiological adaptations and monitoring aspects essential for expectant mothers.

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