Pregnancy Signs and Discomforts

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the approximate diameter of a term placenta?

  • 30-35 cm
  • 5-10 cm
  • 15-20 cm (correct)
  • 40-45 cm

The intervillous space (IVS) in the placenta is filled with what?

  • Amniotic fluid
  • Fetal blood
  • Maternal blood (correct)
  • Lymphatic fluid

What helps to compartmentalize and direct maternal blood flow through the placenta?

  • Intervillous space
  • Septa (correct)
  • Umbilical cord
  • Chorionic villi

A functional unit of the placenta containing umbilical arteries and a vein is known as:

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

What is the outer layer of the blastocyst that comprises the trophectoderm called?

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

The yolk sac can be detected within the exocoelomic cavity (ECC) via ultrasound around which gestational age?

<p>6-10 weeks (C)</p> Signup and view all the answers

What is the most critical aspect of the maternal-fetal relationship during the first trimester?

<p>Establishing access to maternal circulation (B)</p> Signup and view all the answers

During pregnancy, fat content in the fetus is considered LOW around which gestational week?

<p>26 weeks (D)</p> Signup and view all the answers

Which factor DOES NOT correlate with growth restriction, related to placental growth?

<p>High insulin levels (B)</p> Signup and view all the answers

Which body system development is thought to be NOT important for overall fetal growth, but IS IMPORTANT for CNS development?

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

In normal cardiovascular development of the fetus, the heart begins as a contractile tube early in what week?

<p>4th week (D)</p> Signup and view all the answers

The Ductus arteriosus shunts blood one way to allow which ventricle to directly send output to the aorta?

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

In normal cardiovascular development of the fetus, blood with the highest oxygen is delivered to which area?

<p>LA and LV/carotid/vertebral circulations/brain (B)</p> Signup and view all the answers

Throughout fetal heart development, FHR averages greater than what amount over resting adult HR?

<p>2-fold (B)</p> Signup and view all the answers

Fetal urine is the primary source of Amniotic Fluid (AF) between which weeks?

<p>20-40 wks (B)</p> Signup and view all the answers

The fetal hepatic blood supply primarily comes from the _________.

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

What is the principal substrate for oxidative metabolism within the fetal brain?

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

Which term describes the most acute consequence of developmental effects?

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

What is being described: the nutritional, hormonal, and metabolic environment provided by the mother permanently alters organ structure?

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

Small body size at birth, low weight gain in infancy, and rapid BMI gain in childhood are associated with?

<p>coronary heart disease (B)</p> Signup and view all the answers

What type of visit is described as: aims to promote health before conception to reduce preventable adverse pregnancy outcomes?

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

At reproductive health encounters, what two questions should all primary care NPs should ask to pt?

<p>Are you pregnant / avoiding (D)</p> Signup and view all the answers

According to risk factors, what age is considered ideal for pregnancy?

<p>18-34 (A)</p> Signup and view all the answers

What is the term to describe greater than or equal to 35 years old at time of delivery?

<p>Advanced maternal age (AMA) (D)</p> Signup and view all the answers

In regards to weight gain during pregnancy with a woman at term, around how much are they expect to gain from amniotic fluid?

<p>2 lbs (D)</p> Signup and view all the answers

According to study, how much weight loss can improve conception with someone trying to conceive?

<p>Weight loss of 10% (B)</p> Signup and view all the answers

Women should avoid this with toxoplasmosis, found in cat feces.

<p>Scooping cat litter (C)</p> Signup and view all the answers

How little of the pregnancy timeline must there be dietary counseling and focus on, specifically?

<p>1st trimester (A)</p> Signup and view all the answers

If the Rubella vaccine status is non-immune, when should receive the vaccine?

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

Approximately how much increase in kcal/day are pregnant women expected to consume more than normal?

<p>300 kcal/day extra (C)</p> Signup and view all the answers

HCP says a pt should eats salmon, sardines, anchovies, flax seed and walnut oils which fatty acid?

<p>Omega-3 (D)</p> Signup and view all the answers

What is the increased protein intake recommendation in pregnant women (from nonpregnant adult amount) to?

<p>46g/day to 71g/day (C)</p> Signup and view all the answers

What levels must be measured regarding patients and what has happened to their pregnancy that is very specific?

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

A standard pregnancy typically lasts for how long?

<p>280 days or 40 weeks (B)</p> Signup and view all the answers

Naegele's rule determines estimated due date, but is based on what?

<p>A normal 28-day cycle (A)</p> Signup and view all the answers

In early pregnancy, what is the most reliable method for determining gestational age?

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

What is important to do to protect against rubella with the MMR vaccine?

<p>Blood test to check for immunity, protect against rubella with MMR prior pregnancy (A)</p> Signup and view all the answers

How long should someone wait to conceive after receiving the MMR vaccine?

<p>Avoid becoming pregnant until 1 month after (B)</p> Signup and view all the answers

When is the whooping cough vaccine recommended?

<p>27th to 36th week (B)</p> Signup and view all the answers

Pregnant women are more likely to have severe illness from what illness?

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

When is the flu vaccine recommended to receive each year?

<p>By the end of October (D)</p> Signup and view all the answers

Elevated TSH and Free T4 can be found in labs in what condition?

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

When does the initial perception of fetal movement 'quickening' typically occur in first-time pregnancies?

<p>18-20 weeks' gestation (C)</p> Signup and view all the answers

What does Chadwick's sign indicate in pregnancy?

<p>Bluish coloration of vagina/cervix (B)</p> Signup and view all the answers

At how many weeks gestation the fundus of the uterus is at the umbilicus?

<p>20 weeks (C)</p> Signup and view all the answers

Which common discomfort of pregnancy is caused by increased joint relaxation from pregnancy hormones?

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

Nasal stuffiness and epistaxis result from what physiologic change in pregnancy?

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

What causes heartburn during pregnancy as the uterus increases?

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

What can contribute lower calcium contribute to?

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

Increased renal plasma flow and GFR affect what symptom?

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

Breast discomfort is due to what?

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

Dilation of ureters and renal pelvic occurs by what month of pregnancy?

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

Decreasing BUN and Creatinine means?

<p>Increase in renal output (D)</p> Signup and view all the answers

What position improves renal function?

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

Decreased GI mobility causes what?

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

In first trimester ultrasound, what detail provides better imagery or more detail?

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

What is evaluated from a first-trimester US?

<p>Presence, size, and number of gestational sacs (B)</p> Signup and view all the answers

What is the term that is used to measure embryo and fetus used to determine gestational age?

<p>Crown Rump Length (A)</p> Signup and view all the answers

Around what time frame is nuchal translucency assessed?

<p>Between 11 and 14 weeks (C)</p> Signup and view all the answers

What is being examined during a detailed anatomic survey at 18 weeks?

<p>Detailed survey of brain (A)</p> Signup and view all the answers

When is a limited ultrasound typically performed?

<p>Concerned for fetal well being (C)</p> Signup and view all the answers

Pregnancy is considered a hypercoagulable state due to what?

<p>Increased risk of thromboembolic events (B)</p> Signup and view all the answers

What blood part is decreased due to dilution?

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

Heart sounds become functional, and there is an increase in what type of condition of pregnancy?

<p>Functional heart murmurs (D)</p> Signup and view all the answers

When does cardia output increase in pregnancy?

<p>Starts at 6 weeks (C)</p> Signup and view all the answers

At what point (weeks) of gestation does cardiac output peak?

<p>16-28 weeks (D)</p> Signup and view all the answers

When does cardiac output usually return to pre-pregnancy levels following delivery?

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

There is an increase by a total of about 1g during the pregnancy - but what is it an requirement?

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

In regards to body movements, what does the indicator CNS function include:

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

What is the main fuel source?

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

A pregnancy can result in progressively increasing what?

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

How many weeks should someone obtain new eyeglasses or contacts?

<p>Wait until several weeks PP (C)</p> Signup and view all the answers

According to Naegele how many days long are typical pregnancies?

<p>280 (D)</p> Signup and view all the answers

According to Naegele, one must go back on months how many when trying to determine estimated due date?

<p>3 months (D)</p> Signup and view all the answers

What is the main focus of genetic testing?

<p>Investigating the presence, absence, or activity of genes (B)</p> Signup and view all the answers

Testing for what should be considered when weighing if a patient would be a candidate would be for genetic testing?

<p>A comprehensive history of the patient's health and lifestyle (D)</p> Signup and view all the answers

Genetic testing should be linked to what?

<p>Management and educational based therapy (A)</p> Signup and view all the answers

What does genetic counseling aim to address?

<p>Prognosis &amp; diagnosis and risks in the context of the family (A)</p> Signup and view all the answers

What is the first step in Genetic Testing: Direct Detection of Abnormal Genes by DNA Testing?

<p>Patient education and consent (B)</p> Signup and view all the answers

What is a main point regarding chromosomal analysis?

<p>Can give insight into problems (B)</p> Signup and view all the answers

One must ensure with obtaining samples for testing is that....

<p>Labs must be CLIA approved (D)</p> Signup and view all the answers

What is a potential option for parents whom do not wish to harm a fetus?

<p>PTG helps to be specific (A)</p> Signup and view all the answers

Select is autosomal inheritance.

<p>Adult polycystic disease (C)</p> Signup and view all the answers

If something is not a good indicator of something because is not seen in what is it?

<p>In non pregnant women (D)</p> Signup and view all the answers

What factor about pregnancy has to do with gestational diabetes?

<p>Test in the second trimester (D)</p> Signup and view all the answers

Which term best describes the condition during which a woman has new sensitivity with her skin and pigment after and while being pregnant?

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

There is thought from what element that changes the uterus that makes one have heartburn

<p>Progesterone causing sphincter and expanding uterus (C)</p> Signup and view all the answers

There are some contraindications with vaccines but which one MUST be avoided?

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

During prenatal appointments, there is a lab draw with certain markers with trisomy testing - so does one know this marker is increased?

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

During early pregnancy - how does the fetal body get its iron stores if it isn't very able to get enough right away?

<p>The placenta transports Iron from mother (B)</p> Signup and view all the answers

Which vitamin helps the support of forming needed materials such as red blood?

<p>Vitamin B (Iron supplements, if has 65 if pregnant and doesn't increase w/ 8 weeks (A)</p> Signup and view all the answers

What part may show early in exam findings that could be cause or can increase issues if there is a loss?

<p>With yolk sac and abnormalities (B)</p> Signup and view all the answers

Is there one important aspect for building for the placenta with access?

<p>Maternal circulation is needed (C)</p> Signup and view all the answers

What hormone increases when pregnant related to increase of tiredness with early term of pregnancy?

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

Flashcards

Presumptive Signs

Physiologic changes indicating pregnancy, based on patient's experience. Subjective symptoms.

Probable signs

Physiologic and anatomic changes detected by an examiner. Objective findings.

Positive Signs

Signs directly attributable to the fetus, detected and documented by an examiner.

Amenorrhea

Absence of menstruation.

Signup and view all the flashcards

Nausea/Vomiting

Morning sickness; nausea and vomiting.

Signup and view all the flashcards

Quickening

The perception of fetal movement by the pregnant woman.

Signup and view all the flashcards

Hegar's Sign

Softening of the lower uterine segment.

Signup and view all the flashcards

Goodell's Sign

Softening of the cervix.

Signup and view all the flashcards

Chadwick's Sign

Bluish-purple coloration of the vaginal mucosa and cervix.

Signup and view all the flashcards

Melasma (Chloasma)

Darkening of the skin on the face during pregnancy.

Signup and view all the flashcards

Linea Nigra

Dark line that appears on the abdomen during pregnancy.

Signup and view all the flashcards

Gestational Diabetes (GDM)

Elevated blood glucose in pregnancy.

Signup and view all the flashcards

Gestational Hypertension

High blood pressure that develops during pregnancy.

Signup and view all the flashcards

Placenta Previa

Abnormal implantation of the placenta over the cervical opening.

Signup and view all the flashcards

Biophysical Profile (BPP)

A score used to evaluate the baby’s well-being during pregnancy.

Signup and view all the flashcards

Ectopic Pregnancy

Condition where a fertilized egg implants outside the uterus.

Signup and view all the flashcards

Amniocentesis

Procedure to obtain a sample of amniotic fluid for testing.

Signup and view all the flashcards

Chorionic Villus Sampling (CVS)

Sampling of placental tissue for chromosomal analysis.

Signup and view all the flashcards

Oligohydramnios

Lack of amniotic fluid.

Signup and view all the flashcards

Polyhydramnios

Excessive amniotic fluid.

Signup and view all the flashcards

Non-Stress Test (NST)

Procedure to assess fetal well-being using heart rate monitoring.

Signup and view all the flashcards

Gestation

The time period of development inside uterus (approx. 40 weeks).

Signup and view all the flashcards

Estimated Due Date (EDD)

Expected date of delivery.

Signup and view all the flashcards

Calculating a Due Date

Typical pregnancy lasts 280 days or 40 weeks

Signup and view all the flashcards

Vaccines During Pregnancy

Vaccines that are safe and recommended during pregnancy.

Signup and view all the flashcards

1st Trimester

It can be used to measure the gestational (menstrual) age.

Signup and view all the flashcards

Screening for Genetic Issues

Performed between 11 weeks and 13 weeks+ 6 weeks

Signup and view all the flashcards

Evaluate uterus and adnexal region

Evaluate uterus and adnexal region

Signup and view all the flashcards

Biparietal diameter

Biparietal diameter

Signup and view all the flashcards

Placental Anatomy

The point where maternal and fetal systems interface to permit appropriate exchanges

Signup and view all the flashcards

Substrate

Glucose transfer from the placenta to fetus

Signup and view all the flashcards

Amniotic Fluid Volume (AFV)

Volume of amniotic fluid

Signup and view all the flashcards

Gestational programming

Gestational programming that the nutritional, hormonal, and metabolic environment provided by the mother

Signup and view all the flashcards

Preconception care

Promote health before conception to reduce preventable adverse pregnancy outcomes.

Signup and view all the flashcards

Interconception care

Care between delivery and beginning of the next pregnancy.

Signup and view all the flashcards

N / V

Common 1st trimester discomfort

Signup and view all the flashcards

Initial Visit

Trimester visits include

Signup and view all the flashcards

Use in 1st trimester

Avoid if at all possible

Signup and view all the flashcards

PUPS

Goal is symptom relief

Signup and view all the flashcards

Genetic History

Genetic Counseling- Goal to identify individuals/couples at risk for having a child

Signup and view all the flashcards

Deletions

Structural abnormalities

Signup and view all the flashcards

Screening

First trimester: fetal nuchal translucency + maternal serum analysis of pregnancy-associated.

Signup and view all the flashcards

Ultrasound

Ultrasound Studies Pg.862-868

Signup and view all the flashcards

Induction

The process of labor being started by artificial means

Signup and view all the flashcards

Study Notes

  • Presumptive signs of pregnancy are physiologic changes that might indicate pregnancy, including amenorrhea, breast changes, elevated BBT, ptyalism, vaginal mucosa color changes, fatigue, nausea/vomiting, urinary frequency, hyperpigmentation of skin, and fetal movements felt by the woman
  • Probable signs are maternal physiologic and anatomic changes detected by an examiner, including abdomen/uterus enlargement, palpation of fetal outline, uterine changes (Hegar's sign, McDonald's sign, Piskacek's sign), cervical changes (Goodell's sign, Chadwick's sign), and positive pregnancy test
  • Positive signs are directly attributable to the fetus, as detected by an examiner
    • These include ultrasound verification of the embryo or fetus and auscultation of fetal heart tones/cardiac activity

Common Discomforts of Pregnancy

  • Backache can occur with increased joint relaxation due to progesterone and relaxin, difficulty with ambulation, and an enlarging uterus

  • Skin changes include palmar erythema and increased pigmentation

  • Increased pigmentation can result in chloasma, linea nigra, darkening of areola, striae of abdomen, and angiomas

  • Constipation can occur with delayed gastric emptying due to hormones and expanding uterus

  • Dyspnea can occur due to increased estrogen, progesterone, and uterus growth

  • Edema can occur due to decreased blood and increased circulatory volume returning

  • Epistaxis can be due to Estrogen, antihistimines and dry air

  • Heartburn can occur due to hormonal, progesterone and or mechanical factors

  • Elimination of spicy and high acid foods with smaller meals can help

  • Sleep in semi-Fowlers can help with symptoms of heart burn

  • Antacids and Histamine Receptor inhibitors and protein pump inhibitors can be used in treatment

  • Hemorrhoids can result from pressure from growing uterus

  • Insomnia can be caused by increased estrogen and progesterone levels, and uterus putting pressure on the diaphragm causing shortness of breath and discomfort

  • Leg Cramps can occur with lower calcium and changes in blood circulation

  • Nausea and Vomiting can occur from the hCG hormone, hormones and delayed gastric emptying

  • Round ligament pain can occur with stretching of the uterus which acetaminophen, heat and the knees may help

  • Varicosities can occur in feet as full leg support and rest can help

  • Typically the worst in the first and third trimesters; unclear if hormonal the and just discomfort later in pregnancy

  • Urinary Frequency typically occurs in the 1st and 3rd trimester and causes kidney and bladder tone which causes infection

  • Initial OB visit occurs 6-8 weeks after one missed menses

  • Components at each visit include urinalysis, labs, Group Beta Strep test

  • Health guidance in pregnancy includes travel, work, dental care, exercise, sex, immunizations, vaccines, nutrition,genetic screening, medication safety, labs

Genetic Testing Lectures

  • Record personal and family medical history and family history of personal disorders heritable genetic disorders

  • Complete and record maternal and paternal age and ethnic origin; genetic conditions can be more common in selected ethnic groups

  • If indicated, consider referral to a clinical geneticist for genetic counseling

  • Genetic counseling involves preparing patients to be offered counseling, to provide counseling, and to identify risk factors plus offer carrier screening

  • Chromosome abnormalities include disorders autosomal such as trisomy 21, 13 and 18: Trisomy occurs during maternal meiosis and is associated with maternal age effect

  • Chromosome abnormalities Structural include and can be Translocations, deletions, duplications of cri du chat, Williams, Prader-Willi, Angelman, Smith-Magenis

  • Sex chromosome abnormalities include Turner syndrome and Klinefelter Syndrome (XXY)

  • Screening Aneuploidy is when a person has one or few chromosomes above or below the normal number

  • Screening is NOT equivalent to definitive testing

  • First Trimester Screen between 10 and 13 weeks for Nuchal Translucency as well as Serum free B- hCG and analytic pregnancy associate plasma protein A

  • Quadruple Screen between 15 to 23 weeks: includes ultrasound only US when required, hCG, AFP, and inhibin A; age and other factors, provides a Down Syndrome risk estimate

  • Triple Screen includes hCG and AFP without nuchal folds - and is therefore less effective for down syndrome.

  • Integrated and step wide testing: integrated at each stage.

  • Cell Free DNA: Performed early 10 weeks; screen for defects & genetic sex

  • Ultrasound Second trimester: a lack of standardization in measurements makes it impact the use of ultrasound but also the ultra sound picture through mothers that are obese

  • Prenatal genetic diagnosis includes Amniocentesis in week 16

  • Prenatal Genetic diagnosis includes Chorionic Villus sampling for early results

Physiology of Pregnancy

  • Cardiac output increases 30-50 percent
  • HR and Stroke volume increase as well
  • BP decreases in the 2nd trimester and may return to normal in the third
  • Average blood volume expands 40–50%. Hemoglobin is lowered by dilution
  • Patients need 100 g of iron as diet is inadequate
  • Kidney and renal functions increase - with water dilated
  • CO2 is lower, and renal blood flow and GFR increase
  • Thyroid normalizes as estrogen decreases bonding from thyroid binding globulin
  • Estrogen, progesterone, melanocyte - pigmentation happens
  • Bone turnover is high, and pregnancy has reversible loss
  • Cornea thickens. Decreased intraocular pressure. Can't used lenses
  • Last period to know is 40 week period
  • Naegele's is period minus 3 months add 7 days
  • Return visits each 4 before 28 then each 2 until 38 then each week until delivery
  • In pregnancy: avoid 1 month after MMR vaccine
  • Tdap during 27-26 weeks is best.

Trimester Discomforts

  • N/V and urinary frequency are common first trimester discomforts
  • Heartburn and ankle edema are common second and third trimester issues

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Related Documents

More Like This

Pregnancy Signs and Changes Quiz
5 questions
Pregnancy Signs and Symptoms Quiz
3 questions
Signs of Pregnancy Flashcards
9 questions
Signs of Pregnancy Flashcards
12 questions

Signs of Pregnancy Flashcards

SensationalChrysoprase468 avatar
SensationalChrysoprase468
Use Quizgecko on...
Browser
Browser