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Questions and Answers
Which measurement denotes the normal length of the uterus at around 20 weeks of pregnancy?
Which measurement denotes the normal length of the uterus at around 20 weeks of pregnancy?
What physiological change occurs to the vaginal walls during pregnancy?
What physiological change occurs to the vaginal walls during pregnancy?
Which sign is considered a presumptive sign of pregnancy?
Which sign is considered a presumptive sign of pregnancy?
Which of the following is classified as a probable sign of pregnancy?
Which of the following is classified as a probable sign of pregnancy?
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What is the primary nursing intervention for discomfort related to increased breast tissue stimulation during pregnancy?
What is the primary nursing intervention for discomfort related to increased breast tissue stimulation during pregnancy?
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What is a common cardiovascular physiological change during pregnancy?
What is a common cardiovascular physiological change during pregnancy?
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Which hormone is primarily responsible for suppressing FSH during the early stages of pregnancy?
Which hormone is primarily responsible for suppressing FSH during the early stages of pregnancy?
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What is the expected thickness of the uterine wall at the beginning of pregnancy?
What is the expected thickness of the uterine wall at the beginning of pregnancy?
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What is a common nursing intervention for addressing fluid retention in lower extremities during pregnancy?
What is a common nursing intervention for addressing fluid retention in lower extremities during pregnancy?
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Which posture is recommended for pregnant individuals to alleviate backache?
Which posture is recommended for pregnant individuals to alleviate backache?
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How should pregnant individuals manage nighttime dyspnea effectively?
How should pregnant individuals manage nighttime dyspnea effectively?
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What might excessive fluid retention during pregnancy cause, requiring nursing intervention?
What might excessive fluid retention during pregnancy cause, requiring nursing intervention?
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What exercise technique is advised to help maintain balance in pregnant individuals?
What exercise technique is advised to help maintain balance in pregnant individuals?
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What is an appropriate recommendation for pregnant individuals to relieve pressure on cerebral arteries?
What is an appropriate recommendation for pregnant individuals to relieve pressure on cerebral arteries?
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When should nursing interventions for uterine contractions be initiated?
When should nursing interventions for uterine contractions be initiated?
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What is NOT advised to enhance lower extremity circulation during pregnancy?
What is NOT advised to enhance lower extremity circulation during pregnancy?
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What dietary change is recommended to manage slowed peristalsis during pregnancy?
What dietary change is recommended to manage slowed peristalsis during pregnancy?
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Which nursing intervention is most appropriate for managing leg discomfort caused by a distended uterus?
Which nursing intervention is most appropriate for managing leg discomfort caused by a distended uterus?
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What is an effective strategy for managing nausea and vomiting during pregnancy?
What is an effective strategy for managing nausea and vomiting during pregnancy?
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How should a nurse advise a patient to relieve pressure on the rectal veins due to a growing uterus?
How should a nurse advise a patient to relieve pressure on the rectal veins due to a growing uterus?
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What intervention should be avoided when addressing fluid intake in a pregnant patient experiencing discomfort?
What intervention should be avoided when addressing fluid intake in a pregnant patient experiencing discomfort?
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What nursing suggestion can help alleviate discomfort from increased metabolic requirements?
What nursing suggestion can help alleviate discomfort from increased metabolic requirements?
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Which of the following interventions is recommended for managing pooling of blood in the lower extremities during pregnancy?
Which of the following interventions is recommended for managing pooling of blood in the lower extremities during pregnancy?
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Which action is NOT recommended for managing discomfort caused by high levels of HCG?
Which action is NOT recommended for managing discomfort caused by high levels of HCG?
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Study Notes
Reproductive System Changes
- Uterus:
- Length: 6.5 to 32 cm
- Depth: 2.5 to 22 cm
- Weight: 50 to 1000 g
- Volume: 2 mL to more than 1000 mL
- Wall thickness: 1cm to 2cm at the beginning of pregnancy
- Width: expands from 4 to 24 cm
- Amenorrhea is caused by suppression of FSH by rising estrogen levels
- Vascularity increases in the reproductive system during pregnancy
- Fluid between cells increases in the reproductive system during pregnancy
- Endocervix glands secrete mucus that forms a plug called the operculum
- Vaginal walls:
- pH changes from 7 to 4 or 5 during pregnancy
- Ovulation occurs, followed by the development of the corpus luteum, which eventually becomes the corpus albicans
Breast Changes
- Size increases during pregnancy
- Diameter of the areola increases during pregnancy
- Vascularity increases in the breasts during pregnancy
- Estrogen levels increase in the breasts during pregnancy
- Montgomery tubercles become more prominent during pregnancy
- Colostrum is produced during pregnancy
Integumentary System Changes
- Pigmentation changes, including melasma and linea nigra, are common during pregnancy
- Striae gravidarum are stretch marks caused by the expanding uterus
Respiratory System Changes
- Dyspnea (shortness of breath) is a common complaint during pregnancy
- The expanding uterus presses on the diaphragm
- The respiratory rate and tidal volume increase to compensate for decreased lung capacity
Cardiovascular System Changes
- Blood volume increases by 40% to 50% during pregnancy
- Cardiac output increases to meet the demands of the growing fetus and placenta
- Heart rate increases slightly during pregnancy
- Blood pressure may decrease slightly in the first and second trimesters and return to normal during the third trimester
Gastrointestinal System Changes
- Nausea and vomiting is a common symptom during pregnancy
- Constipation is a common symptom during pregnancy
- Changes in digestive functioning can occur, such as:
- Slower peristalsis
- Weight of the growing uterus pressing against the bowel
- Sensitivity to high levels of HCG causes morning sickness
Urinary System Changes
- Frequency of urination increases during pregnancy
- Changes in urinary functioning can occur, such as:
- Pressure on the anterior bladder from the growing uterus
- Increased glomerular filtration rate
Skeletal System Changes
- Changes in posture and gait occur during pregnancy
- The growing fetus and uterus cause:
- Changes in weight distribution
- Increased lumbar lordosis
- Relaxation of ligaments and joints
- Pain in the joints of the pelvis
Diagnosis of Pregnancy
- Presumptive signs are subjective in nature
- Probable signs are objective in nature
- Positive signs definitely indicate a pregnancy
Presumptive Signs of Pregnancy
- Amenorrhea
- Frequent urination
- Melasma
- Breast changes
- Fatigue
- Striae gravidarum
- Nausea and vomiting
- Linea nigra
- Quickening
Probable Signs of Pregnancy
- Ballottement
- Laboratory tests indicating pregnancy
- Serum hCG levels
- Urine hCG levels
- Evidence of gestational sac on ultrasound
- Chadwick’s Sign
- Hegar’s Sign
- Goodell’s Sign
- Braxton Hicks Contractions
- Palpation of fetal outline, but not distinguishable from the mother’s
Positive Signs of Pregnancy
- Fetal heart outline on ultrasound
- Demonstration of a fetal heart separate from the mother’s
- Fetal movement felt by the examiner
Common Discomforts in Pregnancy
- Common discomforts in pregnancy can be caused by hormonal and physical changes.
- Discomfort | Usual Causes | Nursing Interventions
- Breast tenderness | Increased stimulation of breast tissue due to high estrogen levels | Encourage wearing a supportive bra with wide shoulder straps, dress warmly to avoid cold drafts
- Constipation | Slower peristalsis, weight of the growing uterus pressing against the bowel | Increase fiber intake, drink at least 8 glasses of water per day, evacuate bowels regularly, eat dry crackers, toast, or a sourball before getting out of bed, eat small frequent meals, avoid greasy and highly seasoned foods
- Nausea and vomiting | Sensitivity to high levels of hCG, lowered maternal blood sugar due to needs of the developing embryo, lack of pyridoxine (vitamin B6) | Delay meal until nausea passes, make up missed meals at other times of the day, try sipping a carbonated beverage, water, or an herbal noncaffeinated or ginger tea
- Fatigue | Increased metabolic requirements | Advise to increase the amount of rest and sleep
- Leg cramps | Decreased serum calcium levels, increased serum phosphorus levels, and possible interference with circulation | Advise to lie on the back momentarily and extend the involved leg, keeping the knee straight and dorsiflexing the foot until the pain disappears
- Varicose veins | Weight of the distended uterus puts pressure on veins returning blood from lower extremities causing pooling of blood and distention of the vessels | Encourage lying on the back with legs raised against the wall or elevated on a footstool for 15-20 minutes twice a day, encourage the use of elastic support stockings, encourage exercise
- Hemorrhoids | Pressure on the rectal veins from the growing uterus | Encourage assuming a knee-chest position for 10-15 minutes daily, apply cold compress to external hemorrhoids
- Urinary frequency | Pressure on the anterior bladder from the growing uterus | Advise not to restrict fluid intake, educate about the normalcy of urinary frequency during pregnancy provided there are no other symptoms suggestive of UTI
- Dyspnea | Lung compression and shortness of breath due to the expanding uterus placing pressure on the diaphragm | Advise to sleep with head and chest elevated (to relieve nighttime dyspnea), caution to limit activities during the day (to prevent exertional dyspnea), advise to squat rather than bend over to pick up objects
- Backache | As pregnancy advances, lumbar lordosis develops and postural changes necessary to maintain balance lead to backache | Encourage wearing shoes with low to moderate heels to reduce the amount of spinal curvature necessary to maintain an upright posture, encourage pelvic rocking or tilting exercises.
- Edema | Caused by general fluid retention and reduced blood circulation in lower extremities due to uterine pressure | Advise rest in a left side-lying position, elevate legs at least 30 minutes twice a day, avoid constrictive clothing, reduce any possible causative situations such as eye strain or tension, apply cold towels on the forehead
- Headache | Pressure on cerebral arteries due to expanding blood volume | Application of cold towels on the forehead, prescribed analgesics
- Braxton Hicks Contractions | Uterus periodically contracts | Advise to change position, encourage to drink more water, encourage warm baths
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Description
This quiz explores the various changes that occur in the reproductive system and breasts during pregnancy. It covers topics such as uterine growth, hormonal effects, and anatomical changes. Test your knowledge on how these transformations support fetal development and prepare the body for childbirth.
