Podcast
Questions and Answers
What are presumptive signs of pregnancy?
What are probable signs of pregnancy?
What are positive signs of pregnancy?
What is Chadwick's sign?
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What is Goodell's sign?
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What is ballottement?
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What is the most common gynecologic malignancy that occurs during pregnancy?
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What changes occur in the vagina and vulva during pregnancy?
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What is leukorrhea?
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What is the pH of vaginal secretions during pregnancy?
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What stimulates prolactin during pregnancy?
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What changes occur in the breasts during pregnancy?
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What causes supine hypotension?
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What is the gravidity and parity of a woman pregnant for the fourth time with certain birth histories?
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What is a presumptive sign of pregnancy for a woman at 10 weeks gestation?
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Which of the following is a positive sign of pregnancy?
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At 14 weeks of gestation, where would the fundus be palpated?
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What is noted as Hegar's sign during a physical examination?
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Which cardiovascular change is normal during the second trimester?
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The mother's blood volume increases by 25%.
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Is slight hypertrophy (enlargement) of the heart normal during pregnancy?
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What cardiac auscultatory changes happen by the end of the first trimester?
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How should a pregnant woman's blood pressure be measured?
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By what percentage does cardiac output increase during pregnancy?
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What changes occur in the upper respiratory tract during pregnancy?
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Why might a woman in her seventh month of pregnancy experience nasal congestion?
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What should nurses know about leukorrhea during pregnancy?
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What is the gravidity and parity for a woman who had one spontaneous abortion and one stillbirth?
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Which adaptations occur during pregnancy related to fetus presence?
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Study Notes
Signs of Pregnancy
- Presumptive signs include symptoms felt by the woman: amenorrhea, fatigue, nausea, vomiting, polyuria, breast changes, and quickening (fetal movements typically felt between 16-20 weeks).
- Probable signs observed by the examiner suggest pregnancy: abdominal enlargement, Hegar's sign (softening of the lower uterus), Chadwick's sign (bluish cervix), Goodell's sign (softening of cervical tip), ballottement, Braxton Hicks contractions, positive pregnancy tests.
- Positive signs confirm pregnancy through objective evidence: fetal heart sounds, visualization via ultrasound, palpitated fetal movement by an experienced examiner.
Specific Signs and Terms
- Chadwick's Sign: Description of the bluish-purple discoloration in the cervix and vaginal mucosa due to increased vascularity during pregnancy.
- Goodell's Sign: Indicates softening of the cervical tip; an early sign of pregnancy.
- Ballottement: A technique felt between 16-18 weeks where the examiner taps the cervix to feel the unengaged fetus rebound.
- Quickening: Initial sensation of fetal movement, occurring around 14-16 weeks for multiparous women; nulliparous women may not feel it until after 18 weeks.
Obstetric History and GTPAL
- GTPAL stands for Gravida (number of pregnancies), Term (number of term births), Preterm (number of preterm births), Abortion (number of miscarriages), Living (number of living children).
- Example: A woman pregnant for the fourth time with a history of one term birth and two preterm births would be noted as 4-1-2-0-4.
Physiological Changes in Pregnancy
- The vaginal changes during pregnancy include thickening of the vaginal mucosa, loosening of connective tissue, hypertrophy of smooth muscle, and lengthening of the vaginal vault.
- Leukorrhea: A normal white or mucoid vaginal discharge with a faint odor during pregnancy.
- Vaginal pH during pregnancy is between 3.5-6.0, increasing susceptibility to infections like candidiasis.
Cardiovascular Changes
- Blood volume increases by about 50% during pregnancy, causing physiological changes.
- Cardiac output rises by 30-50%, pulse rate increases by 10-15 beats/min, and shifting blood pressure patterns occur.
- Supine hypotension may happen when the fetus compresses the vena cava, causing decreased blood flow.
Upper Respiratory Tract Changes
- Increased vascularity results in nasal congestion, sinus stuffiness, and changes in voice.
- Growth of capillaries leads to susceptibility to mild upper respiratory infections and nosebleeds.
Breasts and Lactation
- Breast changes include fullness, sensitivity, increased pigmentation of nipples, and enlargement of Montgomery's glands.
- Prolactin stimulates colostrum production by the end of the first trimester; lactation is inhibited until after birth.
Nursing Assessment and Education
- Nurses should measure blood pressure with the patient seated and supported; changes in positioning can affect readings.
- Engagement in education about changes helps reassure clients, emphasizing normal vs. abnormal signs of pregnancy.
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Description
Test your knowledge on the different signs of pregnancy, including presumptive and probable indicators. This quiz will cover key changes that might indicate pregnancy from both a woman's perspective and a medical examination. Understand the symptoms and signs that are significant in determining pregnancy.
