Term
| Presumptive Signs of Pregnancy |
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Definition
Changes experienced in woman that make her think she may be pregnant. Subjective symptoms or objective signs. May be result of other physiological factors.
amenorrhea, fatigue, nausea, vomiting, urinary changes, breast changes, quickening (fluttering), uterine enlargement, linea nigra, chloasma, stretch marks |
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Term
| Probable Signs of Pregnancy |
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Definition
Changes that make examiner suspect woman is pregnant. Also can be caused by other physiological factors.
abdominal enlargement (change in size, shape, position of uterus), cervical changes, Hegars sign (softening and compressibility of lower uterus), Chadwicks sign (bluish color of vaginal mucosa due to inc. vascularity), Goodells sign (softening of cervical tip), ballottement (rebound of engaged uterus), Braxton Hicks contractions (false contractions, painless, irregular, relieved by walking), positive pregnancy test, fetal outline felt by examiner |
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Term
| Positive Signs of Pregnancy |
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Definition
Signs that could only be explained by pregnancy
Fetal heart tones, visualization of fetus by ultrasound, fetal movement palpated by examiner |
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Term
| Verifying Pregnancy (Serum and Urine Testing) |
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Definition
| hCG can be detected within 6-11 days in serum and 26 days in urine after conception following implantation; hCG levels peak at 60-70 days, declines until 80 days, and increases from then on until term; Higher levels may indicate multifetal, ectopic, or molar pregnancy or genetic abnormality such as Down Syndrome |
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Term
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Definition
| First day of last menstrual period, subtract 3 months, add 7 days and 1 year |
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Term
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Definition
| Uterine fundal height in cm. from symphysis pubis to top of fundus measured, estimated gestational age should be equal to height of fundus |
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Term
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Definition
G- gravidity (number of pregnancies)
T- term births (38 weeks +)
P- preterm births (from viability (20 wks) up to 37 weeks)
A- abortions/miscarriages (prior to viability)
L- living children |
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Term
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Definition
Gravidity- number of pregnancies
Parity- number of pregnancies in which fetus or fetuses reach viability (20 to 24 weeks or fetal weight >2lb) regardless of if born alive or not |
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Term
Physiological Changes
Reproductive, Cardiovascular, Respiratory, Muskuloskeletal |
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Definition
Reproductive- uterus increases in size, change shape and position; ovulation and menses cease during pregnancy
Cardiovascular- CO, blood volume, HR increase
Respiratory- increased maternal O2 needs, decreased lung capacity, increased respiratory rate
Muskuloskeletal- pelvic joints relax, weight increases
GI- nausea and vomiting due to hormonal changes and increased abdominal pressure, constipation, increased water absorption |
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Term
Physiological Changes
Renal, Endocrine |
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Definition
Renal- filtration rate increases with increase of hormones, metabolic demands, and blood volume. Urine production remains same, but frequency is common
Endocrine- placenta is endocrine organ, produces large amounts of hCG, progesterone, estrogen, HPL, and prostaglandins. Hormones maintain pregnancy and prepare body for delivery |
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Term
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Definition
| Woman requires support from primary care provider and family; first trimester changes are not obvious, second semester there are rapid changes which may lead to negative body image, resentment, and anxiety including enlargement of abdomen, breasts, loss of mobility and balance, discomfort, fatigue etc. |
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Term
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Definition
Blood pressure- within prepregnancy range in first trimester, decreases 5-10 mmHg in second, and returns to prepregnancy baseline after 20 weeks gestation. Pt may experience supine hypotensive syndrome as a result of positioning
Respirations- increase 1-2 per min, SOB may be noted
Pulse- increases 10-15 at 20 weeks gestation, remains elevated |
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Term
| Skin Changes in Pregnancy |
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Definition
Cloasma- mask of pregnancy (pigmentation increases)
Linea nigra- dark line of pigmentation from umbilicus to pubic bone
Striae gravidarum- stretch marks on abdomen and thighs |
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Term
| Physical Assessment Findings |
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Definition
FHR noted at 110-160 bpm
Cardiac hypertrophy may result in murmur or splitting with S3 following 20 weeks gestation
Uterine size changes, by 36 weeks fundus palpated at xiphoid process
Cervical changes- Chadwicks sign (bluish color of cervix), Goodells sign (softened consistency)
Breast changes- increase in size, areolas darkened |
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Term
| Prenatal Care Initial Assessment |
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Definition
| Reproductive and obstetrical hx, medical hx, family hx, recent or current illnesses or infections, current medications, substance use/abuse, psychosocial hx, hazardous enviornmental exposures, current exercise and diet habits |
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Term
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Definition
| Uncomplicated pregnancy; 1 time a month for 7 months, every 2 weeks in 8th month, every week in 9th |
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Term
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Definition
EDD determined by date of LMP, (vaginal US may be done) Obtain medical hx (past med. hx, social support systems, family hx, review of systems and past obstetrical hx)
Perform physical exam including baseline VS, weight, and pelvic exam
Obtain lab work including blood type, Rh factor, HIV status, rubella status, urinanalysis |
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Term
| Ongoing Prenatal Assessment |
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Definition
Weight, BP, urine for glucose/proteins/leukocytes
Monitor for presence of edema
Monitor fetal development (FHR at 10-12 weeks, US at 16-20 weeks, Fundal height beginning at 12 weeks
Education for self care and how to manage discomforts of pregnancy (N/V, fatigue, backache, varicosities, activity, sexuality, heartburn) |
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Term
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Definition
| Given to Rh negative moms around 28 weeks to prevent maternal fetal blood incompatibility or neonatal hyperbilirubinemia |
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Term
| Health Promotion- Behaviors to avoid and encourage |
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Definition
| Avoid OTC meds unless OB has approved usage, avoid alcohol consumption, avoid tobacco use and substance abuse of any kind, encourage client to receive flu shot in fall, treat current infections, avoid use of hot tubs or saunas, consumer 2-3L of water each day, get 30 min of moderate exercise daily (walking or swimming) if not medically contraindicated |
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