Review of Maternal Physiological Adaptations to Pregnancy Nurse

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29 Terms

1

First Trimester Emotional Responses

Ambivalence is normal (the state of having mixed feelings or contradictory ideas about something or someone.)

even in planned pregnancies. Financial and career concerns may arise.

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2

Second Trimester Emotional Changes

Quickening (fetal movement) makes pregnancy feel more real. Some ambivalence may persist.

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3

Third Trimester Emotional Responses

Mothers may become more introverted. Relationship strain is possible.

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4

Prenatal Visit Schedule

First visit in the first trimester, monthly visits until 28 weeks, biweekly visits until 36 weeks, weekly visits until birth.

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5

Gravida & Para System

G = total pregnancies, P = number of births after 20 weeks.

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6

GTPAL System

G = total pregnancies, T = term births, P = preterm births, A = abortions (spontaneous or induced), L = living children.

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7

Calculating Due Date (Naegele’s Rule)

EDB = First day of last period + 7 days - 3 months.

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8

Routine Prenatal Lab Values

Hgb ≥11 g/dL (1st & 3rd trimesters), ≥10.5 g/dL (2nd trimester); Hct ≥33% (1st & 3rd), ≥32% (2nd).

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9

Vital Sign Changes in Pregnancy

BP: Slight/no decrease in systolic; diastolic decreases mid-pregnancy then returns to normal. HR: Increases by 15-20 bpm.

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10

First Prenatal Visit Assessments

Includes medical history, mental health screening, substance use screening, sexual health history, IPV screening, and full obstetric history.

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11

Methods to Determine Pregnancy Status

Two-digit system (Gravida/Para) and five-digit system (GTPAL).

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12

Routine Labs in Pregnancy

Includes CBC, HIV, Hep B & C, rubella, syphilis, blood type & Rh, STI screening, varicella, TB test, genetic screening, urine analysis.

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13

Fundal Height Growth in Pregnancy

20 weeks: At umbilicus; 24 weeks: 2-4 fingerbreadths above umbilicus; 27 weeks: Halfway between umbilicus and xiphoid; 36-38 weeks: 1 fingerbreadth below xiphoid.

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14

Fetal Heart Rate (FHR) Detection

Detectable by Doppler at 10-12 weeks; Normal range: 110-160 bpm.

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15

Iron Needs in Pregnancy

27 mg/day. Best absorbed with vitamin C. Avoid taking with tea, coffee, or milk.

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16

Common First Trimester Symptoms

Nausea, vomiting, breast tenderness, constipation, fatigue, urinary frequency.

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17

Management of First Trimester Symptoms

Nausea: Eat small, frequent meals; Fatigue: Increase rest; Constipation: Increase fiber and water intake.

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18

Second Trimester Maternal Adaptations

Uterus rises above pelvic brim; fundus at umbilicus by 20 weeks; fetal movements (quickening) felt between 16-20 weeks.

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19

Skin Changes in Pregnancy

Areolas darken, veins become more visible, striae gravidarum (stretch marks) appear.

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20

Common Second Trimester Symptoms

Gas, nasal congestion, ligament pain, back pain, varicose veins, increased GFR, increased insulin resistance.

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21

Third Trimester Maternal Adaptations

Thoracic breathing replaces abdominal breathing, cardiac output increases 30-50%, BP increases slightly.

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22

Common Third Trimester Symptoms

Dyspnea, heartburn, swollen ankles, Braxton Hicks contractions, lightening (baby dropping).

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23

Kick Counts

Mothers should monitor fetal movements. Report decreased movement.

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24

Signs of Pre-Eclampsia

Severe headache, vision changes, swelling of face/hands, high BP.

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25

Preterm Labor Symptoms

Regular contractions, pelvic pressure, lower back pain, cramping, watery discharge.

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26

Labor Warning Signs

Vaginal bleeding, rupture of membranes, contractions increasing in intensity and frequency, decreased fetal movement.

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27

Postpartum Education

Teach newborn care, warning signs of postpartum complications, mental health support, contraception options.

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28

Postpartum Warning Signs

Severe vaginal bleeding, fever, leg pain, chest pain, shortness of breath, swelling.

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29

Contraceptive Counseling

Discuss postpartum birth control options before discharge.

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