NURS 2866 Ch. 8 - Nursing Care of the Family During Pregnancy

What are the three categories of pregnancy signs?

Presumptive, Probable, Positive

What are presumptive signs of pregnancy?

Amenorrhea, Fatigue, Breast changes, Nausea/vomiting, Urinary frequency, Quickening

What are probable signs of pregnancy?

Positive pregnancy test, Hegar's Sign, Goodell’s Sign, Chadwick’s Sign, Abdominal enlargement, Braxton Hicks contractions, Ballottement

What are positive signs of pregnancy?

Visualization of fetus by ultrasound, Fetal heart tones by Doppler, Palpable fetal movements by examiner

What causes uterine growth during pregnancy?

High levels of estrogen and progesterone

Where is the uterus at 20 weeks gestation?

At the level of the umbilicus

Where is the uterus by term?

Near the xiphoid process

What is lightening and when does it occur?

Fetus descends into pelvis; around 38–40 weeks

What is measured to estimate gestational age?

Fundal height

What is Goodell’s Sign?

Softening of the cervix (probable sign)

What is Chadwick’s Sign?

Bluish discoloration of cervix/vagina due to increased vascularity

How does the vagina prepare for labor?

Thickens mucosa, loosens connective tissue, increases vascularity

What changes occur in the breasts during early pregnancy?

Fullness, tenderness, tingling, darkening areola, enlarged Montgomery glands

What hormone stimulates colostrum production?

Prolactin

How much does heart rate increase during pregnancy?

15–20 bpm

How does blood pressure change during pregnancy?

Slightly decreases until 32 weeks, then returns to baseline

How much does blood volume increase in pregnancy?

By 40–50% (1,200–1,500 mL)

What happens to cardiac output during pregnancy?

Increases by 30–50%

Why is pregnancy a hypercoagulable state?

Increased risk for blood clots (5–6x)

What respiratory changes occur in pregnancy?

Nasal congestion, nosebleeds, voice changes, ↑ oxygen consumption (20–40%)

What renal changes occur in early pregnancy?

Kidneys excrete water more efficiently → increased thirst

What causes dependent edema in late pregnancy?

Decreased renal blood flow

What position helps circulation and diuresis in pregnancy?

Side-lying position

What is melasma?

Brown blotchy pigmentation on cheeks, nose, forehead

What is linea nigra?

Dark line from pubic symphysis to fundus midline

What are striae gravidarum?

Stretch marks, appearing in second half of pregnancy

What is palmar erythema?

Reddening of palms

What causes lordosis during pregnancy?

Abdominal distension and spinal realignment

What is diastasis recti?

Separation of rectus abdominis muscles in 3rd trimester

What neurological condition can occur during pregnancy?

Carpal tunnel syndrome from peripheral nerve edema

When does nausea/vomiting typically begin and end in pregnancy?

Begins at 4–6 weeks, resolves by end of 1st trimester

What hormone maintains the corpus luteum early in pregnancy?

hCG (Human Chorionic Gonadotropin)

What does progesterone do during pregnancy?

Maintains pregnancy, relaxes smooth muscle, suppresses FSH & LH

What does estrogen do during pregnancy?

Stimulates uterine and breast enlargement, relaxes pelvic ligaments

What does prolactin do?

Prepares breasts for lactation

What does oxytocin do?

Stimulates uterine contractions and milk ejection (let-down reflex)

What is a gravida?

A woman who is pregnant

What is gravidity?

The state of being pregnant

What is a nulligravida?

A woman who has never been pregnant

What is a primigravida?

A woman pregnant for the first time

What is a multigravida?

A woman who has been pregnant two or more times

What is parity?

Number of pregnancies where fetus reached 20 weeks, regardless of outcome

What is a nullipara?

A woman who has never had a pregnancy reach 20 weeks

What is a primipara?

One pregnancy has reached 20 weeks

What is a multipara?

Two or more pregnancies have reached 20 weeks

What defines a preterm pregnancy?

Reaches 20 weeks but ends before 37 weeks

What is late preterm?

34 weeks to 36 weeks and 6 days

What is full term?

39 weeks to 40 weeks and 6 days

What is post-term?

Pregnancy that reaches 42 weeks or beyond

What is viability?

Ability of fetus to survive outside uterus; generally viable between 22–25 weeks

What is the two-digit G/P charting system?

G = total pregnancies, P = pregnancies reaching 20+ weeks

What is the five-digit GTPAL system?

G = gravidity, T = term, P = preterm, A = abortions, L = living

When can hCG be detected in pregnancy?

As early as 7 days before missed menses

When do hCG levels peak?

60–70 days of gestation

When do hCG levels decline?

Between 100–130 days as placenta takes over

What could abnormal hCG levels indicate?

Ectopic pregnancy, miscarriage, or molar pregnancy

What should you tell a patient using a home pregnancy test?

Follow instructions, use first morning urine, retest in 1 week if negative

When should a patient call their provider after pregnancy testing?

If still no period after second test or if test is positive