Maternal Adaptation to Pregnancy – Review Flashcards

These flashcards review key physiological, psychological, and clinical concepts of maternal adaptation, prenatal assessment, danger signs, and care guidelines during pregnancy.

By how much does maternal blood volume typically increase by the 3rd month of pregnancy?

About 30–50% (approximately 1500 mL).

What cardiovascular change can cause nosebleeds (epistaxis) in pregnancy?

Hyperemia of the nasal mucous membranes due to increased blood volume.

What is supine hypotension syndrome and why does it occur?

A drop in maternal blood pressure when lying flat, caused by the weight of the enlarged uterus compressing the inferior vena cava and reducing venous return.

List two common symptoms of supine hypotension syndrome.

Light-headedness/faintness and palpitations.

Define physiologic anemia of pregnancy.

Hemodilution from plasma volume increasing faster than red cell mass, producing low hemoglobin/hematocrit without iron deficiency.

Define pathologic (iron-deficiency) anemia in pregnancy.

True reduction in RBC mass from inadequate iron, usually hemoglobin <11 g/dL (1st/3rd tri) or <10.5 g/dL (2nd tri).

What oral iron dose is commonly prescribed for iron-deficiency anemia in pregnancy?

Ferrous sulfate (e.g., ferrous sulfate 0.3 g TID) taken 1 hour before meals with water.

Which two endocrine hormones rise markedly during pregnancy?

Estrogen and progesterone.

Why do pregnant women often experience shortness of breath?

The enlarged uterus elevates the diaphragm and increases maternal oxygen demand, leading to mild hyperventilation.

Give two nursing tips to relieve morning sickness.

Rise slowly, eat dry crackers before getting out of bed, eat small frequent meals, avoid spicy/greasy food.

What is hyperemesis gravidarum?

Excessive, persistent vomiting during pregnancy leading to dehydration and weight loss.

Define ptyalism in pregnancy.

Excessive salivation caused by hormonal changes.

Which GI complaint is commonly called pyrosis, and how can it be relieved?

Heartburn; relieve by small meals, avoiding fatty/spicy food, sipping milk, good posture.

When is urinary frequency most common during pregnancy?

1st and 3rd trimesters (uterus presses on bladder).

What is glycosuria and how is it detected?

Glucose in urine, detected by Benedict’s test; may be normal or indicate diabetes.

What urinary finding is checked with heat and acetic acid test?

Proteinuria (serum proteins in urine).

Name two interventions to relieve lower-extremity edema in pregnancy.

Elevate legs above heart level; left side-lying positioning.

State one non-pharmacologic measure to help prevent varicosities.

Wear support stockings or elastic bandages; avoid prolonged standing.

Why is aspirin avoided in suspected DVT during pregnancy?

Risk of bleeding; anticoagulation requires specific therapy, not aspirin.

What postural change is called the "pride of pregnancy"?

Lordosis—accentuated lumbar curvature.

Which hormone increases joint laxity, leading to waddling gait?

Relaxin.

What causes leg cramps in late pregnancy and one preventive tip?

Low calcium/pressure on nerves; limit milk to 4 glasses and perform calf-stretching exercises.

Define striae gravidarum.

Reddish or silvery stretch marks on abdomen, breasts, thighs from skin stretching.

What is linea nigra?

A dark vertical line on the abdomen extending from symphysis pubis to umbilicus.

Explain Chadwick’s sign.

Bluish-purplish discoloration of cervix and vaginal mucosa due to increased vascularity.

Explain Goodell’s sign.

Softening of the cervical tip around 6–8 weeks gestation.

Explain Hegar’s sign.

Softening of the lower uterine segment felt on bimanual exam at 6–12 weeks.

Differentiate presumptive, probable, and positive signs of pregnancy.

Presumptive: felt by woman (amenorrhea, nausea). Probable: observed by examiner (Goodell, +HCG). Positive: confirmed by instruments (FHT, ultrasound, fetal movements palpated).

Define quickening and when it is usually first felt.

First perception of fetal movement, around 18–20 weeks (earlier in multiparas).

State the maternal developmental task of the first trimester.

Accepting the biological fact of pregnancy: “I am pregnant.”

What is the maternal task of the second trimester?

Accepting the fetus as a baby: “I am going to have a baby.”

What is the primary task of the third trimester?

Preparing for parenthood and separation: “I am going to be a mother.”

Define antepartum period.

Time from conception to onset of true labor contractions.

Define intrapartum period.

Time from onset of true labor contractions to 1–4 hours after delivery of placenta.

What does GTPAL stand for?

Gravida, Term births (37–42 wks), Preterm births (20–<37 wks), Abortions (<20 wks), Living children.

How is a multiple gestation counted in GTPAL?

Counts as one pregnancy (G) and one birth category (T or P), but each living infant counts individually in L.

State Naegele’s Rule for calculating EDD.

Add 7 days to the first day of the LMP and subtract 3 months (adjust year if needed).

Describe McDonald’s Rule.

Fundal height in cm × 8 / 7 estimates gestational age in weeks; × 2 / 7 estimates age in months.

Where is the fundus at 5 months using Bartholomew’s Rule?

At the level of the umbilicus.

State Haase’s Rule formula for fetal length (cm) after 5 months.

Fetal length ≈ (Month of gestation × 5).

What is the purpose of Leopold’s maneuvers?

Determine fetal presentation, position, lie, attitude, engagement, and locate fetal heart tones.

Which Leopold maneuver is also called Pawlik’s grip and what does it assess?

Third maneuver; identifies the presenting part above pelvic inlet and its mobility (engagement).

During Leopold’s 2nd maneuver, how can you distinguish fetal back from extremities?

Back feels firm, smooth, and resistant; extremities feel irregular and moveable.

How often should routine prenatal visits occur between weeks 1–28?

Once a month.

How frequent are prenatal visits in weeks 36–40?

Every week (twice a week if post-term).

List the five danger signs of pregnancy remembered by SCABS.

Swelling of upper extremities/face, Chills & fever, Abdominal pain, Board-like abdomen, Sudden gush of fluid from vagina.

Why is folic acid supplementation recommended in pregnancy?

Prevents neural tube defects in the developing fetus.

State one guideline regarding sexual activity late in pregnancy.

Avoid intercourse during the last 6 weeks before EDD (or with contraindications such as bleeding, PROM, pre-term labor).

Give two contraindications for sexual intercourse during pregnancy.

Vaginal spotting/bleeding, premature rupture of membranes, or pre-term labor signs.

Name three prenatal exercises that strengthen muscles for childbirth.

Walking, squatting, Kegel’s pelvic floor exercises, tailor sitting, pelvic rocking.

What vaccination series prevents neonatal tetanus and list timing of first two doses.

Tetanus toxoid series: TT1 anytime in pregnancy; TT2 four weeks after TT1 (provides 3-year protection).

Define pseudocyesis.

False pregnancy in which a woman exhibits many signs and symptoms of pregnancy without an actual fetus.

What is couvade syndrome?

Expectant father experiences pregnancy-like symptoms (nausea, weight gain, etc.).

What is the recommended total weight gain for a singleton pregnancy?

About 20–25 lb (9–11 kg).

Which test (name) can detect fetal heart tones as early as 8 weeks?

Doppler ultrasound device (fetal heart tones 120–160 bpm).

At what gestational age can an ultrasound visualize a gestational sac?

Around 5–6 weeks.

Explain the roll-over test in prenatal assessment.

Blood pressure measured supine versus lateral; sustained rise indicates risk for pre-eclampsia.

What acronym helps remember prenatal danger signs and what does the "B" stand for?

SCABS; "B" = Board-like abdomen (possible placental abruption).

Which two types of fetal heart sounds are differentiated when auscultating the uterus?

Uterine souffle (maternal pulse) and funic souffle (fetal heart rate).