Week 4: Nursing Care Related to Psychological and Physiologic Changes of Pregnancy

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Psychological Changes of Pregnancy

Extensive emotional adjustments experienced by a pregnant person, second only to puberty in magnitude.

Prenatal Visits

Health-care appointments during pregnancy, often the first medical contact since childhood for many women.

Social Influences

The impact of friends, community, and social norms on a pregnant woman’s attitudes and behaviors.

Cultural Influences

Beliefs and practices rooted in ethnicity or culture that shape pregnancy perceptions and care.

Family Influences

Expectations and support (or lack thereof) from relatives that affect pregnancy experience.

Individual Differences

Personal traits and coping styles that make each woman’s pregnancy reaction unique.

Partner’s Adaptation

The emotional adjustment a significant other makes to the pregnancy, including feelings of ambivalence.

First-Trimester Psychological Task

Accepting the reality of being pregnant.

Ambivalence (Pregnancy)

Mixed feelings of wanting and not wanting the pregnancy, common in the first trimester.

Second-Trimester Psychological Task

Accepting the baby as a separate individual.

Quickening

The first fetal movement felt by the mother, usually marking acceptance of the baby.

Third-Trimester Psychological Task

Preparing for parenthood and birth.

Nest-Building

Activities such as choosing a name or setting up the nursery to prepare for the infant.

Emotional Responses of Concern

Range of feelings like grief or stress that may require nursing attention in pregnancy.

Grief (Pregnancy)

Sadness over lifestyle changes or past losses triggered by pregnancy.

Narcissism (Pregnancy)

Heightened self-focus on body and well-being during gestation.

Introversion vs. Extroversion

Shifts toward inward or outward focus as a coping style in pregnancy.

Body Image & Boundary

How a woman perceives and protects her changing body during pregnancy.

Stress in Pregnancy

Psychological strain from adapting to fetal and life changes.

Depression in Pregnancy

Persistent sadness that may arise from hormonal or situational factors while pregnant.

Couvade Syndrome

Pregnancy-like symptoms (e.g., nausea) experienced by the partner.

Emotional Lability

Rapid mood swings common during gestation.

Changes in Sexual Desire

Fluctuations in libido resulting from hormonal, physical, or emotional shifts in pregnancy.

Expectant Family Changes

Alterations in family dynamics as members prepare for a new baby.

Presumptive Signs of Pregnancy

Subjective indications such as amenorrhea that suggest, but don’t prove, pregnancy.

Probable Signs of Pregnancy

Objective findings (e.g., Hegar’s sign) that strongly indicate pregnancy but are not conclusive.

Positive Signs of Pregnancy

Definitive evidence such as fetal heart tones confirming pregnancy.

Hegar’s Sign

Softening of the uterine isthmus at 6–8 weeks gestation.

Ballottement

Rebounding of the fetus after a sharp upward uterine tap, considered a probable sign.

Braxton Hicks Contractions

Irregular, painless uterine contractions that serve as ‘warm-up’ for labor.

Amenorrhea

Absence of menstruation; a classic presumptive sign of pregnancy.

Goodell’s Sign

Softening of the cervical tip due to increased vascularity.

Chadwick’s Sign

Violet coloration of the vagina from elevated vascularity during pregnancy.

Candida Albicans

Yeast organism that proliferates in pregnancy, possibly causing ‘thrush’ in newborns.

Vaginal pH Change

Shift from alkaline to acidic (pH 4–5) due to Lactobacillus activity in pregnancy.

Thrush

Oral Candida infection in the newborn contracted during birth.

Trichomonas Vaginalis

Protozoal infection favored by alkaline vaginal environment; causes frothy, itchy discharge.

Flagyl (Metronidazole)

Drug of choice for treating Trichomonas infection in both partners.

Corpus Luteum

Ovarian structure that secretes progesterone early in pregnancy.

Ovulation Suppression

Halting of egg release due to high estrogen-progesterone feedback on the pituitary.

Montgomery Glands

Sebaceous glands in the areola that become prominent during pregnancy.

Colostrum

Thin, high-protein pre-milk fluid producible as early as the 16th week.

Striae Gravidarum

Pinkish stretch marks on abdomen or thighs during pregnancy.

Striae Albicantes

Silvery-white, permanent stretch marks after pregnancy.

Diastasis Recti

Separation of abdominal muscles creating a postpartum ‘pooch.’

Melasma (Chloasma)

Hyperpigmented facial patches nicknamed the ‘mask of pregnancy.’

Lightening

Descent of fetal presenting part into the pelvis, easing breathing late in pregnancy.

Pseudoanemia

Apparent drop in hemoglobin due to plasma volume expansion.

Iron Needs in Pregnancy

Approximately 350–400 mg of iron required for fetal growth; supplementation common.

Heartburn in Pregnancy

Reflux irritation caused by progesterone-slowed gastric motility and uterine pressure.

Constipation in Pregnancy

Reduced bowel activity from progesterone, relaxin, and intestinal displacement.

Morning Sickness

Nausea/vomiting linked to rising hCG and estrogen or low maternal glucose.

Hemorrhoids in Pregnancy

Dilated rectal veins from uterine pressure on intestinal circulation.

Edema of Lower Extremities

Fluid accumulation in legs; often physiologic, not a toxemia sign.

Bandaging Principle

Wrap limbs distal to proximal to promote venous return and prevent congestion.

Urinary Frequency

Increased need to void from bladder compression, hormones, and higher blood volume.

Pride of Pregnancy

Characteristic straight-back posture adopted to adjust the center of gravity.

Lordosis (Pregnancy)

Accentuation of lumbar curve contributing to backache.

Leg Cramps in Pregnancy

Spasms from pressure, fatigue, or altered calcium/phosphorus balance.

Breast Tenderness

Early pregnancy soreness due to estrogen-progesterone breast stimulation.

Palmar Erythema

Reddening of palms caused by elevated estrogen levels.

Supine Hypotension

Drop in blood pressure when lying on the back from vena cava compression.

Varicosities

Dilated, painful leg veins from impaired venous return in pregnancy.

Leukorrhea

Increased whitish vaginal secretions; usually normal in pregnancy.

Dyspnea in Pregnancy

Shortness of breath from diaphragmatic elevation by the enlarging uterus.

Ankle Edema

Swelling at the ankles often relieved by leg elevation or supportive stockings.

Supportive Hose

Elastic stockings worn to enhance venous return and reduce swelling.

Low-Heeled Shoes

Footwear recommended to minimize back strain during pregnancy.

Sim’s Position

Side-lying posture used to relieve varicose veins and hemorrhoid pressure.

Dorsiflexion for Leg Cramps

Pulling toes toward the shin to relieve calf spasms effectively.