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Summary NR 602 Week 4 Midterm Review Signs of pregnancy (presumptive, probable, positive)
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Signs of pregnancy (presumptive, probable, positive) Presumptive signs of pregnancy — possibility of pregnancy  Amenorrhea (no period)  Nausea — with or without vomiting  Breast enlargement and tenderness  Fatigue  Poor sleep  Back pain  Constipat...

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  • July 25, 2022
  • 10
  • 2021/2022
  • Exam (elaborations)
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Summary NR 602 Week 4 Midterm Review Signs of pregnancy (presumptive, probable, positive)




Signs of pregnancy (presumptive, probable, positive)


Presumptive signs of pregnancy — possibility
of pregnancy
 Amenorrhea (no period)
 Nausea — with or without vomiting
 Breast enlargement and tenderness
 Fatigue
 Poor sleep
 Back pain
 Constipation
 Food cravings and aversions
 Mood changes or "mood swings"
 Heartburn
 Nasal congestion
 Shortness of breath
 Lightheadedness
 Elevated basal body temperature (BBT)
 Spider veins
 Reddening of the palms

Probable signs of pregnancy — most
likelihood of indicating pregnancy
 Increased frequency of urination
 Soft cervix
 Abdominal bloating/enlargement
 Mild uterine cramping/discomfort without bleeding
 Increased skin pigmentation in the face, stomach, and/or
areola

Positive signs of pregnancy — confirmation
of pregnancy
 Fetal heartbeat
 Visualization of fetus (ultrasound)
 Positive hCG urine or blood

Pregnancy and fundal height measurement

, After 12 weeks gestation, the top of the uterus, known as the fundus, can be palpated abdominally. By
16 weeks gestation, the fundus is midway between the symphysis and the umbilicus. If the uterus is
larger or smaller than expected from the woman’s LMP, an ultrasound can provide valuable information
on the gestational age of the pregnancy and the number of fetuses.

The measurement is generally defined as the distance in centimeters from the pubic bone to
the top of the uterus. The expectation is that after week 24 of pregnancy the fundal height for a
normally growing baby will match the number of weeks of pregnancy — plus or minus 2
centimeters. For example, if you're 27 weeks pregnant, your health care provider would expect
your fundal height to be about 27 centimeters.
Naegele’s rule – LMP +7days, minus 3 months, the following year
Hematologic changes during pregnancy
Hemoglobin: Non pregnant (12-16) 1st trimester (11.6-13.9) 2nd (9.7-14.8) 3rd (9.5-15)
Hematocrit: non-preg(37-47%) 1st (31-41%) 2nd (30-39%) 3rd (28-40%)
Red blood cell count: non-preg (3.5-5.5) 1st (3.4-5.2) 2nd (2.8-4.5) 3rd (2.7-4.4)
White blood cell count: non-preg (4.5-11) 1st (4-13) 2nd (6-14) 3rd (6-17)

Indications and contraindications for prescribing combined estrogen vs. progesterone-only birth
control.

Indications: In addition to high contraceptive efficacy, COCs have many advantages including
rapid reversibility, regulation of menstrual bleeding, decreased menstrual blood loss, and
dysmenorrhea, as well as population-level reductions in the risk of ovarian and endometrial
cancers. Due to these effects and the ability of COCs to suppress ovulation, they have a
number of noncontraceptive uses and benefits.

Combination pills also treat menstrual cycle disorders, pelvic pain disorders, ovarian cysts,
hyperandrogenism, primary hypogonadism or premature ovarian insufficiency, endometrial and
ovarian cancer risk reduction, and improve bone health.

 Contraindications: Thrombophlebitis or thromboembolic disorders.
Cerebro-vascular or coronary artery disease.
Carcinoma of the breast or other estrogen-dependent neoplasia.
Undiagnosed abnormal genital bleeding.
Known or suspected pregnancy.
Benign or malignant liver tumor.
Menstrual cycle physiology – normal menses results from a functional hypothalamic-pituitary-ovarian
axis (HPOA) that lead to ovulation. If no conception, menses ensues. Premenstrual symptoms like
bloating, fatigue, constipation, and mood changes are common in women with regular cycles.

Ovarian cycle or uterine cycle – ovarian cycle consists of follicular phase, ovulation and luteal phase.
And the uterine cycle consists of menstruation, proliferative phase, and secretory phase. The
menstruation period is the shedding of the uterine lining. The follicular phase is the time between the

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