Maternal & newborn nursing exam 1 2023

Maternal & newborn nursing exam 1 2023 Presumptive signs of pregnancy - Breast changes Urinary frequency Nausea and vomiting Fatigue Amenorrhea Uterine enlargement Quickening Quickening - Fluttering movements a fetus felt by women usually between 16 to 20 weeks of Gestation Probable signs - Ballottement Braxton Hicks contraction Fetal outline Chadwicks sign Hager sign Abdominal enlargement Positive pregnancy test Presumptive signs - subjective signs may not be associated with pregnancy - amenorrhea, NV, fatigue, urinary requency, breast change and quickening Probable signs - Changes that make the examiners suspect the woman is pregnant but signs can still be caused by physiological factors other than pregnancy Hegar's sign - softening and compressibility of lower uterus Chadwick's sign - deepened violet-bluish color of cervix and vaginal mucosa Goodell's sign - softening of cervical tip Ballottement - a sharp upward pushing against the uterine wall with a finger inserted into the vagina for diagnosing pregnancy by feeling the return impact of the displaced fetus Braxton Hicks - Painless, irregular contractions that are usually relieved with walking Positive signs of pregnancy - Fetal heart sounds, visualization of Fetus by ultrasound, fetal movement hCG (human chorionic gonadotropin) - Peaks (60-70) after implantation Declines around days 100-130 days of pregnancy Gradually increases until term High levels-multifetal pregnancy, ectopic pregnancy, hydantiform mole, Down syndrome Lower levels-miscarriage, ectopic pregnancy In pregnancy test for most positive results use first voided morning urine specimen Nagele's Rule - 1st day of LMP - 3 months + 7 days (+1 year if applicable; make sure pregnancy adds up to 9 months) fundal height - measurement of the size of the uterus in centimeters from symphysis pubis to uterine fundus- approximates gestational age Done between 18 to 30 weeks gestation Gravida - number of pregnancies nulligravida - a woman who has never been pregnant multigravida - a woman who has had two or more pregnancies primigravida - first pregnancy Parity ( nullipara, primipara, Multipara) - Number of pregnancies in which the fetus reaches 20 weeks of pregnancy - not affected whether fetus born still born or alive Term birth - 38 weeks + Preterm birth - A birth that occurs after the 20th week and before week 38 Cardiac output - Increases 30-50% along w/ blood volume (30-45%) Heart rate increases during pregnancy to about 10 to 15/min above pre-pregnancy rate maternal heart changes in shape and size resulting in cardiac hypertrophy to accommodate increased blood volume and increased output pap test - used as a screening tool for cervical cancer, herpes simplex type 2 and or human papillomavirus Respiratory adaptations - Maternal oxygen needs increase Respiratory rate increases but lung capacity decreases Diaphragm compressed during pregnancy Congestion due to rising estrogen levels shortness of breath related to fundus reaching the xiphoid process and pushing on diaphragm by 36 weeks of gestation PDD - tuberculosis screening chest x-ray after 20 weeks of gestation i Gastrointestinal adaptations - Nausea and vomiting, gum fragility, constipation and indigestion TORCH infections - Toxoplasmosis Other (hepatitis b) Rubella Cytomegalovirus Herpes Musculoskeletal adaptions - Progressive changes affect strength and movement -ligaments relax and clumsiness results -Lordosis posture change to accommodate growing pregnancy -Center of gravity changes maternal serum alpha-fetoprotein - screening occurs between 15 to 22 weeks of gestation used to rule out down syndrome (indicated by low levels), and neural tube defects (indicated by high levels) integumentary adaptations - Hyper pigmentation(Melisma of breast face and Genitalia) -linea nigra-dark line mid abdomen -striae gravidum- stretch marks -Brittle nails but faster growth - Initially beautiful hair growth followed by hair loss post partum exercise - consistent 30 minutes a walking and swimming daily if not medically contraindicated Renal/ urinary adaptions - kidneys increase in size and blood flow increases to the kidney -increased pressure on bladder later in pregnancy causing urinary frequency -kidney activity increases when laying down fetal movements - should be counted by the mother -two or three times a day for 2 hours after meals or bedtime -fetal movements of less than 3 per hour or movements that entirely cease for 12 hours indicate a need for further evaluation