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NURP 531 SIMMONS Exam 3 Latest Update
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NURP 531 SIMMONS Exam 3Latest Update
Cardiovascular adaptations to pregnancy - Answer Increased cardiac output
Increased stroke volume
Increased heart rate
Increased blood volume
Decreased systemic vascular resistance
Increased blood flow to uterus
Increased ventricular muscle mass
Heart is displaced upward, forward, and to the left
Systolic murmur audible
Blood volume increases 30-50%
BP--
Decreases slightly in 2nd trimester and then gradually returns in 3rd trimester
May decrease in left lateral position
Hematology adaptations in pregnancy - Answer Hgb drop to 9.7-15
Hct drop 28-40%
Coagulability --
Hyper coagulable during pregnancy due to increased clotting factors and decrease
fibrinolysis
Renal changes in pregnancy - Answer Kidney size increases
GFR, renal plasma flow, Cr Cl increases
Some normal glycosuria and proteinuria may occur
Ureters, urethra, and bladder dilate
Decreased bladder capacity and increase urine production
,Increase risk of UTI due to urinary stasis
GI changes in pregnancy - Answer Gingival edema and bleeding gums
Lower esophageal sphincter tone can cause reflux
Nausea and vomiting
Constipation
Metabolic adaptations in pregnancy - Answer Increased protein content
Increased fat deposits
Increased blood lipids
Increase salt accumulation
Increased water retention
Increased body weight
Respiratory adaptations in pregnancy - Answer Increased tidal volume
Increased VO2
Impaired ventilation (rise in diaphragm)
Musculoskeletal adaptations - Answer Shift in center of gravity
Increased joint laxity
Increased risk of strains and sprains
Gradual increase in lordosis
Separation of rectus abdominis due to pressure from an enlarged uterus
Integumentary changes in pregnancy - Answer Estrogen and progesterone together
with melanocytes stimulating hormone induce melanocytes to deposit pigments in the
skin
Striae gravidum -- stretch marks
Mask of chloasma -- irregular brown blotches and pigmentation on the cheeks or
forehead
Endocrine adaptations in pregnancy - Answer Increased LH
Increased HCG
Increased human placental lactogen
,Increases estrogen
Increased progesterone
Emotional adaptations in pregnancy - Answer Increased mood fluctuations
Increased emotional lability
Increased instability
Estrogen during pregnancy - Answer Prepares breasts for lactation
Promotes growth of the uterus and glandular breast tissue
Increase uterine blood flow
Increased insulin like growth factors
Stimulates growth of uterine muscle mass
Enhances myometrial contractility
Increased sensitivity to oxytocin
Progesterone in pregnancy - Answer Mediates immune system function in pregnancy
and prevents rejection of the trophoblast by placenta as foreign antigens
Inhibits production of prostaglandins in uterus prevents myometrial contractions
Withdrawal of progestin at term leads to uterine contractions and onset of labor
Placenta - Answer -Transports substances between mother and fetal circulation and
acts as a respiratory organ for gas exchange
-Metabolizes and synthesizes agents necessary for sustaining pregnancy
-Provides immunologic barrier between maternal and fetal systems
-Functions as major endocrine gland
Hormones produced by placenta --
HCG (human chorionic gonadotropin)
HPL (human placental lactogen)
Estrogen
Progesterone
HCG Human chorionic gonadotropin - Answer Secreted by blastocyst early on by the
developing embryo
, Major role is sustain the corpus luteum and its production of progesterone and estrogen
Secreted for 8-10 weeks at which time the placenta function is adequate and becomes
the major producer of progestin and estrogen
Levels normally double every 48-72 hours and does until it peaks
Stabilizes at 20,000
Nausea and vomiting -- natural rise and fall of HCG levels correspond to nausea and
vomiting of pregnancy during first trimester although no direct cause
Urine pregnancy test -- may be positive 2 weeks after conception or 5 weeks after LMP
HPL Human placental lactogen - Answer Essential to fetal growth as it ensures
adequate fetal nutrition by altering maternal protein carbohydrate and fat metabolism
Increases maternal fatty acids and triglycerides
Increases maternal insulin resistance to reserve glucose for the fetus
Fetus begins to produce insulin just before birth
Relaxin - Answer Secreted by corpus luteum and then by uterus and placenta
Prepares the endometrium decidual tissue to ensure maintenance of early pregnancy
Inhibits uterine activity during pregnancy and together with progesterone, softens
ligaments resulting in minor instability of pelvis to widen and facilitate birth
Presumptive signs of pregnancy - Answer Symptoms noted by mom --
Amenorrhea
nausea, vomiting
fatigue
urinary frequency
skin changes
chloasma
linea negra
striae
breast changes
Probable signs of pregnancy - Answer detected by clinician --
breast changes
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