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Normal Pregnancy
Pregnancy Terms and Values
94
Nursing
Undergraduate 3
03/20/2016

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Term
Gravida
Definition
A pregnant woman
Term
Gravidity
Definition
Pregnancy
Term
Nulligravida
Definition
A woman who has never been pregnant and is not currently pregnant
Term
Primigravida
Definition
A woman who is pregnant for the first time
Term
Multigravida
Definition
A women who has had 2 or more pregnancies (been pregnant more than once)
Term
Para
Definition
A woman who has borne offspring who reached the age of viability (i.e. 20 weeks gestation)
Term
Parity
Definition

Number of pregnancies in which the fetus/fetuses have reached 20 weeks gestation

Note: NOT the number of fetuses born

Term
Term
Definition
Birth occurring from the beginning of the 38th week gestation to the end of the 42nd week
Term
Pre-term
Definition
Any infant born before 38 weeks gestation (up to 37/6)
Term
Post term
Definition
A pregnancy that lasts more than 42 weeks gestation
Term
Gestational Age (GA)
Definition
Number of weeks of pregnancy completed
Term
LNMP
Definition

Last normal menstrual period

GA is determined from the date of LNMP

Term
GTPAL
Definition

Five digit separated by hyphens (ex: 3-1-1-1-2)

Gravida-term-preterm-abortions-living-children

Term
G/P
Definition

Gravida/Para (pregnancies/ deliveries after 20 weeks gestation)

ex: G3P2

Term
Presumptive signs (def.)
Definition
  • Subjective changes 
  • Felt by the woman and reported to provider 
  • Could have other possible causes than pregnancy
Term
Presumptive signs (ex.)
Definition
  • Amenorrhea 
  • Breast changes (enlargement, tenderness) 
  • N/V (morning sickness) 
  • Urinary frequency 
  • Fatigue 
  • Quickening
Term
Probable signs (def.)
Definition
  • Objective changes 
  • Observed by the examiner 
  • Mainly related to physical changes in the uterus and pelvic organs
Term
Probable signs (ex.)
Definition
  • Abdominal enlargement 
  • Positive pregnancy test 
  • Goodell's Sign 
  • Chadwick's Sign 
  • Hegar's Sign 
  • Ballottement 
  • Lightening
Term
Goodell's Sign
Definition
  • Noted at 5 weeks 
  • Softening and velvety appearance of cervical tip (os)
  • Caused by increased vascularity and volume, edema 
  • Cervix bleeds easily
Term
Chadwick's Sign
Definition
  • Noted at 6-8 weeks 
  • Violet-bluish color of the cervix and vaginal mucosa 
  • Due to increased blood flow and volume
Term
Hegar's Sign
Definition
  • Noted at 6-12 weeks 
  • Softening and compressibility of lower uterus (isthmus) 
  • Due to pelvic congestion and edema
Term
Ballottement
Definition
  • Noted at 16-18 weeks 
  • Passive movement of the fetus 
  • Floating structure rebound
  • Not done often (invasive)
  • Insert fingers into vagina, tap up on cervix, should feel tap back (as baby floats back down)
Term
Lightening
Definition
  • Fetal descent into pelvic cavity 
  • Primipara: 2 weeks before labor 
  • Multipara: Concurrent with labor
Term
Positive signs (def.)
Definition
  • Completely objective 
  • Attributed ONLY to the presence of the fetus
Term
Positive signs (ex.)
Definition
  • Ultrasound visualization 
  • Fetal heart tones 
  • Fetal movement palpated (by examiner, not just mom)
Term
Human chorionic gonadotropin (hCG)
Definition
  • Hormone made by the chorionic villi 
  • Found in blood and urine of pregnant women 
  • Blood--detected 6 days after conception (20 days after LMP) 
  • Urine--detected 14 days after conception (28 days after LMP)
Term
Terms for estimating birth
Definition
  • EDC (estimated date of confinement)
  • EDD (estimated date of delivery) 
  • EDB (estimated date of birth)
Term
EDB Wheel
Definition
  • Wheel used to calculate due date 
  • Place arrow "first day of last period" on date of LMP, then read EDB at arrow labeled 40
Term
Nagele's Rule
Definition
  • Formula used to estimate date of birth/ delivery 
  • Method A: Add 7 days to the 1st day of the LMP, then count forward 9 months 
  • Method B: Subtract 3 from the month that LMP occurred, and add 7 days and 1 year
Term
Psychological Tasks of Pregnancy (by trimester)
Definition
  • 1st trimester: acceptance 
  • 2nd trimester: continuation of pregnancy 
  • 3rd trimester: separation
Term
Respiratory changes in pregnancy
Definition
  • RR: unchanged or increased slightly
  • Increased O2 need by fetus and mom
  • Increased chest expansion (b/c of estrogen)
  • Elevated diaphragm (up to 4 cm)
  • Thoracic breathing replaces abdominal breathing
  • Increased tidal volume (30-40%)
  • Nasal stuffiness
  • Epistaxis
Term
Breasts changes in pregnancy
Definition
  • Enlargement 
  • Heightened sensitivity 
  • Heaviness, tingling, fullness 
  • Dilated blood vessels 
  • Darkening of nipples and areola 
  • Montgomery's tubercles 
  • Colostrum
Term
GI changes in pregnancy
Definition
  • Pregnancy gingivitis (hypertrophy and bleed)
  • Heartburn 
  • N/V (morning sickness)
  • Enhanced absorption of nutrients
  • Intestines and stomach displaced
  • Hemorrhoids and constipation 
  • Gastric emptying time and intestinal motility delayed
Term
Vagina changes in pregnancy
Definition
  • Hypertrophy of smooth muscle 
  • Increased length of vaginal vault 
  • Loosened connective tissue 
  • Increased thick white secretions (leukorrhea) 
  • Mucous plug
Term
Integumentary changes in pregnancy
Definition
  • Hyperpigmentation
  • Chloasma (melasma)/ mask of pregnancy
  • Acne vulgaris, dermatitus, spider veins
  • Striae gravidarum  
  • Linea nigra
Term
Metabolism changes in pregnancy
Definition
  • Weight gain 
  • Increased need for H20 
  • Increased fluid retention
  • Increased caloric and nutritional need
Term
Musculoskeletal changes in pregnancy
Definition
  • Increased lumbosacral curve 
  • Altered center of gravity (shifts forward)
  • Duck waddling gait
  • Increased mobility of pelvis (due to softening of cartilage and ligaments)
  • Diastasis
Term
Cardiovascular changes in pregnancy
Definition
  • Increased blood volume, heart rate, and cardiac output 
  • BP--stays the same or decreases slightly 
  • Heart enlargement, murmurs 
  • Increased RBCs and WBCs (in 2nd and 3rd trimester) 
  • Decreased Hgb and Hct
  • Increased plasma
Term
Renal/ urinary changes in pregnancy
Definition
  • Increased urinary frequency (early and late in preg)
  • Increased bladder capacity
  • Increased GFR and renal plasma flow
  • Decreased BUN, creatinine, and uric acid
  • Increased susceptibility to UTIs
  • Glucosuria and albuminuria common (trace amounts)
Term
Uterus changes in pregnancy
Definition
  • Increased size, weight, and connective tissue 
  • Braxton Hicks contractions 
  • Cervical softening
Term
Endocrine changes in pregnancy
Definition
  • Placenta: increased estrogen, progesterone, hCG; produces HPL
  • Pituitary: increased prolactin (anterior) and oxytocin (posterior)
  • Thyroid: increased hormone production and size
  • Pancreas: changing insulin production; diabetogenic effect of pregnancy due to HPL
Term
Role of placenta
Definition
  • Bring nutrients to fetus 
  • Bring waste away from fetus 
  • Produce HPL, estrogen, progesterone, and hCG
Term
Fundus
Definition
  • Top of uterus 
  • Height measured to estimate duration of pregnancy (less accurate after 36 weeks)
Term
Braxton Hicks contractions
Definition
  • Irregular, painless contractions 
  • Begin at 16 weeks 
  • Do not increase in intensity or frequency (like true labor will) 
  • Do not cause cervical dilation and effacement (like true labor does)
Term
Uterine souffle
Definition
  • Sound made by blood in the uterine arteries 
  • Synchronous with mom's pulse
Term
Funic souffle
Definition
  • Sound made by blood rushing through umbilical vessels 
  • Synchronous with fetal heart rate (FHR) 
  • Much faster than mom's pulse and uterine souffle
Term
Quickening
Definition
  • 14-16 weeks in multipara
  • 18-20 weeks primipara 
  • "Fluttery" feeling 
  • First time mom feels the fetus move
Term
Mucous plug
Definition
  • AKA operculum 
  • Barrier against infection during pregnancy
Term
Montgomery's tubercles
Definition
  • Sebaceous glands of areola 
  • Protect and prepare nipples for nursing
Term
Colostrum
Definition
  • Creamy, yellowish to orange pre-milk fluid 
  • Present from 16 weeks gestation 
  • Loaded with antibodies
Term
Supine hypotensive syndrome
Definition
  • Occurs when laying supine 
  • BP drops due to compression of the ascending vena cava 
  • Faint feeling occurs
Term
Physiologic anemia of pregnancy
Definition
  • Caused by increased plasma in relation to RBCs, Hct, and Hgb 
  • Normal, but still treat with iron supplement 
  • If Hgb <10 g/dl or Hct < 33%, consider true anemia
Term
Linea nigra
Definition
Pigmented line from symphysis pubis to top of fundus in midline
Term
Striae gravidarum
Definition
  • Stretch marks
  • Caused by separation w/in underlying collagen
  • Usually fade after birth but never disappear completely
Term
Chloasma/ Mask of Pregnancy
Definition
  • Hyperpigmentation of skin over the cheeks, nose, and forehead
  • Intensified by the sun
  • Usually fades postpartum
Term
Diastasis
Definition
  • Separation of rectus abdominus muscles
  • Gradually regain tone postpartum
  • Separation can persist postpartum
Term
Neurologic changes in pregnancy
Definition
  • Carpal tunnel syndrome
  • Functional changes (ex: increased clumsiness RT smooth muscle relaxation)
Term
Appetite during pregnancy
Definition
  • Early pregnancy: N/V
  • Mid and late pregnancy: increased appetite
  • Cravings common
  • Changes in taste and dietary intake
  • Pica: non-food cravings
Term
Human placental lactogen (HPL)
Definition
  • AKA human chorionic somatomammotropin
  • Growth hormone 
  • Contributes to breast development
  • Decreases maternal metabolism of glucose
  • Increases amount of fatty acids for metabolic needs
Term
Prolactin
Definition
Prepares breasts for lactation
Term
Oxytocin
Definition
  • Stimulates let-down of milk during lactation
  • Stimulates uterine contractions
Term
Estrogen
Definition
  • Promotes enlargement of genitals, uterus, and breasts
  • Relaxes ligaments and joints
  • Causes fat to deposit in SC tissues of back, abdomen, and thighs for use in pregnancy and lactation
Term
Progesterone
Definition
  • Relaxes smooth muscle and decreases uterine contractility 
  • Helps maintain pregnancy and prevent miscarriage
Term
Diabetogenic state of pregnancy
Definition
  • Short amount of time to get on blood sugars and fix them
  • Baby will absorb glucose but not insulin; grows fast and can become hypoglycemic very fast postpartum
  • Start testing mom's glucose levels 24 weeks in (gestational diabetes)
Term
Separation of trimesters
Definition
  • First trimester: weeks 1-13
  • Second trimester: weeks 14-26
  • Third trimester: weeks 27-40
Term
Prenatal Care Schedule (in low risk)
Definition
  • Weeks 4-28: every 4 weeks (once/month)
  • Weeks 28-36: every 2 weeks (twice/month)
  • Weeks 36-birth: every week
Term
Labwork: Initial Prenatal Visit
Definition
  • CBC, WBC w/ differential
  • Hbg/ Hct
  • Blood type, Rh factor
  • Test for antibodies vs. Rubella, Hepatitis B, HIV
  • Urinalysis, urine culture, and renal function tests
  • PAP-smear, vaginal/rectal smears (STDs)
  • 1-hour glucose tolerance test (28th week except for high-risk women)
Term
Immunizations
Definition
  • No live virus vaccines (chickenpox, MMR)
  • Approved vaccines: TDaP, rabies, hepatitis B, pneumococcus, influenza
  • Flu vaccine provides infant protection for up to 6 months postpartum if given to mom during pregnancy
Term
First trimester warning signs
Definition
  • Hyperemesis gravidarum
  • Chills, fever (infection)
  • Burning on urination (UTI)
  • Abdominal cramping or pain (possible miscarriage)
  • Vaginal bleeding (possible miscarriage)
Term
Hyperemsis gravidarum
Definition
  • Severe and persistent vomiting
  • Causes weight loss, dehydration, and electrolyte abnormalities
Term
Second and third trimester warning signs
Definition
  • Those from 1st trimester
  • Fluid discharge from vagina (indicating membrane rupture), vaginal bleeding
  • Severe abdominal pain, back-ache, flank pain
  • Uterine contractions, cramping before 37 weeks
  • Visual disturbances, h/a
  • Sudden weight gain (>2 kg/week)
  • Absence/ change in fetal movement
Term
Hypertension in pregnant women
Definition
  • Systolic pressure >140 OR >30 over baseline
  • Diastolic pressure >90 OR >15 over baseline
  • Mean arterial pressure (MAP) >105 OR >20 over baseline
Term
Fundal height growth
Definition
  • About at the umbilicus at 20 weeks
  • Should equal number of weeks gestation (+ or - 2cm) from weeks 18-30
  • Rise about 1 cm/week from week 20
Term
IUGR (intrauterine growth restriction)
Definition
  • Fetal undergrowth
  • Can be caused by defcient nutrients, oligohydramnios, etc.
  • Often results in low birth weight (LBW) infants
Term
Oligohydramnios
Definition
Too little amniotic fluid
Term
Causes of excessive increase of fundal height
Definition
  • Multifetal gestation
  • Macrosomia (large fetal size)
  • Hydramnios (too much amniotic fluid)
  • Obesity
Term
Fetal Heart Rate (FHR)
Definition
  • Can be heard at 10-12 weeks with doppler
  • Can be heard at 16-20 weeks with stethoscope
  • 110-160 bpm
Term
Exercise
Definition
  • Maintain pre-pregnancy exercise for 35 min/day, 5 days/week
  • Do not exceed pulse 140 bpm
  • Excess water needed before, during, and after
  • Avoid holding breath and falls
  • Decrease exercise as pregnancy progresses
  • Avoid hot-tubs and saunas
Term
Libido
Definition
  • 1st trimester: decreases due to n/v and fatigue
  • 2nd and 3rd trimesters: increases due to pelvic congestion
  • Decreases near term due to discomfort
Term
Contraindications for Sex
Definition
  • Threatened abortion, Hx of multiple miscarriages, incompetent cervix
  • After rupture of membranes (ROM)
  • Cramping, bleeding
  • Multiple sexual partners (infection risk)
Term
Breastfeeding Contraindications
Definition
  • Mother on certain meds
  • Certain medical conditions (breast cancer, TB, hepatitis C, HIV)
Term
Breast Shells
Definition
  • For women with inverted nipples
  • Use in 3rd trimester for 1-2 hours/day
Term
Preventing sore nipples in breastfeeding
Definition
  • Expose nipples to sunlight and air
  • Oral stimulation
  • Rolling and gently pulling nipples
Term
S/S of Pre-term Labor
Definition
  • Contractions every 10 min or more for 1 hour
  • Pelvic pressure/ pain
  • Low, dull back or abdominal pain
  • Menstrual-like cramps
  • Change/ increase in vaginal discharge
  • Vaginal bleeding
  • Intestinal cramping, with or without diarrhea
  • Urinary frequency
Term
Weight Gain
Definition
  • Overall, should gain 25-35 lbs throughout pregnancy
  • 2-5 lbs during 1st trimester, then 1 lb per week until end 
  • Less/ more required for overweight/ underweight women
  • Not enough weight gain = LBW infants and preterm labor risks
Term
First Trimester Discomforts
Definition
  • Breast tenderness, tingling, pain
  • Urinary urgency and frequency
  • Fatigue
  • N/V (morning sickness)
  • Nasal stuffiness and epistaxis
  • Mood swings
  • Gingivitis and epulis (hyperemia, hypertrophy, bleeding, tenderness of gums)
Term
Second Trimester Discomforts
Definition
  • Hyperpigmentation
  • Pruritis (non-inflammatory)
  • Supine hypotension and bradycardia
  • Orthostatic hypotension and syncope
  • Pyrosis (heartburn)
  • Constipation, flatulence, bloating, belching
  • Headaches
  • Carpal tunnel syndrome
  • Varicose veins
  • Round ligament pain
  • Joint pain, backache, pelvic pressure
Term
Nursing Intervention: Supine Hypotension
Definition

Side-lying position with kenes slightly flexed

Avoid supine position

Term
Nursing Interventions: Orthostatic Hypotension
Definition
  • Vigorous leg movement
  • Avoid sudden changes in position
  • Avoid warm, crowded areas
  • Avoid hypoglycemia (eat 5-6 small meals per day)
  • Sit as necessary
Term
Nursing Interventions: Pyrosis
Definition
  • Limit or avoid gas producing/ fatty foods and large meals
  • Sip milk or hot herbal tea for temporary relief
  • PCP may prescribe antacid--administer as ordered
Term
Nursing Intervention: Varicosities
Definition

Recommend a pregnancy girdle (if varicosities are in perineal area)

Girdle applies pressure to pelvic area to relieve pain

Term
Nursing Intervention: Round Ligament Pain
Definition

Stretch as uterus grows and can be very uncomfortable

Effleurage (teach mom) can help

Effleurage--light stroking in circles

Term
Third Trimester Discomforts
Definition
  • Dyspnea
  • Insomnia (later weeks)
  • Urinary frequency/ urgency (as baby drops)
  • Increased anxiety
  • Perineal discomfort and pressure
  • Braxton Hicks contractions
  • Leg cramps
  • Ankle edema
Term
BMI Calculation
Definition
BMI = Weight/ Height2
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