Maternal Infant Anatomy
Maternal Infant Anatomy NSG 330
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This 9 page Class Notes was uploaded by Brieanna Phipps on Monday February 1, 2016. The Class Notes belongs to NSG 330 at University of North Carolina - Wilmington taught by Dr. Goff in Spring 2016. Since its upload, it has received 37 views. For similar materials see Maternal Infant in Nursing and Health Sciences at University of North Carolina - Wilmington.
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Date Created: 02/01/16
Signs and Symptoms of Pregnancy -presumptive (subjective) -probable (objective) -positive (due to the the fetus) Subjective signs -breast changes -soreness and some enlargement -amenorrhea (absence of periods) -may be due to stress and artificial hormones -nausea and vomiting -urinary frequency st -baby is pressing on the bladder on the 1 trimester, not as much on the nd rd 2 , and 3 they are on the bladder again. st -uterine anteflexion during 1 trimester: softening of the lower uterine segment causes urinary frequency -fatigue st -1 trimester, you are extremely fatigued -quickening: first fetal movement of the baby, feels like butterflies -average time frame is 14 to 16 week 2h ndor later pregnancy, 18 th week during the first **Pseudocyesis: usual signs & symptoms of pregnancy, but not pregnant. Phantom pregnancy **Couvad: if your wife is pregnant, you can start feeling the same S&S as your wife Objective signs -Positive Pregnancy Test: Human Chorionic Gonadotropin (HcG) -stimulation of this hormone begins as early as the day of conception -can be detected in urine and serum 7-10 days after conception -the Enzyme-Linked ImmunoSorbent Assay (ELISA) is the most popular test -can have both false positives and negatives -Uterine or Abdominal Enlargement -Palpation of fetus: leopold or ballottement (16-28 weeks) -Braxton Hicks Contractions (16 weeks) -these are irregular, while true contractions are regular -Hegar’s sign -increased blood supply and softening of the lower segment of the uterus at about 6-12 weeks -Goodell’s sign -softening of the cervical tip, about 5 weeks along -Chadwick’s sign -increased blood supply which creates a purplish-blue tint to the vaginal mucosa and cervix at about 6-8 weeks **Chadwick starts with “C” so it deals with color** Positive Signs -Ultrasound (5-6 weeks) and Xray (16 weeks) -Auscultation of fetal heart (8-17 weeks) -about 12 weeks on average -Fetal movements palpated upon examination or can be visible Uterus Changes -Enlarges st -due to the high levels of estrogen and progesterone in the 1 trimester, and also the growing fetus -Changes shape -pear shape to globular to ovoid -2 ounces to 2 pounds -Changes position -rises to umbilicus at 22-24 weeks and xyphoid process at term -Lightening (38-40 weeks) -when the baby drops into the pelvis -Braxton Hicks contractions -irregular and painless Vagina changes -Operculum: mucous plug -Leukorrhea: whitish vaginal discharge -from cervical stimulation of estrogen and progesterone, becomes the operculum -pH -becomes more acidic due to increased lactic acid -possibly due to increased estrogen -prone to vaginal infections, especially yeast -increased vascularity and sensitivity, leads to increased sexual interest and arousal Breast changes -tenderness due to elevated estrogen and progesterone -both nipples and areola darken -Montegomery’s tubercles -nodules around areola (hypertrophy of sebaceous glands) -Progressive breast enlargement -Striae gravidarum (stretch marks) -Colostrum rd -starts developing during the 3 month of pregnancy, can express it at 16 weeks -breast milk doesn’t start until the 2dday after delivery Cardiovascular changes -heart enlarges slightly due to increased blood volume and cardiac output -RBC volume increases by 18-30% -increased vascularity -plasma increases, especially 2 ndtrimester -systolic BP either stays the same or decreases closer to term -diastolic BP decreases then becomes more normal near term -increased pulse 14-20 weeks (15-20 bpm) -heart palpitations may occur Respiratory system changes -gradual increase in O2 consumption/lower threshold for CO2 -increased thoracic cage size -diaphragm displaced by up to 4cm -upper respiratory tract more vascular -BMR increase -compensatory respiratory alkalosis Skin changes -hyperpigmentation -chloasma -linea nigra -striae gravidarum -palmar erythema (reddening of palms) -hirsutism (male-patterned hair growth) -increased perspiration -epulis (tumor-like enlargement on the gums) Musculoskeletal changes -relaxin -diastasis recti abdominis (separation of the abdominal muscles) -increased progesterone > decreased tone of smooth muscle -change in center of gravity GI changes -morning sickness -pica (eating substances with no nutrition) -ptyalism (hypersalivation) -pyrosis (heartburn) Neurological changes -little known -lightheaded -tension headache -acroesthesia (exaggerated sensitivity) Renal changes -increased pH or urine because of increased glucose increased UTIs -renal pelves and ureters dilate, holding more urine, and slow urine flow rate -kidneys more efficienty in early pregnancy Other changes -increased maternal blood glucose -decreased ability to use insulin -fetus needs increased glucose for growth and development -change in position of appendix -distension of gallbladder -gallstones may develop -minor changes in adrenals and liver
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