NURSING > EXAM REVIEW > Families Exam 1 Blueprint. NURS 4407 (All)

Families Exam 1 Blueprint. NURS 4407

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Families Exam 1 Blueprint Normal Physiological Changes of Pregnancy o Presumptive/Positive Signs of Pregnancy (3 questions) o Presumptive Signs—changes that the woman experiences that make her think that she might be pregnant  Amenorrhea, fatigue, urinary frequency, N/V, changes in breasts (darkened areolae, enlarged Montgomery’s glands), quickening (starts between 16-20wks), uterine enlargement o Positive Signs—can be explained only by pregnancy  Fetal heart sounds—listen right above symphysis pubis  Can be detected between 8-12wks  Fetal movement  Visualization of fetus by ultrasound o (Probable Signs—changes that make provider suspect a woman is pregnant)  Abdominal enlargement, Braxton hicks contractions, positive pregnancy test, physical changes of uterus o Physiological/Psychological/Hormonal Changes (3 questions) o Reproductive  Uterus size increases; ovulation/menses cease o Cardiovascular  CO increases; blood volume increases; HR increases & peaks at 10-15bpm above pre-pregnancy rate; murmurs may be heard o Respiratory  O2 needs increase; RR increases; total lung capacity decreases o Musculoskeletal  Weight increases—change in posture needed o Gastrointestinal  N/V—due to hormones/increased pressure in abdominal cavity; constipation o Renal  Filtration rate increases—hormones/increase in blood volume; amount of urine produced remains the same; urinary frequency o Endocrine  Placenta produces lots of hCG, progesterone, estrogen, human placental lactogen, prostaglandins o Integumentary  Stretch marks (striae gravidarum); hyperpigmentation of face (chloasma); linea nigra (dark line of pigmentation from umbilicus to pubic area) o Vitals  BP: in supine position, BP drops due to pressure on vena cava—can lead to fetal hypoxia—if supine, use wedge under one hip  Pulse: increases 10-15bpm around 32wks o Nagele’s Rule (1 question) o To determine estimated due date (EDD):  Take first day of woman’s last menstrual cycle, subtract 3 months, add 7 days and 1 year  Ex. Last menstrual period Aug. 22  EDD: May 29th (Aug-3mos=May; 22+7=29) o GTPAL (1 question) o G: Gravidity—number of pregnancies including current one total o T: Term births (>38wks) o P: Preterm births (20wks-37wks) o A: Abortions/miscarriages (prior to viability; <20wks) o L: Living childre

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