NR 327NR 327 Study Guide Exam 1 November 2018.( 5 star rated document)

1. Describe the Chadwick’s sign - vaginal cervix color change Goodell’s sign - cervical softening Hegar’s sign- changes in uterine direction (consistency) 2. Differentiating between presumptive, probable, and positi ...

1. Describe the Chadwick’s sign - vaginal cervix color change Goodell’s sign - cervical softening Hegar’s sign- changes in uterine direction (consistency) 2. Differentiating between presumptive, probable, and positive signs of pregnancy a. Presumptive-, N&V, amenorrhea (no period), urinary frequency, skin changes, fatigue, Chadwick sign b. Probable- Goodall sign, Hegar sign, palpable fetal outline, pregnancy tests, abdomen enlargement c. Positive- Fetal heart tones, fetal movement, visualization of embryo/fetus 3. Identify the physiologic changes of the pregnant women to the various systems. Cardiovascular- dependent peripheral edema= vascular issues in lower extremities, leg cramps (DVT), varicose veins, hemorrhoids, murmur can develop, increased volume load, supine hypotension, elevate feet, 10-13% goes to the uterus GI- appetite increases, minimum of 2200 cal/day, Mouth issues (bleeding/salivation), Pica, decreased gastric emptying, Indigestion & Gall stones, constipation Respiratory- increased 20-40% (breathing for 2), Progesterone: smooth muscle relaxes, Estrogen: increased mucosa= nasal stuffiness, epistaxis, deepening of the voice, diaphragm lifted 4cm & Ribs flare from hormone relaxin Skin- hyperpigmentation occurs (Melasma/Cholasma), increase hair & nails growth, Linea Nigra, Stria Gravidarum (stretch marks), Urinary- position, capacity doubles by the 1st and 3rd trimester, decreased tone, Musculoskeletal- Lordosis Uterus- grows: (location of the uterus/fundus in the abdomen) 1-12 weeks under the pelvic bone, 16 weeks – midway from pelvic to belly button, 20 weeks – belly button (umbilicus) 36-40 weeks xyphoid process (18-36 weeks the McDonald’s rule) 5. Identify the essential reasons for balanced nutrition and increase in caloric needs of the pregnant woman a. Increase by 340 cal/day e. Vitamins (Iron+Folic Acid) b. Minimum of 2200 cal/day f. Avoid caffeine c. Increase water intake (8-10cups) d. Avoid sodium, fish, unpasteurized products This study source was downloaded by 100000827141222 from CourseHero.com on 05-31-2021 20:50:45 GMT -05:00 https://www.coursehero.com/file/43641613/NR327StudyGuideExam1November2018docx/ This study resource was shared via CourseHero.com 6. Appropriate weight gain per trimester: what is it based on and how much weigh should you gain? BMI before pregnancy Below 18.6 underweight – 28-40 lbs. 18.6-24.9 normal/Healthy – 25-35 lbs. 25-29.9 overweight – 15-25 lbs. 30+ obese – 11-20 lbs. 7. Exercise in pregnancy: can you, can’t you, how much, what kind? 30 minutes a day as you can tolerate. 8. Identify the most common discomforts experienced by many women in all three of the trimesters of pregnancy and interventions for each. a. Varicosities: support hose b. Constipation: increase water intake, exercise, fiber c. Leg cramps: stretching, walking, apply hot/cold d. Candida Albicans (yeast infection): topical -azole antifungals e. N/V/heartburn: small more frequent meals, sit up after eating f. Backache: support devices g. Urinary frequency/UTIs: void every 2/hrs, before/after sex, wipe front→ back 9. Patient teaching as it relates to each trimester: changes like amenorrhea, cervical changes (goodall’s hegar’s, & chadwicks signs), know what quickening & lightening is; know when things occur across the trimesters First Trimester (1-12 weeks) – feta heart tone 10-12 weeks/ 12 weeks the placenta is fully formed and takes over for the ovaries making hormones Second Trimester (13-27 Weeks) – Quickening (movement) Glucose Screening testing @ 24-28 weeks 1 hour – non-fasting above 140mg/dl = hyperglycemia then will have to do the 3 hour test – fasting overnight blood draws at 1, 2, 3 hour marks to check blood sugar Third Trimester (28-40 weeks) – surfactant formed last month (L/S ratio 2:1 (lung maturity) @ 36 weeks, brown fat deposits, lightening @36-40 weeks (dropping of fetus into the pelvis giving the mom room to breathe) GBS at 36 weeks