Concepts for Nursing Practice, 4thEdition 2025
Chapter 1-57 Brand New
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Cardiac output changes
increase 30-50%
Blood volume changes
increase 30-45%
Respiratory changes
1. Decreased lung capacity
2. Increased oxygen consumption
Renal changes in pregnancy
1. increased GFR
2. Uterus places pressure on the bladder
Reproductive changes in pregnancy
1. Thick vaginal mucosa
2. Chadwick's sign
3. Hegar's sign
4. Goodell's sign
5. Increased uterine size
6. Breast tenderness, increased pigmentation
Chadwick's sign
bluish color of cervix and mucosa
Goodell's sign
softening of cervical tip
Hegar's sign
softening and compressibility of lower uterus
Musculoskeletal changes of pregnancy
1. Imbalanced gait
2. Diastasis recti
GI change sin pregnancy
,1. Heartburn
2. Constipation
3. Gingivitis
4. PICA
5. Ptyalism
Integumentary changes in pregnancy
1. Linea nigra
2. Striae gravidarum
3. Chloasma (mask of pregnancy)
Endocrine changes in pregnancy
1. hCG
2. Progesterone
3. Estrogen
4. Human placental lactogen
5. Prostaglandins
Psychological changes of pregnancy
1. Support for family and provider
2. Education on physical changes
Common discomforts of the 1st trimester
1. Breast tenderness
2. Nausea
3. Edema
4. Ptyalism
5. Gingivitis
6. Epistaxis
Signs to report in the 1st trimester
1. Burning on urination (UTI)
2. Severe vomiting (hyperemesis gravidarum)
3. Diarrhea (infection)
4. Fever or chills
5. Abdominal cramping/vaginal bleeding
Signs to report 2nd/3rd trimester
1. PROM before 37 weeks
2. Vaginal bleeding
3. Abdominal pain (premature labor)
4. Changes in fetal activity
5. Hyperemesis gravidarum
6. Severe headaches
,7. Elevated temp
8. Dysuria
9. Blurred vision
10. Edema of face and hands
11. Epigastric pain
12. Sx of hyperglycemia/hypoglycemia
Common discomforts of the 2nd trimester
1. PICA
2. Constipation
3. Heartburn
4. Leukorrhea
5. Headache
6. Carpal tunnel
common discomforts of the 3rd trimester
1. Urination frequency
2. Braxton hicks contractions
3. Round ligament pain
4. Leg cramps
5. Syncope
6. Dyspnea
Weight gain for normal BMI (18.5-24.9)
25-35 lbs
Weight gain for underweight BMI (<18.5)
28-40 lbs
Weight gain for overweight (>25)
15-25 lbs
General rule for weight gain
1. 1-2 kg (2.2-4.4 lbs)for the 1st trimester
2. 0.5 kg (1 lb) for the 2nd/3rd trimesters
Screening tests
1. 1 hour GTT
2. 20 wk ultrasound
3. MSAFP test
Diagnostic test
, 1. 3 hr GTT
2. Cardiac ultrasound
3. Amniocentesis
4. Non stress test
5. BPP
6. Contraction stress test
MSAFP test
screening for neural tube defects
amniocenetsis
-Dx of chromosomal abnormalities
-Dx of neural tube
-Lung maturity
GTT
dx for gestational diabetes
Nonstress test
-mother pushes a button every time FM is felt
-assess CNS development
-rules out fetal death
Contraction stress test
-analyzes FHR response to contractions
RN care to maintain FHR
1. Increase maternal IV fluids
2. Reposition
3. Increase oxygen
5 P's of labor
1. power
2. Passenger
3. Passage
4. Position
5. Psychologic state
1st stage of labor
1. Latent phase (0-3cm)
2. Active (4-7cm)
3. Tranisition (8-10 cm)
transition phase
Chapter 1-57 Brand New
_____________________________________________________________________________________
Cardiac output changes
increase 30-50%
Blood volume changes
increase 30-45%
Respiratory changes
1. Decreased lung capacity
2. Increased oxygen consumption
Renal changes in pregnancy
1. increased GFR
2. Uterus places pressure on the bladder
Reproductive changes in pregnancy
1. Thick vaginal mucosa
2. Chadwick's sign
3. Hegar's sign
4. Goodell's sign
5. Increased uterine size
6. Breast tenderness, increased pigmentation
Chadwick's sign
bluish color of cervix and mucosa
Goodell's sign
softening of cervical tip
Hegar's sign
softening and compressibility of lower uterus
Musculoskeletal changes of pregnancy
1. Imbalanced gait
2. Diastasis recti
GI change sin pregnancy
,1. Heartburn
2. Constipation
3. Gingivitis
4. PICA
5. Ptyalism
Integumentary changes in pregnancy
1. Linea nigra
2. Striae gravidarum
3. Chloasma (mask of pregnancy)
Endocrine changes in pregnancy
1. hCG
2. Progesterone
3. Estrogen
4. Human placental lactogen
5. Prostaglandins
Psychological changes of pregnancy
1. Support for family and provider
2. Education on physical changes
Common discomforts of the 1st trimester
1. Breast tenderness
2. Nausea
3. Edema
4. Ptyalism
5. Gingivitis
6. Epistaxis
Signs to report in the 1st trimester
1. Burning on urination (UTI)
2. Severe vomiting (hyperemesis gravidarum)
3. Diarrhea (infection)
4. Fever or chills
5. Abdominal cramping/vaginal bleeding
Signs to report 2nd/3rd trimester
1. PROM before 37 weeks
2. Vaginal bleeding
3. Abdominal pain (premature labor)
4. Changes in fetal activity
5. Hyperemesis gravidarum
6. Severe headaches
,7. Elevated temp
8. Dysuria
9. Blurred vision
10. Edema of face and hands
11. Epigastric pain
12. Sx of hyperglycemia/hypoglycemia
Common discomforts of the 2nd trimester
1. PICA
2. Constipation
3. Heartburn
4. Leukorrhea
5. Headache
6. Carpal tunnel
common discomforts of the 3rd trimester
1. Urination frequency
2. Braxton hicks contractions
3. Round ligament pain
4. Leg cramps
5. Syncope
6. Dyspnea
Weight gain for normal BMI (18.5-24.9)
25-35 lbs
Weight gain for underweight BMI (<18.5)
28-40 lbs
Weight gain for overweight (>25)
15-25 lbs
General rule for weight gain
1. 1-2 kg (2.2-4.4 lbs)for the 1st trimester
2. 0.5 kg (1 lb) for the 2nd/3rd trimesters
Screening tests
1. 1 hour GTT
2. 20 wk ultrasound
3. MSAFP test
Diagnostic test
, 1. 3 hr GTT
2. Cardiac ultrasound
3. Amniocentesis
4. Non stress test
5. BPP
6. Contraction stress test
MSAFP test
screening for neural tube defects
amniocenetsis
-Dx of chromosomal abnormalities
-Dx of neural tube
-Lung maturity
GTT
dx for gestational diabetes
Nonstress test
-mother pushes a button every time FM is felt
-assess CNS development
-rules out fetal death
Contraction stress test
-analyzes FHR response to contractions
RN care to maintain FHR
1. Increase maternal IV fluids
2. Reposition
3. Increase oxygen
5 P's of labor
1. power
2. Passenger
3. Passage
4. Position
5. Psychologic state
1st stage of labor
1. Latent phase (0-3cm)
2. Active (4-7cm)
3. Tranisition (8-10 cm)
transition phase
