what do we discuss during preconception counseling?
-that the first trimester is crucial for fetal development-importance of a healthy diet-review meds-folic acid intake
do we provide anticipatory care during the prenatal period?
Yes! We anticipate what mom may need to know between visits including-meds-nutrition-self-care-contraception-modifying behaviors to reduce risks
what are the goals of prenatal care?
-regular assessment of health of the pregnancy-assessment and screening for risk factors and possible complications and intervening when necessary-include others in care and education-education and health promotion and disease prevention/complications
physiological changes of the uterus include?
the uterus enlarges d/t estrogen and growing fetushypertrophy of myometrial cells
Where is the uterus at 10-12 weeks?
slightly above the pubic symphysis
where is the uterus at 20 weeks?
at belly button
where is uterus at 36 weeks?
measurement of the size of the uterus
physiological changes of the cervix include?
-mucus plug which seal the endocervical canal-goodells sign-chadwicks sign-hegars sign
physiological changes of the vagina include?
-secretion increase in acidity- may increase risk of yeast infection-become softer, mucosa thickens and the vascularity increases
softening of cervical tip
Bluish-purple coloration of the vaginal mucosa and cervix
softening and compressibility of lower uterus
physiological changes of the breasts include?
-enlarge- more nodular and more glands-veins more prominent-darkening of the areola-nipples erect-striae develop-colostrum produced and may leak in 3rd trimester-tender and tingle sensation
physiological changes of the respiratory system?
-increased o2 demand-diaphragm elevates-changes from abdominal to thoracic breathing-nasal congestion and epistaxis (bleeding from nose) d/t estrogen
physiological changes of the cardiovascular system?
-increased blood volume-increased erythrocytes-increased blood flow to uterus and kidneys-increase in HR of 15-20bpm-edema in LE- from stasis of blood-supine hypotensive syndrome-physiologic anemia-clotting factors increase
intervention for supine hypotensive syndrome?
lay on left side
Relative to increased plasma levels leading to a decrease in hemoglobin concentration and hematocrit; normal adaptation during pregnancy
the hypercoagulable state of pregnancy makes women at risk for?
DVT but helps protect them from bleeding
physiological changes of the GI system?
-N/V in 1st trimester d/t hCG-decreased gastric emptying and peristalsis d/t progesterone leading to heartburn and constipation-possible gallstones-stomach displaces d/t uterus/fetus
physiological changes of the urinary system?
-increased renal blood flow-urinary frequency in 1st and 3rd trimester-urinary stasis can lead to UTI
physiological changes of the skin?
physiological changes of the musculoskeletal system?
center of gravity shifts which leads to posture changes and lordosis
physiological changes of the endocrine system?
-the pancreas secretes increased amounts of insulin and hormones increase insulin resistance-thyroid gland enlarges and BMR increases
hormones of pregnancy
Human placental lactogen (HPL)Human chorionic gonadatropin (HCG)ProgesteroneEstrogen
progesterone action during pregnancy?
acts as smooth muscle relaxant
estrogen action during pregnancy?