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NR602 / NR 602 Primary Care of the Childbearing and Childrearing Family Practicum Midterm Exam Study Guide | Highly Rated | LATEST| Chamberlain College

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NR 602 Midterm Study Guide If time allows, please add which book and page number :) ● [Morgan] Signs of Pregnancy Women’s Health p774 ○ TABLE 29-1 Presumptive, Probable, and Positive Signs of... Pregnancy Sign Clinical Findings Presumptive (subjective signs) Amenorrhea, nausea, vomiting, increased urinary frequency, excessive fatigue, breast tenderness, quickening at 18–20 weeks Probable (objective signs) Goodell sign (softening of cervix) Chadwick sign (cervix is blue/purple) Hegar’s sign (softening of lower uterine segment) Uterine enlargement Braxton Hicks contractions (may be palpated by 28 weeks) Uterine soufflé (soft blowing sound due to blood pulsating through the placenta) Integumentary pigment changes Ballottement, fetal outline definable, positive pregnancy test (could be hydatidiform mole, choriocarcinoma, increased pituitary gonadotropins at menopause) Positive (diagnostic) Fetal heart rate auscultated by fetoscope at 17–20 weeks or by Doppler at 10–12 weeks Palpable fetal outline and fetal movement after 20 weeks Visualization of fetus with cardiac activity by ultrasound (fetal parts visible by 8 weeks) ● [Morgan] Pregnancy and fundal height measurement Women’s Health p774 ○ At 12 weeks’ gestation, the fundus is located at the level of the symphysis pubis. ○ By week 16, it rises to midway between symphysis pubis and the umbilicus. ○ By 20 weeks’ gestation, the fundus is typically at the same height as the umbilicus. ○ Until term, the fundus enlarges approximately 1 cm per week. As the time for birth approaches, the fundal height drops slightly. This process, which is commonly called lightening, occurs for a woman who is a primigravida around 38 weeks’ gestation but may not occur for the woman who is a multigravida until she goes into labor. ● [Morgan] Naegele’s rule Women’s Health p783 ○ The EDB for women with 28-day cycles can be determined by using Nägele’s rule: Add 7 days to the first day of the LMP, then subtract 3 months ( Box 30-1 ). ○ ● [Morgan] Hematological changes during pregnancy Women’s Health p777 ○ During pregnancy, blood volume increases by 30% to 50%, or 1,100 to 1,600 mL and peaks at 30 to 34 weeks’ gestation. The increase in blood volume improves blood flow to the vital organs and protects against excessive blood loss during birth. Fetal growth during pregnancy and newborn weight are correlated with the degree of blood volume expansion. ○ Of the blood volume expansion occurring during pregnancy, 75% is considered to be plasma. There is also a slight increase in red blood cell volume (RBC). ○ The blood volume changes result in hemodilution, which leads to a state of physiologic anemia during pregnancy. As the RBC volume increases, iron demands also increase. ○ Leukocytosis occurs in pregnancy, with white blood cell counts increasing to as much as 14,000 to 17,000 cells per mm3 of blood. Clotting factors increase as well, creating a risk for clotting events during pregnancy. ○ Systemic vascular resistance is reduced due to the effects of progesterone, prostaglandins, estrogen, and prolactin. This lowered systemic vascular resistance, in combination with inferior vena cava compression, is partly responsible for the dependent edema that occurs in pregnancy. ○ Epulis of pregnancy, or hypertrophy of the gums accompanied by bleeding [Show More]

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