Learning Guide
Normal Pregnancy
Chapter 13: Physiologic Adaptations to Pregnancy
Changes in Body Systems:
1. What are the anatomic and physiological changes related to each of the following
reproductive organs during pregnancy and the related signs and symptoms. What are
related nursing interventions and patient teaching?
a. Uterus
b. Cervix
c. Vagina
d. Ovaries
e. Breasts
2. What are the anatomic and physiological changes in the cardiovascular system during
pregnancy and related signs and symptoms? What are specific interventions/teaching
for each?
a. Cardiac enlargement
b. Vasodilation
c. Increase blood volume and hemodilution
d. Increase cardiac output
e. Blood components and related lab tests
3. What are the anatomic and physiological changes in the respiratory system during
pregnancy and related signs and symptoms? What are specific interventions/teaching
for each?
a. How does the body compensate for the increase need for oxygen?
b. What is the impact of progesterone and estrogen on the respiratory system? What
causes nasal stuffiness?
c. What are the physical changes?
4. What anatomic and physiological changes occur in the gastrointestinal system during
pregnancy and related signs and symptoms? What are specific interventions/teaching
for each?
5. What anatomic and physiological changes in the urinary system during pregnancy and
related signs and symptoms? What are specific interventions/teaching for each?
6. What changes occur in the skin and hair during pregnancy and nursing interventions for
each:
a. Changes in skin pigmentation
b. Linea nigra
c. Chloasma
d. Striae gravidarum
e. Spider nevi
f. hair growth
7. What are the anatomic and physiological changes in the musculoskeletal and endocrine
systems during pregnancy and related signs and symptoms? What are specific
interventions/teaching for each?
8. What is the function and changes in the following hormones during pregnancy?
a. HCG
b. Human placental lactogen
c. Estrogen
d. Progesterone
e. Relaxin
Confirmation of Pregnancy
10. Compare the presumptive, probable and positive signs of pregnancy.
11. What tests are used to confirm a pregnancy? These tests measure ___________, a
hormone specific to gestation.
Assessment and Nursing Care
12. What are the essential components included in an antepartal assessment?
13. What does gravida and para mean? How is the woman's obstetrical status determined?
a. Does the current pregnancy count toward gravida?
b. How does the current pregnancy affect parity?
c. What number is assigned to multiple fetus deliveries?
14. What does GTPAL mean and how is this more accurate than just gravida and para
calculations?
15. What specific laboratory studies does the nurse collect at the initial OB visit? What are
normal and abnormal findings, and how do the findings for a pregnant (gravid) woman
differ from those of a non-pregnant (null-gravid) woman? (see Table 13-1)
a. HgBb. Hctc. Blood type & Rh factord. Rubella titere. Hepatitisf. HIV16. How is the "due date" or estimated date of confinement (EDC or EDD) calculated?
a. Nagele's ruleb. McDonald's rule17. How is pelvic adequacy determined?
Common Discomforts of Pregnancy:
18. What information should the nurse provide to assist the pregnant woman in adjusting to
the following discomforts of pregnancy?
a. Nausea and Vomiting
b. Heartburn
c. Backache
d. Urinary frequency
e. Varicosities
f. Hemorrhoids
g. Constipation
h. Leg cramps
19. What information should be included during patient teaching on the following topics:
a. Hygiene
b. Exercise
c. Sleep and rest
d. Employment
e. Travel
f. Activity and Rest
g. Immunizations
h. Medications
20. Upon confirmation of the pregnancy, what teaching should the nurse include regarding
"danger signals" and when to notify the physician? What might each of them implicate?
a. Vaginal bleedingb. Fluid from the vaginac. Abdominal paind. Elevated temperaturee. Dizziness, double visionf. Persistent vomitingg. Edemah. Headachei. Dysuriaj. Absence of fetal movement (quickening-when should this first appear?)Chapter 14
Psychological Response
21. What is the psychological response or reaction of the family to pregnancy in each of the
three trimesters?
22. What are the maternal tasks of pregnancy?
22. What cultural factors influence the pregnant woman's perception of her pregnancy?
Maternal Nutrition: Chapter 15:
23. What is the suggested weight gain for a pregnant woman? What is the distribution of
weight gain? What is the greatest weight gain?
24. What additional nutritional supplements are required in pregnancy?
25. What special instructions regarding calorie intake should the nurse include in teaching
the pregnant woman? Why should empty calories be avoided?