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Maternal Adaptation to Pregnancy - Nursing Lecture

Nursing Lectures・40 minutes read

Pregnancy involves significant anatomical, physiological, and psychological changes to nurture the fetus, with hormonal shifts, structural alterations, and increased blood supply supporting fetal growth and development. Maternal avocation includes understanding signs of pregnancy, hormonal fluctuations, breast changes, cardiovascular adjustments, and nutritional requirements crucial for maternal and fetal health.

Insights

  • Maternal avocation during pregnancy leads to extensive physical changes in the body, including hormonal fluctuations, increased blood supply, and structural adaptations like uterine growth and placenta development.
  • Pregnancy involves various signs, with presumptive signs based on reported symptoms, probable signs observed by healthcare providers, and positive signs definitively confirming pregnancy, highlighting the complexity and stages of diagnosing pregnancy.

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Recent questions

  • What are the signs of pregnancy?

    Signs include presumptive, probable, and positive categories.

  • How do hormonal changes affect pregnancy?

    Hormonal changes involve increased estrogen and progesterone levels.

  • What are the physiological changes during pregnancy?

    Changes include uterus growth, placenta development, and increased blood supply.

  • How does pregnancy affect the cardiovascular system?

    Pregnancy leads to a 20% increase in cardiac output.

  • What are the nutritional requirements during pregnancy?

    Nutritional requirements increase for fetal development and maternal changes.

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Summary

00:00

"Maternal Pregnancy: Anatomical, Physiological, and Psychological Changes"

  • Maternal avocation during pregnancy involves significant anatomical and physiological changes to nurture the fetus and prepare for labor.
  • Changes start immediately after conception, affecting every organ and system in the body.
  • Psychological changes occur as women transition to motherhood.
  • Chapter six links to chapter sixteen, focusing on pregnancy signs, physiological and psychological changes, and nutritional requirements.
  • Signs of pregnancy include presumptive, probable, and positive categories.
  • Presumptive signs are subjective and based on a woman's reported symptoms, not definitive for pregnancy.
  • Probable signs are observed by healthcare providers but do not confirm pregnancy conclusively.
  • Positive signs are definitive and only attributed to the fetus, confirming pregnancy.
  • Hormonal changes during pregnancy involve increased estrogen and progesterone levels to support fetal development.
  • Structural changes in the body include uterus growth, placenta development, and increased blood supply to accommodate the growing fetus.

20:54

Physiological Changes in Pregnancy: A Summary

  • Spontaneous abortion or miscarriage can occur due to the cessation of hormonal support necessary for pregnancy development, with the corpus luteum safeguarding and maintaining the pregnancy until the placenta takes over.
  • The cervix typically remains 2.5 centimeters long during pregnancy, softening later on and experiencing painless contractions signaling impending delivery.
  • The "Goodell sign" denotes significant softening of the vaginal portion of the cervix due to increased vascular supply, resulting from vessel hypertrophy and engorgement beneath the growing uterus.
  • Hormonal changes and increased blood supply cause the vagina to take on a bluish-purplish hue, known as the "Chadwick sign," with increased secretions from the vagina and cervix due to enhanced blood flow to mucous glands.
  • Breast changes during pregnancy include tenderness, increased size influenced by estrogen, and nodularity due to prolactin, with darkening areolas, prominent Montgomery tubercles, and stretch marks possibly appearing.
  • Colostrum, a nutrient-rich fluid preceding milk production, is produced by mammary glands during the first three days of breastfeeding, providing essential nutrients to the baby.
  • Hormonal changes during pregnancy involve significant alterations in the endocrine system, with pituitary gland enlargement and increased levels of hormones like prolactin and oxytocin crucial for lactation initiation and uterine contractions during labor.
  • Plasma volume increases by about 50% by week 34 of gestation, leading to potential decreases in hemoglobin concentration, hematocrit, and red blood cell count, with platelet count falling progressively but remaining within normal limits to prevent bleeding complications.
  • Pregnancy shifts the coagulation system towards clotting, increasing the risk of venous thrombosis, especially in the first trimester and postpartum period, with venous stasis in the lower limbs due to vasodilation and decreased flow.
  • Cardiovascular changes in pregnancy involve a 20% increase in cardiac output by week eight, primarily due to vasodilation and decreased systemic vascular resistance, leading to lower blood pressure and potential fainting episodes, with supine hypotensive syndrome alleviated by resting on the left side.

40:44

Pregnancy: Changes, Risks, and Recommendations

  • Ureters decrease in the gastrointestinal system, leading to urinary spaces and an increased risk of infections.
  • Glomerular filtration rate increases by 50% due to increased cardiac output and decreased renal vascular resistance.
  • Increase in glomerular filtration rate is evident by week 10 of pregnancy, leading to increased urination frequency in the first trimester.
  • Urination frequency decreases in the second trimester but returns in the third due to pressure from the expanding uterus on the bladder.
  • Presence of glucose in urine during pregnancy may indicate kidney inability to reabsorb glucose, triggering tests for gestational diabetes.
  • Presence of proteins in urine during pregnancy triggers further testing to rule out kidney pathology.
  • Pituitary gland enlarges by 135% during pregnancy due to increased production of FSH, LH, oxytocin, and prolactin.
  • Nutritional requirements increase during pregnancy for fetal development and maternal body changes.
  • Caloric intake increase during pregnancy is minimal in the first trimester but rises to 300 kilocalories per day in the second and third trimesters.
  • Weight gain recommendations vary based on pre-pregnancy BMI, with inadequate weight gain linked to low birth weight and excessive gain to high birth weight and cesarean section risk.

01:08:00

"Pregnancy Cravings, Pica, and Back Pain"

  • Cravings during pregnancy may develop and disappear post-pregnancy, sometimes linked to iron deficiency anemia.
  • Immediate alert to a registered nurse or physician is crucial upon suspecting or discovering pica in pregnant women for specialized counseling.
  • Questions to self-assess learning: causes of back pain in pregnant women, effects of lying on the back while pregnant, and descriptions and classifications of Chadwick sign, Goodell sign, and Lyeft psychological tasks for each trimester.
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