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1. Differentiating between presumptive, probable, and positive signs of pregnancy a. Presumptive-, N&V,
amenorrhea (no period), urinary frequency, skin changes, fatigue, Chadwick sign b. Probable- Goodall
sign, Hegar sign, palpable fetal outline, pregnancy tests, abdomen enlargement c. Positive- Fetal heart
tones, fetal movement, visualization of embryo/fetus
2. Identify the physiologic changes of the pregnant women to the various systems.
Cardiovascular- dependent peripheral edema= vascular issues in lower extremities, leg cramps (DVT),
varicose veins, hemorrhoids, murmur can develop, increased volume load, supine hypotension, elevate
feet, 10-13% goes to the uterus
GI- appetite increases, minimum of 2200 cal/day, Mouth issues (bleeding/salivation), Pica, decreased
gastric emptying, Indigestion & Gall stones, constipation
Respiratory- increased 20-40% (breathing for 2), Progesterone: smooth muscle relaxes, Estrogen:
increased mucosa= nasal stuffiness, epistaxis, deepening of the voice, diaphragm lifted 4cm & Ribs
flare from hormone relaxin
Skin- hyperpigmentation occurs (Melasma/Cholasma), increase hair & nails growth, Linea Nigra, Stria
Gravidarum (stretch marks),
Urinary- position, capacity doubles by the 1st and 3rd trimester, decreased tone,
Musculoskeletal- Lordosis
Uterus- grows: (location of the uterus/fundus in the abdomen) 1-12 weeks under the pelvic bone, 16
weeks – midway from pelvic to belly button, 20 weeks – belly button (umbilicus) 36-40 weeks xyphoid
process (18-36 weeks the McDonald’s rule)
3. Appropriate weight gain per trimester: what is it based on and how much weigh should you gain? BMI
before pregnancy Below 18.6 underweight – 28-40 lbs. 18.6-24.9 normal/Healthy – 25-35 lbs. 25-29.9
overweight – 15-25 lbs. 30+ obese – 11-20 lbs.
4. Exercise in pregnancy: can you, can’t you, how much, what kind? 30 minutes a day as you can tolerate.
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