Physiologic Changes
Question 1 of 8
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Which reasoning is appropriate when documenting reported fetal movement as a presumptive sign of pregnancy?
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- The symptoms have no alternative causes.Positive signs of pregnancy do not include quickening. However, palpation of fetal movement by the examiner would be a positive sign.
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- The symptoms could have alternative causes such as uterine tumors, polyps, or ascites.Ballottement is a probable sign of pregnancy that occurs when the health care provider taps on the cervix during a vaginal examination, which may cause the fetus to rise in the amniotic fluid and then rebound to its original position.
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- The symptoms are associated with a “woman’s intuition.”Intuition is not a sign of pregnancy.
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- The symptoms could have alternative causes such as peristalsis, flatus, or abdominal muscle contractions.Quickening is a presumptive sign of pregnancy that typically starts around 16 to 20 weeks’ gestation.
Question 2 of 8
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Match the category of pregnancy signs and symptoms to the example.
- Positive
- Probable
- Presumptive
Question 3 of 8
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Which clinical finding is considered a positive sign of pregnancy?
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- Visualization of the fetus by ultrasoundThe visualization of a fetus via an ultrasound transducer is considered a positive sign of pregnancy because there is no alternative explanation to the finding.
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- Positive serum pregnancy testA positive serum pregnancy test is considered a probable sign of pregnancy because a positive serum pregnancy test can have an alternative explanation such as a molar pregnancy or choriocarcinoma.
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- Breast enlargementBreast enlargement is considered a presumptive sign of pregnancy because breast enlargement can have an alternative explanation such as premenstrual changes, chronic cystic mastitis, or hyperestrogenism.
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- Braxton Hicks contractionsBraxton Hicks contractions are considered a probable sign of pregnancy because Braxton Hicks contractions can have an alternative explanation such as uterine tumors that cause the uterus to enlarge and the muscles to tighten.
Question 4 of 8
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Which physiologic change in a pregnant woman is likely responsible for frequent vaginal yeast infections?
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- Increased estrogen levelsIncreased estrogen hormone levels during pregnancy are not associated with the incidence of yeast infections. Estrogen is associated with skin changes and vasocongestion.
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- Increased prolactin levelsIncreased prolactin hormone levels during pregnancy are not associated with the incidence of yeast infections. Prolactin is associated with milk production for lactation.
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- Decreased progesterone levelsProgesterone levels are increased during pregnancy.
- Correct
- Increased glycogen secretion within the vaginal wallsIncreased glycogen secretion from the vaginal walls favors the growth of yeast infections during pregnancy.
Question 5 of 8
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Which physiologic change in a pregnant woman is associated with nasal congestion?
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- Increased estrogen levelsIncreased estrogen levels are associated with increased vascularity to the mucous membranes of the upper respiratory tract during pregnancy. This increases incidence of congestion.
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- Increased oxytocin levelsIncreased oxytocin levels during pregnancy are not associated with nasal stuffiness and congestion during pregnancy. Oxytocin helps with the labor process and is also associated with milk let-down for lactation. Increased oxytocin levels also occur with stress.
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- Increased prolactin levelsIncreased prolactin levels during pregnancy are not associated with nasal stuffiness and congestion during pregnancy. Prolactin is associated with milk production for lactation.
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- Increased progesterone levelsIncreased progesterone levels are not associated with nasal stuffiness and congestion during pregnancy. Progesterone helps maintain the pregnancy and it is also associated with milk production.
Question 6 of 8
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Which nursing education is appropriate to provide to a pregnant patient reporting hyperemia?
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- Encourage the woman to brush her teeth carefully.Softening and bleeding of the gums can occur due to increased estrogen levels and may be exacerbated by aggressive tooth brushing.
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- Advise the woman to have her blood pressure checked regularly.Hyperemia is the softening and bleeding of the gums and is related to gastrointestinal changes; it does not affect blood pressure.
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- Encourage the woman to wear supportive hosiery.Hyperemia is the softening and bleeding of the gums and is related to gastrointestinal changes; it does not affect the venous system.
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- Advise the woman not to lie flat on her back.Hyperemia is the softening and bleeding of the gums and is related to gastrointestinal changes; it is not related to supine hypotension or vena cava syndrome.
Question 7 of 8
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Which physiologic finding influences balance changes in a pregnant woman?
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- KyphosisKyphosis is an excessive outward curvature of the spine causing hunching of the back. Kyphosis is not a physiologic change in pregnancy but is more often associated with osteoporosis.
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- LordosisLordosis is the excessive inward curvature of the spine that occurs as the growing fetus pulls the center of gravity forward. Typically, the spine will adjust to realign the pregnant woman’s center of gravity; however, balance changes (including falling) may occur because of this physiologic change in pregnancy.
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- Diastasis rectiDiastasis recti is the partial or complete separation of the rectus abdominis muscle, which meets at the midline of the stomach. Diastasis recti is very common during and after pregnancy due to the uterus stretching the muscles in the abdomen to accommodate the growing fetus.
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- Back painBack pain is a symptom in pregnancy that occurs due to lordosis of the spine. Back pain is not a physiologic change in pregnancy.
Question 8 of 8
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Which nursing education is appropriate for a pregnant patient when discussing breast changes?
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- Increased relaxin levels may lead to darkening of the areola.Skin pigmentation of the areola darkens as the pregnancy advances and is due to increased estrogen production.
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- Secretion of colostrum is normal in the first trimester.Nipples become more erect and sensitive and colostrum may be seen in the third trimester of pregnancy.
- Correct
- “Bumps” on the nipples are normal.Montgomery glands (small bumps on nipples) become more prominent and may produce a small amount of breast milk or a natural, oily substance that cleans and lubricates the nipple and areola.
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- Breasts lose sensitivity during pregnancy.Changes in both the breast size (increase in size) and sensitivity (increase in sensitivity) begin in the first trimester due to the increase in estrogen and progesterone production in pregnancy.