Physical and Psychological Changes of PregnancyChapter 9

Physical ChangesReproductive changesUterus, cervixOvarian, vaginalBreast tissue

CardiovascularPulse and BPVena Cava syndromeHemodilution and anemiaHypercoagulation

Physical ChangesRespiratory- increase volume, pressure on diaphragmGI-N/V, delay in GI emptying due to progesteroneConstipation and hemorrhoidsUrinary- frequency, GFR increase, glycosuria

Physical ChangesSkinColorStriaeHyperactive sebateous/ sweat glandsAlteration in hair growth

MusculoskeletalTeethPostureDiastasis recti

MetabolismWeight gainWater retentionNutrient demands increaseDelay in gastric emptying

Endocrine and HormonalPlacental hormoneshCGhPLEstrogenProgesteroneRelaxin

Signs of PregnancyPresumptive/Subjective- statementN/V, amenorrhea, fatigue, quickeningProbable/Objective-observableGoodells, Chadwicks, fundal heightDiagnostic/PositiveHeart beat, gestational sac

Psychological ResponsesMaternal responseFirst tri- ambivalence, disbelief, fearSecond tri- excited, tells others, fear abandonment, body imageThird tri- tired, fears delivery

Psychological ResponsesSpouseFirst tri- Only one to knowSecond tri- May be turned off by changesFetal movement= realityThird tri-Couvade, observance of rituals, development of s/s of pregnancy

Familial ResponsesGrandparentsSiblingsToddlersSchool ageAdolescents

Cultural ResponsesWellness vs. IllnessFood/WaterHot vs. ColdHerbsHealersIncorporate culture into care