Term
| Normal RBC count for non-pregnant women is |
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Definition
|
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Term
| Normal RBC count for pregnant women is |
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Definition
|
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Term
| How does RBC production change in each trimester? |
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Definition
| increased levels of erythropoietin in all trimesters causes an increase in RBC production. Magnitude of change is affected by Fe+ stores. |
|
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Term
| Increased levels of erythropoietin is stimulated by |
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Definition
| progesterone, prolactin, and human placental lactogen |
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Term
| What is the basis for change in hemoglobin and hematicrit levels in pregnancy? |
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Definition
| bc plasma volume is 3x greater than RBC volume, the net resuls is a decrease in total RBC count, and H and H. |
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Term
| What are the mechanisms that will facilitate intestinal absorption of iron in pregnancy? |
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Definition
| iron storage affects iron absorption. The better iron storage a woman has, the better absorption of dietary iron by her intestines |
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Term
| Is folate metabolism increased during pregnancy? |
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Definition
| Yes, bc folate demands increase three-fold during pregnancy due to it's need for DNA synthesis, cell duplication, growth of the fetus and plancenta, as well as maternal RBC production |
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Term
| What is the average increase in total blood volume during pregnancy? |
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Definition
|
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Term
| What is the avg increase in plasma volume in pregnancy? |
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Definition
| 45-50% (5200ml) by 32 wks |
|
|
Term
| What is the avg increase in RBC mass in pregnancy? |
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Definition
|
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Term
| During pregnancy, the mean cell diameter and thickness of _______ change due to ____ and _______. This leads to a cell which is more______ in shape. |
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Definition
| RBCs, Epo, and rapid RBC production, and spherical |
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Term
| How much blood is loss at a singleton vaginal delivery? |
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Definition
|
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Term
| How much blood is loss during a c-section? |
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Definition
|
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Term
| hemoglobin levels_________ during labor due to___________ |
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Definition
| increase and hemoconcentration |
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Term
| The increase in Hgb during labor is caused by |
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Definition
| erythropoiesis by the kidneys as a stress response; as well as muscular activity and dehydration |
|
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Term
| __________ increase by 30,000/mm3 due to __________ as stress response |
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Definition
| WBCs and nuetraphil increase |
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Term
| During placental seperation_____ is released from the placenta decidua which ________. |
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Definition
| tissue factor, activates coagulation |
|
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Term
| during pregnancy, women need an additional _____ mg of iron. |
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Definition
| 500-700; this is 2-8mg/day more than normal |
|
|
Term
| iron requirments during pregnancy increase by about ______gram over usual body stores of ________grams in adult women |
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Definition
|
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Term
| The amount of iron needed by the fetus and placenta is an ________ requirement regardless of the cost to ________ |
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Definition
| obligatory and maternal iron stores |
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Term
| hematologic changes during pregnancy are thought to result in an ongoing low grade activation of __________ |
|
Definition
| the coagulation system in the uteroplacental circulation. |
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Term
| Uteroplacental circulation is characterized by __________ and _________ |
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Definition
| thrombin formation and local consumption of clotting factors. |
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Term
| When discussing pregnancy as a hypercoagulable state, fibrin deposits are found in the____,____, and ______ |
|
Definition
| uteroplacental circulation, intervillous spaces, and placental bed. |
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Term
| Tissue factor is found in______,_____, and _____ |
|
Definition
| amniotic fluid, placenta decidua, and endometrial stroma. |
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Term
| Factors 7,8,9,10,12, and von Willebrand's are ________ during pregnancy |
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Definition
|
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Term
| Proteins S is _______ during pregnancy |
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Definition
|
|
Term
| Adaptive changes in the cardiovascular system begin around |
|
Definition
|
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Term
| An increase in plasma, total blood volume, RBCs, stroke volume, HR, and cardiac output, skin perfusioin, uterine blood flow, ox consumption, and heart sounds are some of the |
|
Definition
| most important changes in maternal circulation |
|
|
Term
| What are important hymodynamic decreases noted in pregnacy? |
|
Definition
| systemic vascular resistance, pulmonary vascular risistance, colloid osmotic pressure, and BP |
|
|
Term
| The heart enlarges during pregnancy. The greastest change is seen in the ____ |
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Definition
|
|
Term
| During pregnancy, the cardiac ventricular wall muscle mass____ |
|
Definition
|
|
Term
| As the uterus grows the heart shifts to a more___________position. |
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Definition
|
|
Term
| During pregnancy the left ventricle's pont of maximum impact may be shifted towards the |
|
Definition
|
|
Term
| What is the cause of the systolic murmur head at the base of the in pregnancy in as early as 12-20wks gestation? |
|
Definition
| increased CV load; caused by ejection of blood from the RV in to the pulmonary trunk or from LV into the aorta |
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Term
| Cardiac output increases by _____ by the 8th wk gestation. |
|
Definition
|
|
Term
| Cardiac outpt continues to increase throughout pregnancy by __________ by the third trimester |
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Definition
|
|
Term
| A slight decline in cardiac outpt may be seen in late pregnancy due to |
|
Definition
| a decrease in stroke volume |
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|
Term
| Supine hypotension is associated with acute |
|
Definition
| hemodynamic change; from recombent to sitting to standing |
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|
Term
| Supine hypotension occurs when blood _____ in dependent vessels,__________ venous return, and ______ cardiac outpt and BP. |
|
Definition
| pools, reducing, and decreasing |
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|
Term
| What are the uterine blood requirements at term? |
|
Definition
| 10-20% of maternal cardiac output |
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|
Term
| Increases in blood volume and cardiac output during pregnancy are_________ associated with with either ________ or _________ pressure |
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Definition
|
|
Term
| Blood pressure reaches a nadir (lowest point) by |
|
Definition
| mid-pregnancy (24-32wks); but returns to normal by the end of pregnancy |
|
|
Term
| Blood flow to the uterus increases to ___ by the term of a pregnancy |
|
Definition
|
|
Term
| Blood flow to the kidneys________ during pregnancy and_______ towards term |
|
Definition
|
|
Term
| Skin perfusion_________during pregnancy |
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Definition
|
|
Term
| ________ causes the dissipation of excessive heat created by fetal metabolism. |
|
Definition
|
|
Term
| Increased peripheral flow to the mucous membranes of the nasal passages causes |
|
Definition
|
|
Term
| Uterine blood flow during exercise is redistributed to the skeletal muscles and to the skin, this leads to a |
|
Definition
| decrease in blood flow to the uterus during exercise |
|
|
Term
| What are the benefits to exercise during pregnancy? |
|
Definition
| shorter labors and less perinatal complications |
|
|
Term
| Contractions during labor causes an additional _______ of blood volume to the circulation |
|
Definition
|
|
Term
| What are common problems associated with increased mucous and membrane swelling in the nasopharnyx and ears? |
|
Definition
| stuffy nose, airway swelling, difficulty with intubation, hoarness, nose bleeds, and rhinitis |
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|
Term
| During pregnancy, the anterior-posterior and transverse diameter of the chest wall |
|
Definition
|
|
Term
| The changes to the size of the chest wall during pregnancy is about |
|
Definition
| 4cm elevation of the diaphragm |
|
|
Term
| total lung compacity is reduced by |
|
Definition
|
|
Term
| Minute ventilation increases by______ during pregnancy |
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Definition
|
|
Term
| The capacity of _____ will increase to aid in the gas return from fetus to maternal________ |
|
Definition
| CO2 and pulmonary circulation |
|
|
Term
| ________ stimulates the respiratory areas in the brainstem thereby increasing maternal pulmonary ventilation by____ |
|
Definition
|
|
Term
| Progesterone increases rbc levels of ______________ |
|
Definition
|
|
Term
| Carbonic anhydrase B facilitates _______ transfer and lowers _________ |
|
Definition
|
|
Term
| Progesterone increases rbc levels of |
|
Definition
|
|
Term
| Respiratory alkalosis in pregnancy facilitates the transfer of ________ from the _________ to the __________. |
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Definition
|
|
Term
| Which prostaglandin acts as a bronchoconstrictors? |
|
Definition
|
|
Term
| During pregnancy, dilation of the _____, _____, and ________ begin around 7 wks gest. |
|
Definition
| renal calyces, pelvis, and ureters |
|
|
Term
| Renal volume increases by |
|
Definition
|
|
Term
| During pregnancy GFR is increased by |
|
Definition
|
|
Term
| GFR increase at 6wks gest precedes ______ and _____. |
|
Definition
| plasma volume expansion and increased cardiac output |
|
|
Term
| Renal volume increases by _____ during pregnancy |
|
Definition
|
|
Term
| ___________ and _________ of the ureters are mediated by prostaglandines |
|
Definition
| hypomotility and reduced peristalitic movements |
|
|
Term
| _________elongate and become tortouse because of its displacement by the uterus. |
|
Definition
|
|
Term
|
Definition
|
|
Term
| name the four elements involved in the changes of the urinary tract during pregnancy |
|
Definition
| uterine pressure, progesterone, relaxin, and cardiovascular changes |
|
|
Term
| The ____ is a triangular regional muscle of the _________ |
|
Definition
|
|
Term
| The trigone becomes elevated between the _________ and ________ during pregnancy because of the influence of estrogen |
|
Definition
| ureters and urethral openings |
|
|
Term
| Elevation of the trigone causes a slowed flow of |
|
Definition
| blood and lymph to the lower area |
|
|
Term
| Trigone elevation may cause the pt to experience |
|
Definition
| inflamed lymph nodes in the groin area |
|
|
Term
| Right ureter enlargement is a ______ during pregnancy |
|
Definition
|
|
Term
| Renal blood flow increases by______ in the second trimeseter |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Tubular reabsorption increases to prevent depletion of ____,_____,____,____, and _____. |
|
Definition
| Na, Cl, glucose, K+, and H2O |
|
|
Term
| What maternal position lowers GFR and BP? |
|
Definition
|
|
Term
| ________ decreases in the first five days after delivery. |
|
Definition
|
|
Term
| GFR remains ________during the first pp day and then__________ over the next two weeks. |
|
Definition
elevated and decreases
-but remains at 20% elevation |
|
|
Term
| how long does it take for RPF, GFR, BUN, Creatinine clearance, and creatinine plasma to return to pre-pregnant status? |
|
Definition
|
|
Term
| During the first 2-5 days pp, women will |
|
Definition
| diurese and get rid of excess sodium |
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