NR 602 Midterm Study Guide:

Signs of pregnancy (presumptive, probable, positive)

o Presumptive — Clinical findings include amenorrhea (menstruation is absent), nausea, vomiting, increased urinary frequency, excessive fatigue, breast tenderness, quickening at 18-20 weeks (All subjective signs)

o Probable — Clinical findings include uterine enlargement, Braxton hicks contractions (may be

palpated by 28 weeks), uterine souffle (soft blowing sound due to blood pulsating through placenta), integumentary pigment changes, ballottement, fetal outline definable, positive pregnancy test, Goodell sign (softening of cervix), Chadwick sign (cervix is blue/purple), Hegar's sign (softening of lower uterine segment). {All Objective signs}

o Positive — Fetal heart rate auscultated by fetoscope at 17 —20 weeks or by Doppler at 10 — 12 weeks, palpable fetal outline, and fetal movement after 20 weeks, visualization of fetus with cardiac activity by ultrasound (fetal parts visible by 8 weeks). (All Diagnostic)

Pregnancy and fundal height measurement

o As pregnancy progresses, the fundus rises out of the pelvis. At 12 weeks' gestation, the fundus is located at the level of the symphysis pubis. By week 16, it rises to midway between symphysis pubis and the umbilicus. By 20 weeks' gestation, the fundus is typically at the same height as the umbilicus. Until term, the fundus enlarges approximately 1 cm per week. As the time for birth approaches, the fundal height drops slightly. This process, which is commonly called lightening, occurs for a woman who is a primigravida around 38 weeks' gestation but may not occur for the woman who is a multigravida unfil she goes into labor.