Nursing 209

N209: Reproductive Health Study Guide

Endocrine changes: •

Most endocrine gland function is altered in pregnancy • Due to placental hormones and an increase in protein binding during pregnancy, most hormones circulate in protein-bound forms • Thyroid hyperplasia, increased vascularity, and moderate thyroid enlargement occur as a result of placental hormones • Increase in adrenal hormones due to corticotropin produced by placenta can lead to edema • Insulin resistance increases due to increase in progesterone and corticosteroid production • Increase in prolactin levels due to pituitary enlargement (lactation hormone) Dermatologic changes: • Chloasma or “Mask of pregnancy” • PUPPP: Pruritic Urticarial Papules and Plaques of Pregnancy • Increase in spider angiomas and dilated capillaries Feelings of ambivalence and frequent mood changes o Considered a stressor; can affect perinatal outcome o Depressive reactions to excitement o Changes in body appearance and sexuality o Anxiety related to anticipated role change and delivery • Paternal: o Changes in self-esteem related to fertility o Often cannot perceive the growing child until fetal movement or sonogram o Feelings of rejection when pregnancy symptoms decrease sexual interest o Difficulty coping with changing maternal body o Couvade syndrome: Physical symptoms experienced by the man that mimic pregnancy symptoms of the woman • Sibling adaptation: o Sense of loss or jealousy o Younger toddlers have a more difficult transition than older children o Need increase in time and attention to provide reassurance • Grandparents o Depends upon their age, beliefs about grandparent roles, and number of grandchildren 3.4 Psychosocial Changes in Pregnancy • Maternal: o

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