Prep U Chapter 10: Nursing Care Related to Psychological and Physiologic Changes of Pregnancy

During a vaginal exam, the nurse notes that the lower uterine segment is softened. How should the nurse document this finding? Ortolani sign Hegar sign Chadwick sign Goodell sign

Hegar sign

During late pregnancy, the nurse teaches a pregnant woman to lay on her left side to avoid what condition? Preeclampsia Frequent urination Heartburn Supine hypotension syndrome

Supine hypotension syndrome

A client comes to the clinic and tells the nurse, "I think I might be pregnant." After completing the history and physical examination, the nurse obtains a blood specimen for pregnancy testing. When explaining this test to the client, which hormone will the nurse identify as being measured by this test? estrogen human chorionic gonadotropin follicle-stimulating hormone progesterone

human chorionic gonadotropin

Increased pigmentation on the face of some pregnant women is called: melanotropin nigra melasma (chloasma) striae gravidarum (stretch marks)

melasma (chloasma)

Increased pigmentation on the face of some pregnant women is called: melasma (chloasma) nigra striae gravidarum (stretch marks) melanotropin

melasma (chloasma)

Which change related to the vital signs is expected in pregnant women? Pulse decreases. Lung space increases. Blood pressure decreases. Temperature decreases.

relaxin

The nurse teaches a primigravida client that lightening occurs about 2 weeks before the onset of labor. The mother will most likely experience which of the following at that time? dyspnea dysuria urinary frequency constipation

urinary frequency

A client at 39 weeks' gestation calls the OB triage and questions the nurse concerning a bloody mucus discharge noted in the toilet after an OB office visit several hours earlier. What is the best response from the triage nurse? "A one time discharge of bloody mucus in the toilet might have been your mucus plug." "Bloody mucus is a sign you are in labor. Please come to the hospital." "It might be nothing. If it happens again call your provider who is on-call." "If the provider did an exam, it might be just normal vaginal secretions, so don't worry about it."

"A one time discharge of bloody mucus in the toilet might have been your mucus plug."

A client at 39 weeks' gestation calls the OB triage and questions the nurse concerning a bloody mucus discharge noted in the toilet after an OB office visit several hours earlier. What is the best response from the triage nurse? "It might be nothing. If it happens again call your provider who is on-call." "If the provider did an exam, it might be just normal vaginal secretions, so don't worry about it." "A one time discharge of bloody mucus in the toilet might have been your mucus plug." "Bloody mucus is a sign you are in labor. Please come to the hospital."

"A one time discharge of bloody mucus in the toilet might have been your mucus plug."

A woman who is planning to become pregnant comes to the clinic for a visit. During the visit, the woman tells the nurse that she is planning to use a home pregnancy test to check if she is pregnant. After teaching the woman about this type of test, the nurse determines that additional teaching is needed based on which client statement? "I should test my urine first thing in the morning." "I can test my urine a day or two before the date of my expected period." "I'll avoid drinking a lot of water before testing my urine." "I need to read the result at the exact time stated in the instructions."

"I can test my urine a day or two before the date of my expected period."

The nurse is teaching the pregnant woman about nutrition for herself and her baby. Which statement by the woman indicates that the teaching was effective? "Because I am pregnant, I can eat anything I want and not worry about weight gain." "I will need to take iron supplementation throughout my pregnancy even if I am not anemic." "I can eat any seafood that I like because it contains phosphorus, which is a nutrient that pregnant women need." "Milk production requires higher levels of calcium; therefore, if I am going to breastfeed, I must take a calcium supplement during pregnancy."

"I will need to take iron supplementation throughout my pregnancy even if I am not anemic."

The nurse is teaching the pregnant woman about nutrition for herself and her baby. Which statement by the woman indicates that the teaching was effective? "Because I am pregnant, I can eat anything I want and not worry about weight gain." "I will need to take iron supplementation throughout my pregnancy even if I am not anemic." "Milk production requires higher levels of calcium; therefore, if I am going to breastfeed, I must take a calcium supplement during pregnancy." "I can eat any seafood that I like because it contains phosphorus, which is a nutrient that pregnant women need."

"I will need to take iron supplementation throughout my pregnancy even if I am not anemic."

The nurse is teaching the pregnant woman about nutrition for herself and her baby. Which statement by the woman indicates that the teaching was effective? "I can eat any seafood that I like because it contains phosphorus, which is a nutrient that pregnant women need." "I will need to take iron supplementation throughout my pregnancy even if I am not anemic." "Milk production requires higher levels of calcium; therefore, if I am going to breastfeed, I must take a calcium supplement during pregnancy." "Because I am pregnant, I can eat anything I want and not worry about weight gain."

"I will need to take iron supplementation throughout my pregnancy even if I am not anemic."

The nurse is teaching a prenatal class about preparing for their expanding families. What is helpful advice from the nurse? "Caring for your new infant is instinctual and will come naturally to you." "Your old coping methods will adequately get you through this period of adjustment." "The hormones of pregnancy may cause anxiety or depression postpartum." "Expect your other children to react positively to their new brother/sister."

"The hormones of pregnancy may cause anxiety or depression postpartum."

The nurse is teaching a prenatal class about preparing for their expanding families. What is helpful advice from the nurse? "The hormones of pregnancy may cause anxiety or depression postpartum." "Expect your other children to react positively to their new brother/sister." "Your old coping methods will adequately get you through this period of adjustment." "Caring for your new infant is instinctual and will come naturally to you."

"The hormones of pregnancy may cause anxiety or depression postpartum."

On a prenatal visit, a woman in her second trimester has an ultrasound that confirms that the baby is a girl. Which statement by the mother would be troubling to the nurse concerning this finding? "We are not naming her yet because ultrasounds have been known to be wrong sometimes." "In our culture, she will not be named until she is 2 weeks old." "We want to wait on naming her until she is born and we can see her." "We don't want to name her because we don't want to get too attached."

"We don't want to name her because we don't want to get too attached."

A client in her second trimester of pregnancy arrives at the health care facility for a routine follow-up visit. The nurse is required to educate the client so that the client knows what to expect during her second trimester. Which information should the nurse offer? "You will be more conscious of the changes taking place in your body now." "You will experience quickening, and you will actually feel the baby." "You may feel physical discomfort as the baby inside grows." "You may have mood swings that could overwhelm your partner."

"You will experience quickening, and you will actually feel the baby."

The nurse is assessing a pregnant client at 20 weeks' gestation and obtains a hemoglobin level. Which result would be a cause for concern? 11.2 g/dl 11.9 g/dl 10.6 g/dl 12.8 g/dl

10.6 g/dl

A urinalysis is done on a client in her third trimester. Which result would be considered abnormal? Specific gravity of 1.010 Trace of glucose Straw-like color 2+ Protein in urine

2+ Protein in urine

The nurse obtains a human chorionic gonadotropin (hCG) level from a woman who thinks that she is pregnant. Which result would the nurse identify as a positive pregnancy result? 8 mIU/mL (8 IU/L) 24 mIU/mL (24 (IU/L) 32 mIU/mL (32 IU/L) 16 mIU/mL (16 IU/L)

32 mIU/mL (32 IU/L)

Before becoming pregnant, a woman's heart rate averaged 72 beats per minute. The woman is now 15 weeks' pregnant. The nurse would expect this woman's heart rate to be approximately: 85 beats per minute. 95 beats per minute. 90 beats per minute. 100 beats per minute.

85 beats per minute.

Before becoming pregnant, a woman's heart rate averaged 72 beats per minute. The woman is now 15 weeks' pregnant. The nurse would expect this woman's heart rate to be approximately: 90 beats per minute. 85 beats per minute. 100 beats per minute. 95 beats per minute.

85 beats per minute.

The nurse has messages from four pregnant woman. Which woman would the nurse call back and ask for more data first? A woman at 34 weeks' gestation who reports, "My feet swell up in the late afternoon." A woman at 38 weeks' gestation who states, "I have been leaking clear, vaginal fluid." A woman at 18 weeks' gestation who is asking for something for heartburn that occurs "every evening." A woman at 28 weeks' gestation who is asking for advice on leg cramps during the night.

A woman at 38 weeks' gestation who states, "I have been leaking clear, vaginal fluid."

A pregnant client in her third trimester, lying supine on the examination table, suddenly grows very short of breath and dizzy. Concerned, she asks the nurse what is happening. Which response should the nurse prioritize? Blood is trapped in the vena cava in a supine position. Sympathetic nerve responses cause dyspnea when a woman lies supine. Cerebral arteries are growing congested with blood. The uterus requires more blood in a supine position.

Blood is trapped in the vena cava in a supine position.

A pregnant client in her third trimester, lying supine on the examination table, suddenly grows very short of breath and dizzy. Concerned, she asks the nurse what is happening. Which response should the nurse prioritize? Cerebral arteries are growing congested with blood. Sympathetic nerve responses cause dyspnea when a woman lies supine. Blood is trapped in the vena cava in a supine position. The uterus requires more blood in a supine position.

Blood is trapped in the vena cava in a supine position.

A pregnant client in her third trimester, lying supine on the examination table, suddenly grows very short of breath and dizzy. Concerned, she asks the nurse what is happening. Which response should the nurse prioritize? Sympathetic nerve responses cause dyspnea when a woman lies supine. The uterus requires more blood in a supine position. Blood is trapped in the vena cava in a supine position. Cerebral arteries are growing congested with blood.

Blood is trapped in the vena cava in a supine position.

A client in her second trimester of pregnancy arrives at the health care facility for a routine follow-up visit. The nurse is required to educate the client so that the client knows what to expect during her second trimester. Which information should the nurse offer? "You may feel physical discomfort as the baby inside grows." "You will experience quickening, and you will actually feel the baby." "You may have mood swings that could overwhelm your partner." "You will be more conscious of the changes taking place in your body now."

Blood pressure decreases.

A woman in the third trimester of her first pregnancy expresses fear about the birth canal being wide enough for her to push the baby through it during labor. She is a petite person, and the baby seems so large. She asks the nurse how this will be possible. To help alleviate the client's fears, the nurse should mention the role of the hormone that softens the cervix and collagen in the joints, which allows dilation (dilatation) and enlargement of the birth canal. What is this hormone? estrogen human placental lactogen relaxin progesterone

Both findings are normal at this point of the pregnancy.

During an exam, the nurse notes that the blood pressure of a client at 22 weeks' gestation is lower, and her heart rate is 12 beats per minute higher than at her last visit. How should the nurse interpret these findings? Both findings are normal at this point of the pregnancy. The heart rate increase may indicate that the client is experiencing cardiac overload. The blood pressure should be higher since the cardiac volume is increased. Combined, both of these findings are very concerning and warrant further investigation.

Both findings are normal at this point of the pregnancy.

Which information provided by a client would be considered a presumptive sign of pregnancy? Weight gain Breast tenderness Ballottement Reports of increased hunger

Breast tenderness

The nurse is assessing a pregnant client at her 20-week visit. Which breast assessment should the nurse anticipate documenting? Darkened breast areolae Enlarged lymph nodes Slack, soft breast tissue Deeply fissured nipples

Darkened breast areolae

The nurse cares for a pregnant client at the first prenatal visit and reviews expected changes that will occur during pregnancy. Which information will the nurse include in the education? Hemoglobin levels rise significantly during pregnancy. Pregnancy typically causes a decrease in respiratory rate. Blood pressure decreases in the third trimester. During pregnancy blood volume can increase by at least 40%.

During pregnancy blood volume can increase by at least 40%.

The nurse is counseling a young woman who has just entered her second trimester, after an uneventful first trimester. She tells the nurse, "It still doesn't seem real. It's just hard to believe that I will really have a baby." Which future events should the nurse point out that will help the young woman come to believe it is real? Select all that apply. Feeling the baby kick Giving up alcohol Taking prenatal vitamins Receiving a positive result on a pregnancy test Seeing an ultrasound image of the baby

Feeling the baby kick Seeing an ultrasound image of the baby

A client at 16 weeks' gestation comes to the office for a routine exam. At what location within the abdomen would the nurse anticipate the uterus to be found? Halfway between the symphysis pubis and the umbilicus At the level of the umbilicus At the xiphoid process Below the symphysis pubis

Halfway between the symphysis pubis and the umbilicus

A client at 16 weeks' gestation comes to the office for a routine exam. At what location within the abdomen would the nurse anticipate the uterus to be found? Halfway between the symphysis pubis and the umbilicus Below the symphysis pubis At the xiphoid process At the level of the umbilicus

Halfway between the symphysis pubis and the umbilicus

A pregnant mother may experience constipation and the increased pressure in the veins below the uterus can lead to development of what problem? Hemorrhoids Gastrointestinal reflux Umbilical hernia Varicose veins

Hemorrhoids

A pregnant mother may experience constipation and the increased pressure in the veins below the uterus can lead to development of what problem? Varicose veins Gastrointestinal reflux Umbilical hernia Hemorrhoids

Hemorrhoids

What would the nurse recommend to a pregnant client at 35 weeks' gestation who reports irregular contractions and lower backache? Ask her if she is having urinary frequency that may indicate an infection. Lie down and rest and see if the contractions stop and pain subsides. Have a family member rub her back and place moist heat on it. Suggest that she try some isometric exercises to relieve the back pain.

Lie down and rest and see if the contractions stop and pain subsides.

The nurse is explaining the latest laboratory results to a pregnant client who is in her third trimester. After letting the client know she is anemic, which heme iron-rich foods should the nurse encourage her to add to her diet? Legumes Dairy Meats Grains

Meats

The nurse is assessing a pregnant client at 12 weeks' gestation and the client reports some new bumps on the dark part of her nipples. What is the best response from the nurse when questioned by the client as to what they are?

Montgomery glands (Montgomery tubercles); secrete lubricant for the nipples

The partner of a pregnant client in her first trimester asks the nurse about the client's behavior recently, stating that she is very moody, seems happy one moment and is crying the next and all she wants to talk about is herself. What response would correctly address these concerns? Her body is changing and she may be angry about it. What you are describing may be normal but we need to talk to her more in depth. Moodiness and irritability are not usual responses to pregnancy. Pregnant women often experience mood swings and self-centeredness but this is normal.

Pregnant women often experience mood swings and self-centeredness but this is normal.

The partner of a pregnant client in her first trimester asks the nurse about the client's behavior recently, stating that she is very moody, seems happy one moment and is crying the next and all she wants to talk about is herself. What response would correctly address these concerns? What you are describing may be normal but we need to talk to her more in depth. Pregnant women often experience mood swings and self-centeredness but this is normal. Moodiness and irritability are not usual responses to pregnancy. Her body is changing and she may be angry about it.

Pregnant women often experience mood swings and self-centeredness but this is normal.

During a prenatal visit at 28 weeks' gestation, the client tells the nurse, "I am always hot now, and usually I am the one wearing an extra sweater. And I normally run a low temperature, around 98.2°F (36.7°C). But when they take it at the clinic, it is between 98.6°F and 98.9°F (37°C and 37.2°C). Do you think I have an infection?" Which responses by the nurse are appropriate in this situation? Select all that apply. The increased metabolic rate during pregnancy makes some women feel warmer. Do you have any signs of an infections, such as painful urination? Let's do an ultrasound and see if the fetus is growing and developing as expected. Pregnant women typically are 0.4°F to 0.6°F (0.275°C) warmer than their baseline temperatures. I will order some blood work to see if you have an infection.

Pregnant women typically are 0.4°F to 0.6°F (0.275°C) warmer than their baseline temperatures. The increased metabolic rate during pregnancy makes some women feel warmer. Do you have any signs of an infections, such as painful urination?

What effect does progesterone have on normal gallbladder function? Progesterone interferes with gallbladder contraction, leading to stasis of bile. It has no effect on the gallbladder. Bile will be produced at a more rapid rate due to the progesterone. The gallbladder will hypertrophy.

Progesterone interferes with gallbladder contraction, leading to stasis of bile.

A client makes an appointment with an obstetrician and assessment reveals positive Hegar and Chadwick signs. What should the nurse teach the client about these results? The client more likely has a gynecologic disorder rather than pregnancy She is probably pregnant, but this must be confirmed by other means Pregnancy cannot be confirmed The client is definitively pregnant

She is probably pregnant, but this must be confirmed by other means

The community nurse is preparing a presentation for a health fair illustrating successful pregnancies. Which component should the nurse prioritize as the most critical to ensure a positive psychological experience with the pregnancy by the mother? Social support Early prenatal care Age at the time of pregnancy Having a planned pregnancy

Social support

During a physical exam, the physician notates that the pregnant client has a positive Chadwick sign. What client findings would be noted for this symptom? The cervix has a bluish, purple discoloration. The cervix is reddened and swollen. There is a rebound of the fetus felt when the physician pushes on the abdomen. There is hyperpigmentation of the abdomen.

The cervix has a bluish, purple discoloration.

A pregnant client at 24 weeks' gestation calls the clinic crying after a prenatal visit, where she had a pelvic exam. She states that she noticed blood on the tissue when she wiped after voiding. What initial statement by the nurse would explain this finding? She may have a bleeding disorder so she needs to come back to the clinic for blood work. It is possible she is losing her mucus plug, which can cause bloody show. Some bleeding during pregnancy is not uncommon and this finding is expected. The cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual.

The cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual.

The nurse is helping a pregnant client adapt psychologically. What outcome best demonstrates that the client has successfully adapted to the second trimester? The client accepts the reality and uniqueness of the baby. The client accepts the pregnancy. The client states that she is fully prepared for parenthood. The client finishes making a detailed plan for labor and birth.

The client accepts the reality and uniqueness of the baby.

The nurse is teaching a pregnant teenager the importance of proper nutrition and adequate weight gain throughout the pregnancy. What is the best response when the client refuses to eat due to fear of possible weight gain? The infant will be smaller but should quickly gain weight. It will just make the baby smaller, but there are no other problems associated. The infant will be small and could have problems. There may be little impact on the infant, but the mother can suffer complications.

The infant will be small and could have problems.

The nurse is assessing a pregnant client in her third trimester who is reporting a first-time occurrence of constipation. When asked why this is happening, what is the best response from the nurse? This shouldn't be happening. hCG is delaying peristalsis. The intestines are displaced by the growing fetus. There is not enough fiber in your diet.

The intestines are displaced by the growing fetus.

A woman in her second trimester comes to the clinic for a routine follow-up visit. The woman's prepregnancy blood pressure was 112/70 mm Hg. On this visit, the woman's blood pressure is 104/64 mm Hg. The nurse would interpret this finding as suggestive of which event? indication that the woman is experiencing orthostatic hypotension a normal pregnancy finding secondary to progesterone effects sign that the woman is anemic signal that the woman is developing gestational hypertension

a normal pregnancy finding secondary to progesterone effects

Which of the following changes, with highest priority, should the nurse teach a pregnant client to report to the health care provider as soon as possible? heartburn awakening her at night during the first trimester abdominal pain coming and going during the third trimester frequent urination, every 1 to 2 hours, during the first trimester vomiting 2 to 3 times a day during first trimester

abdominal pain coming and going during the third trimester

Which of the following changes, with highest priority, should the nurse teach a pregnant client to report to the health care provider as soon as possible? heartburn awakening her at night during the first trimester frequent urination, every 1 to 2 hours, during the first trimester vomiting 2 to 3 times a day during first trimester abdominal pain coming and going during the third trimester

abdominal pain coming and going during the third trimester

Which of the following changes, with highest priority, should the nurse teach a pregnant client to report to the health care provider as soon as possible? vomiting 2 to 3 times a day during first trimester frequent urination, every 1 to 2 hours, during the first trimester abdominal pain coming and going during the third trimester heartburn awakening her at night during the first trimester

abdominal pain coming and going during the third trimester

A woman who is 10-weeks pregnant comes to the health center for an evaluation. As part of the interview, the nurse assesses how the woman is adjusting to the pregnancy. The nurse would most likely expect the woman to display which emotional response? ambivalence introversion acceptance narcissism

ambivalence

A woman who is 10-weeks pregnant comes to the health center for an evaluation. As part of the interview, the nurse assesses how the woman is adjusting to the pregnancy. The nurse would most likely expect the woman to display which emotional response? narcissism introversion ambivalence acceptance

ambivalence

The nurse is examining a woman who came to the clinic because she thinks she is pregnant. Which data collected by the nurse are presumptive signs of her pregnancy? Select all that apply. fetal heartbeat ultrasound pictures breast changes amenorrhea morning sickness hydatidiform mole

breast changes amenorrhea morning sickness

The nurse is assessing a 37-year-old woman, pregnant with twins in her second trimester, and notes the following over the past 3 visits: blood pressure 128/88, 134/90, and 130/86. Which nutritional supplement should the nurse suggest the client take? vitamin A iron lactase calcium

calcium

A nurse is caring for a pregnant client who has been diagnosed with lordosis. The nurse offers preventive measures for which consequence of lordosis when caring for this client? diastasis recti edema in lower extremities melasma (chloasma) chronic backache

chronic backache

During pregnancy a woman has many psychological adaptations that must be made. The nurse must remember that the baby's father is also experiencing the pregnancy and has adaptations that must be made. Some fathers actually have symptoms of the pregnancy along with the mothers. What is this called? couvade syndrome pregnancy syndrome pseudo pregnancy cretinism

couvade syndrome

During pregnancy a woman has many psychological adaptations that must be made. The nurse must remember that the baby's father is also experiencing the pregnancy and has adaptations that must be made. Some fathers actually have symptoms of the pregnancy along with the mothers. What is this called? cretinism couvade syndrome pseudo pregnancy pregnancy syndrome

couvade syndrome

Which assessment finding in the pregnant woman at 12 weeks' gestation should the nurse find most concerning? The inability to: detect fetal heart sounds with a Doppler. feel fetal movements. palpate the fetal outline. hear the fetal heartbeat with a stethoscope.

detect fetal heart sounds with a Doppler.

Which effect would the nurse identify as a normal physiologic change in the renal system due to pregnancy? shortening of the ureters decrease in glomerular filtration rate dilation of the renal pelvis reduction in kidney size

dilation of the renal pelvis

A client arrives to the clinic very excited and reporting a positive home pregnancy test. The nurse cautions that the home pregnancy test is considered a probable sign and will assess the client for which sign to confirm pregnancy? Chadwick sign Hegar sign fetal movement felt by examiner positive office pregnancy test

fetal movement felt by examiner

A client arrives to the clinic very excited and reporting a positive home pregnancy test. The nurse cautions that the home pregnancy test is considered a probable sign and will assess the client for which sign to confirm pregnancy? fetal movement felt by examiner Chadwick sign positive office pregnancy test Hegar sign

fetal movement felt by examiner

A client comes to the clinic and tells the nurse, "I think I might be pregnant." After completing the history and physical examination, the nurse obtains a blood specimen for pregnancy testing. When explaining this test to the client, which hormone will the nurse identify as being measured by this test? estrogen human chorionic gonadotropin progesterone follicle-stimulating hormone

human chorionic gonadotropin

A nurse is assessing a pregnant woman and suspects that the woman may be experiencing pica. To help support this suspicion, the nurse evaluates the woman for signs and symptoms of which condition? heartburn diarrhea urinary tract infection iron-deficiency anemia

iron-deficiency anemia

A woman in her third trimester shows the nurse a narrow, brown line that has formed on her abdomen, running from her belly button down to her pubic region. She expresses concern about this and asks the nurse whether it is normal. The nurse explains that this is a normal occurrence of pregnancy and that it results from the release of melanocyte-stimulating hormone from the pituitary, causing the appearance of extra pigmentation on the skin. What is the name of this phenomenon? melasma (chloasma) striae gravidarum (stretch marks) diastasis recti linea nigra

linea nigra

The nurse is preparing to teach a community class to a group of first-time parents. Which information should the nurse include concerning what the pregnant woman's partner may experience as a normal response? desire to be the woman and give birth no changes, only the mother has changes during pregnancy physical symptoms similar to the mother feeling distanced from the mother

physical symptoms similar to the mother

In a client's seventh month of pregnancy, she reports feeling "dizzy, like I'm going to pass out, when I lie down flat on my back." The nurse explains that this is due to: a 50% increase in blood volume. physiologic anemia due to hemoglobin decrease. pressure of the presenting fetal part on the diaphragm. pressure of the gravid uterus on the vena cava.

pressure of the gravid uterus on the vena cava.

A client's menstrual period is two weeks late. She has been feeling tired and has had episodes of nausea in the morning. What classification of pregnancy symptoms is this client experiencing? positive probable presumptive no classification

presumptive

A woman in the third trimester of her first pregnancy expresses fear about the birth canal being wide enough for her to push the baby through it during labor. She is a petite person, and the baby seems so large. She asks the nurse how this will be possible. To help alleviate the client's fears, the nurse should mention the role of the hormone that softens the cervix and collagen in the joints, which allows dilation (dilatation) and enlargement of the birth canal. What is this hormone? estrogen relaxin human placental lactogen progesterone

relaxin