Maternal Nursing- Chapter #4~ Cardiovascular system changes during pregnancy

The maternal heart rate increases by how many bpm to meet the demands of the growing fetus

10-15 bpm

During the first trimester, blood pressure normally remains the same as prepregnancy levels, but then gradually decreases until how many weeks gestation?

20 weeks

What can occur if the pregnant woman lies directly on her back?

Supine hypotension, or vena cava syndrome

As the fetus grows, the maternal heart shifts during pregnancy. Where does the growing uterus displace the maternal heart to?

The heart shifts upward and to the left, rotating on the axis with a more lateral apex.

When do murmurs during pregnancy resolve and are they typically associated with any issues?

Murmurs during pregnancy are typically asymptomatic and resolve within the first 2 weeks postpartum after plasma volume levels return to normal.

After 20 weeks gestation, vascular volume expands and what increases to reach prepregnancy levels by term?

Blood pressure

What symptoms can be associated with vena cava syndrome

Dizziness diaphoresis pallor

What is a normal physiological increase that the maternal heart experiences during pregnancy that results from the increased blood volume and cardiac output?

Cardiac hypertrophy

When does cardiac output increase peak during pregnancy and at what percentage? How long does it remain increased for?

Cardiac output increase peaks around 20-24 weeks gestation at about 30-50% above prepregnancy levels. It remains increased for the rest of the pregnancy.

What type of heart sounds are common during pregnancy?

Exaggerated 1st and 3rd heart sounds and systolic murmurs

Does cardiac output increase or decrease during pregnancy?

Increase

How to relieve vena cava syndrome?

Lie on left side or in semi-Fowler s position to reduce pressure on the vena cava. If the patient needs to lie supine, a wedge should be placed under the hp to relieve direct pressure.

As the fetus grows, the diaphragm is shifted where?

Upwards

What reduces blood pressure during the second trimester that is related to progesterone induced relaxation of the vascular smooth muscles?

Vasodilation

The pressure from the enlarged uterus exerted on this area decreases the amount of venous return from the lower extremities and causes a marketed decrease in blood pressure-

Vena cava