Asynchronous Activity#2

Ateneo de Zamboanga University
College of Nursing
Level 2 - NCM 107j - CARE OF MOTHER, CHILD AND ADOLESCENT (WELL CLIENTS)
Asynchronous Learning Topics (ALT-Module #2)
Focus: Psychological and Physiologic changes of Pregnancy
Learning Objectives:
After completing the asynchronous learning topics, the students should be able to:
1. Define key terms related to psychological and physiologic changes of pregnancy and pregnancy health
assessment;
2. Recognize common psychological and physiologic changes that occur with pregnancy, the underlying
principles for these changes, and
3. Determine the relationship of the changes to pregnancy diagnosis;
4. Describe the areas of health assessment commonly included in prenatal visits like: History, current
pregnancy (EDD, AOG, gravid, para), previous pregnancies & outcomes (TPAL score), gynecologic
history, medical history, nutritional status, etc.;
Psychological Changes in Pregnancy

Pregnancy is such a huge change in a woman’s life that it brings about more psychological
changes than any other life event besides puberty (Rojas, Wood, & Blakemore, 2007). A woman’s
attitude toward a pregnancy depends a great deal on psychological aspects such as the
environment in which she was raised, the messages about pregnancy her family communicated to
her as a child, the society and culture in which she lives as an adult, and whether the pregnancy has
come at a good time or less than a good time in her life (Darby, 2007).
Case scenario: Lauren Maxwell is a part-time model who has come to your clinic for her first
prenatal visit. She tells you she missed her period 4 weeks ago and immediately took a home
pregnancy test. She’s excited that it was positive, because she and her husband have been trying for
several months to get pregnant. She is also anxious. “I know there’s no turning back now, but I
wonder what this will do to my career,” she tells you. She adds that her husband, John, doesn’t seem
a bit scared. “I don’t know if that’s a good thing or not,” she confides. She’s also worried about being
a good parent. “I’d die,” she says, “if I turned into the same kind of parent as my parents.” In
addition to the positive home pregnancy test, Lauren presents with amenorrhea, breast tenderness,
fatigue, and morning sickness. She is interested in knowing when she will begin to look pregnant
and what she can do for the morning sickness (Psychological and Physiological Changes of
Pregnancy - Maternal & Child Health Nursing 7th Edition Vol. 1, by Adele Pilliteri pp. 217)
Task/s and Activities:

#1 - Formulate (3) nursing diagnosis related on the given scenario.
Psychological Tasks of Pregnancy
During the 9 months of pregnancy, a woman and her partner run a gamut of emotions
ranging from the surprise at finding out the woman is pregnant (or wishing she were not), the pleasure
and acceptance of the fact as they begin to identify with the coming child, the worry for themselves
and the child, as well as the acute impatience near the end of pregnancy (Table 10.1). Once the child is
born, a woman and her partner may feel surprise again that the pregnancy is over and that the
mother has really given birth. From a physiologic standpoint, it is fortunate that a pregnancy is 9
months long, because this gives the fetus time to mature and be prepared for life outside the protective
uterine environment. From a psychological standpoint, this period is also fortunate for the family
because it gives them time to prepare emotionally as well. How well a woman adjusts to the potential
stress of pregnancy can affect her relationship with the child and may even influence whether she is
able to carry the pregnancy to term (Box 10.3). (Maternal & Child Health Nursing 7th Edition Vol. 1, by
Adele Pilliteri pp. 217)
Discussions and Explanation (#2- What psychological developmental tasks of pregnancy will Lauren
need to complete?)
Discussions and Explanation (# 2- What suggestion could you make to ease her worry about being a
good parent?)
Discussions and Explanation (#3 - What are the psychological changes in pregnancy?)
First Trimester
Second Trimester
Third Trimester
The Pregnancy
Pregnancy is the term used to describe the period in which a fetus develops inside a woman's
womb or uterus.
Pregnancy usually lasts about 40 weeks, or just over 9 months, as measured from the last
menstrual period to delivery. Health care providers refer to three segments of pregnancy, called
trimesters.(https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo#:~:text=Pregnancy%20is% 20the%20term%20
used,segments%20of%20pregnancy%2C%20called%20trimesters.)
Guide Questions:
1. In figure 1. Classify the signs and symptoms of Pregnancy into presumptive, probable and positive.
Explain briefly the signs/symptoms as why it happens, when it is evident, how it occurs.
PRESUMPTIVE S/S why it happens when it is evident how it occurs
PROBABLE S/S why it happens when it is evident how it occurs
POSITIVE S/S why it happens when it is evident how it occurs
(may use extra sheet/s)

Physiologic Changes of Pregnancy
Physiologic changes that occur during pregnancy can be categorized as local (confined to the
reproductive organs) or systemic (affecting the entire body). Both symptoms (subjective findings) and
signs (objective findings) of the physiologic changes of pregnancy are used to diagnose and mark the
progress of pregnancy.
Guide Questions:
1. What are the physiological changes of a pregnant woman that occur during pregnancy?
2. Which physiologic changes may occur during the first, second and third trimester of pregnancy?
Categorize the physiologic changes as local and systemic?
Local changes Description and Significant changes

Uterus
Cervix
Vagina
Breast
Systemic changes Description and Significant changes
Integumentary system
Respiratory system
Circulatory system
Skeletal system
Endocrine system

Uterus
Cervix
Vagina
Breast

Respiratory system
Circulatory system
Skeletal system
Endocrine system

Uterus
Cervix
Vagina
Ateneo de Zamboanga University

Breast
College of Nursing
Level 2 - NCM 107j - CARE OF MOTHER, CHILD AND ADOLESCENT (WELL CLIENTS)
Synchronous Learning Topics
Focus: Prenatal Assessment
Respiratory system
Circulatory system
Skeletal system
Endocrine system
READ AND REVIEW THIS PATIENT SCENARIO:
Psychological and Physiologic Changes of Pregnancy
CARE STUDY: A WOMAN ENROLLING IN PRENATAL CARE

Anita is a 26-year-old woman you meet at a prenatal clinic.
CHIEF CONCERN:
“I’m pregnant. At least that’s what my home test showed.”
HISTORY OF PRESENT CONCERN:

Client has been taking a birth control pill for 5 years. She forgot to take two pills one weekend so thinks
that’s how she got pregnant. Calculates she is about 8 weeks pregnant now. Not totally happy she is
pregnant; was planning on divorcing her husband and now has questions about doing that. Admits she
only told her husband last night that she could be pregnant. Her last menstrual period was 10 weeks ago.
Her urine tested positive for pregnancy 7 weeks ago by home test kit.
PERSONAL/SOCIAL:
Client lives with husband in three-bedroom house. She works as a dental assistant. He worked as a
newspaper reporter up until 2 weeks ago when he lost his job. Finances are reported as “terrible” because
husband has no job. Anita’s mother lives nearby and serves as Anita’s best support person.
PAST HEALTH HISTORY:

Client had no childhood illnesses; husband had mumps as a child so has always worried his sperm count
might be subnormal.
PREGNANCY HISTORY:
Client has had no alcohol to drink for 2 months; does not smoke cigarettes although husband smokes a
pack a day. She has symptoms of morning nausea, frequency of urination, and breast tenderness. She
states, “How sore my breasts are scares me. How bad is this going to get?” Her mother has told her birth
is “the worst pain you can get.” She asks you, “Are there some exercises or something I can do to make
that not so bad?”
GYNECOLOGICAL HISTORY:
Menarche at 14 years; usual cycle is 28 days with 4 to 5 days of menses. Used oral contraceptive for 5
years before stopping now because she might be pregnant.
REVIEW OF SYSTEMS:
Negative except for chief concern and occasional headaches she attributes to stress or eye strain. Urinary
infection at 14 years; treated with no return.
PHYSICAL EXAMINATION:
General Appearance: Well appearing young female.
HEENT: Normocephalic. Sclera of right eye reddened and tearing.“Sniffing” as if nose is stuffy.
Neck: Full range of motion; no palpable nodes.
Chest: Respiratory rate: 22 breaths per minute. No rales or rhonchi present. Good aeration all lobes.
Abdomen: Soft to palpation. Uterus not palpable.
Extremities: Full range of motion. Normal gait.
Pelvic Exam: Normal female genitalia. Vagina purple hued. Cervix soft to touch. Pap smear obtained and
plated.
Anita was diagnosed as pregnant and her due date was calculated. She appears to be
in good health except for a possible conjunctivitis of her right eye, which was
cultured.
Evaluation: 3-2-1 Ticket- Out Activity
3 – things / concepts you

learned from the
asynchronous activity
2 – interesting things /
concepts about the
1 – question that you like to

ask about the topic on
Note:
 Do not limit your answers/discussions on the questions asked.

 Answers must be properly cited. Please provide sources/ references that
support your answer.
 All Deliverables for Asynchronous learning topic/s will be submitted on or
before September 01, 2020 (12:00 midnight) @ [email protected]
or [email protected]
 You may ask questions or clarification through [email protected].

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Ateneo de Zamboanga University

Psychological Changes in Pregnancy

Task/s and Activities:

PROBABLE S/S why it happens when it is evident how it occurs

POSITIVE S/S why it happens when it is evident how it occurs

(may use extra sheet/s)

Local changes Description and Significant changes

Systemic changes Description and Significant changes

Local changes Description and Significant changes

Systemic changes Description and Significant changes

Local changes Description and Significant changes

Ateneo de Zamboanga University

Psychological and Physiologic Changes of Pregnancy

CARE STUDY: A WOMAN ENROLLING IN PRENATAL CARE

HISTORY OF PRESENT CONCERN:

PAST HEALTH HISTORY:

3 – things / concepts you

1 – question that you like to

 Do not limit your answers/discussions on the questions asked.

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