I.

In bullet form, identify all local and systemic physiologic changes to diagnose and mark the progress of
pregnancy.

1st Trimester 2nd Trimester 3rd Trimester

Uterus  The uterus  The placenta is  During your third

increases in growth forming estrogen trimester, the uterus
and begins to and progesterone, will finish growing
press on the steady increased and be the size of a
watermelon. When
bladder. This growth.
you reach full term,
causes the mother your uterus will
the need to urinate  Grows to the extend from the
more often. height of the pubic area to the
bellybutton around bottom of your rib
20 weeks, making cage.
the pregnancy
visible.

 May be able to feel

the movement of
the fetus for the
first time around 20
weeks. This
phenomenon is
called quickening.

Cervix  Softening of the  Softening  Consistency of butter

lower uterine increases. or is said to be
segment or Hegar "RIPE"
sign.  Braxton Hicks
 A mucus plug,
contractions, also called operculum,
called "false labor" forms to seal out
are a tightening of bacteria and help
your uterine prevent infection in
muscles. It’s one of the fetus and
the ways the membranes.
uterus prepares for
 cervix (the lower
labor and delivery.
end of your uterus)
Braxton Hicks
will begin to thin
make the belly feel
(effacement) and
very tight and hard
open (dilate).
 and may cause
discomfort. The
contractions are
irregular in timing
and should go
away within a few
minutes. 

Vagina  White discharge is  May have a white-  Whitish discharge

present. colored vaginal increases in
discharge called amount.
 Amenorrhea
leukorrhea. (A
occurs, or the
absence of colored or bloody
menstruation. discharge may
signal possible
complications and
should be
examined
immediately.)

Ovaries  The corpus luteum  Corpus luteum  The right ovary

starts to become fading showed a significant
change in position
active. during pregnancy,
 with a measurement
of 2.5 cm to the iliac
spine.

Breast  The mammary  The breast size  The nipples may

glands enlarge, increases a size or be tender and leak
causing the two, as the a yellowish liquid,
breasts to swell mammary alveoli called colostrum. If
and become tender and fat deposits the mother
in preparation for increase in size. breastfeeds, this
breast-feeding. fluid will be the
This is due to an baby’s first food.
increased amount
of the hormones
estrogen and
progesterone.

 The areolas
enlarge and
darken.
  Veins become
more noticeable on
the surface of the
breasts.
Endocrine  Increase in  There is an increase  The increase in
insulin occurs in in human placental melanocyte-
lactogen, prolactin
the first trimester and cortisol levels. stimulating
because estrogen, These are anti- hormones causes
progesterone and insulin hormones; increase in skin
HPL have insulin therefore, they pigment.
increase insulin
antagonistic resistance in the
properties. mother and reduce  As the breasts are
peripheral uptake of prepared for
 The human growth glucose. lactation,prolactin
hormone increase increases in
to aid the fetus in production.
growing.
 Relaxin increases
 Human placental to soften the cervix
lactogen increases and collagen of
glucose levels to joints.
supplement the
growing fetus.

 A slight
enlargement in the
thyroid and
parathyroid gland
increases the basal
metabolic rate of a
pregnant woman
and for better
consumption of
calcium and
vitamin D.

 Partly due to
surges in
hormones, you
may experience
mood swings like
premenstrual
 syndrome.

 Increased levels of
hormones to
sustain the
pregnancy may
cause “morning
sickness,” which
causes nausea
and sometimes
vomiting.


Integumentary  The stretching of  Linea nigra is a  Striae gravidarum

the abdomen narrow, brown line or pinkish to
causes rupture of that runs from the reddish marks on
the small segments symphysis pubis to the sides of the
of the connective the umbilicus and abdominal wall are
layer of the skin. separates the the result of the
abdomen into right rupture.
 Palmar erythema and left
also occurs hemispheres.  Hair may begin to
because of the grow on your arms,
increase in the  Melasma or legs and face due
to increased
estrogen level of chloasma (mask of hormone
the pregnant pregnancy) refers stimulation of hair
woman. to the darkened follicles. Hair may
areas on the also feel coarser.
cheeks or the nose
that may appear  Dry, itchy skin may
persist, particularly
during pregnancy.
on the stomach, as
the skin continues
to grow and
stretch.

 Skin pigmentation
may become more
apparent,
especially dark
patches of skin on
the face.
Respiratory  Minute ventilation  Nose may become  Shortness of
starts to increase congested, and breath is also a
significantly (by up you may common
to 48%) during the experience discomfort of
first trimester of nosebleeds. This is pregnancy as the
gestation, due to due to the increase pregnant uterus
higher tidal volume in hormones pushes
with unchanged (estrogen and the diaphragm
respiratory rate. progesterone) and upward.
blood flow that
 Shortness of affect the mucous
breath occurs. membranes and
blood vessels in
 Become more
the nose.
sensitive to certain
odors and sense of
 Pregnancy can
taste might
cause the gums to
change. 
become more
sensitive to
flossing and
brushing, resulting
in minor bleeding.

 Frequent vomiting
could also affect
tooth enamel and
make the pregnant
woman more
susceptible to
cavities.

Cardiovascular  Blood volume  Blood pressure  Blood pressure

increasing. slightly decreased. returns to pre-
 Psuedoanemia pregnancy levels.
may occur.
 Clotting factors
increasing.
Gastrointestinal  The muscular  Slower  Hemorrhoids also
 contractions in the intestinal persitalsi occur from the
intestines, which s occurs during the increased pressure
help to move food second trimester of of the uterus on the
through the
the pregnancy veins in the lower
digestive tract, are
slowed due to high which causes extremities.
levels of heartburn,
progesterone. This flatulence,
may, in turn, cause and constipation.
heartburn,
indigestion,
constipation and
gas.

Urinary  The frequency of  Even when the  By the last two

urination already woman has an weeks of
increases.  increased urine pregnancy, the
output, frequency of
her potassium urination reaches
levels are still up to 10 to 12
adequate due to times per day. 
progesterone,
which is pottasium-
sparing

 The need to
urinate often may
decrease as the
uterus grows out of
the pelvic cavity,
relieving pressure
on the bladder.

 Urinary Tract
Infection are
common during
pregnancy.
Musculoskeletal  Bone turnover is low  Progressive  Possible back or
in the first trimester cartilage softening. pelvic girdle pain.

 Lordosis increasing  Symphysis Pubis

or the pride of widens up to 3 to 4
pregnancy. mm

 Leg cramps are  Swelling of the

 common as
pregnancy ankles, hands and
progresses, often face may happen
striking at night (called edema), as
you continue to
retain fluids.

 Leg cramps may

happen more
often.

 Varicose veins in
the legs may
persist and
increase in
severity.

II. In bullet form, list the discomforts experienced during pkregnancy per trimester and its corresponding
rationale nursing interventions.

DISCOMFORTS RATIONALE NURSING INTERVENTIONS

First Trimester ● Increased levels of estrogen in Eat a diet high in fruits,

● Nausea early pregnancy seem to vegetables, low-fat forms of
● Vomiting stimulate a part of the brain protein, and fiber. Drink lots of
● Heartburn that triggers fatigue, nausea, water. Eat enough calories (about
● back pain and vomiting. Estrogen also 300 calories more than normal).
● leg cramps affects your gastrointestinal
● Fatigue tract, relaxing smooth muscle
tissue and causing your food
to digest at a slower pace,
which can result in an upset
stomach.
● Ligaments in your body
naturally become softer and
stretch to prepare you for
labor. This can put a strain on
the joints of your lower back
and pelvis, which can cause
back pain.

Second Trimester ● Cramps happen because as ● To help yourself relax, take a

● cramps or aches in your lower your uterus expands during warm bath, sip some warm
belly pregnancy, it puts pressure on herbal tea, change your
● Nasal problems nearby muscles and body’s position, or drink more
● Dental issues ligaments. water.
● Dizziness ● Your hormone levels increase, ● Saline drops or a saline rinse
and your body makes more can help relieve congestion.
blood. This can cause your Also, drink plenty of fluids, use

Third Trimester
● Braxton-Hicks contractions
● Backaches
● Shortness of breath
● Heartburn
● Spider veins, varicose veins,
and hemorrhoids
● Frequent urination
mucous membranes to swell a humidifier, and dab
and bleed easily, resulting in petroleum jelly around the
stuffiness and nosebleeds. edges of your nostrils to help
● Pregnancy can cause your moisten skin.
gums to become more ● Rinsing with salt water and
sensitive to flossing and switching to a softer
brushing, resulting in minor toothbrush can decrease
bleeding.  irritation. 
● Pregnancy causes changes in ● If you're having trouble with
circulation that might leave dizziness, drink plenty of
you dizzy. fluids, avoid standing for long
periods, and move slowly
when you stand up or change
position.
● You might feel these mild, ● Contact your health care
irregular contractions as a provider if the contractions
slight tightness in your become regular and steadily
abdomen. increase in strength.
● Pregnancy hormones relax ● Get regular exercise. Wear
the connective tissue that low-heeled — but not flat —
holds your bones in place, shoes with good arch support.
especially in the pelvic area. ● Practice good posture to give
These changes can be tough your lungs more room to
on your back, and often result expand.
in discomfort during the third ● To ease swelling, exercise
trimester of pregnancy.  and elevate your legs
● Increased blood circulation frequently, include plenty of
might cause tiny red-purplish fiber in your diet and drink lots
veins (spider veins) to appear of fluids.
on your face, neck, and arms.  ● If this is a problem, consider
● As your baby moves deeper using panty liners. If you think
into your pelvis, you'll feel you might be leaking amniotic
more pressure on your fluid, contact your health care
bladder.  provider.