Inside this tutoring session, we’ll help you as nail down presumptive, probable and positive signs of pregnancy for your OB patients! Come with questions and be ready to learn the difference between these topics!
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Where is everybody from?
Or any of my live NRSNG live people. Oh, chance.
Fancy. Yes. So I am here in Virginia and I just got back from NRSNG live, which was so fun. If any of you are able to be there. Um, we had a blast, so hopefully if you weren’t there or if you were, you guys will join us next year. Florida. I love Florida. Really? I just love Disney world, but if you live in Florida you’re probably over it.
All right. So today we are going to be talking about signs of pregnancy, which sounds super easy. Um, just nausea, vomiting, that kind of thing. But really they’re broken into category. So we have presumptive probable and positive. I’m going to kind of break this down and make it a little bit easier and explain some different pieces to it. So I’m an ob nurse and haven’t for about 10 years now. Um, and love it. So I am going to talk to you about all these signs and see if we can clear it up. And then at the end I’ll give you a chance to ask any questions that you have. So the first one we have are gonna be presumptive. So presumptive means that the patient, the mom might be pregnant. Um, so might be it’s a possible, um, so presumptive, these are gonna be things that only the patient or the mom, um, experiences. So what are some things that women feel when they are pregnant? Got It. A second to type,
so things mom would feel and experience. So things like the first sign, right is amen area or that missed period. So we have that, um, nausea and vomiting, those are signs of pregnancy. She’s going to have breast tenderness. So these are only things that she would feel or experience is going to be kind of your key for this one. Also a positive urine. And I’m stressing urine and I’ll explain why here in a minute. A positive urine test. And the reason why this is presented, false positives, right? So people get these, um, tests that are positive and really they’re not pregnant. So these are things mom feels, this is our presumptive. All right. Our next one, oh I know another one that I want to put in there is quickening. So quickening is movement of the fetus that the mom feels, those little flutters, those first few kicks only things she can’t experience.
Nobody can feel them from the outside yet cause it’s just those first early kicks and movements. So that is quickening. So things she feels all right, our next category is going to be probable. So probable means it’s a possibility. It’s probable. It’s probably happening. Probably true. It’s amazing. So still not a hundred percent positive. So with these, this is going to be things that the provider, the physician, the doctor, the midwife, whoever it is, um, notices. So some of our key things for this and then I’ll explain them in more detail. Our Chadwick’s, our Goodell sign, sorry. And then Hagar sign. So these are things that the provider is aware of and seeing. Um, and then the other one is going to be below [inaudible].
The allotment is when the provider will push their hand up on the cervix and feel kind of that bag of water, that head move up in the bag of water and then land back down on the cervix. So that’s felt by the provider or the midwife, whoever it is. So of allotment, um, or if the provider feels extra Anil kicks. So are, let me tell you what these Chadwick’s Hagar you down. So Chadwick sign, I got my little uterus pillow guys. So Chadwick’s sign is going to be the tip of the cervix. So this is our uterus. Here’s our cervix down at the bottom. The tip of the cervix is going to be turning a bluish purple color. And that’s a positive chatbot sign that is happening because when a woman gets pregnant, a lot of extra blood flow goes to the uterus, right? Cause we’re growing a baby.
So there’s a lot more increased vascularity. So we get purple-ish blue color. Um, so that is Chadwick sign. Our Goodell sign is going to be the vaginal parts of the lower uterine piece is softened. Um, and then the one above that is Hagar. So the top of the cervix into the uterus where it attaches. So I remember this and I’m like, it’s reverse alphabetical order. So we have our Chadwick’s, Dell and then Hagar. So Chadwick’s again is the tip. And then we have goo Dow, which is the lower part of the cervix softens. And then Hagar is the upper part of the cervix. Connecting to that uterus is the, um, is Hagar sign and softening. Alright. So those are um, those signs felt by the doctor. And our last category is going to be positive. So positive means yet you definitely are pregnant, no doubt about it.
So what things would be here? It’s going to be where there’s no question, right? So we have an ultrasound that’s been done that sees a fetus in there, right? You will only have a fetus in there if you are pregnant. Fetal heart tones are determined. You only have heart tones in your belly if you are pregnant. Um, so those are are positive definite signs. Um, fetal movement, I think I accidentally said fetal movement felt by the doctor on the last one. It’s not, this is fetal movement felt by the provider is a positive sign. So sorry about that. So if you don’t mean that the fetal heart tunes and then visualization on an ultrasound image are all going to be are positive signs. Now the reason why, um, we talked about that urine pregnancy test and we said drug test, urine pregnancy tests, that being a presumptive as remember because we are um, can have false positives.
A positive blood test is a probable sign. And the reason why is because there is a small chance, there’s something called molar pregnancy and there’s a lesson on and our g if you want to look at that, but a positive blood test could indicate a molar pregnancy, which is not a true pregnancy. It’s just a rise in HCG that happens. So that is a probable. So your positive pregnancy tests will never be an absolute definite positive sign. The only positive signs are the things felt by the provider or the movement felt by the provider. And then visualization. So you visualize that, um, on ultrasound and you visualize or here heart tunes on with the Monitor. So those are positive signs. All right. What questions do you guys have about, um, are signs of pregnancy? Yeah. Or other things I’m going to put in while you guys are typing cause I knew that that can take a few minutes. Um, the link to the lesson [inaudible]
Okay. That’s still linked to the lesson.
And then this one is the link to our Google doc and you should be able to click right on it. And that helps us just make sure we’re giving you guys what you need in the tutoring sessions. If you have any extra ideas for things that you would like to see for ab or communication, which is the other little lessons I do, then please let us know so that we can get them for you. And again, I just want to make sure that you guys, cause I did miss say it, that the um, fetal movement felt by the provider is a positive, definite, not a probable sense. I think I misspoke with that and I don’t want you to get messed up.
You have no questions. There’s gotta be something. Should I go back to my pregnancy uterus pillow and we’ll talk about that again while we wait. Okay. So Chadwick’s is that bluish purple color. And this is, um, when we’re pregnant, a woman is pregnant, it’s going to turn this color because we have that vascularity. We’re growing a baby. We get extra blood flow there and that’s a good thing. We want that. Um, so that happens. And then we have Goodell sign, which is the softening of the cervical kind of the tip. Um, area is going to soften because things are, we have more vascularity, things are getting softer, things are able to stretch. Um, so that’s our good out. And Hagar is the upper part of the, um, uterine segment that is getting softened. So remember, you can remember it in reverse alphabetical order. So it’s just climbing up the uterus towards the top.
So chadwicks, Udal and Hagar. That way when you get those test questions, because they’ll definitely be on there, you have the right order and you guys don’t have to ask questions about this. If you’ve seen something in clinical and if somebody you were probably on summer break, um, but if you’ve seen other things that you have questions about that you see in a clinical or practice that is ob related. Um, I’m here for ya infused about the pregnancy test. So, okay, so the pregnancy test, if it is a home pregnancy, the urine pregnancy test, that is going to be our presumptive signs. So because of the false positives ability test, yes, it will still only be a probable sign and not positive. And that’s just because there is a small chance that the blood test could be positive for Hcg, but it’s actually a molar pregnancy and then a molar pregnancy.
There’s just this quick rise in hcg that’s happening, but there’s no fetal content. Um, there’s actually no pregnancy. So if you look at that lesson, it’ll explain that a little bit more. But that’s why I am willing to bet because that is a minute detail that on a test they’re not going to differentiate. Like they’re probably more going to ask you the urine test. Um, but when you’re breaking it into categories, the urine is a presumptive to, um, presentive sign, sorry. And a probable is going to be the, um, blood tests. Does that make better sense? Scale?
The blood test is not presented. That is probable. So you’re in presentive correct. Chance and beloved is probable. Okay. Glad that’s more clear. It’s a little confused. Chances graduated. I’m promoting him ob. What other questions do you guys have about anything kind of yes. Random question. Hopefully I know the answer that I am not 100%. So other hormones Mimic Hcg? I don’t believe so. Um, I do know that the people take hcg sometimes for a diet thing and so that can show up on a, um, tests and they think they’re pregnant and they’re actually not. But, um, I am not a hundred percent sheriffs, so if anybody knows that gets or doesn’t know and needs to know, we can do contact to nrsng.com with the attention and I’m happy to find out, but I don’t think so. You’re welcome.
Signs of possible miscarriage. Okay. So, um, there are several different categories of miscarriage. This would actually be a good othen for us to add for tutoring too, just to break down all the different ones. But so side note it. Awesome. Okay. So size of possible miscarriage. So you will have, um, cramping spotting. Those are kind of a threatened. Um, so there is no tissue loss that happens with the threatened because it doesn’t happen. It’s just a threat. Um, then we have where there are definite and we have dilation of the cervix happening and we have lost the tissue and bleeding. What’s your biggest signs of a miscarriage or going to be the cramping and the spotting that happened. Um, now of course women have that anyways cause they feel the cramping of that uterus growing. Um, so of course sometimes they might feel these symptoms but it’s not, um, indicative that it’s happening.
So with a definite miscarriage is going to happen. We have dilation, loss of tissue and lots of bleeding and cramping. Sometimes they’re also going to have that lower back. Pain is a big one is it’s just this cramps radiating into the back. Um, it’s kind of like a mini laborers as your body’s trying to get rid of it. Um, then we also have ones that are incomplete and those incomplete ones are the ones where we might have lost some fetal tissue. We have the bleeding, the spotting, the cramping, but we didn’t lose it all. So those are the ones that have to have a DNC to clean it out and get all that extra tissue out that was not, um, miscarried either body on its own. Hopefully that helps. So those are your big sides. You’re always gonna have science with cramping and spotting, I should say, always in quotations because of course, you know, some women might feel nothing, um, and just all of a sudden have a vegetable Ed. But typically you’ll have the spotting and the cramps that happen. You’re welcome.
So spotting is not normal. Okay? So this is one of those things. Okay. So spotting is not normal. We don’t want to see spotting, but spotting can be, okay. Hey, so I won’t say that it’s normal, but some women have spotting with implantation, bleeding, which that’s fine. And that’s normal. But not every women has implantation bleeding. So normal. Um, if you have spotting accompanied by cramping, that’s usually the sign want to be seen in us. Also spotting is not as concerning as like more blood being lost. Um, so no, it’s not normal, but it doesn’t necessarily mean that it’s a problem because it clearly implantation, bleeding. It could be old blood, like if it’s Brown, it could just be old blood that the body’s clearing out. So, or from implantation. So I would say that it’s not normal. We don’t want to see it, but it’s not always a bad thing.
Sorry. That was like not a clear yes or no. But as you know, nursing, nothing really ever is. I guess it’s just kind of gonna depend on your question and what other little signs that they have in with your question or symptoms. What else do you highs have today? What other questions? And it can be anything. I’m trying to think of a good story to tell you all while we wait, but I can’t and my mind is blank. Oh, chance. No, I think I got, I got his question. The hormones. Oh did you ask another question?
I was going to say it and show up on my screen. Alright, well maybe I will throw out some little different signs and you guys can tell me which category they go in. So remember our categories are presumptive, probable and positive. Okay, so allotment where what’s below are aware of what categories allotment. You can type just the first few letters if you want.
probable. Correct. Okay. If you have quickening, what are, and let me remind you while you guys are typing for quickening Blockman is that where you have the bag of water and the doctor or provider is going to push on it? It’s the head’s going to bounce up and come back. Come down on the survey. All right, so what’s our quickening? Where does that go?
actually going to be presumptive. So remember quickening is the flutters, the fetal first initial movement and that is felt by the mother. Nobody else can feel that. So quickening is going to be our, um, presumptive. How about um, a kick felt by a doctor? Where’s that going to go? Yes, so positive. So I felt by the doctor. Um, versus felt by mom. Um, Amen. Or Rhea,
Perfect. Yes. Presumptive. Um, okay. Our positive urine tests. So if I’m think I’m pregnant and I take a test and it’s positive.
Yes. So presumptive again. Um, okay. We see, um, fetal heart tones at one 30 on the Monitor, not probable. That one’s going to be positive. So yes. So positive we are a fetal heart tones are on the monitor so it’s definite right? We are 100% pregnant. You are not going to have a heart rate of one 30 living in your valley. And last there is something growing in there. So a baby. So we are definitely pregnant with that. Um, we have the um, bluish purple cervix. What category is that? Yes. Probable. And what was the bluish Purple Cervix called? What’s that one known as?
What’s that called? Yes, Chadwick sign. Um, okay. If we have the, what is the one that is the softening of the upper cervical into uterine segment? So up here, what’s that called? Yes. So that is our, um, um, Hagar. And then how about the softening of the cervical tip? So softening of the cervical tip. What’s that one called? Yes. So that one is um, [inaudible]. So remember we have Chadwick, Goodell, Hagar, so Chadwick’s the color and we have good Dallas, the cervical tip softening. And then um, Hagar is that upper uterine or lower uterine into the cervix segment. Um, okay. And so all three of those are probable signs of pregnancy. So those are things the doctor is going gonna feel and the doctor is going to visualize or midwife or whoever it may be. Um, how about skin changes? So someone’s pregnant and they’re getting a lot of skin breakout. What’s that going to be categorized? Yeah, so presumptive, so something that maybe she’s pregnant but people can have that anyways happen. So those are things mom feels along with our amen, Maria, the quickening and the nausea, vomiting, breast tenderness, all those typical signs of pregnancy. All right. Do you guys have any other questions? I’ll give you guys a second to do that. I’m going to put the links in one more time. For anybody that’s joined us,
that’s the Google doc. Say,
please do that because that helps us help you.
And then here is the lesson right into an arrest in g.
that will take you right to this, um, topic. We’ll give you guys another second just to make sure if you have any questions. I was going to try to pull up the molar pregnancy one, um, because of the hcg if I can for you guys real quick. Give me just a second.
Okay. So this one is our molar pregnancy. That or hydrotic form mole, um, is also called. So that’s the one that will cause your ACG levels to rise when it’s not an actual pregnancy. Super duper rare. Um, so, but it is, uh, that’s the reason why the blood test is a probable sign and not a positive sign. Alright. If you guys don’t have any other questions, if you go out and be your best selves today and as always, happy nursing. Yeah.