Signs of Pregnancy (Presumptive, Probable, Positive)
Included In This Lesson
Study Tools For Signs of Pregnancy (Presumptive, Probable, Positive)
Outline
Overview
- Signs of pregnancy are divided into 3 categories:
- Presumptive signs of pregnancy= “You might be pregnant”
- Presumptive signs of pregnancy are the first indicators that you might be pregnant. These signs include missed periods, nausea, breast tenderness, fatigue, and frequent urination. Unlike probable signs of pregnancy, which are noted by a physician upon examination, presumptive signs can be observed by the patient. It’s important to note that these signs are not definitive, and a pregnancy test or examination by a healthcare provider is necessary for confirmation.
- Probable signs of pregnancy= “It’s highly likely you’re pregnant”
- Positive signs of pregnancy= “Yea, you’re definitely pregnant”
- Presumptive signs of pregnancy= “You might be pregnant”
Nursing Points
General
- Presumptive
- Amenorrhea, N/V, larger and fuller breasts, urinary frequency, pronounced nipples skin changes, fatigue, Quickening, changes in the color of vaginal mucosa, positive home pregnancy test
- Probable
- Ballottement, Chadwick’s sign, Goodell’s sign, Hegar’s sign, uterine enlargement, Braxton Hicks contractions, positive blood pregnancy test
- Positive
- Active fetal movement felt by practitioner, visual confirmation of fetus on ultrasound, fetal heartbeat heard on ultrasound (6-8 weeks) or by a doppler at around 12 weeks
Assessment
- Assess patient’s symptoms
- Quickening: Maternal feeling of the fetus move, the earliest usually around 16 weeks
- Ballottement: examiner inserts finger into the vagina, pushes on uterus and feels the return of the fetus to the finger
- Chadwick’s sign is a purple/blue/violet discoloration of the cervix, labia and vagina due to increased vascularity and blood flow
- Hegar’s sign is a softening at the bottom of the uterus, usually around 4-6 weeks
- Goodell’s sign is at approximately 4 weeks gestation, the vaginal portion of the cervix gets softer due to increased vascularization
Therapeutic Management
- Patients should be started on prenatal vitamins as soon as they show probable signs of pregnancy if they haven’t already started
- Patients should be questioned about medications they currently take if confirmed pregnant
- If patients have severe nausea and vomiting, they can be prescribed an anti-nausea medication
Nursing Concepts
- Reproduction
- Human Development
- Hormone Regulation
Patient Education
- Help patients understand the difference between possible, probable, and positive signs of pregnancy.
- Offer education on the importance of a prenatal vitamin if they are pregnant.
ADPIE Related Lessons
Related Nursing Process (ADPIE) Lessons for Signs of Pregnancy (Presumptive, Probable, Positive)
Transcript
In this lesson we are going to discuss the important signs of pregnancy and how to classify them.
There are 3 main classifications for our signs of pregnancy. They are either presumptive, probable or positive. For presumptive the signs are things such as amenorrhea, nausea/vomiting, larger and fuller breasts, urinary frequency, pronounced nipples skin changes, fatigue, Quickening, changes in the color of vaginal mucosa, positive home pregnancy test. Why would a home pregnancy test only be presumptive? That’s because it could be a false positive. Probable are things the mom observes or experiences. Probable are signs such things as ballottement, Chadwick’s sign, Goodell’s sign, Hegar’s sign, uterine enlargement, Braxton Hicks contractions, positive blood pregnancy test. Why would the blood test be probable? It could be ectopic of a hydatidiform molar pregnancy so not a true viable pregnancy. Probable signs are things the doctor observes or visualizes. Positive signs mean its definite. The patient is pregnant. So these are signs that would only be present if there is a fetus present. Signs would be active fetal movement felt by practitioner, visual confirmation of fetus on ultrasound, fetal heartbeat heard on ultrasound (6-8 weeks) or by a doppler at around 12 weeks.
For this we need to assess patient’s symptoms so we can classify first if she is pregnant and second if her symptoms are presumptive, probable, or positive. Let’s break down what some of these signs mean. Quickening is the maternal feeling of the fetus move. The earliest this is usually gelt is around 16 weeks. Ballottement is felt by the practitioner. It occurs when an examiner inserts finger into the vagina, pushes on uterus and feels the return of the fetus to the finger. Think of this as popping a water balloon up and feeling it come back down on your fingers. Chadwick’s sign is also observed by the practitioner and is purple/blue/violet discoloration of the cervix, labia and vagina due to increased vascularity and blood flow. Hegar’s is felt by the practitioner and is softening at the bottom of the uterus, usually around 4-6 weeks. Goodell’s sign is felt when the vaginal portion of the cervix gets softer due to the increased vascularization.
For our management there are a few things we need or can do. Patients need to be started on prenatal vitamins as soon as they show probable signs of pregnancy if they haven’t already started. Prenatal vitamins are important so that the patient gets extra folic acid which is needed to prevent neural tube defects. We also need to question about medications they currently take if confirmed pregnant. We need to make sure the medications are safe to be continued during pregnancy and will not harm the baby. If they are having symptoms of severe nausea and vomiting they can be prescribed an anti nausea medication to help with symptom management.
Reproduction, human development, and hormones are the nursing concepts. The patient has reproduced, she is developing a human, and hormones are a huge cause to all the pregnancy signs that she is experiencing.
The key points to remember and help pull it together are that presumptive signs mean“You might be pregnant” and they are usually felt by the patient. Probable signs mean “It’s highly likely you’re pregnant” and are observed by physician or provider. Last are positive signs which mean “Yea, you’re definitely pregnant”. These are signs that would only be present if the patient is pregnant.
Make sure you check out the resources attached to this lesson. Now, go out and be your best selves today. And, as always, happy nursing.
Study Guide pre LPN-RN
Concepts Covered:
- Cardiac Disorders
- Cardiovascular
- Emergency Care of the Cardiac Patient
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Gastrointestinal
- Upper GI Disorders
- Liver & Gallbladder Disorders
- Lower GI Disorders
- Central Nervous System Disorders – Brain
- Neurological
- Noninfectious Respiratory Disorder
- Respiratory
- Hematologic Disorders
- Delegation
- Perioperative Nursing Roles
- Acute & Chronic Renal Disorders
- Respiratory Emergencies
- Disorders of the Adrenal Gland
- Documentation and Communication
- Preoperative Nursing
- Legal and Ethical Issues
- Immunological Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Cognitive Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Medication Administration
- Vascular Disorders
- Renal Disorders
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Gastrointestinal Disorders
- Newborn Complications
- Peripheral Nervous System Disorders
- Studying
- Integumentary Disorders
- Communication
- Microbiology
- Emergency Care of the Trauma Patient
- Urinary Disorders
- Integumentary Disorders
- Musculoskeletal Disorders
- Circulatory System
- EENT Disorders
- Postoperative Nursing
- Neurological Emergencies
- Disorders of Thermoregulation
- Neurological Trauma
- Basics of NCLEX
- Fundamentals of Emergency Nursing
- Integumentary Important Points
- Multisystem
- Test Taking Strategies
- Tissues and Glands
- Urinary System
- Emergency Care of the Neurological Patient
- Neurologic and Cognitive Disorders
- Central Nervous System Disorders – Spinal Cord
- Renal and Urinary Disorders
- Nervous System
- Respiratory Disorders
- Respiratory System
- Infectious Disease Disorders
- EENT Disorders
- Emergency Care of the Respiratory Patient
- Health & Stress
- Skeletal System
- Endocrine System
- Hematologic System
- Digestive System
- Reproductive System
- Endocrine and Metabolic Disorders
- Muscular System
- Sensory System
- Basics of Human Biology
- Adult
- Anxiety Disorders
- Depressive Disorders
- Dosage Calculations
- Understanding Society
- Concepts of Pharmacology
- Newborn Care
- Adulthood Growth and Development
- Pregnancy Risks
- Postpartum Complications
- Substance Abuse Disorders
- Bipolar Disorders
- Learning Pharmacology
- Psychotic Disorders
- Prenatal Concepts
- Prefixes
- Suffixes
- Fetal Development
- Terminology
- Proteins
- Statistics
- Med Term Basic
- Med Term Whole
- Labor Complications
- Labor and Delivery
- Postpartum Care
- Hematologic Disorders
- Cardiovascular Disorders
- Musculoskeletal Disorders
- Oncologic Disorders
- Eating Disorders
- Personality Disorders
- Trauma-Stress Disorders
- Developmental Considerations
- Concepts of Mental Health
- Psychological Emergencies
- Somatoform Disorders
- Prioritization
- Factors Influencing Community Health
- Community Health Overview