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LCON OB > Exam 1 Blueprint > Flashcards

Exam 1 Blueprint Flashcards

1
Q

What are Germ layers (embryonic development stage)?

A

• Cells are arranged into 3 primarily layers

🔸Ectoderm: outer layer.
* Skin, nervous system, and other external parts of the body

🔹Endoderm: inner layer.
* Thymus, thyroid, digestive, respiratory and parts of the GU system

🔸Mesoderm: inner layer
* Circulatory system, urinary and reproductive organs, muscles, bones.

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2
Q

What are all signs of pregnancy?

A

🔸 Presumptive.
🔹 Probable
🔸 Positive

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3
Q

What are the Presumptive signs of pregnancy?

A

Presumptive signs (Subjective Signs)

🔸 3-4 wks - Breast changes

🔹 4 wk - Amenorrhea

🔸 4-14 wks - Nausea & Vomiting

🔹 6-12 wks - Urinary frequency

🔸 12 wks - Fatigue

🔹 16-20 wks - Quickening= 1st recognition of fetal movement

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4
Q

What are the Probable signs of pregnancy?

A

Probable signs: subjective

🔸 5 wks: Goodell sign= softening of cervical tip in a normal unscarred cervix (around 6 wks)

🔹 6-8 wks: Chadwick signs= a bluish color of cervix (6-8 wks)

🔸 6-12 wks: Hegar sign= softening and thinning of lower segment of uterus – about the 6th wk) – probable sign

🔹 4-12 wks: Positive result of pregnancy test (serum)

🔸 6-12 wks: Positive result of pregnancy test (urine)

🔹 16 wks: Braxton hicks contraction= irregular/ painful contraction (DO NOT CAUSE CERVICAL DILATION)

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5
Q

What are the Positive signs of pregnancy?

A

Positive signs (Diagnostic Signs)

🔸 5-6 wks: visualization of fetus by real-time ultrasound

🔹 6 wks: FHT’s detected by ultrasound

🔸 16 wks: visualization of fetus by radiographic study

🔹 8-17 wks: FHT’s detected by Doppler ultrasound stethoscope

🔸 17-19 wks: fetal heart tones detected by fetal stethoscope

🔹 19-22 wks: fetal movement palpated

🔸 late pregnancy: fetal movement visible

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6
Q

What are the uses of Contraception?

A
  • Intentional prevention of pregnancy
  • Birth control is the device or practice to decrease the risk of conceiving
  • Family planning is the conscious decision on when to conceive or avoid pregnancy
  • May still be at risk for pregnancy
  • Nearly half of all US pregnancies are unplanned
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7
Q

What are the functions of the Placenta?

A

1) Provides your baby with oxygen and nutrients.

2) Removes harmful waste and carbon dioxide from your baby.

3) Produces hormones that help your baby grow.

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8
Q

Estimate Due Date (EDD)

A

🔶 Nagele rule

  • Determine first day of last menstrual period.

🔸LMP + 7 days – 3 months = EDD

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9
Q

Intimate partner violence (IPV)

A
  • Its defined as sexual violence, stalking, physical violence, and psychological aggression perpetrated by an intimate partner.
  • Maternal exposure to domestic violence is associated with significantly inscreased :-
    * Risk of low birth weight.
    * Preterm birth.
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10
Q

What are the differences between an Embryo and Fetus?

A

🔸 Embryo.
- Day 15 - 8 wks (organs are forming & greatest vulnerability).

🔸 Fetus.
- 9 wks - birth

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11
Q

What are the Development milestones?

A

🔸 Embryonic stages
➤ 3 weeks:
* Heart beating and blood circulates

➤ 4 weeks:
* 2 chamber forms a 4- chamber heart
* Respiratory system begins

➤ 5 weeks:
* umbilical cord developed

➤ 8 weeks:
* gender distinguishable- not definitive

🔸 Fetal stages
➤ 9 weeks:
* fingers, toes, eyelids, nose and jaw evident

➤ 12 wks:
* placenta complete
* organ system complete
* thumb sucking
* fetus urinates in amniotic fluid- 11 weeks

➤ 16 weeks:
* Meconium in bowel

➤ 20 wks:
* hearing developing
* quickening (mom feels movement)
* lanugo covers the body
* wake/ sleep cycles evident

➤ 24 weeks
* circulation visible
* rapid brain growth
* hiccups
* vernix caseosa is thick
* lecithin (L) is present

➤ 28 weeks
* eyes open and close
* process sights and sounds
* taste buds developing
* hair on head

➤ 32 weeks
* fingernails, toenails & fingerprints present
* subq fat develops
* vigorous fetal movement
* L/S ratio= 1:2:1 (lung maturity 2:1)

➤ 36 weeks
* lanugo disappearing
* amniotic fluid decreases
* L/S ratio >2:1

➤ 40 weeks
* fetal development complete

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12
Q

Fetal Circulation

A

🔸 Normal circulation
Lungs ➤ Pulmonary veins ➤ Left atrium (bicuspid AV valve) ➤ Left ventricle (aortic semilunar valve) ➤ Aorta ➤ Body tissues ➤ Vena cava ➤ Right atrium (tricuspid AV valve) ➤ Right ventricle (pulmonary semilunar valve) ➤ Pulmonary arteries ➤ Lungs

🔸 Fetal valves (shunts)
3. Ductus arteriosus: valve that shunts blood around the lung (just enough to keep lungs valve)
⬆️
2. Foramen ovale: valve allowing blood to flow directly from right to left atrium
⬆️
1. Ductus venosus (1st shunt- valve): valve that shunts around the liver
⬆️
* Placenta starts bottom to up

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13
Q

Which blood vessels supply blood in a fetus?

A

Vessel (2 arteries, 1 vein) supply nutrient and O2 from mother.

🔸 Arteries- carry deoxygenated blood from the embryo

🔹 Veins carry oxygenated blood to the embryo

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14
Q

STI’s And their treatments

A

🔸 Chlamydia - Azithromycin 1 gram
🔹 Gonorrhea - Ceftriaxone
🔸 Syphilis - Pencillin
🔹 Trichomoniasis - Metronidazole or tinidazole
🔸 GBS - Penicillin

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15
Q

What is Polyhydramnios?

A
  • Its excessive amniotic fluid.
  • Severe polyhydramnios may cause:-
    * Shortness of breath,
    * Preterm labor etc.
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16
Q

What is Oligohydramnios?

A
  • Its a disorder of amniotic fluid resulting in decreased amniotic fluid volume for gestational age.
  • Oligohydramnios may also cause:-
    * Deformities
    * Preterm birth.
    * Miscarriage.
    * Stillbirth.
17
Q

Antenatal tests (and what each test is testing for)

A

🔸 NST (Non stress test)
- Its a screening test used in pregnancy to assess fetal status by means of the fetal heart rate and its responsiveness.
- Acceleration 15 X 15

🔹 BPP (Biophysical Profile)
- Its an abdominal ultrasound that measures :-
* Fetal breathing movements
* Gross body movement
* Fetal tone
* Amniotic fluid index
* NST Results (Acceleration 15 X 15)

🔸 MSAFP (Maternal Serum Alpha-Fetoprotein)
- Its used to check the baby’s risk of birth defects and genetic disorders, such as neural tube defects or Down syndrome.
- Performed at (15-20 wks) gestation.
- Screening tool Only.

🔹 CST (Contractions Stress Test)
- Its a test that measures the fetal heart rate after the mother’s uterus is stimulated to contract.

  • This test is done to make sure the fetus can handle contractions during labor and get the oxygen needed from the placenta.

🔸 Amniocentesis.
- Its an Ultrasound-guided needle through the abdomen and uterus to obtain a sample of amniotic fluid.

  • Performed at or after 15 weeks gestation.
  • L/S ratio: assess fetal lung maturity.
  • A ratio of 2:1 or higher is considered mature.
  • Alpha-fetoprotein: screens neural tube defects.

🔸 Chorionic Villus Sampling (CVS)
- Its where a sterile syringe and needle is inserted through the abdomen or through the vagina under U/S guidance.

  • Performed at 10 -13 wks gestation.
  • Assessment of a portion of the developing placenta.

🔸 Percutaneous Umbilical Blood Sampling (PUBS)
- An ultrasound-guided needle is inserted into the abdomen and umbilical cord vein and blood is extracted and tested for a large range of conditions i.e. infections, genetic disorders, and blood disorders.

  • Performed after 18 weeks of gestation
  • Generally considered safe but it is an invasive procedure
  • Can also be used for fetal blood transfusions in utero

🔸 Indirect Coomb’s Test.

  • Maternal blood test
  • Screens for Rh incompatibility
  • If the titer result is greater than 1:8, further testing should follow
  • Risk of hemolytic anemia of fetus
18
Q

What ate the None Stress Test (NST) results?

A
  • The fetal monitoring for 20 - 30 mins
  • 15 x 15 Accelerations
19
Q

Gestational Diabetis Mellitus (GDM)

A
  • Its a type of diabetes that can develop during pregnancy in women who don’t already have diabetes or its any degree of glucose intolerance with onset or
    recognition during pregnancy
  • Its has both:-
    * Maternal Risks
    * Fetal risks
20
Q

What are the Maternal & Fetal Risks of Gestational DM?

A

🔸 Maternal risks and complications
* Macrosomia
* Polydramnios
* Ketoacidosis
* Hyperglycemia
* Hypoglycemia

🔹Fetal/ Neonatal risks and complications
* Perinatal mortality risk increased
* Congenital malformations
* Respiratory distress syndrome (RDS)
* Prematurity
* IUFD (intrauterine fetal demise)

21
Q

When does the screening for Gestational Diabetes Mellitus start?

A
  • Early pregnancy screening
  • Screening at 24 to 28 weeks
22
Q

What are the interventions of Gestational Diabetes Mellitus in (Antepartum, Intrapartum, postpartum)?

A

🔸 Antepartum
￭ Diet
￭ Exercise
￭ Self-monitoring of blood glucose
￭ Pharmacologic therapy
￭ Fetal surveillance

🔹 Intrapartum
￭ Glucose monitoring hourly (Very important)
￭ Insulin infusion
￭ Avoid dextrose solutions

🔸 Postpartum
￭ Most return to normal
￭ High risk for future GDM in pregnancy
￭ Increased risk of type 2 diabetes
￭ Reassess at 6-12 weeks

23
Q

What are the Cardiac class I-III?

A

Class I - Asymptomatic
Class II - Symptomatic w/ slight activity limitations
Class III - Symptomatic w/ marked activity limitations
Class IV - Symptomatic- unable to carry out any activity

  • Determined at 3 months and again at 7 or 8 months
    of gestation as progression may occur
24
Q

Anemia and epilepsy

A

🔸 Anemia
- Its the most common medical condition of pregnancy
* Iron deficiency anemia
* Folic acid deficiency anemia
* Sickle cell hemoglobinpathy
* Thalassemia

🔸 Epilepsy (neurological disorder)
- Most common neurological disorder in pregnancy
* Failure to take med is common factor
* Should receive preconception counseling
* At risk of congenital anomalies if mother is taking anticonvulsants (meds mainly not used only kepra and lapito are approved)
* Addiction during pregnancy

25
Q

What are the Addiction treatments while pregnant?

A

Interventions
🔸Medical management
* Education
* Consequences of drug use
* Monitoring
* Treatment programs (Methadone therapy for
Opioid Use)

🔹Nursing interventions
* Low threshold for pain requires additional approaches to management
* Decreased involvement with infant requires advice and education
* Considerations for breastfeeding related to infant exposure

26
Q

What are the Autoimmune disorders in pregnancy?

A

🔸 Systemic Lupus Erythematosus
- Autoimmune antibody production affects skin, joints,
kidneys, lungs, central nervous system, liver, and
other body organs.

🔹 Myasthenia Gravis
- Autoimmune motor (muscle) endplate disorder, that causes muscle weakness in the eyes, face, neck, limbs, and respiratory muscles

LCON OB (5 decks)

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