chapter 14 Flashcards
(167 cards)
1
Q
Is it possible for ova to be fertilized up to 5 days after release into the fallopian tubes
A
FALSE
2
Q
____________ is secreted by the ovaries after ovulation
A
estrogen
3
Q
the formation of fetal organs, or _________, is a critical period of fetal development that occurs between 3 and 10 weeks of gestation
A
organogenesis
4
Q
Amenorrhea is a(n) ______ sign of pregnancy
A
presumptive
5
Q
Gravidity (G) is the number of pregnancies a woman has had in her lifetime regardless of outcome
A
True
6
Q
A pregnancy that is 37 0/7 weeks through 38 6/7 weeks is referred to as a(n) __________ term pregnancy
A
early
7
Q
Good __________ and having an open mind are essential for cultural competence
A
communication
8
Q
It is not necessary to seek early prenatal care if a woman is healthy
A
false
9
Q
Luteinizing hormone is the hormone responsible for the release of the mature egg from the follicle
A
True
10
Q
To be a culturally competent nurse, one must understand all aspects of a person’s culture
A
false
11
Q
which weeks of gestation does organogenesis occur
A
between 3 and 10 weeks of gestation
12
Q
what pregnancy ages are considered high risk
A
34 years and older. but also, pregnancies under the age of 20 years old
13
Q
the likelihood of getting pregnant spontaneously (fecundity) begins to reduce at the age of _____ years
A
32
14
Q
what ages are at higher risks for fetal abnormalities, spontaneous abortion, hypertension, neonatal morbidity, and complications in labor and delivery
A
woman over 35 + and 50 +
15
Q
What does the acronym GTPA stand for
A
G: the number of pregnancies a woman has had in her lifetime
T: The number of pregnancies that have ended at term (37 wk plus)
P: The number of pregnancies that end by spontaneous of elective abortion before 20 wk.
L: The number of living children
16
Q
39 0/7 wk through 40 6/7 wk is considered ______ _______
A
full term
17
Q
41 0/7 wk through 41 wk 6/7 is considered ______ ______
A
late term
18
Q
42 0/7 wk and beyond is considered _________
A
Postterm
19
Q
_______ is a pregnancy should be counted as preterm if it ends between 20 and 36 weeks 6 days. As with term, a twin pregnancy would still be counted as one, not two.
A
Preterm
20
Q
_________ is any pregnancy ending prior to 20 weeks should be accounted for as this, regardless of the number of fetuses included in a pregnancy
A
abortion
21
Q
__________ is any substance a woman may be exposed to that causes damage to pregnancy, leading to physical or functional birth defects
A
teratogen
22
Q
date of MP refers to
A
the first day of the most recent menses. this helps us predict when a woman may be most likely to conceive
23
Q
These two STI’s may cause permanent mechanical damage to the fallopian tubes, impairing fertility
A
Gonorrhea and chlamydia
24
Q
A woman with hepatitis ___ may pass the infection onto her child
A
C
25
surgery on the _____ may make it less likely to dilate
cervix
26
surgery on the ____ may make it more likely to rupture during labor
uterus
27
surgery for a woman with endometriosis may ______ her chances of getting pregnant
improve
28
endometriosis can make it more ______ to get pregnant
difficult
29
a malformed uterus may make it ______ likely that a pregnancy can be successfully carried to term
less
30
poorly controlled diabetic is at higher risk for a pregnancy with
congenital defects
31
uncontrolled hypothyroidism can compromise
neurologic development in the fetus
32
some medications used to control hypertension are ____ recommended in pregnancy
not
33
many healthcare providers will recommend that a woman seeking to conceive abstain from alcohol completely, or at least during the last ___ days of their menstrual cycle when a pregnancy may not have begun but is not yet detectable
14
34
vaccinations containing live virus are contraindicated because of a theoretical chance of
fetal harm
35
patients are strongly encouraged to reach and maintain a goal weight between the BMIs of ___ and ____ prior to seeking pregnancy
18.5; 30
36
obesity in pregnancy is associated with
birth defects, infertility, gestational diabetes, and other implications
37
a maternal BMI below 18.5 is correlated with
low birth weight and preterm birth
38
how much of folic acid daily in advance to conception is advised
at least 400 to 800 ug
39
the neural tube closes between _____ and ____ days post conception
18; 26
40
adequate folic acid intake could eliminate approximately ____% of neural tube defects such as spina bifida
70%
41
What kind of diet is encouraged
lean protein, fruits, vegetables, and a minimum of processed foods and simple sugars
42
Vaccinations that may be administer during pregnancy
annual influenza vaccine, Tdap during each pregnancy (27-26wk), and Hep. B virus
43
Vaccinations that should be administered preconception or postpartum if indicated
MMR, Varicella virus, Hep. A virus, Pneumococcal virus, Polio virus, Human papillomavirus
44
environmental toxins may also be teratogens and cause
birth defects, childhood cancer, impaired brain development, miscarriage, and stillbirth
45
women should limit their exposure to
large fish with high mercury content, pesticides, solvents, dietary animal fat, BPA-containing plastics, processed foods, and fruits and vegetables that have not been thoroughly washed
46
many toxin pass the ______ to impact the fetus, and toxins may also be found in ______ ______
placenta; breast milk
47
How does the Zika virus affect pregnancy
fetal abnormalities including microcephaly, spontaneous abortion, stillbirth, fetal growth restrictions, and other complications
48
Which test should be done only at the time of a preconception visit if a woman was due for one per the standard screening or follow-up schedule
Pap test
49
periodontal disease (oral disease) has been associated with
poor pregnancy outcomes, including preterm birth
50
Glands on either side of the vaginal vestibule that secrete mucus for vaginal lubrication
Barholin's glands
51
the visible portion of the clitoris and the most sensitive erogenous zone of the female body
clitoris glans
52
the skin at the posterior of the vulva
fourchette
53
a membrane partially covering the opening of the vagina
hymen
54
the exterior skin folds, which are hair-bearing in mature females and extend from the mons pubis to the perineum
labia major
55
the inner mucosal skin folds, which extend from the mons pubis to the perineum
labia minora
56
a rounded area, padded with fat, that is anterior to the pubic symphysis; hair-bearing in mature females
mons pubis
57
the opening to the urethra
urethra meatus
58
the area between the vulva and the anus
perineum
59
glands at the anterior of the vulva that drain into the urethra
Skene's glands
60
the opening into the vagina. when referred to as the vulvar vestibule, the term includes the urethral meatus
vaginal vestibule
61
the vaginal orifice
introitus
62
paired reproductive organs that produce ova, estrogen, testosterone, and progesterone, and are approximately that size and shape of walnuts
ovaries
63
also called the "womb"; the site of implantation of fetal growth and development
uterus
64
three layers of the uterus
endometrium, myometrium, serosa/perimetrium
65
which layer of the uterus sheds with menstruation
endometrium (innermost layer)
66
a pregnancy implants in the ______
endometrium
67
the endometrium is referred to as the _______
decidua
68
myometrium is primarily
smooth muscle
69
non pregnant uterus is approximately the size and shape of an
upside down pear
70
the uppermost, rounded part of the uterus, which contains the greatest volume of smooth muscle
fundus
71
the main body of the uterus, located between the isthmus and the fallopian tubes
corpus
72
the area of the uterus between the cervix and the corpus, which has thinner, more narrow musculature
isthmus
73
a muscular tube that extends from the vestibule to the cervix and that accommodates penetrative sex and childbirth
vagina
74
the lowest portion of the uterus, which extends into the vagina. it is approximately an inch in diameter and has a small opening at its center called the os
cervix
75
the opening between the cervix and the body of the uterus
internal os
76
the canal between the internal os and the outer os
cervical canal
77
the opening between the cervix and the vagina
outer os
78
a pair of cilia-lined tubes between the uterus and the ovaries, also referred to as the uterine tubes
fallopian tubes
79
the portion of the tube that travels through the musculature of the uterus
interstitial
80
the portion of the tube between the interstitial and the ampulla
isthmus (fallopian tubes)
81
the distal portion of the tube, located between the isthmus and the infundibulum, where fertilization most often occurs
ampulla
82
the funnel-shaped part of the tube, located between the fimbriae and the ampulla
infundibulum
83
a fringe of tissue at the end of the fallopian tube, not attached to the ovary, that gently draws the ovum into the fallopian tube with a sweeping motion
fimbriae
84
a pair of ligaments attaching the ovaries to the uterus
ovarian ligaments
85
a pair of ligaments starting where the fallopian tubes join the uterus ("the uterine horns") and ending deep in the pelvis. stretching of these ligaments in pregnancy can cause pain
round ligaments
86
a wide ligament connective the uterus to the pelivs
broad ligaments
87
the hypothalamus releases
gonadotropin-releasing hormone (GnRH).
88
in response to the release of GnRH, the anterior pituitary secretes
LH and FSH
89
the primary hormone responsible for maturation of the follicles of the ovary that will subsequently release eggs for fertilization
FSH
90
___ is responsible for the final maturation and release of the egg from the follicle
LH
91
levels of ____ peak approximately 12 to 24 hours prior to follicle rupture (ovulation)
LH
92
after follicle rupture, ____ stimulates the ruptured follicle, free of its ovum. this process is called ________
LH; luteinization
93
after luteinization, the follicle is now called the _____ _______
corpus luteum
94
corpus luteum produces
large amounts of progesterone and a smaller amount of estrogen
95
progesterone is responsible for the
secretory phase of the endometrial cycle, during which the lining of the uterus is nourished and maintained in the event of a fertilized embryo and implantation
96
GnRH from the hypothalamus regulates
gonadotropin (luteinizing and FSH) release from the anterior pituitary
97
the corpus luteum begins to lose its secretory function approximately a week after ovulation, this lowers levels of both ________ and _______
progesterone and estrogen
98
When progesterone and estrogen levels are lowered, it stimulates the hypothalamus to produce _______, thus cueing the anterior pituitary to produce ____ and ____, thus restarting
GnRH, FSH and LH
99
if conception occurs, the pregnancy cues the continuation of the corpus luteum and the maintenance of the endometrium/decidua by producing _______ , thus inhibiting GnRH
hCG
100
Estrogen hormone is primarily responsible for
female patterns of fat distribution, development of breasts
101
estrogen is the dominant hormone in the ____ half of the menstrual cycle
dominant
102
estrogen is secreted by the
ovaries, and to a smaller degree, by the corpus luteum
103
progesterone is produced by the ______ ______ after rupture of the ovarian follicle
corpus luteum
104
in the second half of the menstrual cycle after ovulation, ________ helps maintain the uterine lining as well as relaxing the smooth muscle of the uterus, causing vasodilation (this all supports the implantation of pregnancy)
progesterone
105
which hormone creates the small rise in body temperature after ovulation
progesterone
106
what are the two phases of the ovarian cycle
follicular phase and the luteal phase
107
the ____ phase is prior to ovulation and may be as short as 8 days. however, the average phase lasts 14-21 days. this phase concerns maturation of the follicles and the associated oocytes. at the end of this phase, the now mature follicle is called the graafian follicle.
follicular
108
the _____ phase is 12 to 14 days for most women. as women approaches menopause, this phase shortens, making successful implantation and maintenance of a pregnancy less likely.
luteal
109
what are the cells that line the follicle, that produces progesterone after ovulation when the empty follicle becomes the corpus luteum
granulosa cells
110
what helps move the egg towards the uterus
the cilia within the fallopian tubes
111
the ______ cycle refers to the period of time between the start of one meses to the start of the next. this cycle is usually 21 to 35 days long. this cycle can be broken down into four phases: ______, _______, ______, and _______
menstrual; menstrual, proliferative, secretory, and ischemic
112
_______, or the creation of gametes (ova and sperm), occurs by a process called meiosis
gametogenesis
113
spermatogenesis: one spermatogonium gives rise to _____ spermatozoa
four
114
oogenesis. from each oocyte, ____ mature ovum and ____ polar bodie(s) are produced
one; three
115
presumptive signs of pregnancy include
amenorrhea, fatigue, nausea, vomiting, breast changes, quickening, uterine enlargement, urinary frequency
116
proable signs of pregnancy are primarily related to the
physical changes of the uterus
117
proable signs of pregnancy includes
abdominal enlargement, Hegar's sign, Chadwick's sign, Goodell's sign, Ballottement, Braxton Hicks contractions, positive pregnancy test, fetal outline `
118
Hegar's sign
softening and compressibility of the lower uterus
119
Chadwick's sign
deepened violet-bluish color of the cervix and vaginal mucosa
120
Goodell's sign
softening of the cervical tip
121
Ballottement
rebound of unengaged fetus
122
Braxton Hicks contractions
false contractions that are usually painless, irregular, and usually relieved by walking
123
hCG productions starts as early as the day of implantation and detected as early as __ to ___ days before expected menses
7 to 8
124
after the day of implantation, when do hCG levels start to peak
60 to 70 days
125
after the peak of hCG levels, when does the levels of hCG start to decrease and level out for the remainder of the pregnancy?
100-130 days after implantation
126
____ levels of hCG indicated multifetal pregnancy, ectopic pregnancy, hydatidiform mole (gestational trophoblastic disease), or a genetic abnormality such as Down syndrome)
increased
127
_____ levels of hCG might suggest miscarriage or ectopic pregnancy
decreased
128
meds such as anticonvulsants, diuretics, and tranquilizers can cause a false-positive pregnancy test
true
129
for the most accurate results of a urine pregnancy test, urine sample should be
first-voided morning specimen
130
this rule tells you to take the first day of the clients last menstrual cycle, subtract 3 months and then add 7 days and one year
Nagele's rule
131
to measure the ______l height, in cm from the symphysis pubis to the top of the uterine _____ (between 18-32 weeks gestation). approximately the gestational age, plus or minus 2 gestational weeks.
fundal; fundus
132
Gravidity is the
number of pregnancies
133
nulligravida means
the client has never been pregnant
134
primigravida means the
client is in their first pregnancy
135
multigravida means
the client has had two or more pregnancies
136
the parity is the
number of pregnancies where the fetus reaches 20 weeks, NOT the number of fetuses. (this is not affected whether the fetus is born stillborn or alive)
137
nullipara means
no pregnancy beyond the stage of viability
138
primipara means
they have completed one pregnancy to the stage of viability
139
multipara means
they completed two or more pregnancies to viability
140
viability is the
point in time when an infant has the capacity to survive outside the uterus. infants born between 22-25 weeks are considered on the threshold of viability
141
the uterus ____ in size and ovulation and menses cease during pregnancy
increases
142
O2 needs ______. in the last trimester the size of their chest may ______. this allows for lung expansion as the uterus pushes upward. thus, the respiration rates ____ and the total lung capacity _______
increases; enlarge; increase; decrease
143
nausea and vomiting are symptoms due to
hormones and or increased pressure with abdominal cavity
144
constipation is due to _______ transit of time and food through the gastrointestinal tract. therefore ______ water absorption
increase; increase
145
filtration rate _______ secondary to the influence of pregnancy hormones and _______in blood volume and metabolic demands
increases; increases
146
the _______ becomes an endocrine organ
placenta
147
the placenta produces large amounts of which hormones
hCG, progesterone, estrogen, human placental lactogen, and prostaglandins
148
cardiac output _______ and blood volume _______ to meet greater metabolic demands
increases; increases
149
HR ______ during pregnancy beginning around week 5, and reaches a peak around ____ weeks
increases; 32
150
when do BP measurements start to change during pregnancy
diastolic BP slightly decreases around 24-32 weeks
151
what position can affect the BP
supine position
152
a supine position can affect BP due to
the weight and pressure of the gravid uterus on the vena cava. this decreases venous blood flow to the heart. this can lead to maternal hypotension and fetal hypoxia. this is also called supine hypotensive syndrome or supine vena cava syndrome
153
what are manifestations of supine hypotensive syndrome or supine vena cava syndrome
dizziness, lightheadedness, pallor, clammy skin
154
if a patient has supine hypotensive syndrome or supine vena cava syndrome manifestations, what should you encouragethem to do
encourage the client to engage in maternal positioning on the left lateral side, semi fowler's, or, if supine, with a wedge placed under one hip to alleviate pressure to the vena cava
155
ones pulse increase 10-15/min around ____ weeks, and remains elevated throughout the remainder of pregnancy
32
156
what indicates an intact fetal CNS
fetal heart tones are heard at a normal baseline rate of 110 to 160/min with reassuring FHR accelerations noted
157
does a pregnant womans heart change in size and shape?
yes, this also means the heart sounds also change
158
why does a pregnant womans heart change in size and shape?
to accommodate with increased input and volume
159
which heart sounds are more distinguishable in a pregnant woman?
splitting of S1 and S2, with S3 more easily heard following 20 weeks
160
is it common to hear murmurs in a pregnant woman
yes
161
uterine size will start to weigh of _____ to _____g
50-1000g (0.1 to 2.2 lbs)
162
at _____ weeks, the top of the uterus and fundus will reach the ______ process, which can contribute to having shortness of breath
36 weeks' xiphoid process
163
breast changes include
increased size, darkening of the areola
164
skin changes include
chloasma, linea nigra, and striae gravidarum
165
chloasma is the
increase of pigmentation on the face
166
linea nigra is the
dark line of pigmentation from the umbilicus extending to the pubic area
167
striae gravidarum are
stretch marks most notably found on the abdomen and thighs
