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Womens Health > Exam 1 > Flashcards

Exam 1 Flashcards

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1
Q

Maternal mortality rate is

Mortality rate in US

A

Number of deaths related to pregnancy, delivery or postpartum / 100,000 births

19 per 100,000 live births

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2
Q

Factors affecting maternal mortality in US

A

Low SES, pre-existing conditions, hemorrhage, pregnancy related hypertensive disorders, infections

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3
Q

Ovarian cycle comes in 3 phases which are

A

Follicular phase (day 1 - 10 to 14)
Ovulation (day 14)
Luteal phase (day 15 - 28)

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4
Q

Follicular phase day 1-14 what happens & what hormones are involved

A

FSH - stimulates maturation of new follicle
As follicle increases, more estrogen is released
ESTROGEN - shuts down FSH so 1 egg is in play
ESTROGEN encourages production of LH which triggers ovulation

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5
Q

Ovulation phase day 14 what occurs & what hormones play a role

A

Surge of LH causes mature follicle to be rupture & release an ovum
Levels of estrogen drop & progesterone increases

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6
Q

Luteal phase (day 15-28) & hormones associated

A

Begins at ovulation & last until menstrual phase of next cycle
Follicle forms the corpus luteum & produces PROGESTERONE
Progesterone maintains thick uterine lining
Corpus luteum produces Estrogen that continues to thicken endometrium
FSH & LH are at lowest level

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7
Q

What happens if the egg is not fertilized

A

Corpus luteum will stop secreting hormones so the lining will begin to shed & begin menstruation
Since ESTROGEN levels drop, FSH increases & restarts the ovarian cycle

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8
Q

What happens if the egg is fertilized

A

Body will release hGh so corpus luteum is maintained & endometrium maintains thickness so egg can grow

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9
Q

What is menstruation
Which hormone is high & why

A

Lining of endometrium is being shed because egg wasn’t fertilized (day 1-5)
FSH is high to stimulate maturation of new follicle & begin ovarian cycle

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10
Q

Amniotic fluid is made up of
What are abnormalities & associated problems

A

98% water & 2% organic matter
Oligohydramnios (< 500ml, too little) : uteroplacental insufficiency & renal abnormalities
Hydramnios (> 2,000ml, too much) : maternal diabetes, neural tube defects, chromosomal deviations, CNS malformation, GI alterations

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11
Q

Role of amniotic fluid

A

Cushions the fetus from trauma
Maintains constant body temp for fetus
Promotes fetal movement

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12
Q

Down syndrome is an
Affects which chromosome
Characteristics of downs

A

Abnormality of chromosome number
Trisomy 21; extra material on chrom.
Small low set ears, wide set eyes, simian crease, open mouth with protruding tongue

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13
Q

Tay sachs disease is an
What does it affect & why

A

Autosomal recessive inheritance
Affects nervous system of the brain due to fatty substances accumulating

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14
Q

Antibodies that fetus has at end of pregnancy (immunoglobulins)

A

IgG - only one that crosses the placenta providing passive acquired immunity (most common antibody)
IgM - fetus will produce as first line of defense
IgA - produced in colostrum (breast milk) is given to baby through milk

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15
Q

Roles of the placenta

A

Placenta serves as an interface between mother and fetus (O2 & nutrients)
Baby gets oxygen from placenta
Makes hormones
Protects fetus from immune attack by mother
Removes waste products from fetus (CO2)

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16
Q

Presumptive signs of pregnancy

A

Amenorrhea, fatigue, breast tenderness, nausea & vomiting, urinary frequenc, quickening, breast enlargement

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17
Q

Probable signs of pregnancy

A

Braxton hicks contractions, abdominal uterine enlargement, positive pregnancy test, ballottement, hegars sugn, Chadwick’s sign, goodwills sign

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18
Q

Hegars sign
Chadwick’s sign
Goodells sign

A

Softening of lower uterine segment or isthmus
Bluish-purple coloration of vaginal mucosa and cervix
Softening of cervix

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19
Q

Positive signs of pregnancy

Study These Flashcards
A

Ultrasound verification, fetal movement felt by clinician, auscultation of fetal heart tones via Doppler

20
Q

Naegele’s rule for EDB

Study These Flashcards
A

First day of LMP
Subtract 3 months
Add 7 days
Add a year

21
Q

Pre-term
Term
Post-term

Study These Flashcards
A

Pre : less than 37 weeks
Term : 37 - 42
Post : more than 42 weeks

22
Q

GTPAL stands for
GP is

Study These Flashcards
A

Gravida (total pregnancies)
Term births (> 37 weeks)
Preterm births (between 20 - 37 wks)
Abortions/miss (ends before 20wks)
Living children

Gravida (pregnancies)
Para (number of births)

23
Q

How is fundal height measured
Expected location in pregnancy

Study These Flashcards
A

From the symphysis pubis to top of uterus
20 weeks - level of umbilicus; 20cm

24
Q

What is vena cava syndrome

Study These Flashcards
A

In the supine position the uterus can compress the inferior vena cava which reduces venous return, cardiac output & blood pressure , with increasing orthostatic stress

25
GI system adaptations during pregnancy
Dental problems; gingivitis Ptyalism (excessive salivation) Decreased peristalsis & smooth muscle relaxation Hemorrhoids Reflux - heartburn Nausea & vomiting
26
Cardiovascular system changes during pregnancy
Increased blood volume, cardiac output & heart rate BP decreases in 2nd trimester Increased RBCs & plasma volume Hypercoagulable state Increased WBC count
27
Musculoskeletal changes during pregnancy
Waddle gait Lordosis Softening & stretching of ligaments & joints
28
Psychological changes A I A M C
Ambivalence: conflicting feelings Introversion: mother increasingly preoccupied with herself & fetus Acceptance: bring reality & validity to pregnancy Mood swings Changes in body image
29
1st trimester discomforts
Urinary frequency, fatigue, breast tenderness, constipation, epistaxis Nausea & vomiting (eat small, frequent meals, bland, low fat)
30
Foods for morning sickness
Dry crackers, ginger, hard candy, gum
31
Counting fetal movements
Relaxed & comfortable Same time each day Be aware if decrease in movement Count to 10 method - contact HCP if longer than 2 hours
32
When traveling mother should Braxton hicks contraction Amount of water per day
Walk around every 2 hours Hydrate, rest in side lying, breathing techniques 2 liters / 8 glasses
33
Nutritional considerations during pregnancy PICA Lactose intolerance Vegetarians
Pica - pregnant women wanting to eat weird things like soil, clay, pebbles, paint chips, chalk (driven by iron deficiency) Lactose - substitute foods include dairy free products or calcium enriched, peanuts, almonds, seeds, salmon Vegetarians - protein (soy, beans, nuts, grains). Iron (meat alternatives & vitamin C rich). Calcium (soy, tofu, calcium fortified OJ). Vitamin B12 (fortified soy foods & B12 supp)
34
Foods to avoid during pregnancy
Artificial sweeteners Seafood high in mercury (shark, swordfish, king mackerel, tuna, tilefish) Processed foods (hot dogs, deli meats) Refrigerated smoked seafoods Salads made in stores
35
Maternal weight gain related to BMI Normal, underweight, overweight, obese
Normal BMI (18.5-24.9) = 25-35lbs Underweight BMI (<18.5) = 28-40lbs Overweight BMI (>25) = 15-25lbs Obese BMI (30+) = 11-20lbs
36
Epidural block is Interventions before During After
Most common form of pain relief Before: assess vitals/ BP, administer IV bolus to hydrate & avoid hypotension, assess FHR During: assist provider with placement of epidural & placement of patient in lateral or sitting position After: Monitor BP & assess for side effects, monitor contractions, assess FHR
37
True vs false Labor
Contraction timing (false: irregular & not together) (True: come at regular times & get closer together) Contraction activity (false: they stop when walking or resting) (true: they continue despite resting) Contraction strength (false: usually weak) (true: get steadily stronger) Contraction pain (false: felt only in front) (true: starts in back & moves to front)
38
Signs of labor
Cervical softening or dilation Increased energy Lightening: fetal begins to descend Bloody show: mucous plug Braxton hicks contractions Spontaneous rupture of membranes
39
Pelvis shapes
Gynecoid : favorable for V delivery Android: male shaped; unfavorable Anthropoid: usually adequate Platypelloid: not favorable
40
Effacement & dilation
Effacement is the shortening & thining of the cervix Dilation is how open the cervix gets Cervix must dilate to 10cm & 100% effacement for delivery
41
Main fetal presentations
Cephalic (vertex) - head down Breech - pelvis down Shoulder - scapula first Malpresentation will lead to cesarean
42
Fetal station refers to 0 station is What is engagement
The presenting part to the level of the ischeal spines 0 - level to the ischeal spines Engagement is when presenting part is at 0
43
1st stage of labor is Includes what 3 phases & dilation + effacement
The longest of all stages Latent (dilation 0-3cm; efface 0-40%) Active (dilation 4-7cm; efface 40-80%) Transition (dilation 8-10cm; efface 80-100%)
44
Second stage of birth Degrees of tear Episiotomy is
Full dilation ; lasts about 30-50min Birth of head, shoulders, body 1st degree tear - least severe 4th degree - goes down to anus A surgical laceration to prevent rupture during labor
45
3rd stage of labor Signs of placental separation 4th stage
Birth of infant to placental separation Uterus rises upward, umbilical cord lengthens, trickle of blood from vagina, uterus changes shape to globular Restorative stage 1-4hrs pp Recovery, interactions & care of newborn

Womens Health (3 decks)

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