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Womens Health > Exam 1 > Flashcards

Exam 1 Flashcards

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

A

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

20
Q

Naegele’s rule for EDB

A

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

21
Q

Pre-term
Term
Post-term

A

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

22
Q

GTPAL stands for
GP is

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

A

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

24
Q

What is vena cava syndrome

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
Q

GI system adaptations during pregnancy

A

Dental problems; gingivitis
Ptyalism (excessive salivation)
Decreased peristalsis & smooth muscle relaxation
Hemorrhoids
Reflux - heartburn
Nausea & vomiting

26
Q

Cardiovascular system changes during pregnancy

A

Increased blood volume, cardiac output & heart rate
BP decreases in 2nd trimester
Increased RBCs & plasma volume
Hypercoagulable state
Increased WBC count

27
Q

Musculoskeletal changes during pregnancy

A

Waddle gait
Lordosis
Softening & stretching of ligaments & joints

28
Q

Psychological changes
A
I
A
M
C

A

Ambivalence: conflicting feelings
Introversion: mother increasingly preoccupied with herself & fetus
Acceptance: bring reality & validity to pregnancy
Mood swings
Changes in body image

29
Q

1st trimester discomforts

A

Urinary frequency, fatigue, breast tenderness, constipation, epistaxis
Nausea & vomiting (eat small, frequent meals, bland, low fat)

30
Q

Foods for morning sickness

A

Dry crackers, ginger, hard candy, gum

31
Q

Counting fetal movements

A

Relaxed & comfortable
Same time each day
Be aware if decrease in movement
Count to 10 method - contact HCP if longer than 2 hours

32
Q

When traveling mother should
Braxton hicks contraction
Amount of water per day

A

Walk around every 2 hours
Hydrate, rest in side lying, breathing techniques
2 liters / 8 glasses

33
Q

Nutritional considerations during pregnancy
PICA
Lactose intolerance
Vegetarians

A

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
Q

Foods to avoid during pregnancy

A

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
Q

Maternal weight gain related to BMI
Normal, underweight, overweight, obese

A

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
Q

Epidural block is
Interventions before
During
After

A

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
Q

True vs false Labor

A

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
Q

Signs of labor

A

Cervical softening or dilation
Increased energy
Lightening: fetal begins to descend
Bloody show: mucous plug
Braxton hicks contractions
Spontaneous rupture of membranes

39
Q

Pelvis shapes

A

Gynecoid : favorable for V delivery
Android: male shaped; unfavorable
Anthropoid: usually adequate
Platypelloid: not favorable

40
Q

Effacement & dilation

A

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
Q

Main fetal presentations

A

Cephalic (vertex) - head down
Breech - pelvis down
Shoulder - scapula first
Malpresentation will lead to cesarean

42
Q

Fetal station refers to
0 station is
What is engagement

A

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
Q

1st stage of labor is
Includes what 3 phases & dilation + effacement

A

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
Q

Second stage of birth
Degrees of tear
Episiotomy is

A

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
Q

3rd stage of labor
Signs of placental separation

4th stage

A

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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