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EXAM 1 Flashcards

1
Q

DEFINE BALLOTTMENT

A

When provider pushes in mom’s cervix the cervix rebounds as if there is a fetal head on other side

PROBABLE SIGN

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2
Q

What is Goodells sign

A

Softening of cervix indc pregnancy

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3
Q

What is Chadwick’s sign

A

bluish color of the vulva, vagina, and cervix

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4
Q

What is Hegar’s sign

A

the lower part of the uterus is soft (can squeeze the uterus through insertion of fingers through vaginal pushed against hand up top

PROBABLE SIGN

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5
Q

what are the positive signs of fetal presence

A

doc/nurse sees’feels visible movment

on ultrasound

fetal hr

baby is delivered

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6
Q

Describe the function of hormones’ w/ in the 1st trimester (0-13 weeks)

A

the corpus luteus (follicle that just released an egg, will die if their egg isn’t fertilized) in the ovaries secretes estrogen and progesterone to support the fetus and creation of placenta. Also decreased GnRH to stop cycle

estrogen’s steadily rises until week 38.5: suppresses FSH and LH, grows the fetus’s organs, increase’s maternal tissue growth (mammary glands and uterus)

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7
Q

Describe the function of hormones’ w/ in the 2nd trimester (14-26 weeks)

A

the placenta takes over for the corpus luteum in the ovaries and secretes estrogen and progesterone to support the fetus and creation of placenta

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8
Q

What is the effect of estrogen on mom’s body?

A

mask of pregnancy (hyperpigmentation around face)

suppresses FSH and LH (except at high levels such as during ovulation)

grows the fetus’s organs

increase’s maternal tissue growth (mammary glands and uterus)

increase blood volume

increase Na and water retention

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9
Q

What is the effect of progesterone on mom’s body?

A

secreted by corpus luteus

maintains endometrium (no early miscarriages), makes period lining during luteal phase

inhibits contractions

aids in duct development

decreases smooth muscle tone which can turn into constipation and heartburn and varicose veins

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10
Q

What does HCG do?

A

Stimulates the corpus luteum in the ovaries to secrete estrogen and progesterone to support the fetus and create the placenta

eventually taken over by placenta by beginning of 2nd trimester

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11
Q

How do you measure the position of the fundus?

A

The relationship between the symphysis pubis (cartilage between anterior pelvis) and the fundus (top, meaty part of the uterus)

  1. Have pt lay on back
  2. use taper measure to measure the distance between the symph pub and fundus

See if length matches the gestational age of the pregnancy

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12
Q

the fundus is positioned just above the symphysis pubis. About hoe many weeks gestation is she?

A

12 weeks (+/-2cm)

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13
Q

the fundus is positioned at the belly button. About how many weeks gestation is she?

A

20 weeks (+/-2cm)

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14
Q

the fundus is positioned at the xiphoid process. About how many weeks gestation is she?

A

36 weeks (+/-2cm)

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15
Q

where do you expect the fundus to be at 36-40+ weeks?

A

down about 4cm from the xiphoid process

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16
Q

How do you calculate a woman’s estimated due date

A

add 7 days to LMP and count forward 9 months

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17
Q

what is the fertile pd for a 28 day cycle

A

days 9-16

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18
Q

high levels of estrogen can cause
_____ on microscope slide

A

ferning

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19
Q

what would the characteristics of a woman’s cervical mucus be during their early follicular phase, ovulation, and luteal phase?

A

follicular phase: Spinnbarkeit 6cm (white)

ovulation: Spinnbarkeit 12cm (clear)

luteal: Spinnbarkeit 3cm

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20
Q

define menarche

A

occurrence of first menstrual period

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21
Q

define menorrhagia

A

Regularly occurring bleeding excessive in
duration and flow (longer than 7 days)

Soaking through pad/tampon in 1 hour, clots, gush

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22
Q

define metrorrhagia

A

Bleeding at irregular intervals

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23
Q

define oligomenorrhea

A

infrequently occurring menses at intervals
greater than 35 days

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24
Q

polymenorrhea

A

Menses at intervals of 21 to 24 days or fewer

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25
hypomenorrhea
Regular bleeding in less than normal amount
26
primary Amenorrhea
 No menses by age 14 in the absence of secondary sex characteristics  No menses by age 16 in the presence of secondary sex characteristics
27
secondary Amenorrhea
Absence of menses for 3 cycles or 6 months in women who have previously menstruated
28
labs for Amenorrhea
 Amenorrhea workup: ßHcG, TSH, prolactin, FSH & LH may be ordered if ovarian failure suspected  Progesterone challenge test
29
what are some lifestyle habits that may cause dysmenorrhea
smokers, and women who are obese
30
primary vs. secondary dysmenorrhea
Primary - when ovulation is established  excess prostaglandins  Usually starts 6-12 months following 1st pd  Lasts 48-72 hours Secondary - usually with underlying pelvic pathology
31
What are the trimesters of pregnancy
 First: week 1 through 13  Second: weeks 14 through 26  Third: weeks 27 through 40
32
what are the sounds made by uterine arteries called
Uterine souffle. Should be the same as the maternal pulse
33
when would Quickening-first recognition of fetal movement expected to be present
14 to 16 weeks for multips (already has a kid) 18-20 weeks for primips
34
what are Montgomery’s tubercles
hypertrophied sebaceous glands on areolas (lubricate things for breastfeeding)
35
Blood volume and composition increases by
30-50% = dilution of iron causes anemia
36
what is a Daily fetal movement count (DFMC)
count number of kicks in 1 hr Further evaluation needed: mom reports decreased activity or no FM in 12 hours
37
how do you use Ultrasonography to determine baby's gestation
CROWN TO RUMP LENGTH CAN INDICATE GESTATIONAL AGE
38
how do you use Ultrasonography to determine 5 fetal variables
breathing movement body movement tone amniotic fluid volume (all found via ultrasound)
39
what is IUGR
Intrauterine growth restriction, or IUGR, is when a baby in the womb (a fetus) does not grow as expected.
40
What are the scores for the Biophysical Profile of a fetus
0-2 strongly suspect chronic asphyxia 10: normal
41
There difference between reactive, nonreactive, and unsatisfactory NST (non-stress test to determine fetal activity)
reactive NST at least 2 15-bpm FHR accelerations lasting 15 seconds or more with fetal movements over 20 minutes (over 32 weeks gestation) nonreactive NST reactive criteria not demonstrated or met (flat-ish line despite contractions) unsatisfactory NST inadequate external monitor tracing of FHR
42
why would you perform a Contraction stress test (CST)
Indicated for pregnancies at risk for placental insufficiency or fetal compromise as a result of IUGR diabetes mellitus Post term or 42 week’s gestation or more nonreactive NST abnormal or suspicious BPP do it by Nipple-stim or Oxytocin-stimulated contraction test don't do if there is a risk of bleeding/infection
43
Why do an Amniocentesis
genetic concerns (16-18w) and lung maturity (30-35 weeks)
44
2 most frequent tests to test Fetal lung maturity
L/S (lecithin / sphingomyelin) ratio: 2 components of surfactant Phosphatidylglycerol (PG) lungs are mature if PG is present in conjunction with L/S ratio of 2:1 expected at at about 32-35 weeks’ gestation
45
when are fetus' lung mature
32-35 weeks’ gestation
46
Preterm labor is defined as
cervical changes and uterine contractions occurring between 20 and 37 weeks gestation (when birth is considered a miscarriage) characterized by uterine activity, discomfort, and vaginal discharge Fix by Decrease activities that result in PTL symptoms or bed rest
47
what threshold is considered a Low birth weight:
less than 2500 grams at birth
48
when would you use betamethasone on L/D
Suppression of preterm birth by decreasing uterine activity: Tocolytics (Mag, nifedipine, terbutaline, indomethacin) its an antenatal glucocorticoids that Accelerates fetal lung maturity & Reduces severity of respiratory distress in preterm births Effective for 24-34 week gestation pregnancies
49
Tocolytic drugs
Terbutaline (Brethine)-beta adrenergic receptor Nifedipine (Procardia)-calcium channel blocker Indomethacin (Indocin)-prostaglandin inhibitor NSAID Magnesium sulfate-calcium antagonist
50
at what point would pre-term labor inevitably become preterm birth?
Labor progressed to cervical dilation of 4 cm
51
How can you tell if a pt is Premature Rupture of Membranes (PROM)
test discharge for amniotic fluid Nitrazine: amniotic fluid will be higher than 6.5-alkaline (rub paper on soaked pad to test PH) Fern test: fluid on slide and let dry-fern pattern
52
When would PROM pts have to be induced if no labor starts?
If no labor in 12 hours, usually will induce-some will wait 24 hours
53
when is testing for Group B Streptococcus (GBS)
Testing routinely done between 35-37 weeks Results valid for 5 weeks Prophylactic antibiotics: 4 hours prior to delivery Ampicillin or cephalexin
54
what is the Cullen sign
Ectopic pregnancy Note @ 5-6 weeks: BRUISED BELLY BUTTON
55
what are the types of hydatidiform moles
Complete (or classic) mole, which results from fertilization of egg with lost or inactivated nucleus Partial mole, a result of two sperm fertilizing normal ovum
56
Prophylactic cerclage is placed at _______ weeks of gestation
11 to 15
57
A Miscarriage is _____
Pregnancy ending before 20 weeks most common cause is chromosomal abnormalities Some r/t hormonal deficiency (progesterone)
58
Difference in pain between placenta previa and placenta abrupta
previa painless, abruption painful
59
Diabetes during pregnancy affects on baby
BABY STARTS TO PRODUCE INSULIN ON THEIR OWN TO COMPENSATE FOR MOM’S HYPERGLYCEMIA, CAUSING THEM TO BECOME LARGER AND OFTEN HAVE CARDIAC ISSUES. (CHECK GLUCOSE X3, NORM RANGE 45)) baby at risk of crashing
60
will a breastfeeding mom or a non-breast feeding mom make more insulin?
non-brest feedin mom makes more insulin
61
gestational diabetes is when
perform 1hr oral glucose screening, positive if greater than 130-140 Unable to meet increased insulin demand during 2nd & 3rd trimester Insulin either not produced by pancreas or not utilized by cells appropriately
62
medications for gestational diabetes
Oral hypoglycemics (glyburide, glipizide, metformin) Insulin therapy-only option in the past
63
Difference between chronic and gestational hypertension
chronic (hypertension before 20 weeks) gest (hypertension after 20 weeks)
64
Difference between chronic/gestational hypertension and pre-e
new onset proteinuria & pathologic edema BABY ISNT GETTING ENOUGH NUTRIENTS D/T POOR PERF FROM VASOSPASM SO PLACENTA TELLS MOM’S BODY TO DECREASE THE DIAMETER OF VASCULATURE TO INCREASE PRESSURE OF FLOW THROUGH PLACENTAL VASCULATURE
65
Eclampsia vs. pre-e
eclampsia is Seizure activity in preeclamptic woman
66
what 3 things cause gestational hypertension
VASOSPASM, INTRAVAS COAG OF BLOOD, AND INCREASED PERMEABILITY OF VASCULATURE (PROTEINURIA) CAUSE HYPERTENSION
67
Mild Preeclampsia parameters
BP greater than 140 systolic or 90 diastolic (>20 weeks gest.) ≥0.3 urine protein/creatinine ratio300mg proteinuria in 24 hour specimen
68
Severe preeclampsia parameters
BP greater than 160 systolic or 110 diastolic Oliguria (less than 500cc in 24 hours) & elevated serum creatinine Altered LOC or visual changes Hepatic involvement: lab changes, epigastric and/or RUQ pain Thrombocytopenia: platelets <100,000 Pulmonary edema or cyanosis Fetal growth restriction
69
Eclampsia can happen up to ____ hours post partum
72 Later eclampsia can occur after 48 hours and up to 4 weeks post partum
70
what is HELLP syndrome
variant of severe preeclampsia involving hepatic dysfunction and characterized by: (H)Hemolysis (EL)Elevated liver enzymes (LP)Low platelets Can develop HELLP syndrome up to 72-96 hours post partum May continue Magnesium for 24 hours as this is most critical period
71
MAGNESIUM _____________ REFLEXES. ALSO A _____________. CAN _________BP, BUT OFTEN WON’T AND WILL NEED BP MEDS ON TOP.
DEPRESSES TOCOLYTIC DECREASE
72
Oligohydramnios:
<300 mL of amniotic fluid (which can cause some renal issues)
73
Hydramnios
>2000 mL of amniotic fluid (which can cause GI problems
74
amniotic fluid 32-39 weeks
700- 800 mL
75
amniotic fluid 41 weeks
500 mL
76
difference in amniotic fluid at 8 weeks vs. 16 weeks
8 weeks- less than 10 mL 16 weeks- 250 mL
77
umbilical cord length at term
40 to 70 cm
78
vasculature of umbilical cord
2 arteries carry DEOXYGENATED blood from the fetus to the placenta 1 vein carries OXYGENATED blood from the placenta to the fetus
79
3rd week of gestation
formation of blood occurs in the yolk sac
80
By 6th week
Blood type develops in the fetus
81
By 5th month
swallowing and peristalsis begins
82
8 weeks:
can detect EEG waves (brain waves
83
By 11 to 12 weeks
baby makes respiratory movements and extremity movements
84
By 16 to 20 weeks
mom can feel fetal movement
85
24 weeks:
babies start to respond to sound and they can see and taste
86
At about 20 weeks:
Baby produces insulin, but it’s still affected by mom glucose level
87
By week 7:
Sex differentiation occurs
88
what is the First organ system to develop
fetal circulation
89
normal fetal heart rate is
110 to 160 bpm
90
when in gestation do fetal lungs mature?
32-35 weeks’ gestation
91
contractions that are felt as early as 4 months
Braxton Hicks sign
92
Leukorrhea is
a white vaginal discharge in response to stimulation by estrogen and progesterone – eventually forms mucus plug which is kind of a barrier against bacteria in the neck of the cervix
93
Differentiation of alveolar epithelial cells into lactocytes (produce colostrum) is caused by
prolactin, progesterone, and human placental lactogenstimulate
94
TBV increases by ____%
40- 45
95
Norm BP/HR for pregnant person
BP remains the same or slightly decreases due to reduced systemic vascular resistance HR increases 10- 20 bpm
96
What physiologic functions increase during pregnancy
Cardiac output increases by 30- 50% Increase in RBC mass of (20-30%) Increase in WBCs Increases in clotting factors and decreases in coagulation inhibition Maternal oxygen consumption increases by steadily (40% by term) Tidal volume, the amount of air exchanged during normal inspiration and expiration, increases by 40% Chronic mild hyperventilation (pH increases slightly- respiratory alkalosis) renal ureters dilate more during pregnancy More urine is stored and stagnant Tubular reabsorption of sodium increases to meet those demands Reabsorption of glucose occurs at a fixed rate – increased volume
97
food w/ mg
Magnesium: whole grains, dark green leafy vegetables
98
food w/ Zinc
oysters, red meat, poultry
99
food w/ Vitamin B
liver, seafood, poultry, eggs
100
what is Chorioamnionitis
a bacterial infection of the amniotic cavity
101
what is Funneling
the cervix stretches and gets thinner
102
difference between Shirodkar, McDonald cerclages
. Shirodkar – higher in cervix and more involved2. McDonald (purse string) – opening of cervix – easy to access procedure
103
What is the difference between asymptomatic bacteriuria, cystitis, and pyelonephritis?
bacteruira: no sx cystits: sx Pyelonephritis: kidney infection
104
the Gonadotropin-releasing hormone is released in the ______
Hypothalamus

WOMENS (5 decks)

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