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EXAM 1 Flashcards

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1
Q

Which hormone stimulates ovulation?

A

LH and FSH

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2
Q

what initiates the shedding of the endometrial lining in a non pregnant woman?

A

a drop in estrogen and progesterone

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3
Q

True statements about corpus luteum

A

It becomes corpus albicans if conception does not occur (degenerates if not pregnant)

It is maintained by HCG if conception occurs

it produces estrogen and progesterone for the first 8-12 weeks of pregnancy

it is located on the ovary

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4
Q

Conception occurs in

A

ampulla of fallopian tube

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5
Q

Zygote

A

gertilized ovum

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6
Q

Embryoblast

A

Part of the blastocyst that will develop into the embryo

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7
Q

Trophoblast

A

part of the blastocyst that will develop into the placenta

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8
Q

Blastocyst

A

The fertilized egg as it separates into 2 parts, embryoblast and trophoblast

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9
Q

what occurs in intervillous space developing placenta

A

oxygen and nutrients perfuse across the chorion villi to enter fetal circulation

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10
Q

functions of amniotic fluid

A

prevent congenital amputations and amniotic bands

enable fetal musculoskeletal movement

maintain fetal hydration

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11
Q

Teratogen examples

A

cigarettes
rubella
alcohol
Phenytoin (Dilantin) anti-seizure med
Isotretinoin (Accutane)

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12
Q

Foramen Ovale

A

Fetal shunt that connects the right and left atria

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13
Q

Ductus arteriosis

A

fetal shunt that connects the pulmonary artery and the aorta, bypassing the lungs to perfuse lung tissue

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14
Q

Ductus Venosus

A

Fetal Shunt that allows the umbilical vein to bypass the liver to flow into the inferior vena cava. most blood bypasses fetal liver because it doesnt need to be filtered, mom does filtering in her own liver.

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15
Q

pregnant woman take for a cold?

A

Cetrizine (Zyrtec)
Loratadine
Claritin
Acetaminophen

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16
Q

True about Pap Smears

A

should sample the squamocolumnar junction

screen for vaginal and cervical cancer

hpv history, increased risk

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17
Q

HCG

A

keeps corpus luteum alive! until placenta starts making estrogen and progesterone, then corpus luteum degrades and becomes corpus albicans

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18
Q

instructions for taking iron

A

with vitamin C, orange juice
on empty stomach
not with calcium or dairy, interferes with absorption
dont ever double dose
away from children

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19
Q

additional calories in pregnancy

A

1st trimester- 340

2nd and 3rd- 450

Breastfeeding- 330 first 6 months
440- 6-12 months

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20
Q

recommended weight gain

A

normal BMI- 25-40lbs
underweight- 28-40
overweight- 15-25
twin- 37-54

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21
Q

Folic Acid

A

400mcg daily
prevents neural tube defects
liver, green veggies, beans citrus

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22
Q

Presumptive signs of pregnancy

A

amenorrhea
nausea vomiting
breast tenderness
fetal movement (felt by woman)

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23
Q

Probable signs of pregnancy

A

positive urine and blood test
chadwicks sign (discoloration of vulva)
goodells sign (softening of cervix)
abdominal enlargement

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24
Q

Positive signs of pregnancy

A

fetal movement felt by provider
ultrasound
auscultation of fetal heartbeat

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25
4 changes in cardiac system
increased blood flow maternal heartrate increases 10-15bpm soft systolic murmer sometimes audible palpitations
26
epitaxis
nosebleeding, common in pregnancy
27
what causes heartburn in pregnancy
progesterone, lower esophogeal sphincter to relax, digestion slowed
28
Mothers basal metabolic rate in pregnancy
increases gradually can double by time of delivery
29
Striae gravidarium
stretch marks from rapid weight gain
30
Sequential Screen
2 steps, accurate. blood draw at 14 weeks, then 16-18. ultrasound too. Tests for Down syndrome, trisomy 28. false negs and pos
31
NIPT
10 weeks on, blood test, very accurate but still not diagnostic
32
CVS
10-14 weeks, diagnostic, aspirate fetal cells from chorionic villi through abdominal wall. spontaneous abortion -2%, ROM, infection, hemorrhage. Only 1st trimester diagnostic
33
amnio
16-20 weeks 1/200 spontaneous abortion
34
When does a woman receive RhoGAM
if Rh- During SAB/ectopic/any abortion amnio CVS at 28 weeks within 72 hrs of delivering baby with Rh+ blood
35
normal fetal heart rate
110-160
36
heart rate during pregnancy
68-105 bpm
37
pregnancy respiratory rate
9-22 breaths/min
38
Maternal WBC
normal range 5800-15000
39
Maternal BP
2nd trimester goes down 5-10 mmHg systolic and diastolic should return to baseline in third trimester 120/80 normal BP
40
BMI ranges
less than 18.5 underweight 18.5-25 normal more than 25 overweight 30+ obese
41
why is hcg so important in early pregnancy
it maintains the corpus luteum, which produces estrogen and progesterone, to prevent sloughing of the endometrium
41
Ductus arteriosus
shunts blood from the pulmonary artery to the aorta
42
the foramen ovale
is an opening between the right and left ATRIA
43
median length of labor primiparas
11 hours
43
the ductus venosys
bypasses the liver, bringing some blood from the umbilical vein directly to the inferior vena cava
44
median length of labor- multiparas
6 hours
45
early labor characteristics
cervix not yet dilated to 4 cm
46
active labor
4cm-8 cm 4-8hrs first time moms
47
labor 5-1-1 rule
contractions are: 5 minutes apart last 1 minute pattern happening for 1 hour
48
what is endometrium called once an embryo implants?
decidua
49
placental formation
trophoblast releases enzyme, break down moms capillaries, blood leaks into spaces between chorionic villi and decidua. where o2 nutrient and waste is exchanged.
50
how long do eggs live after ovulation
24 hrs
51
how long can sperm live in womans body
3 days
52
Fetal circulation
Vena Cava --> R Atrium --> tricuspid valve --> R Ventricle --> Pulmonary Artery --> Lungs --> Pulmonary Veins --> L Atrium --> L Ventricle --> Aorta -->
53
foramen ovale is an opening between
R & L Atria
54
what shunt allows fetal blood in the Right Ventricle to bypass the lungs and flow into the aorta?
Ductus Arteriosus
55
ductus venosus enables most blood to bypass the liver because most fetal blood is cleansed in
moms liver
56
functions of placenta
o2 and nutrients to babe makes hormones stores carbohydrates
57
most important hormone to maintain pregnancy
progesterone
58
Low risk prenatal care schedule
every 4 weeks- 28weeks every 2 weeks 28-36 every week after 36
59
leopolds maneuvers
whats in fundus, butt or head? is head down? wheres babys back, listen to heart through back
60
Fundal height
12 weeks- just above pubic symphysis 16 weeks- midway b/w ps and umbilicus 20 weeks- at umbilicus after 20- measure by cm
61
EDD
=7 days, - 3 months
62
when to avoid coitus
placenta previa active bleeding preterm labor ROM STI
63
hormone activity that causes menstruation
estrogen and progesterone dropere
64
Where are LH?FSH produced
pituitary gland
65
where are estrogen and progesterone produced
ovaries, follicle in ovary
66
what is corpus luteum and what is its function
produces estrogen and progesterone until placenta takes over at 8 -10 weeks progesterone most responsible for maintaining pregnancy till 8 weeks (corpus luteum). then placenta HcG acts on OVARY to keep corpus luteum alive so it produces more estrogen and progesterone
67
3 hormones made by placenta
estrogen- causes maternal breast, uterine genital enlargement, uterine contractility progesterone- maintains endometrium, decreases uterine contractility, stimulates metabolism and breast development Relaxin
68
The umbilical arteries carry
DEOXYGENATED blood from fetus TO the placenta and then into maternal circulation for excretion
69
The umbilical vein carries
OXYGENATED blood from maternal circulation through the placenta and then to the fetus
70
amniocentesis in early pregnancy
bladder must be full ultrasound guidance 0.5% risk of miscarriage Rh- woman needs RhoGAM
71
Hyperemesis gravidarum
electrolyte imbalance deyhdration weight loss 5% pre-pregnancy weight
72
Molar pregnancy
purple brown small amt blood NO PAIN grape cluster on ultrasound no fetus very high HcG extreme nausea vomiting no pregnancy for 1 year to watch for choriocarcinoma
73
signs of hypovolemic shock
tachycardia restlessness cool clammy skin hypotension Dyspnea (shortness of breath) Oliguria (low urine output)
74
maternal conditions associated with IUGR
chronic hypertension cytomegalovirus smoking
75
What to expect IUGR
serial ultrasounds for fetal growth every 10-14 days doppler flow studies to help determine placental perfusion if adequate twice weekly tests of fetal wellbeing NST/BPP
76
Reasons for bleeding Mid-late pregnancy
cervical dilation placenta previa placental abruption vasa previa
77
risk factors for placenta abruption
hypertension cocaine use previous abruption trauma ROM premature multiples
78
signs of Abruption
vaginal bleeding abdominal pain rigid abdomen (sometimes) fetal distress signs of shock
79
Abruption Care
assess bleeding palpate uterus for tone and tenderness monitor for FHR & Contractions maternal vitals, signs of hypovolemic shock
80
Abruption Care if fetal distress or shock
1. oxygen mask 8-10 L 2. IV Fluids with large guage in case she needs blood transfusion 3. Prepare for c-section
81
Placenta Previa
no intercourse C-section if complete or partial Follow up ultrasounds every 4-6 weeks to check for placental migration
82
IUGR
Estimated fetal weight <10% for gestational age signs: fundal height too small
83
IUGR Management
measure fundal height every visit address causes (smoking, substance abuse, nutrition etc) serial u/s NST 2x weekly bpp weekly doppler flow
84
4 symptoms of HYPERthyroid
tachycardia hyperemesis sweating fatigue anxiety
85
symptoms of HYPOthyroid
weight gain lethargy coarse hair dry skin
85
treatment for hyperthyroid in pregnancy
PTU (Propylthiouracil)
86
HYPOthyroid treatment pregnancy
synthroid take apart from Iron and PNV
87
40 year old primigravida at increased risk for:
preterm birth chromosomal abnormalities gestational hypertension IUGR Placenta Previa
88
Methotrexate (ectopic treatment) side effects
increased abdominal cramping rise in HCG levels for 1-3 days vaginal spotting bleeding avoid folic acid, alcohol, sun, sex, nsaids
89
signs of ectopic pregnancy
spotting, abdominal pain that may radiate to shoulder, not a lot of bleeding (if she is bleeding, into the peritoneum)
90
how to avoid toxoplasmosis
cook meat well dont change kitty litter
91
placenta previa treatment
pelvic rest f/u ultrasound c section
92
nursing actions- 37 weeks vaginal bleeding/abdominal pain
likely placental abruption ask- how much bleeding? monitor bleeding. palpate abdomen for rigidity consistent pain or on off? when did it start? take Vitals, CBC for H&H put her on monitor to check FHR and contractions if a lot of bleeding, start IV fluids
93
Signs of hypovolemic shock
restlessness hypotension clammy skin tachycardia SOB
94
no cervical checks
placenta previa or if woman present to ER in labor, no records. no cervical check until u/s to make sure no previa
95
instructions for a woman getting amnio
could cause SAB if Rh- need RhoGAM come with full bladder you'll feel pressure ultrasound guided needle we'll put baby on fetal monitor and keep on for 30 min after procedure if baby ok and no contractions you'll be free to go call us if: signs of infection, ROM, globally tender, continue to monitor fetal mvmt
96
2 functions of ovaries
produce hormones (estrogen & progesterone) store and release egg for fertilization
97
how often women get PAPs
21-29 every 3 years 30-65 every 5 yrs (cotesting with HPV) or every 3 over 65- never (if no history of abnormal pap)
98
Layers of uterus
Perimetrium (outer) myometrium (middle) endometrium (inner)
99
menstrual cycle - no pregnancy
GnRH produced by hypothalamus LH & FSH released by anterior pituitary stimulates follicle development in ovary follicle produces estrogen and progesterone E&P stimulate endometrial profusion in uterus LH Surge- Ovulation empty follicle (corpus luteum) degenerates E&P drop menstruation starts
100
menstrual cycle --> conception
GnRH produced by hypothalamus LH & FSH released by anterior pituitary stimulates follicle development in ovary follicle produces estrogen and progesterone E&P stimulate endometrial profusion in uterus LH Surge- Ovulation fertilization preplacental cells make HcG HcG maintains corpus luteum corpus luteum produces E&P until placenta takes over at 8 weeks progesterone maintains pregnancy and endometrium
100

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