Exam 1 Content Flashcards
(150 cards)
1
Q
What is the meiotic process by which male gametes ( mature germ cell ) are produced.
A
Spermatogenesis
2
Q
What is the process by which female gametes ( mature germ cell ) are produced.
A
Oogenesis
3
Q
______ occurs when the germ cell divides & decreases their chromosomal numbers by ½ and are called gametes or zygote
A
Meiosis
4
Q
Ph of the fluid that carries sperm is ____ helps to neutralize the normally _____ female vagina in an attempt to assure viability of the sperm until it can fertilize an ovum.
A
alkaline ; acidic
5
Q
Lifespan of sperm is ____ after ejaculation
A
48-72 hours
6
Q
Average travel time for the sperm to reach the egg is ________ , but can be as little as _______
A
4-6 hours ; 5 minutes
7
Q
At birth a female has a lifetime supply of oocytes.
Oocytes form by ______ weeks gestation.
A
12 weeks
8
Q
_______ secretes _____ to make sure that the corpus luteum remains viable. Corpus luteum secretes estrogen and progesterone first 2-3 months of pregnancy.
A
Blastocyst; HCG
9
Q
___________ extend into endometrium and tap into maternal blood supply for O2 and nutrients
A
Chorionic villi
10
Q
Term for conception to day 14
A
Ovum
11
Q
Term for Day 15 to 8 weeks
A
Embyro
12
Q
Term for 8 weeks to birth
A
Fetus
13
Q
_________ STAGE IS THE MOST CRITICAL TIME IN THE DEVELOPMENT OF THE ORGAN SYSTEMS AND THE EXTERNAL FEATURES
A
Embyronic
14
Q
Inner membranes that surround the baby.
A
Amniotic Sac
15
Q
What is amnitoic fluid
A
- Source of oral fluid for fetus
- Repository for wastes (urine and meconium)
- Assists in lung development
- Volume – 800-1200 ml; Fetal urine contributes to volume
- Transparent yellow liquid.
- Characteristic odor but should not be mal-odorous
16
Q
How much amniotic fluid is present at delivery?
A
100-1200 mL
17
Q
What is Meconium
A
the babys first stool
18
Q
Functions of Amniotic Fluid
A
- Protects fetus from mechanical injury & infection
- Maintains stable thermal environment
- Helps in fluid & electrolyte homeostasis
- Allows freedom of movement for baby
19
Q
Terms associated with AF:
Ballottement
Oligohydramnios
Polyhydramnios
A
- Ballottement – baby bounces against examiner’s hand.
- Oligohydramnios - < 300 mL. Associated with fetal kidney obstruction or renal abnormalities
- Polyhydramnios - > 2000 mL. Associated with esophageal atresia, Gastrointestinal malfromations, and severe CNS anomalies.
20
Q
Properties of Amniotic Fluid contains Lecithin and Sphingomyelin
A
L/S a major component of Surfactant (a liquid made by the lungs that keeps the airways (alveoli) open.) (Surfactant liquid makes it possible for babies to breathe air after delivery)
L:S ratio 2:1 indicates fetal lung maturity
21
Q
Amniotic fluid completely replaces itself every ___ hours, even after rupture of membranes (water breaks) occurs.
A
3
22
Q
Amniotic fluid completely replaces itself every ___ hours, even after rupture of membranes (water breaks) occurs.
A
3
23
Q
Rupture of Membranes (ROM) Nursing Action:
A
ALWAYS CHECK THE FETAL MONITOR
FOR DECELERATIONS IN FETAL HEART RATE (FHR)
24
Q
Placenta
A
- Flat, disc shaped
- Provides nutrients (O2) and removes waste (CO2)
- Metabolizes drugs…other substances
- Produces hormones estrogen/progesterone for maintenance of pregnancy
- When Human Chorionic Gonadotrophin is released it produces as the placenta and begins to grow. An increase in HCG levels =indication of pregnancy
25
The umbilical cord has __ Arteries and ___ vein.
2 arties and 1 vein
26
Umbilical vein transports ______
oxygenated blood
27
Umbilical Arteries transport ______
Deoxygenated blood
28
Corpus luteum main source of estrogen and progesterone until ___ month of pregnancy. By end of ___ month
3rd ; 3rd
29
______ stimulates uterine development to provide environment for baby
Estrogen
30
______ relaxes uterine muscle …prevents spontaneous abortion
Progesterone
31
If Mom is dizzy and faint. Baby is suffocating. What is the treatment?
Turn slightly to one side and wedge a small pillow under the hip.
32
Fetal Viability
the ability of the fetus to survive outside the uterus
33
Fetal Viability is ___ weeks
20 weeks and/or fetus weight is 500g or greater
34
Hematopoiesis
the formation of blood starting in the yolk sac (3rd week)
35
Blood cells and heart functioning at __ weeks
3
36
Heart is fully developed by __ weeks
8
37
Normal fetal heart rate
110-160 bpm
38
Dizygotic twins
each embryo has their own amniotic sac & their own placenta (fraternal)
39
Monozygotic twins
2 embryos 1 sac 1 placenta (Always Identical)
40
Mary has just delivered. Her OB history is as follows: 1st child was born at 40 weeks, 2 pregnancy was twins born at 34 weeks, she had a miscarriage at 16 weeks and she just delivered a baby boy at 39 weeks. She told you that 3 years ago her 1st child was run over by a drunk driver .
Whats her GTPALM
G4 T2 P1 A1 L3 M1
41
```
What types of signs of pregnancy is this?
Breast changes
Amenorrhea
N/V
Fatigue
Quickening
```
Presumptive
42
```
What signs of pregnancy are these?
Goodell sign
Chadwick sign
Hegar sign
Positive pregnancy test blood and urine
Braxton Hicks
Ballottement
```
Probable
43
```
What signs of pregnancy are these?
Visualization of fetus on U/S
FHT detected by U/S
Visualization of fetus on radiographic study
Fetal heart tones detected
Fetal movements palpated
Fetal movements visible
```
Positive
44
Braxton hicks are often mistaken for early labor but its not true labor because it ...
Does not cause cervical dilation
45
Softening and thinning of lower segment of uterus
Hegars sign
46
fundal height decreases as fetus descends into the pelvis in preparation for delivery (38 – 40 weeks)
is called ...
Lightening
47
A nurse is assessing a pregnant client for the presence of ballottement. To make this determination, the nurse would:
Assess the cervix for thinning
Auscultate for fetal heart sounds
Palpate the abdomen for fetal movement
Initiate a gentle upward tap on the cervix
Initiate a gentle upward tap on the cervix
48
Fetal movements, feels like butterflies
Quickening
49
Bluish color of cervix (6-8 weeks)
Chadwicks sign
50
Softening of cervical tip in a normal unscarred cervix (around 6th week)
Goodell’s sign
51
seals endocervical canal --> prevents ascent of bacteria from vagina to the uterus
Mucus plug (operculum)
52
white or slightly gray mucoid vaginal discharge that occurs in response to cervical stimulation by estrogen & progesterone
Leukorrhea
53
What is used to treat primary, secondary and early latent syphilis
Penicillin 2.4 million units IM once
54
What is used to treat Chlamydia in pregnant women
Erythromycin 500 mg oral qid (for baby)
X 7 days or Amoxicillin 500 mg tid X 7 days
Azithromycin 1g PO once (ok during pregnancy/for mom)
55
Chlamydia and Gnhorrea is the most common cause of _______ ________
ophthalmia neonatorum (an acute infection occuring in the first 4 weeks of life in a newborn)
56
What may leak from nipple (precursor to milk – yellow in color) This usually happens after delivery but can start before delivery. Usually called liquid gold
Colostrum
57
What hormone causes production of milk?
Prolactin
58
What is responsible for milk letdown?
Oxytocin
59
Absolutes for preeclampsia
140/90 mmHg OR
Systolic elevated 30 mmHg over baseline and
Diastolic elevated 15 mmHg over baseline
60
ALL PREGNANT CLIENTS ARE SCREENED FOR GESTATIONAL Diabetes at _______ weeks gestation.
High Risk patients tested earlier…
24-28
61
Cardinal Signs of PRE-ECLAMPSIA.
```
PROTEINURIA
EDEMA
ELEVATED BP
HEADACHES OR DIZZINESS
BLURRED VISION
```
62
_____ position compromises renal flow, cardiac and uterine flow
Supine
63
_____ position improves urinary output and helps decrease edema
Side-lying
64
Postural and gait changes
Lordosis ---> results in back pain
65
correct exercises for cramps
Knee extended…another person dorsiflexes foot…Never extend…pull down.
Or stand and lean forward…dorsiflexing foot…
66
Gastrointestinal System
-Ptyalism (excessive salivation)
Check for starchy food consumption or nausea
-Nausea and Vomiting
Early subjective sign of pregnancy
May be related to hormonal changes
Subsides past 1st trimester.
-R/O hyperemesis gravidarum if persists longer than 1st trimester.
67
GI changes cont.
- Pyrosis is common (heartburn) Increased progesterone causes decreased tone and motility of smooth muscles resulting in reflux, have a slower stomach emptying time and reverse peristalsis (also can cause constipation)
- Hemorrhoids r/t constipation and increased pressure on blood vessels in the rectum
- Gallbladder sluggish. Along with increased secretion of cholesterol may predispose to gallstones.
- Pica – craving non-nutritive substances.
68
Maternal Nutritional Recommendations
Weight Gain (total = 25-35lbs)
2 to 4 lbs (1st trimester)
1 lb/week (2nd & 3rd trimester)
Adequate fluid intake (3L/day)
8-10 glasses/day
4-6 glasses should be water
Increase caloric intake by 300 calories per day
Breastfeeding = 450-500 calories per day
Increase Vitamin A, C , & folate (0.4mg daily when pregnant)
Take prenatal vitamins & supplemental iron as prescribed.
Avoid constipation by eating raw fruits, vegetables, cereals, and bran
Avoid heartburn by eating small, frequent meals, avoiding fatty foods, avoid lying down after meals, & carbonated soda
Avoid alcohol/tobacco
Limit caffeine
Avoid certain foods
69
Underweight effects
Preterm labor
Low Birth Weight (LBW)
Intrauterine Growth Restriction (IUGR
70
Overweight effects
Macrosomia & Cephalopelvic Disproportion (CPD)
Operative Vaginal Birth & Emergency Cesarean Section
Postpartum Hemorrhage
Infection (wound, genital tract, urinary tract)
Birth Trauma
Late Fetal Death
Preeclampsia
Gestational Diabetes
71
What is the earliest biochemical marker for pregnancy
Human chorionic gonadotropin (hCG)
72
Accepting the fact of pregnancy
Ambivalence – normal response
Denial…especially adolescents
Seeks validation of pregnancy
73
-Initial Assessment
- Reason for seeking care
- Current Pregnancy…Signs
-Reproductive History
Details of previous pregnancies
Contraceptive history
STD history
-Review of Systems
74
1st trimester
week 1-13
75
2nd trimester
week 14-26
76
3rd trimester
week 27-40
77
Term pregnancy is ...
37.0 to 40.0 weeks
78
Medical/Surgical conditions that may affect the pregnancy
Diabetes
Hypertension
Epilepsy
79
Ask about current medications
```
Prescription drugs
OTC drugs or herbs
Smoking, alcohol, illegal drugs
NO (Ex: Coumadin or Flagyl)
Coumadin is a blood thinner.
```
80
What is the appropriate way to position the client on examining table to measure the fundal height
Supine position with legs extended
81
_______ well rounded inlet, wide pubic arch. This is what we want to see…absolutely no way to tell by appearance.
Gynecoid
82
If moms body is Rh ___ , they need rogam. Only if mom is ___. Also get it after baby is born
Negative
83
Physical Examination each Visit
```
Data base updated with each visit
BP…absolute values…
Weight – presence of edema
Urinalysis
Abdominal examination
Bladder empty
Small pillow to tilt to one side
Measure Height of Fundus
```
84
Prenatal Visit Schedule
1st visit should be within the 1st 12 weeks or earlier
16 – 28 weeks – q 4 weeks
29 -36 weeks – q 2 weeks
36 weeks until term – q 1 week
Post term – 2times a week with fetal monitoring:
85
```
Supine Hypotension symptoms:
Pallor
Dizziness
Increased HR
Nausea
Skin damp, cool, sweating
What interventions do you do?
```
Position on side until symptoms subside and VS stable…
86
Determination of Gestational Age
```
Auscultation of FHT
US Doppler at 10-12 weeks gestation
Fetoscope (bone conduction) 18-20 weeks
Date of quickening
Leopold’s maneuvers for position
LEOPOLDS MANEUVERS…TO DETERMINE LIE/POSITION…BEST PLACE TO DETERMINE FHR
```
87
If a patient comes in with bleeding, they could possibly have a _______ or ________. Never stick fingers in the mom if she's bleeding.
placenta abruption or abrevia.
88
Signs of Potential Complications
```
Discharge of fluid from vagina before 37 w
Vaginal bleeding
Severe abdominal pain
Change in FM
UC…pressure and/or cramping before 37 wks
Visual disturbances
Edema…swelling of face, fingers, sacrum
HA
Muscular Irritability
Epigastric or abdominal pain
Glycosuria
```
89
Emergency Situation
Uterine contractions q10 minutes or less for one hour or more
Vaginal bleeding
Fluid leaking from vagina (ROM) ??
Odorous vaginal discharge
Instruct to proceed to hospital immediately
90
True labor defined as
Cervical dilation (opening) and regular contractions
91
Preterm labor instructions
```
If no regular contraction pattern is established and ROM has not occurred:
Empty bladder
Drink 2-3 glasses water or juice
Rest on left side X1 hour
Palpate for UC (teach)
If symptoms persist …call or go
```
92
You don’t let a women push till she's ___ cm
10cm
93
Aged pregnant client
Over 35 more likely to experience gestational diabetes
Vascular problems are more common, for example hypertension
Chromosomal changes
Increase risk for miscarriages, stillbirth, placenta previa, placenta abruption and c/sections
94
died after 20 weeks gestation (AKA Stillbirth) is called.
a. early 20-27 week
b. late > 28 weeks
Fetal death
95
Death of a live birth.
Early-- fewer than 7 days old
Late-- 7-28 days old
Neonatal death
96
Death from 28 days to 1 year from live birth
Infant death
97
What to say to grieving parents:
Be Simple
“I’m sorry for your loss.”
Be Honest
“I don’t know what to say. I can’t imagine what you’re going through.”
Be Comforting
“I care about you and your family. Please tell me what I can do to help.”
It’s okay to just sit in silence if you feel that is appropriate as the family gets their thoughts together – but do not avoid their concerns.
98
If a pregnant woman has Chlamydia what medication do you NOT give her?
Doxycycline bc it can make the babies teeth yellow when it gets older
99
Toxoplasmosis
(1. Raw meat,
2. Infected animal (cat) feces
3. Transplacental)
Maternal Effects:
1. Influenza-like aching
2. Lymphadenopathy
3. Spontaneous abortion
Fetal/Neonatal:
Congenital toxoplasmosis, LBW; hepatosplenomegaly c Jaundice and anemia.
100
Varicella Zoster (chicken pox)
(1. Direct contact
2. Respiratory droplets.)
Maternal effects:
Preterm labor, encephalitis, and varicella pneumonia.
Fetal/Neonatal:
Congenital varicella syndrome c limb hypoplasia, cataracts, microcephaly, and symetric IUGR during 1st trimester.
101
Rubella
(1. Transplacental
2. Direct contact
3. Respiratory droplets)
Maternal:
Rash, fever , malaise. Spontanteous ab during 1st trimester of pregnancy.
Fetal/Neonatal effects:
Deafness, MR, IUGR, cardiac defects and microcephaly.
102
Cytomegalovirus (CMV)
| A herpes virus. Becomes latent after primary infection. Periodic reactivation and shedding.
Maternal Effects:
Flu-like symptoms; cervical discharge
Fetal/Neonatal Effects:
Fetal or neonatal death; Severe generalized disease c hemolytic anemia, jaundice, hydrocephaly (fluid accumlates in brain, leading to a big head but can cause brain damage) or microcephaly (a small head inconjucntion with incomplete brain development)
103
Hepatitis B
1. Transplacental
2. Body fluids: blood, saliva, vaginal secretions, semen and breast milk;
3. Contaminated needles or blood transfusion.
Maternal effects:
Fever, rash, arthralgia, abdominal pain, liver enlarged and tender.
Fetal/Neonatal effects:
Prematurity; LBW. Development of acute infection at birth and perhaps neonatal death.
104
Vernix Caseosa
White, creamy, biofilm that covers the skin of the fetus during last trimester of pregnancy
105
Lanugo
fine, soft hair that covers the body of a newborn
106
Ductus Arteriosus
A heart defect caused by the problems in the hearts development. Is an opening between two blood vessels leading from the heart
107
Ductus Venosus
A shunt that allows oxygenated blood in the umbilical vein to bypass the liver
108
Foreman Ovale
An opening into the left atrium of the fetal heart. Normally closes after birth but if it remains surgery is performed.
109
IUGR – Intrauterine Growth restriction
a condition of inadequate fetal growth not necessarily correlated with preterm delivery due to intrauterine placental perfusion. A baby can be SGA (small for gestational age) due to conditions arising from IUGR. Baby is not growing enough for the age it is gestational.
110
tocolytic
is medication that is given to try to stop labor. These are considered “off-label” since they were not created for this purpose
111
What are some tocolytics (is medication that is given to try to stop labor. These are considered “off-label” since they were not created for this purpose)
Magnesium Sulfate
Terbutaline
Nifedipine
Indomethacin
112
Magnesium Sulfate
Monitor mom’s BP, this is given in high doses so make sure mom’s room is very cool and she has a fan. She will feel like she is having real bad hot flashes. Get support person a blanket because they will probably get cold. Mom gets a 4-6 gram load dose over 20 -30 minutes, then 1-4 grams an hour maintenance dose. Baby will react with decreased variability nonreactive NST. IV fluids will be limited to 125mL/hr and mom is usually only on iy for 24-48 hours. Everything decreases with mom, watch urine output, Absent DTRs, hypotension, Magnesium & calcium level will be monitored. LOC will decrease, but mother should never be comatose. Calcium Gluconate is the reversal medication.
113
Terbutaline
– also called Brethine. given subque. 0.25 mg q 20 minutes until ctx stop up to 3 doses. When 3rd dose is given MD should be called. Your book states q 4 hours, this is no longer the best practice. Mainly watch mom. Check her Heart rate before each dose. If her heart rate is greater than 120, you will hold the dose and call the MD. The mom will tell you it feels like her heart is about to jump out of her chest because it is beating so fast. Can cause N&V, headache, hypotension, hyperglycemia, chest pain, nervousness. The baby usually does well, but may have episodes of tachycardia. Be sure to give the medication at the top of the contraction so the mom gets more than the baby due to constriction
114
Nifedipine
may also see Procardia or Aldalet – Usually given orally – 10-20 mg q 3-6 hours. Once contractions have slowed the mom will get extended release 30-60mg PO 8-12 hours. Be sure to take mom’s Bp before giving because it can cause hypotension, Headache, flushing, dizziness and nausea
115
Indomethacin
May give 50 mg PO then 25-50 mg PO q6 hours for 48 hours. Before 32 weeks may be given as a rectal suppository. Mom may complain or heartburn or nausea. Watch for bleeding (NSAID). The fetus may start to have decreased urine output, and the ductus arteiosis may constrict decreasing fetal circulation
116
mom’s membranes have spontaneously ruptured before labor has started at any gestational age is called?
PROM – Prelabor Rupture of Membranes
117
Mom’s membranes have spontaneously ruptured before 37 weeks gestation is called?
PPROM – Preterm Premature Rupture of Membranes
118
Placenta abruption
occurs when the placenta detaches from the inner wall of the womb before delivery. The condition can deprive the baby of oxygen and nutrients.
119
Placenta Previa
occurs when the babys placenta partially or totally covers the mothers cervix
120
Maternal Risks and Complications with Gestational diabetes
Worsening of pre-existing disease vascular problems retinopathy
Hypoglycemia 1st half of pregnancy
Hyperglycemia Ketoacidosis 2-3rd trimesters (high blood values)
Preeclampsia and Eclampsia
Polyhydramnios in 10-20% of diabetic
Dystocia (shoulder)
121
Effects on baby with mom with diabetes
-Macrosomia r/t excess glucose from Mom (poor glucose control… BIG baby greater than 4000 grams)
-Large for gestational age (LGA)
-IUGR r/t maternal vascular involvement
-Delayed lung maturity RDS
-Hypoglycemia after birth
-Congenital anomalies
Neural tube defects
Skeletal defects (Sacral agenesis)
122
Management of DM During Pregnancy
Monitor Glucose
Diet
Exercise
Insulin (may or may not if diet and exercise can make it come back down.)
123
HYPEREMESIS
- Severe vomiting of pregnancy that causes weight loss of at least 5% of prepregnancy weight.
- Accompanied by dehydration, electrolyte imbalance, nutritional deficiencies and ketonuria.
- Usually begins at 4 weeks and can last up until 20 weeks of pregnancy.
- Could be caused by increasing levels of estrogen, progesterone & human chorionic gonatrophins (hCG) .
124
Fetal risk from hyperemesis
-IUGR
-Abnormal development (anomalies)
-Death from lack of nutrition, hypoxia or maternal ketoacidosis
Ketoacidosis = accumulation o f ketones in the blood from hyperglycemia that leads to metabolic acidosis. Be very careful with Terbutaline and corticosteroids – these can contribute to DKA
125
Symptoms of Hypoglycemia
```
Nervousness
HA
Shaking/irritable
Hunger
Blurred vision
Diaphoresis
```
126
HELLP Syndrome
A variant of severe preeclampsia.
- Hemolysis
- Elevated liver enzymes (liver is not getting rid of toxins it needs to get rid of)
- Low platelets (not making it to where they can coagulant)
-Lab work will tell you if they have HELLP Syndrome
Nursing responsibilities: Assess and observe for signs of bleeding. Pt can have bad epigastric pain, if pt tells you it feels like bad ingestation that means liver involvment, see if she looks yellow or jaundice. Can mean placenta abruption.
127
Glucose screening is done when?
at 24-28 weeks gestation. Higher risk patients will be done earlier.
Routine:
-fasting glucose will be taken
-Pt will drink the 50g of oral glucose cola
-Pt will wait 1 hour then they will check glucose
-If glucose is > 130-140 mg/dL it is POSITIVE (gestational diabetes)--> requires follow up appt.
- If have to come back they will take a 3 hr glucose tolerance test. They can eat whatever they want. They will be npo after midnight. Will drink 100 g glucola. Blood will be drawn at 1,2, and 3 hours.
- A positive test is when 2 or more values are equal or exceed
128
Euglycemia (normal glucose)
65-95 before meal
| 130-140 1 hour after meal
129
Treatment for hypoglycemic mom
Tell them to eat like half of a sandwhich or give them whole milk to drink. If its really low give them some SL glucose paste
130
Amniocentesis
Ultrasound guided needle through abdomen into uterine cavity to obtain amniotic fluid for testing.
Done after 14 weeks gestation when uterus rises above the symphysis pubis and fluid amounts are adequate to get sample.
Fluid shows:
Lecithin/syhingomyelin (L/S ratio) or shake test
Checks for Fetal Maturity
Alpha-fetoprotein
Used as screening tool for Neural Tube Defects
Desquamated fetal cells
Allows for genetic testing
131
Timing of Amniocentesis
Early pregnancy – to detect chromosomal abnormalities
Late pregnancy – most often to determine fetal lung maturity with L/S ratio to detect the amount of surfactant production in fetal lungs.
Ratio of 2:1 indicates fetal lung maturity
Surfactant is a substance that reduces the surface tension of pulmonary fluids to allow gas exchange in the alveoli
132
Alpha- fetoprotein
Is used to test for down syndrome and for neural defects
133
Fetal heartbeat is heard by ____ weeks
10-12
134
Amniotic fluid is adequate amount for amniocentesis as early as ___
14 weeks but by end of 16 weeks
135
Sufactant forms on alveolar surfaces by ____ week
end of 28 weeks
136
L/S ratio 2:1 at _____ weeks
35 weeks
137
Contraction Stress Test (CST) or Oxytocin Contraction Test (OCT)
Findings are Negative, Positive or Equivocal
No Late Decelerations = Negative CST/OCT
Late Decelerations = Positive CST/OCT
*CST - you want a Negative test = Baby not stressing because of ctx
138
PROM or PPROM may cause precipitous labor, which is..
labor that last 3 hours or less from onset of contractions to birth of baby
139
S/S: Nervousness, HA, Shaking, Irritable, Increased hunger (Polyphagia), Blurred Vision, Diaphoresis
What is this?
Hypoglycemia: Glucose less than 70 mg/dL
140
S/S: Ketones in urine, Skin is dry and flushed, Increased Thirst (Polydipsia), Increased Urination (Polyuria), Kussmaul Respirations, Fruity odor to breath
What is this?
Hyperglycemia: Glucose greater than 130 mg/dL
141
Triangular helmet shaped cells found in blood, usually indicative of disorders of small blood vessels
Burr cell
142
Menstrual cycle
Hypothalamus secretes GnRH
GnRH stimulates Pituitary to secrete FSH (follicle stimulation hormone)
FSH stimulates growth of a follicle(s)
Follicles contain an egg in them along with cells that secrete estrogen
As the follicle starts to matures, the Hypothalamus released even more GnRH which then makes the Pituitary secrete a large spike of LH at once(luteinizing hormone)
LH essentially bursts open the follicle and releases the egg into the fallopian tube into the uterus
The bursted follicle turns in the corpus luteum
Corpus luteum secretes progesterone
If there’s no fertilization of the egg, the corpus luteum withers and progesterone & estrogen decline
This decline leads to shedding of the uterus & the cycle repeats
If there is fertilization, no menstruation occurs. Corpus luteum continues to secrete progesterone & estrogen for the first few months.
143
Placenta Previa
the placenta is implanted in the lower uterine segment such that it completely or partially covers the cervix or is close enough to the cervix to cause bleeding when the cervix dialtes or the lower uterine segment effaces
144
Placenta Abruption
the detachment of part or all of a normally implanted placenta from the uterus
145
Glucocorticoids: This is medication that mom will take, but will help the baby by accelerating fetal lung maturity.
Betamethasone is given 12 mg IM for 2 doses, each dose 24 hours apart OR. Dexamethasone is given 6 mg IM for 4 doses 12 hours apart. HER NOTES: Things to watch for in mother are her WBC may increase, It will also raise the mom’s glucose levels, so precautions should be taken for the diabetic mom. The baby may have minimal variability for 72 hours. GIVE Z track method – deep into the muscle. The medication is painful.
146
Sex is apparent by the end of
12 weeks
147
Surfactant forming on alveolar surfaces by the end of
28 weeks
148
onset of hypertension without Proteinuria after 20 weeks gestation
Gestational Hypertension
149
Usually occurs 20 weeks after gestation in a previously normotensive pt AND has proteinuria May be mild or severe.
Proteinuria at or above 30mg (> 1+ on dipstick) or more in 2 random specimens at least 6 hours apart or > 300 mg in 24 hours
Preeclampsia
150
What is the major pathological factor in preeclampsia
is poor perfusion as a result of vasospasm, NOT ELEVATED BP
