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Flashcards in Exam 3 seinor year Deck (188):
1

intentional physical abuse or neglect, emotional abuse or neglect or sexual abuse of children, usually done by adults

abuse/child maltreatment

2

who is at higher risk of death of children

younger parents (inadequate knowledge)

3

failure to provide for kids basic needs

neglect

4

deliberate attempt to destroy or significantly impair a child's self esteem or competence

emotional abuse

5

deliberate infliction of physical injury on a child, usually by the child's caregiver

physical abuse

6

inappropriate touching of child's breast or genitalia

sexual abuse

7

signs and symptoms of child abuse

fearful behavior, bed wetting, UTI's abdominal pain, extreme sexual behavior

8

characteristics of the typical child abuser

male, knows victim, any social level

9

illness that one person fabricates or induces in another person

Munchausen syndrome by proxy

10

infant can suffer trauma resulting from an intentional or non accidental head injury by caregiver

shaken baby syndrome

11

Signs and symptoms of shaken baby syndrome

increase ICP
decrease LOC
resp compromise
vomiting
seizures
coma
death

12

when is the babies brain synapses being produced

first 3 years

13

cranio-cerebral patho of infant

heads disproportionably larger, weak cervico-spinal muscles, larger subarachnoid spaces

14

violent shaking of a baby causes

soft tissue of the brain to bounce around inside the skull

15

who is the least likely to be the perpetrator of the child during abuse

mother

16

injuries due to shaken baby syndrome (SBS)

increase ICP
retinal hemorrhage and or detachment
skeletal fractures

17

who is responsible for mandatory reporting of suspected child abuse

healthcare professionals, including nurses

18

when is a child diagnosed with failure to thrive

child's weight for age is below 3rd or 5th percentile or falls more than 2 major percentile lines (ex. 75-25)

19

organic failure to thrive

cardiac, neurological, renal, GI, endocrine
Ex. cleft lip or palate, GERD, celiac, DM, hyperthyroidism

20

non organic failure to thrive

poverty, health beliefs, knowledge deficit, family stress

21

what are characteristics of failure to thrive

growth failure, failure to maintain growth patterns, developmental delays, flattened occiput, apathy, avoid eye contact, poor hygiene, feeding disorders

22

how do you Tx a child with failure to thrive

reverse malnutrition & provide sufficient calories to support "catch up" growth (150%), don't overstimulate (cause baby to use more calories than needed)

23

what do you need to obtain during initial assessment

growth, diet hx, elimination pattern, medical hx, family hx, social hx (socioeconomic status of family)

24

overweight

85-95 percentile

25

obese

over 95 percentile

26

health risks due to obesity

DM, HTN, sleep apnea, cancer, obesity as adult

27

what is the #1 cause of obesity

inactivity

28

BMI

weight (lbs) x 703
------------------------
Ht (inches) 2 (squared)

29

treatment for obesity

exercise
5, 2, 1, almost none
(5 fruits/veggies, 2 hours of TV, 1 hour of activity, almost no sweets/sodas)

30

goal for obesity

maintain and allow for growth (plate method)

31

puberty

transition btwn childhood and sexual maturity

32

menarche

first menstruation

33

menstruation

periodic uterine bleeding
avg blood loss is 20-80 ml
14 days after ovulation

34

female hormones during menstrual cycle

F-follicle stimulating hormone
E-estrogen
L-leutinizing hormone
O-ovulation
P-progesterone

35

corpus luteum

provides progesterone, helps with gestation of fetus

36

if the corpus luteum is not fertilized what will happen to it

shrink and degenerate (go away)

37

bleeding occurs when?

decrease of estrogen and progesterone

38

what does the fertilized egg secrets and what does it do

HCG, keeps corpus luteum "alive" which produces progesterone that keeps the fetus alive

39

effects of estrogen

endometrial growth, uterine change, liquidity and elasticity of cervical mucus, dilation of cervical os

40

effects of progesterone

relaxation of uterus, ripens uterine lining, prepares uterus for implantation, changes in cervical mucus, breast tissue preparation

41

what phase is estrogen seen the greatest

proliferative phase

42

what phase is progesterone seen the greatest

secretory phase (luteal)

43

phase 1 is

menstrual phase (shedding of endometrium)

44

phase 2 is

proliferative phase (rapid endometrial growth)

45

phase 3 is

luteal phase, increase of progesterone from corpus luteum matures endometrial lining

46

phase 4 is

ischemic phase (if egg is not fertilized, corpus luteum reaches end of life cycle,

47

unable to achieve conception after one year of unprotected intercourse

infertility
(less than 6 months is over age of 35)

48

absolute factor preventing reproduction

sterility

49

both partners have reduced fertility

subfertility

50

couple has never had a child

primary infertility

51

couple previously conceived, now unable to conceive

secondary infertility

52

factors that contribute to infertility

weight, smoking, stress, chemical exposure, age, reproduction organ issues

53

uterine fibroids

benign growths on uterine wall that interfere with embryonic and fetal development

54

what is the most common cause of tubal issues

PID

55

what is the most important determinant of infertility

age

56

male factors that are associated with infertility

substances, infections, heat exposure, pelvic radiation

57

varicocele

vein in testicle has inadequate valves causing blood to back up, results in poor sperm quality

58

retrograde ejaculation

ejaculate enters bladder instead of exiting penis

59

when can a sperm analysis be done

2-3 days after abstinence, deliver within one hour of collection, maintain body temperature

60

BBT

determines approx. time of ovulation
take temperature before rising our of bed, record for 3-4 months, ovulation temp will increase 0.4- degrees for 3 days

61

cervical mucus does what during ovulation

thins for sperm to be able to move easier

62

ferning capacity

shows lined channels that favor sperm migration (lok like road ways, look like a maze when ovulation is not occurring)

63

what must the cervical mucus be like for the sperm

thin, clear, watery, profuse, alkaline, acelluar

64

hysterosalpingography

checks tubal patency and uterine abnormalities, cause cramps

65

diagnostic laparascopy

general anesthesia, pump CO2 into pelvis for visualization, have post op neck and back pain

66

what is the first line therapy for females in infertility

clomid, simulates follicle growth, take po for 5 days, can have hot flashes, blurred vision, HA

67

when with polycystic ovarian disease may be given what

hypoglycemic, help to induce ovulation

68

homologous

husbands sperm used

69

heterologous

donors sperm used

70

gamete intra fallopian tube transfer (GIFT)

eggs retrieved and placed directly in fallopian tube with sperm before fertilization

71

IVF

women's egg collected and fertilized in lab then placed in uterus

72

gene

basic unit of heredity

73

chromosomes

total of 46 (1 pair of sex chromosomes, 22 other pairs)

74

is the sex chromosomes is X and Y then the baby is

male

75

phenotype

outward appearance of gene

76

genotype

actual genetic composition

77

genome

complete set of genes present

78

homozygous

two like genes for a trait

79

heterozygous

unlike genes for a trait

80

dominate

dominant in their action over others

81

autosomal dominance

person with dominant gene for a disease which is Heterozygous

82

autosomal recessive

most genetic disorders are inherited as recessive traits

83

X linked dominant

some genes for disorders are located on and transmitted only by female sex chromosome

84

X linked recessive

female-normal gene also present blocks expression of the disease, only male children will have the disease (mother is carrier, father is normal)

85

chromosomal abnormalities

mutation of chromosomes, usually lethal or cause profound disabilities

86

meiosis

2 stage reduction, daughter cells, cell division

87

what happens if you have 45 chromosomes or less

death

88

a part of the chromosome breaks during cell division causing a normal number of chromosomes plus or minus an extra portion of a chromosome

deletion abnormalities

89

child gains an additional chromosome through another route, one or more chromosomes are released or jumped to another one, still have the correct # of chromosomes

translocation abnormalities

90

late division error, nondisjunction disorder occurs after fertilization of ovum as the structure begins mitotic division

mosaicism

91

consanguineous couple

closely related

92

visual presentation of a persons chromosome pattern

karyotyping, done by scraping of cells from buccal membrane

93

Barr body

determine the sex of a child, scrape cells from buccal cavity, stain, magnify, dye will appear black.

94

chorionic villi sampling

retrieve and analyze chorionic villi for chromosome analysis (10-12 weeks gestation)
cant detect neural tube defects

95

amniocentesis

15-20 weeks gestation, 15-20 ml of amniotic fluid is aspirated , cant detect neural tube defects

96

percutaneous umbilical blood sampling

cordocentesis, direct fetal blood sample from cord

97

fertilization occurs where

outer 1/3 of the fallopian tube

98

the highest estrogen production is during ovulation because

increases contractibility of FT, helps move ovum, thins cervical mucus, facilitates penetration of sperm

99

what enzyme is used for the sperm penetration of ovum

hyaluronidase

100

female pronucleus

once the ovum is penetrated the ovum completes maturation

101

when do chromosomal abnormalities happen

moment of fertilization

102

when does implantation occur

7-10 days after fertilization

103

decidua

prevents menstrual sloughing, protects and nourishes embryo, after birth it becomes lochia

104

purpose of amnion

protect and support the embryo as it grows and develops, contains amniotic fluid

105

chorion

thick outer membrane, has villi on surface until month 4

106

allantois

out pouching of yolk sac, forms basis of umbilical cord

107

placenta

begins to shrink after 8 months, exchanges nutrients and waste products, functions as lungs

108

umbilical cord has how many arteries and veins

2 arteries, one vein

109

name the three primary germ layers

ectoderm (outer)
mesoderm (middle)
endoderm (inner)

110

the primary germ layers eventually develop into what

all organ systems, organs and tissues

111

pre embryonic stage

from zygote to implantation (about 2 weeks)

112

embryonic period

15 days-8 weeks, all internal organs begin to form here, most vulnerable period

113

fetal period

8-9 weeks to birth, 1st half growth and development, 2nd half weight increases

114

first lunar month

1-4 weeks, germ layers develop, arm & leg buds, heart has 2 chambers, brain is visable

115

second lunar month

5--8 weeks, all organs present, fetal circulation has begun, largest organ is brain

116

3rd lunar month

9-12 weeks, end of 1st trimester, head is 1/3-1/2 of size of entire fetus, eye lids fuse together, FHT are heard with Doppler, kidney secretion by week 10 now responsible for amniotic fluid production, intestines now have bile

117

4th lunar month

13-16 weeks, lanugo on head, Quickening, meconium present, sucking motions, swallow (this allows for swallowing of amniotic fluid which causes meconium to form)

118

5th lunar month

17-20 weeks, prominent lanugo, sub Q fat, vernix, regular habits (sleep, suck, kick)

119

6th lunar month

21-24 weeks, end of 2nd trimester, substantial weight gain, fetal respiratory movements (as breathe take in amniotic fluid into lungs),onsidered viable at the end of lunar month

120

7th lunar month

25-28 weeks, surfactant production (allows aveoli opening, crucial part of getting the lungs to inflate, life depends on it), eyelids reopen, testes descend, respiratory and circulatory system sufficiently developed

121

8th lunar month

29-32 weeks, mineral storage in bones, can be conditioned to respond to sounds outside of mothers body

122

9th lunar month

33-36 weeks, increase of fat deposits, lanugo disappears

123

10th lunar month

37-40 weeks, considered full term, fills uterus completely, acquires antibodies from mother

124

Fetal nervous system

first to appear last to mature, full brain potential will occur after birth

125

fetal respiratory system is fully developed at

age 8

126

fetal urinary system

secretions begin at 9 weeks, urine present in bladder 16 weeks, prior not stored at all

127

fetal GI system

umbilical hernia until week 10, bowels empty after birth, fetus begins swallowing amniotic fluid @ 4 months

128

fetal musculoskeletal system

muscles contract week 7, calcium formation at 9 weeks

129

what is the most common site for ectopic pregnancy

fallopian tube, increase of risk with surgeries, and use of intrauterine devices

130

endometriosis

uterine tissue outside of uterus

131

symptoms of ectopic pregnancy

N/V, breast tenderness, amenorrhea

132

prior to rupture of ectopic pregnancy s/sx

abd pain, tenderness, delayed menses, spotting

133

after rupture of ectopic pregnancy s/sx

severe pain, referred shoulder pain (phrenic nerve is irritated) shock, faint/dizzy

134

gestational trophoblastic disease

trophoblastic cells on outer layer of blastocyte, grow abnormally fast, nonviable pregnancy
under 15, over 45, Asian/Latin American

135

choriocarcinoma

cancer found in placenta during pregnancy, bloody brown discharge all the time

136

10th lunar month

37-40 weeks, considered full term, fills uterus completely, acquires antibodies from mother

137

Fetal nervous system

first to appear last to mature, full brain potential will occur after birth

138

fetal respiratory system is fully developed at

age 8

139

fetal urinary system

secretions begin at 9 weeks, urine present in bladder 16 weeks, prior not stored at all

140

fetal GI system

umbilical hernia until week 10, bowels empty after birth, fetus begins swallowing amniotic fluid @ 4 months

141

fetal musculoskeletal system

muscles contract week 7, calcium formation at 9 weeks

142

what is the most common site for ectopic pregnancy

fallopian tube, increase of risk with surgeries, and use of intrauterine devices

143

endometriosis

uterine tissue outside of uterus

144

symptoms of ectopic pregnancy

N/V, breast tenderness, amenorrhea

145

prior to rupture of ectopic pregnancy s/sx

abd pain, tenderness, delayed menses, spotting

146

oral hypoglycemic

cause facial deformities, be alert for newborn hypoglycemia

147

gestational trophoblastic disease

trophoblastic cells on outer layer of blastocyte, grow abnormally fast, nonviable pregnancy
under 15, over 45, Asian/latin american

148

why is smoking bad for pregnancy

decreases fetal blood flow, decreases O2 to fetus

149

abortion

termination of a pregnancy before 20 weeks

150

spontaneous abortion

miscarriage, early in pregnancy

151

threatened abortion

days of unexplained bleeding/cramping, cervix is closed, risk of expulsion

152

blighted ovum

fertilized ovum stops developing in 1st 12 weeks, no gestational sac or fetal heart beat

153

elective abortion

prior to 12 weeks gestation any women can get it, from 12-20 weeks state regulated, over 20 weeks is prohibited except to save moms life

154

RU486, methotrexate

abortion pills

155

substance that adversely affect the normal fetal growth and development

teratogens

156

most birth defects happen bc of what

exposure happens before know they are pregnant

157

accutane

increase risk of spontaneous abortion and congenital anomalies

158

mycins

odotoxic, have damage to inner ear

159

oral hypoglycemics

cause facial deformities, be alert for newborn hypoglycemia

160

how much caffeine is considered safe

300 mg of caffeine is considered safe (3 cups)

161

why is smoking bad for pregancy

decreases fetal blood flow, decreases O2 to fetus

162

preterm delivery is at what week

26 6/7 weeks

163

what is the most common teratogen and leading cause of intellectual disability

alcohol use

164

umbrella term that includes all categories of prenatal alcohol exposure

fetal alcohol syndrome

165

facial characteristics of FAS

strabismus, ptosis, eyes wide set, short, upturned nose, broad nasal bridge, thin upper lip, smooth phitrum, flattened cheeks

166

neonatal abstinence syndrome

set of behaviors that results from fetal exposure to substance abuse in utero

167

the closer to deliver a mom takes the drug the ____ the delay in onset of withdrawal

greater, usually within 72 hours

168

do you use narcan on NAS babies

No, can cause automatic withdrawal, cause seizures

169

signs of neonatal withdrawal

hypertonia, seizures, excess crying, yawning/sneezing than 3 consecutive yawns/sneezes, vomiting, por swallowing, fever, sweating, apnea/tachypnea, rash

170

abstinence scoring system

used to objectively measure withdrawal symptoms, done within 2 hours of birth, Q4 hours after that

171

assessment of NAS

urine and meconium toxicology screen (on 1st voids only), give higher cal meals

172

mifepristone

stops pregnancy that is less than 49 days in duration, stops progesterone, 2 doses

173

birth control

contains estrogen and progesterone, stops ovaries from releasing egg

174

depo

prevents ovaries from releasing eggs, increases the mucus thickness

175

diaphragm, cervical cap, leas shield

barrier method

176

implonon

implant into arm, progesterone, increases cervix mucus

177

sterilization (essure, tubal ligation)

tubes placed in FT (scar tissue forms)
tubes tied

178

standard days method

calendar method, need to abstain btwn 8-19 days

179

symptothermal

temperature, abstained 2 days prior and after ovulation

180

lactational amenorrhea

moms who have child less than 6 months and are amenorrheic and are fully breast feeding

181

plan b

taken as soon as after unprotected sex

182

ovulation method

tracking changes in cervical mucous for BBT daily to determine fertility

183

Ductus arteriosis

Opening in circulatory system that allows blood to bypass lungs, if closes prematurely can cause abnormal pressure in lungs & heart

184

What anticoagulant is safer for pregnant women

Heparin

185

What is a significant modifiable cause of poor pregnancy outcomes

Smoking

186

HCG prevents what

Prevents menstrual Sloughing
Increase endometrium growth

187

Amnion

Protects embryo thin membrane

188

Chorion

Outer membrane has villi