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Maternity > Maternity Exam 1 > Flashcards

Maternity Exam 1 Flashcards

1
Q

making everyone fit the same cultural pattern and excluding those who don’t fit- forced assimilation. (emphasis on difference as barriers)

A

cultural destructivness

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2
Q

do not see or believe there are cultural differences among people. everyones the same

A

cultural blindness

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3
Q

being aware that we all live and function within a culture of our own and that our identity is shaped by it

A

cultural awareness

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4
Q

understanding and accepting different cultural values, attitudes, behaviors

A

cultural sensitivity

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5
Q

capacity to work effectively with people, integrating elements of their culture- vocab, values, attitudes, rules, norms. translate knowledge into their care

A

cultural competence

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6
Q

lifelong process of self-reflection and self-critique that begins, not with an assessment of a cultures belief but rather assessment on own

A

cultural humility

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7
Q

the average cost of a vaginal birth

A

$32,093

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8
Q

average cost of c section

A

$50,373

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9
Q

for younger people, those who are under or uninsured

A

medicaid

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10
Q

infant mortality rate

A

6 out of 1,000

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11
Q

medicaid is funded by ???
- determined by each state, but must meet federal minimal requirements (income, household size, state of pregnancy)

A

federal and state monies

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12
Q

The Affordable Care Act gave states the option of extending Medicaid eligibility to people living at or below ___% of the
federal poverty level.

A

133%

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13
Q

with medicaid, women are covered through the month in which their 60 -day ________ period ends

A

postpartum

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14
Q

t/f: Health outcomes improve with the amount of money spent on care.

A

false

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15
Q

full labor- period spent actually birthing baby

A

intrapartum

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16
Q

only __% of women in US report receiving preconception care

A

31%

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17
Q

what part of pregnancy is most crucial?

A

first few weeks

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18
Q

reason for taking folic acid during pregnancy, how much?

A

prevents neural tube defects, 1mg

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19
Q

Pregnancies after age 35 are considered high risk due to:

A
  • dimished egg quality
    -increased risk for preg- related complications
  • increased risk of preexisting health conditions
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20
Q

adolescent pregnancy under age of ___ are considered high risk due to socioeconomic status

A

20

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21
Q

35 and older is

A

advanced maternal age

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22
Q

gynecological history includes:

A

-age of menarche (menses)
-LMP date (last menstrual period)
-cycle length/regularity
-STI’s
-gynecological conditions/surgeries

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23
Q

obstetric history includes:

A
  • prior delivery dates
  • gestational age at deliveries
    -mode of delivery
    -delivery location
    -anesthesia type
    -pregnancy outcome
  • sex of child
    -length of labor
    -birth weight/ percentile according to gestational age
    -past pregnancy complications
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24
Q

GTPAL stands for: (each letter)

A

G- number of pregs in their lifetime
T- number of pregnancies ended at term
P- number of pregnancies ended at preterm
A- spontaneous elective abortion (before wk 20)
L- number of living children

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25
Q

GP stands for: (each letter)

A

G- number of pregs they have had in their lifetime
P- number of pregs carried to viable gestational age (usually 20-24 wks)

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26
Q

holistic health history interview:

A

-sexual history
-self-care/healthy behaviors
-systems review
-biographic data
-allergies
-diet
-sleep patterns
-immuns
-workplace/environmental patterns
-eating habits
-fam history

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27
Q

Interactions between the ovaries, anterior pituitary, and the
hypothalamus regulate the ________ ________ _____

A

female reproductive cycle

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28
Q

When estrogen and progesterone levels are low, the hypothalamus is stimulated to produce _______ ________ ______

A

gonadotropin-releasing hormone (GnRH).

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29
Q

In response to GnRH, the anterior pituitary releases _______ and _________

A

follicle-stimulated hormone (FSH) and luteinizing hormone (LH)

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30
Q

this is responsible for maturation of ovarian follicles that will release eggs for fertilization.

A

FSH

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31
Q

___ levels peak approximately 14 days before menses to cause ovulation.

A

LH

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32
Q

After ovulation, the ovarian follicle is called a

A

corpus luteum

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33
Q

first day/onset of bleeding to the start of next bleed

A

cycle length

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34
Q

first day to last day of bleeding

A

duration

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35
Q

The corpus luteum produces large amounts of __________ and a smaller amount of _______, which maintain the uterine lining for implantation.

A

progesterone, estrogen

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36
Q

If implantation does not occur, the corpus luteum begins to lose its secretory function after about ______

A

a week

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37
Q

Progesterone and estrogen levels are decreased causing the hypothalamus to produce ____.

A

GnRH

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38
Q

Menstrual cycle occurs when an ovum is ___ _________ and typically
begins __ to __ days after ovulation.

A

not fertilized, 12 - 14

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39
Q

The first half of the menstrual cycle is known as the

A

follicular phase.

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40
Q

ovaries are stimulated to mature follicles and their associated oocytes. At the same time, the uterine lining
begins to proliferate.

A

follicular stage

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41
Q

ends with: one mature follicle (graafian
follicle) ruptures and expels an ovum (ovulation).

A

end of follicular stage

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42
Q

The second half of the menstrual cycle is called the

A

secretory phase.

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43
Q

the corpus luteum secretes estrogen
and progesterone to maintain the uterine lining for implantation.

A

secretory phase

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44
Q

full term is

A

37 weeks and beyond

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45
Q

preterm is

A

20 weeks to 36.6 (36 weeks and 6 days)

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46
Q

19 weeks its considered ______
once you hit 20 weeks, its considered _____

A

abortion, preterm

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47
Q

the creation of gametes (ova and sperm) through meiosis.

A

gametogenesis

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48
Q

Females are born with ___ to __ _________ oocytes in their ovaries.

A

1 to 2 million

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49
Q

in the female, one ovum and three polar bodies are formed
through ______.

A

oogenesis

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50
Q

In males, spermatogenesis does not begin until _______

A

puberty

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51
Q

in spermatogenesis, one spermatogonium gives rise to ____
spermatozoa.

A

four

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52
Q

Presumptive symptoms of pregnancy include

A
  • Amenorrhea
  • Breast tenderness
  • Nausea
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53
Q

estrogen makes things _____

A

grow

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54
Q

Probable signs of pregnancy include:

A

-Braxton Hicks contractions
-Positive pregnancy test
-Softening of the cervix (Goodell’s sign)
-Bluish discoloration of the female genitalia (Chadwick’s sign)

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55
Q

Positive signs of pregnancy include:

A
  • Fetal heartbeat obtained
  • Fetus visualized on ultrasound
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56
Q

______ produced at the time of implantation.

A

hCG

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57
Q

____ doubles in early pregnancy approximately every 48 to 72 hours.

A

hCG

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58
Q

Home pregnancy tests detect ___ in the urine

A

hCG

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59
Q

calculating estimated date of delivery by last menstrual period using what?

A

naegeles rule

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60
Q

example of naegeles rule”
- first day of LMP: June 6
- Subtract 3 months: March 6th
Add 7 days: = EDD = __??

A

EDD= March 12th

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61
Q

Fertilized ovum becomes a morula and then blastocyst before entering the uterus

A

preembryonic stage

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62
Q

embryonic stage is what weeks?

A

weeks 2-8

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63
Q

embryonic stage:
implantation occurs by the end of week __

A

2

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64
Q

embryonic stage:
Neural tube fuses at the center and tubular heart
begins to beat in week __

A

3

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65
Q

embryonic stage:
Respiratory and digestive tracts begin to form
and the neural tube fusion is complete in week __

A

4

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66
Q

embryonic stage:
Limb buds appear in week __

A

5

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67
Q

embryonic stage:
the heart is in its final form in week __

A

6

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68
Q

embryonic stage:
the first brain waves are detectable in week __

A

8

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69
Q

fetal stage is what weeks?

A

weeks 9-38 +

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70
Q

fetal movement begins, kidneys begin to function, genitalia fully differentiated in weeks __ to __

A

weeks 9-12

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71
Q

oogenesis established in females, blood vessels visible under the skin, ridges that will form fingers and toe prints are present in weeks __ to __

A

weeks 13 to 16

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72
Q

fetal swallowing is present and insulin production begins. Lanugo and vernix caseosa cover the body by the end of week __

A

20

73
Q

**lungs begin to form surfactant by what week?

A

24th week (surfactant- help to breath)

74
Q

testes descend in males, the fetus often moves to a head down position, and blood is produced in the bone marrow by week __

A

week 28

75
Q

subcutaneous fat is deposited and the fetal heart rate variability is more pronounced due to central nervous system maturity by weeks __ to __

A

weeks 29 to 34

76
Q

visual acuity is 20/600, vernix caseosa is visible in skin creases, and lanugo only on back and shoulders. The lungs and central nervous system mature while the fetus continues to grow and
gain weight by weeks __ to ___

A

weeks 33 to 38

77
Q

A patient is 37 weeks pregnant and exposed to a
teratogen that can impede neural tube fusion. The
nurse understands that:

A

There is little risk because neural tube fusion is
complete in the embryonic stage.

78
Q

A circulatory interface between the mother and the
embryo/fetus

A

placenta

79
Q

placenta forms at the site of ________ _________

A

blastocyst implantation

80
Q

placenta attaches with finger-like projections known as ____ ____

A

chorionic villi

81
Q

placenta expands over the inner surface of the uterus until about ___ weeks gestation

A

20

82
Q

*what 3 primary functions from placenta:

A

circulation, protection, hormone production (secretes hormones to support pregnancy)

83
Q

how big is placenta when fully developed?

A

approx. 2.5-3cm thick and 38-51 cm in diameter

84
Q

placenta: fetal surface is smooth and translucent called

A

shiny Schultze (baby is shiny and new, shiny schultze touches baby)

85
Q

placenta: maternal side has red, meaty appearance called

A

dirty duncan (dirty side touches us)

86
Q

hormones that tells us were pregnant

A

hCG, found in urine

87
Q

hPO and hCS

A

interchangable

88
Q

the umbilical cord has how many arteries and veins?

A

2 arteries and 1 vein (AVA)

89
Q

umbilical arises from _____ side of placenta

A

fetal

90
Q

umbilical cord fn:

A

serves as conduit for blood traveling to and from embryo/fetus

91
Q

large vein carries ________ blood to embryo/fetus and 2 smaller arteries that carry ________ blood to placenta

A

oxygenated, deoxygenated

92
Q

stretch marks, often genetic, common on breasts, abdomen, thighs
- may appear dark and red then become paler and silvery over time

A

striae gravidarum

93
Q

a dark line from the pubic symphysis to the fundus, is more often found in women with darker skin and gradually disappears after pregnancy

A

linea nigra

94
Q

mask of pregnancy, darkens with sun exposure and disappears after pregnancy

A

chloasma

95
Q

Hair grows longer and thicker in pregnancy due to

A

estrogen stimulating the hair follicles; Hair growth returns to normal during the first 4
months after delivery.

96
Q

caused by increased blood flow and is harmless and painless.

A

palmar erythema

97
Q

Blood vessels dilate and become more prominent
in early pregnancy due to

A

increased estrogen levels.

98
Q

Mother supplies thyroid hormones to the fetus until the ___ week of pregnancy when the fetus can produce on its own.

A

12th; thyroid hormones is critical to fetal neurologic development and often increase during pregnancy

99
Q

Insulin needs increase steadily beginning when?

A

the second half of pregnancy.

100
Q

Women whose pancreases cannot keep up with increased insulin demands develop

A

gestational diabetes

101
Q

Cortisol levels increase in the ______ trimester of pregnancy and may promote lung and neurologic development.

A

second

102
Q

Oxytocin is produced by the _______ _______ and has a role in producing contractions, postpartum uterine contraction, and milk ejection.

A

posterior pituitary

103
Q

Oxygen consumption increases __% to __% during pregnancy.

A

15-20%

104
Q

Mild hyperventilation and sense of dyspnea results in a state of physiologic ??

A

respiratory alkalosis

105
Q

frequent nose bleeds d/t

A

engorged capillaries (from congestion from increased estrogen)

106
Q

cardiac output increases by as much as __%

A

50%

107
Q

Total blood volume increases by 40% to 50% while red blood cell count increases by 30%. Result is

A

physiological anemia

108
Q

Rise in fibrinogen and other clotting factors thought to prevent excessive postpartum bleeding puts women at risk for blood clots, which could lead to

A

pulmonary embolism or stroke.

109
Q

hemoglobin stays around 10-10.1 with _______ anemia, no treatment needed is asymptomatic

A

physiologic; need to treat psychologic

110
Q

GFR increases about __%

A

50

111
Q

More salt and water is reabsorbed in pregnant women than nonpregnant women. (Water gain is approximately _____)

A

1.6 L

112
Q

a yellowish form of early milk, is produced and may leak from the nipple.

A

colostrum

113
Q

Between the ___ and ___th week of pregnancy, the size of the uterus (in centimeters) from the symphysis pubis to the fundus equals the number of weeks’ gestation.

A

16 and 36th

114
Q

forms inside the cervical canal to create a barrier against pathogens.

A

mucus plug (operculum)

115
Q

fundus levels:
12 weeks-

A

level of symphysis

116
Q

fundus levels:
16 weeks-

A

halfway between symphysis and umbilicus

117
Q

fundus levels:
20 weeks-

A

level of umbilicus

118
Q

fundus levels:
24 weeks

A

2 fingers above umbilicus

119
Q

fundus levels:
30 weeks

A

midway between umbilicus and xiphoid process

120
Q

fundus levels:
36 weeks

A

level of xiphoid process

121
Q

fundus levels: 40 weeks

A

2 fingers below the xiphoid process, drops at 34 weeks level because of lightening

122
Q

an exaggerated curve to the lumbar spine, causes shift to the mother’s center of gravity and increases the risk of falls.

A

lordosis

123
Q

_______ and ______ increases mobility of pelvis for delivery but makes joints less stable.

A

relaxin and progesterone

124
Q

______ ________ which position and stabilize the uterus, can stretch
and cause pain.

A

round ligaments

125
Q

Abdominal walls separate at the midline

A

diastasis recti

126
Q

increased calcium reabsorption due to

A

increased parathyroid hormone

127
Q

Reduced peristalsis in gastrointestinal tract causes delayed stomach emptying and results in

A

heartburn, constipation, gallstones

128
Q

t/f: A nurse expects a patient’s hemoglobin and
hematocrit to be lower at the end of pregnancy
than they were at her initial prenatal visit.

A

true

129
Q

Headaches are common during pregnancy, but may be a sign of preeclampsia and should be evaluated after ____ weeks gestation

A

20

130
Q

craving nonfood items and may be associated with nutritional deficits.

A

pica

131
Q

increased saliva

A

ptyalism

132
Q

Nausea and vomiting is common in the first trimester and likely caused by increased

A

hCG levels

133
Q

things to avoid with heartburn:

A

avoid fatty foods and excess liquids with meals, avoid lying down after eating, avoid eating 3 hours before sleep

134
Q

things to increase with constipation

A

dietary fiber, fluids, light exercise

135
Q

Prenatal care appointments should be every __ weeks until week __.

A

4, 28

136
Q

Appointments should be every __ weeks between 28 and 36 weeks’ gestation.

A

2

137
Q

After 36 weeks’ gestation, patients should be seen ______ for prenatal care.

A

weekly

138
Q

Women should drink approximately ???? cups of fluids that are mostly water each day.

A

8-10

139
Q

march of dimes caffeine reccomendation:

A

200mg/day (12 oz cup of coffee)

140
Q

normal weight gain during 1st trimester

A

1 to 4 lbs (second and third depend on BMI)

141
Q

involuntary uterine contractions (Ferguson relfex), occurs in upper 2/3 of uterus

A

primary powers

142
Q

voluntary action of pushing

A

secondary powers

143
Q

reflex to push

A

Ferguson reflex

144
Q

_________ can be administered to augment strength and frequency of contractions

A

oxytocin (pitocin)

145
Q

stimulated when presenting part of fetus
reaches pelvic floor

A

Ferguson reflex

146
Q

time from complete dilation of cervix
(10cm) to birth of fetus

A

2nd stage of labor

147
Q

Voluntary bearing down efforts of laboring woman
-increases intraabdominal pressure → potentiates contractions

A

secondary powers

148
Q

Anatomy of the bony pelvis and soft tissue of
the pelvic floor muscles, vaginal canal & introitus (vaginal opening). (depends on ability of soft tissue to stretch)

A

passageway

149
Q

_______ pelvis shape provides most ideal passageway

A

gynecoid

150
Q

The relationship between the fetal presenting part and the pelvis is assessed by

A

fetal station

151
Q

The level of the ischial spines is referred to as

A

zero station

152
Q

Fetus is engaged when the presenting part has
reached ??

A

zero station

153
Q

The part of the fetus that enters the pelvis 1st

A

fetal presentation (presenting part)

154
Q

Majority of fetuses enter pelvis head first –

A

cephalic presentation

155
Q

buttocks or feet & shoulder presentation

A

breech

156
Q

Position of fetal body parts in relationship to one another (flexion/extension)

A

fetal attitude

157
Q

Relationship of the long axis of the fetus to the long axis of the mother

A

fetal lie

158
Q

The relationship of the presenting part to the maternal pelvis

A

fetal position

159
Q

a womans ____ can impact labor; anxiety, stress, fear, pain tolerance can all delay labor progress

A

psyche

160
Q

Contractions are generally more effective when a woman is

A

upright and ambulating

161
Q

The angle of the pelvis is most conducive to birth when a woman’s hips are sharply flexed →

A

squatting

162
Q

signs of impending labor: contractions become regular =

A

q 4 mins x 1 min x 1 hour (411)

163
Q

signs of impending labor: Descent of the fetus into the birth canal

A

lightening

164
Q

signs of impending labor; GI distress such as

A

heartburn, nausea, diarrhea

165
Q

signs of impending labor; weight loss just before onset of labor of how many lbs?

A

1-3

166
Q

regular contractions that cause progressive dilation and effacement of the cervix (longest stage – divided into 3 phases)

A

first stage

167
Q

primigravida

A

having first baby

168
Q

multigravida

A

has had baby before

169
Q

3 phases of first stage

A

latent, active, transition

170
Q

latent phase dilation

A

0-3 cm

171
Q

active phase dilation

A

4-7 cm

172
Q

transition phase dilation

A

8-10 cm

173
Q

starts with complete dilation of cervix, pushing,
and ends with the birth of the baby

A

second stage

174
Q

begins just after the birth of the baby and ends with delivery of the placenta

A

third stage

175
Q

begins just after the delivery of the placenta and ends after 4 hours or when the mother becomes clinically stable

A

fourth stage

176
Q

After delivery of the placenta, the uterus continues to contract to “pinch” or close the open blood vessels in the decidua to prevent
maternal hemorrhage; failure to contract = _________; primary cause of postpartum hemorrhage

A

uterine atony

177
Q

Assessment of uterine contractions looks at the number of contractions during a __ ______ window, averaged over ___ ______

A

10-minute, 30 mins

178
Q

normal uterine contractions

A

< or equal to 5 contractions in 10 mins

179
Q

tachysystole uterine contractions

A

> 5 contractions in 10 mins

Maternity (1 decks)

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