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ABSN > Maternity I > Flashcards

Maternity I Flashcards

1
Q

What are 4 risk factors for maternal mortality?

A

age <20 or >35
lack of education
unmarried
non-caucasian

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2
Q

What are the 4 leading causes of maternal mortality in the US?

A

pre-existing conditions
hemorrhage
HYPERtension
infection

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3
Q

The US is ____ in the world for maternal mortality.

A

50th

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4
Q

How many women die per day giving birth in the US?

A

2-3

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5
Q

What are 2 benefits of vaginal delivery versus c-section?

A

exposure to mother’s flora

better breathing

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6
Q

What cells react to HPV? Where are they located?

A

transformation cells in the ectocervix (the outer, visible part of the cervix)

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7
Q

What is the isthmus?

A

the lower part of the body of the uterus that stretches and thins during pregnancy

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8
Q

What’s up with the os?

A

there’s an internal AND external os before reaching the inner body of the uterus

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9
Q

Why does being an adolescent make for a higher risk pregnancy?

A

they are psychologically unprepared
their hips may not be wide enough
they may not understand the importance of prenatal care
the may try to hide the baby with tight clothes

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10
Q

What is the normal duration range of the menstrual cycle?

A

21-35 days

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11
Q

What is the average age that girls begin menstruating?

A

12.8 years old

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12
Q

How long can an egg live?

A

24-48 hours

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13
Q

How long can sperm live?

A

72 hours

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14
Q

What are the 3 phases of the ovarian cycle? What days do they fall?

A

follicular (1-14)
ovulation (14)
luteal (15-28)

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15
Q

What happens during the follicular phase?

A

ovary follicles grow to form a mature egg
FSH and LH are secreted
Estrogen climbs

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16
Q

What causes the rupture of the mature follicle and subsequent release of the egg? When does this occur?

A

surge of LH hormone during ovulation

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17
Q

What stays behind in the ovary when the mature egg is released?

A

the corpus luteum (shell of the follicle)

secretes progesterone to keep potential pregnancy going

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18
Q

When is estrogen at its peak?

A

ovulation

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19
Q

When is progesterone (the pregnancy hormone) at its peak?

A

luteal phase

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20
Q

What vital sign changes during the luteal phase?

A

increase in body temp by 0.5 to 1 degree Fahrenheit

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21
Q

When are LH and FSH at their lowest?

A

during the luteal phase

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22
Q

WTF if the role of the corpus luteum?

A

it secretes progesterone which interacts with the endometrium to prepare it for implantation.

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23
Q

What is the corpus?

A

the main body of the uterus

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24
Q

How do you calculate the fertile period of a woman?

A

take the first of her last period and subtract 14 days

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25
Q

What term describes too MUCH amniotic fluid? Too little?

A

too much: Hydramnios (over 2000mL) associated with renal

too little: Oligohydramnios (under 500mL) associated with maternal diabetes and CNS malformation

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26
Q

Amniotic fluid is ____% water

A

98%

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27
Q

Are the amniotic fluid’s contents fluid or stable?

A

they are constantly changing.

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28
Q

What are 4 functions of amniotic fluid?

A

maintains temperature
allows symmetric G&D
cushions fetus from trauma
prevents cord compression

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29
Q

What are the 3 genetic variations that can cause Down’s syndrome?

A

trisomy 21 ***
mosaic
translocation

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30
Q

How long is the fertile period?

A

120 hours (5 days)

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31
Q

What is fetal nuchal translucent suggestive of?

A

Trisomy 21

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32
Q

What increases the risk of Trisomy 21?

A

maternal age

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33
Q

What are 2 defining characteristics of Down’s syndrome?

A

Simian crease

Open mouth with protruding, large tongue

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34
Q

What is Tay-Sachs? What population is most a risk?

A

an autosomal recessive disorder Ashkenazi Jews

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35
Q

What factors would influence a family to seek genetic counseling?

A

maternal age >35

paternal age >50

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36
Q

Which antibodies are present during the fetal stage of development?

A

IgG - crosses the placenta
IgM - produced by the fetus
IgA - not produced by fetus

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37
Q

When is surfactant produced?

A

Week 24

38
Q

Since fetal circulation bypasses the right side of the heart b/c they don’t use their lungs, what structures do they use instead?

A

foramen ovale
ductus arteriosus
ductus venosus

39
Q

What vitamin do babies lack?

A

vitamin K

40
Q

When does development of the brain/spinal cord occur?

A

3-4 weeks

41
Q

When can fetuses hear? taste? see?

A

hear- 4 months
taste- 5 months
see- 7 months

42
Q

When does sex differentiation occur?

A

week 7, but we can’t tell until week 20

43
Q

how likely is it to pass down an autosomal dominant disorder? autosomal recessive?

A

dominant - 50%

recessive - 25%

44
Q

What is the role of the placenta as an interface b/w mother an baby?

A

protects fetus from immune attack by the mother if they are respectively Rh- and Rh+

45
Q

What is Wharton’s Jelly?

A

tissue surrounding the vein and 2 arteries to prevent compression

46
Q

Function of hCG?

A

preserves corpus luteum and progesterone production (basis for pregnancy test)

47
Q

Function of progesterone?

A

maintains endometrium

decreases uterine contractility

48
Q

Function of estrogen?

A

enlarges breast and genital tissue

relaxation of pelvic ligaments and joints

49
Q

Function of relaxin?

A

relaxation of pelvic ligaments

softens cervix

50
Q

Function of hPL or hCS?

A

regulates metabolism
development of breasts for lactation
increases glucose availability for fetus

51
Q

Where is oxytocin released?

A

posterior pituitary

52
Q

Function of oxytocin?

A

stimulates uterine contractions
decreases bleeding after delivery
ejects milk during BF

53
Q

What is meconium?

A

baby’s first stool
contains bile
forms during week 12

54
Q

What is vernix caseosa?

A

slimy, cottage cheese covering fetus that protects it from amniotic fluid

55
Q

What is lanugo?

A

fine hair

56
Q

How many weeks is a term pregnancy?

A

37-42

57
Q

Describe GPTAL

A 
Gravida - total pregnancies
Para - preterm births after 20 weeks
Term - births over 37 weeks
Abortion- # of pregnancies ended before 20 weeks
Living children
58
Q

How do you use Naegele’s Rule?

A

used to calculate date of delivery

  1. 1st day of last period
  2. (+) 9 months
  3. (+) 7 days
59
Q

What are the ONLY positive signs of pregnancy?

A

US verification
Fetal movement felt by clinician
Doppler finding of heart

60
Q

What is Hegar’s Sign?

A

softening of the lower uterine segment/isthmus at 6-12 weeks

61
Q

What is Chadwick’s Sign?

A

blue coloration of the vagina/cervix at 6-8 weeks

62
Q

What is Goodell’s Sign?

A

softening of the cervix at 5 weeks

63
Q

How do you measure fundal height?

A

top of pubic bone to top of fundus

20 cm should be 20 weeks(at umbilicus)

64
Q

When does fundal height stop correlating to weeks of pregnancy?

A

36 weeks

65
Q

Describe the cardiovascular changes that happen during pregnancy.

A

50% increases in plasma by week 30 which results in “physiologic anemia” (hematocrit <11)
pregnancy is a hyper coagulable state.
HR increases by 10-15

66
Q

What happens to BP during pregnancy?

A

standard during the 1st and 3rd trimester

DROPS by 5-10 in the 2nd trimester

67
Q

What BP is considered HYPERtension in pregnancy?

A

140/90

68
Q

Do normal HgB and HcT increase or decrease during pregnancy?

A

increase in plasma causes decrease in HgB and HcT.

69
Q

What is the term for excessive saliva that is normal in pregnancy?

A

ptyalism

70
Q

what 5 integumentary changes happen to the mother during pregnancy?

A

hyperpiguentaion of breasts and genitalia
melasma or cholasma (butterfly face - 70% of women)
linea nigra
striae gravidarum (stretch marks)
vericosites (poor circulation r/t poor venous return)

71
Q

Who would receive Rhogam? When?

A

an Rh (-) mother with an Rh (+) baby at 28 weeks gestation and again 72 hours after birth

72
Q

When do pregnant women experience urinary frequency? Why?

A

trimesters 1 and 3
NOT 2
glomerular filtration rate (GFR) speeds up

73
Q

What should mom eat when she gets morning sickness?

A 
Crackers 
Cheerios
Cheese
Ginger
Lemonade
74
Q

During which trimester will mom experience Leukorrhea?

A

1st trimester

cottage cheesey, acidic secretions

75
Q

How do you distinguish between a yeast infection and leukorrhea?

A

a yeast infection looks like leukorrhea but presents with itching

76
Q

Amount of water recommended during pregnancy?

A

2L/day

77
Q

Fetal movement count

A

“count to 10” method

if longer than 2 hours, call HCP

78
Q

What methods are allowed during L&D?

A

Lamaze method - breathing and relaxation
Bradley - partner coached childbirth
Dick-Reed (natural childbirth) - fear reduction via knowledge

79
Q

What vaccinations MAY be given during pregnancy? Which may NOT be given?

A

Yes:

TRIM-H (keep it trim-hunny, jus a lil)
Tetanus
Rabies
Influenza (deactivated)
Meningococcal 
Hep B

No:

I M Telling Vou B, do not take these vaccines:
Influenza (activated)
MMR
Typhoid
Varicella
BCG
80
Q

When is the rubella vaccine recommended?

A

after birth prior to discharge
nursing mothers OK
getting pregnant again NOT OK for 28 days

81
Q

How many pounds should be gained for each BMI during pregnancy?

A

Underweight: 28-40 lbs
Normal: 25-35 lbs
Overweight: 15-25lbs
Obese: 11-20lbs

82
Q

Foods high in mercury to AVOID:

A 
SSKOTT
Shark
Swordfish
King Mackerel
Orange Roughy
Tuna 
Tilefish
83
Q

Foods low in mercury you can EAT:

A 
Shrimp
Salmon
Tuna (canned light)
Talapia
Catfish
Cod
Pollock
84
Q

Which supplement should NOT be taken with antibiotics or estrogen?

A

calcium

85
Q

What needs to be kept balanced with calcium?

A

vitamin D

86
Q

What supplements should be taken before and during the early weeks of pregnancy?

A

Folic acid and iron - hard to get the needed amounts just through diet

87
Q

Sources of Folic Acid

A

Dark leafy greens

88
Q

What foods that may contain the bacteria Listeria should be avoided during pregnancy?

A

processed meat
soft cheese
smoked seafood
salads made in stores

89
Q

What should not be taken with vitamin C?

A

antacids with aluminum

90
Q

What should not be taken with vitamin A?

A

antibiotics and warfarin

91
Q

How should iron supplements be taken?

A

withOUT food

92
Q

What is the mucous plug called?

A

operculum

ABSN (18 decks)

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