midterm Flashcards

Question

Bowel assessment

Answer 1

may or may not have BM 3x/day or 1x/3days offer stool softeners post c/s normal findings: bowel sounds present minimal abd distension flatus passed may eat/drink when hungry/thirsty

Answer 2

amount. colour. clots. odour. stage of involution scant <2.5cm light <10cm moderate >10cm heavy one pad saturated within 2 hours rubra- bright red. 1-3 days pp serosa - pink/brown 3-10 days pp alba - yellow/white 10 days-6 wks pp loonie sized clots normal as long as can break apart no saturation of pad in one hour trickling when ambulating no foul smell overall 4-8 wks lessens

Answer 3

pain <4/10 well approximated no swelling, bruising, hematoma, discharge no infection analgesics, teabags, stool softeners edema pedal pulses present no DVT signs

Answer 4

response to birth PPD support sleep

Answer 5

VS out of range -> boggy uterus -> lots of lochia -> pain action: -retake VS, sedation -massage and observe flow -compare against prev. pain assessment What should you do if you have a pt in PPH? 1. notify the obstetric hemorrhage team 2. maintain circulation 3. identify cause 4. treat cause NURSING INTERVENTIONS FOR POSTPARTUM HEMORRHAGE (quizlet) Check fundus for firmness, bleeding color, & amount VS Maintain venous access Assess bladder distention Give oxygen Call primary healthcare provider Draw labs = PT, pTT, HCT, HGB

Answer 6

for bonding and attachment parents interact and respond to feeding cues cuddling, eye contact, talking effective consoling techniques respond to infant in loving sensitive manner and is emotionally and physically available

Answer 7

support system family function safe home environment healthy lifestyle (no smoke, drug, alcohol) healthy eating and fluid intake activity and rest and ambulation

Answer 8

communicable diseases -HIV, STI RH, blood group -RH incompatibility when mother rh neg and infant rh pos GDM HTN Birth history GTPAL Baseline VS

Answer 9

pp pathway - must be all N (normal) or plan in place for V (variances) must have all discharge education complete

Answer 10

Gravida Term (37-0 + wks) Preterm (20-0 - 36-6 wks) Abortion <20 wks Living post term is beyond 42 wks

Answer 11

-onset of copious production by day 3-4 post birth -firm tugging on nipple but no pain -uterine contractions and increased vaginal bleeding while feeding (1st week) -increased thirst -breasts soften/lighten milk ejection (let down) warm rush, leaking -baby feeds 8-12x/24 hrs -latches without diff -bursts of 15-20 sucks -audible swallowing -sleepy and relaxed appearance -starts feed eager, appears content after -at least 3 substantive BM -6-8 wet diapers q24h after day 4 pp

Answer 12

-exclusive BF 6 months -continue BF for 1 year, after that your choice -start giving foods at 6 months

Answer 13

for mom: -faster completion of uterine involution and lochia flow (=saving iron stores=higher hemoglobin= more energy to do stuff) -enhanced metabolism -bonding -decreased risk of breast cancer ovarian cancer HTN CVD hypercholesterolemia post-menopausal osteoporosis, RA -natural contraceptive. hormone level is high enough to suppress ovulation (lactational amenorrhea) -contains stem cells for baby: -contain oligosaccharides which feed the gut microbiome -bonding -immune system, reduced risk of common childhood diseases -bifidus factor, interferon, resistance factor, lipase, anti-inflam agents -higher intelligence exclusively BF children have 10 IQ points higher than non-BF -decrease risk of SIDS for BFing at least 2 months, doesn't need to be exclusive. Duration of BFing decreases risk overall: BFing decreases healthcare costs

Answer 14

can be harmful if not produced, prepared, given according to directions

Answer 15

-establishes colonization of newborn gut microbiome. to develop immune system -fat soluble vitamins -protein fetal hemoglobin needs to breakdown and bind to bilirubin protein to be excreted -less fat (fat is hard to digest) -lactoferrin acts as a transport for iron from the gut to the body. -laxative effect to bring about massive BM to clear the gut and excrete bilirubin from the breakdown of fetal hemoglobin -aids in rapid gut closure of their gut - helps with resistance against organisms

Answer 16

first 24 hrs - 2-10 ml. happens within first 2 hours of birth then crash recovery sleep for 6-8 hrs then feed q2-3 hrs 24-48 hrs - 5-15 ml 48-72 hrs - 15- 30 ml 72-96 hrs - 30- 60 ml

Answer 17

colostrum: first 24 hrs - 37 ml. (7 - 123 ml range) Breast milk: day 5 - 500 ml/24hrs 3-5 months - 750 ml/24 hrs

Answer 18

-first stimulated by hormones, then by adequate milk removal -early and often removal increases milk supply -need good quality latch to stimulate receptors deep in the areolar -nerve impulses from sucking -> prolactin released -> prolactin induces breasts to secrete milk

Answer 19

-temp regulation -decrease stress and cortisol in baby -establish flora -promote BFing -triggers ventral feeding reflex

Answer 20

L - latch -mouth to nipple -nose to nipple -mouth as wide as a yawn A - audible swallowing -normal for bursts of sucking before swallowing -frequency of swallowing increases -allow rest periods to massage breasts to bring down more milk T - type of nipple -everted - spontaneously -flat -inverted -no introduction of nipple shield in 1st 24 hrs C - comfort -good latch should not be painful -if trauma from poor latching, apply EBM to nipple H - hold -use pillows to release tense pectoral muscles -baby at breast level -cup breast with C or U -positions include football, laid back, sidelying

Answer 21

early - stirring, mouth opening, seeking/rooting mid - stretching, increasing physical movement, hand to mouth late - crying, red, agitated movements -cuddle, skin to skin, talking, stroking

Answer 22

delay infant bathing delay maternal bathing until S2S in first 2 hrs pp maximize. S2S teach mom how to assess quality feed/latch

Answer 23

premature SGA, LGA mom is diabetic interventions used during birth cerebral anoxia before or after birth cranial-facial or genetic abnormalities

Answer 24

-all BF babies need vitamin D 400 IU / day. 1 drop otc -no iron supplements for BF babies -vegan mom= need vitamin B12 supplement

Answer 25

-danger of improper prep and feeding practice -amount calculated from birth wt -need to "finish it all" -do not switch brands. infant gut needs consistency -run tap water for 1-2 min, then boil for 1-2 min = sterile - because powdered formula is not sterile, hx of bacterial contamination, leftover thrown away -no other milk products can substitute

Answer 26

4. Newborn Assessment: * Key points of assessment for newborn * Moulding and caput (concerns) * Jaundice * Thermoregulation * Fontanelles

Answer 27

stages are mediated by the CNS - HR, Resp, Temp, GI function stage 1. "period of reactivity" - lasts for up to 30 min pp CNS: alert, spontaneous startle reflex HR: increases to 160-180 bpm Resp: may be irreg, nasal flaring, fine crackles, 60-80 Temp: GI: bowel sounds present, may pass mec. -baby whose mom abuses substances will be jittery all the time stage 2: period of decreased responsiveness -lasts 60-100 min -baby exhausted. decreases motor activity, sleeps -baby can handle 20 min activity at a time -baby that is stressed/tired will shut down in the blink of an eye stage 3: second period of reactivity -waking up from recovery sleep -onset and duration depend on last feed and activity in the first 2 hrs -acrocyanosis: blue tinge on extremities is normal in the beginning because the heart is just starting to work. If not resolved by itself quickly (couple hours) or moves up the body = concern. Interventions: S2S, stimulate heat, VS

Answer 28

-chemical, physical, thermal, sensory -c/s more likely to retain lung fluid -premature lungs don't develop fully -resp distress- nasal. flaring, grunting, intercostal retractions, RR <30 or >60. Central cyanosis is a late sign. interventions: supp. O2 or ventilator -transient tachypnea (TTN) (>60 breaths/min) -retained fluid in lungs shortly after delivery -diagnosed in first hours -lasts less than 24 hrs -catecholamines like dopa, epinephrine, norepinephrine surge promotes clearance

Answer 29

-blood vol 300ml = take bruising, anything out of the ordinary seriously -increased and ongoing assessments to sudden changes -decreased pressure in pulm arteries decreased pressure in R atrium increased pulm blood flow = closure of foramen ovale at ~6months -increased O2 and prostaglandins = closes within 2-3 hours, permanently at 3-4 wks -listen to heart at 4th intercostal space for term nb SBP 60-80 DBP 40-50 variations in 1st month -signs of CVS problems: murmur, pallor with murmur, cyanosis -persistent tachycardia >160bpm dt anemia, hypovolemia, hyperthermia, sepsis -persistent bradycardia <100bpm dt congenital heart block, hypoxemia, hypothermia

Answer 30

-Hemoglobin and RBC are increased, drop in 1st month -leukocytes increase 1st day, then rapid decrease -inject vit K because nb cannot synthesize it. for clotting factors -blood group via cord blood -hyperbilirubinemia also tested - product of RBC breakdown and nb cannot rid easily -

Answer 31

goal: neutral thermal environment -Convection: heat from body to cool air -conduction: heat from body to cool surface -radiation: heat from body to non direct ex draft -evaporation: liquid into vapour -no shivering mech. instead flex to lower SA, vasoconstriction of peripheral blood vessels -hypothermia common dt thin layer of subcutaneous fat, blood vessels close to surface, large SA -heat loss metabolizes brown fat energy stores = shut down quickly -amount of brown fat according to GA -interscapular, axillae, around kidneys -cold stress: increased RR and HR leads to vasoconstriction and reopening of ductus arteriosus -hyperthermia >37.5 dt excess heat production or sepsis. ex sun, clothes = vasoconstriction

Answer 32

most void at birth -feed 8x/day = void 8x/day -void q3h minimum -5-10% weight loss normal dt urine, feces, lungs, increased metabolic rate -uric acid crystals can be normal. they are concentrated urine. stain. watch for persistence -fluid and electrolyte balance. 75% body wt is water -low GFR so less ability to remove nitrogenous and waste from blood -signs of renal problems: lack of steady stream, hypospadias, epispadias -

Answer 33

no lipase. lipase comes from milk bacteria not present at birth -stomach capacity 1st day 30 ml -hydrated = mucous membranes moist and pink. soft and hard palates intact -teeth extracted dt risk of aspiration -meconium- green/black dt occult blood -stool helps remove bilirubin -BF- yellow, sour milk smell dt more used up by body -nonBF - pale yellow, stinkier dt made up of lots of extra crap which is excreted ***White stool is a blockage in tubes from gallbladder to liver. After meconium, poop should be yellow. White poop = bad, tell supervisor -no BM = bowel obstruction, imperforated anus

Answer 34

liver and gallbladder forms by 4th wk gestation -iron storage in liver for 4-6 months pp = BF exclusively for 6 months -nonBF need formula with supplemental iron -more bioavailability of iron in breast milk (low amount but well used) ***not much iron in breast milk so relies on liver stores until given solid food w/iron at 6 months -preterm and SGA have low iron stores

Answer 35

immunoglobulin IgG passes across placenta passive immunity 1-3 months pp IgM -against blood bourne pathogens IgA - in breast milk. lessens risk of food allergy signs of infection: temp hypothermia lethargy poor feeding irritability v&d

Answer 36

vernix caseosa: white cheese substance after 35 wks -prevents fluid loss, antioxidant properties, decreases skin pH, improves hydration Acrocyanosis - blue tinge. normal for first 7-10 days Lanugo: fine hair Eccymosis aka bruising: edema of face dt forceps or vacuum extraction sweat glands: seat produced after 24 hrs milia: small white sebaceous glands on face desquamation: peeling of skin few days after birth. they were just in water and need to lose skin cells creases on palms and feet to be assessed during 1st hours for # of creases -premature wont have many Mongolian spots: congential birthmarks. blue/black pigments on back, buttocks erythema toxicum: transient nb rash in first few days. no tx nevi: storkbite. blanched flat pink spots petichea: nonblanching spots signs of problems: -deep purple, central cyanosis, jaundice, petechea -birth trauma injuries -bruising can increase risk of hyperbilirubinemia -petechiae can be dt low platelet count or infection

Answer 37

vernix caseosa: white cheese substance after 35 wks -prevents fluid loss, antioxidant properties, decreases skin pH, improves hydration Acrocyanosis - blue tinge. normal for first 7-10 days Lanugo: fine hair Eccymosis aka bruising: edema of face dt forceps or vacuum extraction sweat glands: seat produced after 24 hrs milia: small white sebaceous glands on face desquamation: peeling of skin few days after birth. they were just in water and need to lose skin cells creases on palms and feet to be assessed during 1st hours for # of creases -premature wont have many Mongolian spots: congential birthmarks. blue/black pigments on back, buttocks erythema toxicum: transient nb rash in first few days. no tx nevi: storkbite. blanched flat pink spots petechia: nonblanching spots signs of problems: -deep purple, central cyanosis, jaundice, petechia -birth trauma injuries -bruising can increase risk of hyperbilirubinemia -petechiae can be dt low platelet count or infection

Answer 38

female: discharge spotting dt increase of estrogen in preg and drop at birth edema of labia will subside male: -testes descend into scrotum by birth -rugea appears 28-36 wks -swelling of breast tissue dt lots of mom's estrogen

Answer 39

more cartilage than bone -Caput succedaneum – slower venous return causes an increase in tissue fluids within the skin of the scalp – leads to edematous swelling. Extends across suture lines of skull. Disappears in 3 -4 days. -Cephalhematoma – does not cross suture lines. Largest on 2nd or 3rd day. Resolves in 3 – 6 weeks. As it resolves, the hemolysis of RBCs and may cause jaundice -subgaleal hemorrhage – DIC – disseminated intravascular coagulation -

Answer 40

anterior and postierior fontanelles frontal, parietal bones, and occipital bone

Answer 41

reflexes tremors normal dt stimulation

Answer 42

involuntary - resps, HR, temp voluntary - random movements, muscle tone state regulation - modulate consciousness ex develop predictable sleep/wake states, react to stress influencers: GS, stimuli, medication

Answer 43

vision: -muscles immature -detect colour at 2 months -respond to light -accommodation at 3 months -focus best at 12 inches away hear: -startle reflex smell: attracted to sweet taste: sweet touch: sensitive especially mouth, hands, feet

Answer 44

0-3 SEVERE 4-6 mod diff 7-10 min dif 1 and 5 min. 10 min if <7 at 5 min HR, RR, muscle tone, reflex irritability, colour

Answer 45

general appearance VS - temp, rr, hr PAIN - facial expressions, increased hr, rr, bp, crying, clenched fists discharge wt length head circumference skin head eyes - PERL nose ears mouth neck chest abdomen genitalia extremities back anus stools

Answer 46

hemo, hct blood glucose leukocytes ABG from cord drug serum levels heel stick venipunture urine speimen hearing after 24 hrs

Answer 47

bilirubin is a product of metabolic breakdown of fetal hemoglobin conjugated by liver (made soluble in water) to be excreted in the bile via duodenum accumulation of unconjugated bilirubin = jaundice hyperbilirubinemia = lipid-soluble uncong. bilirubin can cross the blood brain barrier and cause hearing loss, irreversible brain damage, or death interventions- BF more often for lax effect, sunlight, it D drops physiological jaundice- appears days after birth as bilirubin levels rise dt liver starting up pathological jaundice - occurs in first 24 hrs dt liver problem

Answer 48

SVD: 24 hrs without complications CS: 48+ hrs without complications -discharge ordered signed -discharge teaching complete -followup/plan in place for any variances

Answer 49

bonding: proximity, interaction attachment: mutual meeting of needs -parents gains confidence + baby experiences security influencers: -S2S, cultural practices, physical complications, psychosocial complications ex. unmet expectations ex emotional detachment

Answer 50

-infection control -promote BFing -to not suppress lactation -promote nutrition -1800-2200 kcal/day. lactating women need 350-400 extra per day because generating milk,, recovering energy, and recovering iron stores increases metabolic needs -maintenance of uterine tone - to prevent excessive bleeding -fundal massage and/or uterotonic meds -pad saturated in <15 min = excessive blood loss -promote bladder function/bowel -first void 6-8 hrs after birth -measure it -encourage frequent voiding to avoid distension (distension can prevent the uterus from contracting) -activity, stool softeners, fiber -comfort measures -rest, ambulation -prevent clot formation

Answer 51

general guideline: after at least 6 wks dt closing of cervix and vulnerability to infection

Answer 52

blues: -50-80% -temporary -common PPD: -8-20% -longer lasting

Answer 53

a normal development stage that will pass begins at 2 wks. lasts for 3-4 months baby resists soothing P-peak of crying U - unexpected R-resists soothing P -pain-like face L-long lasting E-evening

Answer 54

LMP + 1 year. -3months. + 7 days

Answer 55

nutrition (adequate intake, quality, availability, accessibility) personal: genetics, cultural influence environment: home, community, exposure to teratogens dedication: knowledge, skills, comprehension Socioeconomic status: income to meet needs for food, shelter, clothing, health insurance Family support health status: physical, emotional psychologic

Answer 56

8-9 wks Physical exam, pap smear lab tests- urine C&S, Blood -blood for TSH, blood group, CBC, rubella titre) -screen for infectious diseases (chlamydia, gonorrhea, HIV, hep B, syphilis) Schedule U/S Offer genetic testing -test amniotic fluid. -down's syndrome, neural tube defects

Answer 57

-symphysis fundal height -14 wks palpable -at 18 wks, measurement = GA. ex. measure 18 cm from pubic bone. 25 wks = 25 cm -fetal heart tone (electrical pulse and flutter of chambers) at 12 wks -BP -Urine dipstick - for ketones, protein -Maternal wt -Leopoid's maneuver -Specific tests -U/S for anatomy -GBS at 35-37 wks -GDM 24-28 wks -

Answer 58

inadequate nutrition = LBW baby. <2500 g 1st trimester= organogenesis need folic acid to prevent neural tube defect 1st trimester +100kcal/day 2,3 trimester +300kcal/day normal BMI 18.5-24.9 weight gain 7-11 kg in 1st tri, 0.3kg/wk in 2-3 tri blood 4lb breasts 3 lb placenta 1 lb baby 7.5 lb uterus 2.5 lb amniotic fluid 2 lb extra body supplies for preg & BFing 5-8 lb fluid retention varies obese = risk for C/S birth, HTN, osteoarthritis, heart disease, GDM, DM, breast cancer, colon cancer, endometrial cancer, development of pre-eclampsia, gestational HTN after birth, obese women at heightened risk for DVT, PPH, wound infections, UTI, prolonged hospital stays adverse fetal outcomes of obese pregnancy: -fetal macrosomia-associated birth injuries -very low birth weight -LBW has risk of childhood and adult obesity and CVD -neural tube defects -preterm birth note: women with normal BMI who gain >50lb have these same risks

Answer 59

n, v, c, -resolves by 20 wks -pyrosis (heartburn) -cause: not well understood, probably from increase of hormones that disrupt GI function Diclectin (vit B6 + antihistamine) Hyperemesis gravidarum: enough to cause weight loss, electrolyte imbalance, nutritional deficiencies and ketonuria Interventions: -drink ginger ale -sniff lemons, ginger -eat soda crackers, potato chips before getting up -eat small meals often -drink fluids 30 min before or after a meal -get up and move slowly -do not skip meals -avoid cooking -get lots of rest (nausea may worsen if tired) -eat whatever you feel like eating

Answer 60

next up: Conception and pregnancy Anatomy and physiology

Answer 61

appearance, pulse, grimace, activity, resps HR, RR Reflex irritability colour muscle tone

Answer 62

primary oocyte: 2 million formed during fetal dev. secondary oocyte: develops second meiosis happens when fertilization occurs = zygote optimal fertility is age 17-28 and then decreases at 35 35-40 = geriatric = more assessments and testing during pregnancy dt increase of risk factors

Answer 63

****video. tested on**** -purpose is to prepare the uterus for pregnancy -starts 14 days after ovulation (usually every 28 days) --hypothalamic-pituitary cycle -ovarian cycle -endometrial cycle

Answer 64

-hypothalamus releases Gonadotropin-releasing hormone (GnRH) = stimulates LH & FSH from anterior pit. gland -Follicle Stimulating Hormone: starts at menstruation causing ovum to mature -Luteinizing Hormone: rupture of follicle and conversion of ovum to the corpus luteum -end of cycle = decrease in Prog. & Estro. from hypothalamus

Answer 65

-proliferative phase: estrogen causes proliferation of ovarian mucosa until ovulation -secretory phase: progesterone causes maturation and secretion by uterine glands until about 3 days prior to onset of menses -Ischemic phase: blood supply to linin stops and lining prepares to slough

Answer 66

-Follicular phase -1-30 ova develop & estrogen increases = one ovum is released -Ovulation at day 14. Mature ovum -Luteal phase -the follicle develops into the corpus luteum. Increased progesterone maintains the uterine lining -Ischemic phase -progesterone levels fall

Answer 67

-fertilization can happen anywhere -not every fertilization results in a pregnancy -it has to implant at day 10 after ovulation, therefore pregnancy is actually 4 wks preg -when the fertilized egg has implanted into endometrium = becomes a zygote -this starts to develop rapidly and differentiates -three layers of developing zygote (3 derm layers) -amniotic cavity where ultimately will have fetal development -trophoblast becomes the zygote

Answer 68

-happens 6-10 days after fertilization -trophoblast: a thin layer of cells that help a developing embryo attach to the uterus wall, protects the embryo, and forms part of the placenta -trophoblast secretes enzymes to burrow into the endometrium -trophoblast develops chorionic villi to act as vascular processes for O2/nutrients and CO2/waste removal -chorionic villi: tiny projections of placental tissue that look like fingers and contain the same genetic material as the fetus -endometrium termed decidua - under chorionic villi is the decidua basalis -decidua basalis: the portion of the decidua that is related to the chorion and participates with it in the formation of the placenta, becoming the maternal component of the fully formed placenta -prefers anterior or posterior fundal region -wants to implant on front or back of uterus. -a placenta on the bottom is high risk if it covers the cervix and the internal os, will need a C/S -if placenta is on top, it will put pressure on the diaphragm -trophoblasts become the zygote -developmentally, the zygote is a microscopic clump of cells

Answer 69

use Negal's rule. First day of LMP + 1 year - 3 months + 7 days -weeks of pregnancy is counted from the 1st day of last menstrual period (LMP) -since ovulation doesn't occur until day 14, the moment fertilization occurs, the zygote is already considered to be at least 2 weeks gestational age -when women misses her first period (approx day 28), the embryo has been developing for 2 weeks but is considered 4 weeks gestational age

Answer 70

1. pre-embryonic - conception until day 14 -this is a lump of cells that are differentiating and form the baby later on -prior to placental function, it is a cavity that forms, helps transport maternal O2 and nutrients to the embryo via diffusion -creates blood cells and plasma -cellular replication, blastocyst formation, initial development of embryonic membranes, primary germ layers -during embryogenesis, 3 germ layers form as the source of all embryo tissues and organs -ectoderm, mesoderm, endoderm 2. Embryonic - day 15 until week 8 post-conception -1 cm in length -humanoid -teratogens are biggest threat -grows head down -all organ systems and structures are in place 3. Fetal - week 9 until birth -"viability" = able to survive outside of uterus -called a fetus at wk 9- 24/25 weeks -if born at 24-25 wks, has a 50/50 chance of viability -2 months on outside = 1 month in utero *current age of viability is 2-25 wks

Answer 71

1. Fetal shunts -figure 12.13 p. 243 -***video -ductus venosus: fetal circulatory pathway where fetal blood (O2-rich blood) from the umbilical vein (from the placenta) bypasses the fetal liver and enters inferior vena cava. -ductus arteriosus: fetal circulatory pathway where fetal blood bypasses the lungs because fetal lungs do not provide gas exchange -foramen ovale; an opening between fetal atria where deoxygenated blood from the fetal legs and abdomen and returning from the fetal lungs flows into the left ventricle and out the aorta Check these structures on ultrasound because it tells what developmental issues could be happening If liver function doesn’t pick up, leads to jaundice -the O2 rich blood going to the upper fetal head and torso first causes cephalocaudal growth Purpose: Bypass fetal lungs Route oxygenated blood into circulation quicker 2. Heart beat rate is faster 110-160 bpm 3. Higher hemoglobin concentration in circulation -additional RBC's, 50% greater 4. Hemoglobin has higher affinity for O2 -20-30% more oxygen

Answer 72

1 vein -carries oxygen-rich blood and nutrients into fetal circ. 2 arteries -carry blood from EMBRYO to the placenta where it releases waste and gains nutrients and oxygenated blood Wharton's jelly: connective tissue on cord that prevents compression

Answer 73

start at implantation Chorion -outer membrane -contains placenta Amnion -inner membrane -fills with amniotic fluid -touching the baby

Answer 74

-secreted by maternal vessels in the decidua and fetal vessels in the placenta -baby swallows and urinates it (wk 11) -baby breathes it into lungs -volume increases throughout preg, peaks at 2 wks before EDD -vol ~700-1000 ml at term -Polyhydramnios: >2 L. puts stress on membranes -Oligohydramnios: <300 ml not enough room to dev. fully. cannot inject. fluid need to intervene by taking baby out and let dev. on outside

Answer 75

1. maintains constant temp 2. provides oral fluid for babe to practice breathing and swallowing 3. cushions fetus from trauma 4. allows freedom of movement for musculoskeletal dev. 5. prevents the fetus from becoming entangled

Answer 76

-development begins at implantation -structurally complete at 14 wks -chorionic villi burrow into decidua basalis -placenta has a series of functional units called "cotyledons": group of vessels supplying each villi -chorionic villi + deciduous basalis = placenta -placenta starts functioning before 14 wks (approx at end of 1st timester)

Answer 77

-production of proteins -stores proteins, calcium, iron endocrine: -manufactures hormones (takes over prod. from the maternal endocrine system) transport: -delivery of O2, nutrients, excretion of waste, CO2 -heat transfer

Answer 78

1. Human Chorionoic Gonadotropin (hCG) -"pregnancy hormone" detected in preg. tests -signals body that pregnancy has taken place 2. Human placental lactogen (hPL) -stimulates material metabolism to supply nutrients for fetal growth -increases insulin resistance and facilitates glucose transport across placenta 3. Estrogen -uteroplacental blood flow - growth 4. Progesterone -relaxation and maintenance -by wk 9, placenta has taken over material hormone production

Answer 79

-only one cell layer separates mat and fetal circ. -transport mechanisms: -diffusion: water, gases, vitamins -active transport: glucose, amino acids, minerals -pinocytosis: albumin, immunoglobulins

Answer 80

Maternal BP too high = damages small capillaries too low: insufficient perfusion Maternal position -left lateral provides best blood flow = pillow under right hip -flat on back not great dt compresses maternal vena cava in 3rd trimester lifestyle choices -smoking, cocaine, contraindicated meds

Answer 81

monozygotic= 1 ovum becomes 2. same gender. share placenta, more risky, more likely to be premature dizgotic= 2 separate placentas, 2 amnions and 2 chorions, fraternal

Answer 82

surfactant and alveoli function to let lungs expand and do gas exchange at wk 23-25 = matches with age of viability -lungs are last organs to dev. and mature = premature birth, expect resp issues -brain, heart, GI tract can all develop once on outside but not the lungs

Answer 83

1st conception until 13-14 wks organogenesis fundus not palpable till 18 weeks 2nd 13 - 26 wks growth and development by end = viable 3rd 27 - birth (40-42 wks) storage, bulking term: considered 37 +1 - 42 wks

Answer 84

substances that can cause abnormal fetal development hot tubs live vaccines. preg get dead or fragments

Answer 85

Presumptive -changes felt by mom ex amenorrhea, fatigue, breast changes Probable -observed by examiner -ex ballottement (insert fingers, push up on cervix. not preg= flat stationary object. Preg= collected fluids so will feel a bounce; preg tests measuring hCG Positive -signs attributed to the presence of a fetus ex. hearing fetal heart tones, U/S, palpating movement human chorionic gonadotropin (HcG) is the earliest biochemical marker of preg. -starts being produced as early as day of implantation -detectable in maternal serum or urine as soon as 7 days before the expected menses

midterm Flashcards

(114 cards)