Midterm: Modules 1-4 Flashcards
(103 cards)
1
Q
What are the four sections of the fallopian tubes?
A
- Interstitial
- Isthmus
- Ampulla
- Infundibulum (fimbrae)
2
Q
What are the four functions of the fallopian tubes?
A
- Passageway for sperm to meet the ovum
- Site of fertilization
- Safe, nourishing environment for the ovum or zygote (fertilized ovum)
- Means of transporting ovum or zygote to the corpus of the uterus
3
Q
What are the two functions of the ovaries?
A
- Production of hormones (estrogen and progesterone)
2. Stimulate maturation of an ovum during each reproductive cycle
4
Q
What are the functions of the bony pelvis?
A
- Support and distribute body weight
- Support and protect pelvic organs
- Form the birth passageway
5
Q
What is the ideal pelvis shape for a vaginal delivery?
A
Gynecoid
6
Q
What are the Montgomery glands?
A
Small sebaceous glands
Secrete a substance to lubricate and protect breasts during lactation
7
Q
What is the first sign of puberty for a female?
A
Development of breasts occurs
8
Q
What are some preventative health care measures for women?
A
Teaching how to perform breast self-examination (BSE) Professional Breast Examination Mammography Pelvic exams Vulvar self-examination Pap smear
9
Q
Does trichomoniasis cross through the placenta?
A
No, but can cause postpartum infection
10
Q
What are the signs and symptoms of bacterial vaginosis?
A
Thin, grayish-white discharge that has a fishy odor
It is associated with preterm delivery and can infect the infant at birth
11
Q
If untreated, what can chlamydia cause?
A
Can cause scarring in fallopian tubes
12
Q
How is gonorrhea transmitted to the newborn, and what does it cause?
A
Transmitted to newborns eyes during birth causing ophthalmia neonatorum (conjunctivitis of the newborn)
Eye infection that occurs within the first 30 days of life.
Caught during birth by contact with the mother’s birth canal that is infected with a sexually-transmitted disease.
13
Q
What can syphilis do to the baby?
A
Can cause congenital syphilis, stillbirth, and spontaneous abortions
This is transmitted through the placenta
14
Q
What is the cause of a baby being born with laryngeal papilloma?
A
Human Papillomavirus (HPV)
15
Q
When is Herpes Simplex Virus Type 2 contagious?
A
When the vesicles are open, the virus hides in nerve cells and can reemerge
16
Q
How is HIV spread to the infant?
A
It can be transmitted if there are breaks present in the skin of the mother and infant
As well as through breast milk, so the infant should be bottle-fed
17
Q
What are some reasons for female infertility?
A
Ovarian factors Tubal and peritoneal factors Uterine factors Vaginal–cervical factors Isoimmunization (Rh-/Rh+)
18
Q
What are some reasons for male infertility?
A
Can be caused by structural and hormonal disorders:
-Undescended testes
-Hypospadias
-Varicocele (varicose vein of the scrotum)
-Low testosterone levels
Substance use
19
Q
What are some factors that influence choice of contraceptive methods?
A
Age
Health status
Religion or culture
Impact of unplanned pregnancy on the woman/family
The desire for future children (ex. IUD in for 5-10 years)
Frequency of sexual intercourse
Convenience
Expense (Birth control costing 15-30$ per month)
Number of sexual partners (ex. condoms)
20
Q
What is natural family planning? (fertility awareness)
A
It is the learning of identifying the signs and symptoms associated with ovulation
It requires no administration of medication or the use of devices
Uses the appearance of your cervical mucous to tell you about your fertility
Failure rate of 20%
21
Q
What does hormonal contraception do to the cervix/uterus?
A
Makes cervical mucous thick and resistant to sperm penetration.
Makes uterine endometrium less hospitable if fertilized ovum arrives
22
Q
What is the acronym used for warning signs to report when taking oral contraceptives
A
A - abdominal pain (severe)
C - chest pain, shortness of breath, bloody sputum
H - headache (severe), weakness, numbness of extremities
E - eye problems
S - severe leg pain or swelling, speech disturbance
23
Q
How soon must the morning after pill (Plan B) be taken?
A
Must be taken no later than 72 hours after unprotected sex
24
Q
Can you become pregnant during the climacteric (perimenopausal period)
A
Yes, pregnancy can still occur during climateric, as this is still 2-8 years before menstruation ceases
25
What can biological development be influenced by?
Teratogens
Undernutrition
Smoking
26
What is considered the age of viability?
20 weeks of gestation, but requires NICU care to survive
27
How many arteries/veins are in the umbilical cord?
Two arteries carry blood away from the fetus
| One vein returns blood to the fetus
28
What are some functions of amniotic fluid?
Maintains even temperature
Prevents amniotic sac from from adhering to the fetal skin
Allows symmetrical growth of fetus
Acts as a cushion to protect fetus and umbilical cord from injury
29
Explain the circulation after birth
Foramen ovale closes within 2 hours after birth (permanently by age 3 months).
Ductus arteriosus closes within 15 hours (permanently in about 3 weeks).
Ductus venosus closes functionally when cord is cut (permanently in about 1 week).
After permanent closure, the ductus arteriosus and ductus venosus become ligaments.
30
What are some of the presumptive signs of pregnancy?
```
Missed/no period
Nausea
Breast tenderness
Deepening pigmentation
Urinary frequency
Fatigue and drowsiness
```
31
What are some of the probable signs of pregnancy?
```
Goodell sign (softening of the vagina)
Chadwick sign(bluish colour of the cervix)
Hegar sign(softening of the uterus)
Abdominal enlargement
Braxton hicks contractions
Positive pregnancy test result
```
32
What are the positive signs of pregnancy?
Audible fetal heartbeat
Fetal movement felt by examiner
Ultrasound visualization of fetus
33
What is the five digit numeric scoring system for obstetric history?
G - Gravida (number of times a woman is or has been pregnant, regardless of the outcome)
T - Term (number of times a woman has carried a baby to birth, 37 weeks or more and delivered)
P - Preterm (number of times a woman has carried to less than 37 weeks, but more than 20 and delivered)
A - Abortion (number of times a woman has lost a pregnancy, elective or spontaneous, before 20 weeks gestation)
L - Living (number of live births/live children)
34
What is Nageles rule for determining the estimated due date?
Identify first day of last normal menstrual period
Count backward 3 months
Add 7 days
Update year(if applicable)
35
What are some common discomforts in pregnancy?
```
Fatigue
Nasal stuffiness
Nausea
Heartburn
Constipation
Vaginal discharge
Backache
Leg cramps
Edema of lower limbs
```
36
What is the weight gain for a woman of normal weight, overweight and obese?
Normal: 25-35lb
Overweight: 15-25lb
Obese: 11-20
37
What are some changes to the GI tract that may happen when pregnant?
The uterus displaces the stomach and intestines
Oral mucosa may become tender and bleed more easily
Appetite and thirst may increase
Gastric acid secretions decrease
38
Why is the mucous plug formed?
To prevent ascent of organisms into uterus
39
How much does the blood volume increase during pregnancy?
increases to 45% greater than pre-pregnant state
40
What are the goals of prenatal care?
Promote the health of the mother, fetus, newborn and family
Ensure a safe birth for mother and baby
Reducing risk factors and promoting good health habits
Educate self care during pregnancy
Prepare parents for parenthood
41
What is the recommended schedule for prenatal visits?
Conception to 28 weeks - every 4 weeks
29 to 36 weeks - 2 to 3 weeks
37 weeks to birth - weekly
42
What is done at the first visit assessment?
```
Blood work (discuss genetic screening)
Pelvic exam
STI testing
Urine
Weight
Vital signs
Full health history
Partners health history
Pregnancy education
```
43
What are some routine assessments done at each prenatal visit?
```
Vital signs and weight
Urinalysis
Blood glucose screening
Fundal height
Fetal heart rate
Nutrition intake
Any discomfort/problems since last visit
```
44
When is the glucose tolerance test done?
Completed between 24 - 28 weeks gestation
45
When is group B streptoccous tested for? and why?
It is tested using a vaginal rectal swab done at 36-38 weeks
| It is done because it is dangerous to the baby and mom would need antibiotics if she has it
46
When should fetal kick count monitoring start?
Should start between 26 to 32 weeks, until delivery
47
What is the normal baseline for fetal heart auscultation
110-160bpm, and it is auscultated for one minute
48
What is the Biophysical marked on?
```
Fetal breathing movements
Gross body movement
Fetal tone
Amniotic fluid volume
Non-stress test
Normal = 2 points
Abnormal = 0 points
A score of 4 or less is considered abnormal and the baby should be delivered
```
49
What is a doppler used for?
To listen to the baby's heart beat
50
What is amniocentesis?
It is when a thin needle is inserted through the abdomen and uterine walls to get a sample of amniotic fluid
This can then be used for genetic testing, identifying fetal lung maturity, chromosomal abnormalities, and biochemical disorders
51
What are some of the danger signs in pregnancy?
```
Sudden gush or fluid from the vagina
Vaginal bleeding
Abdominal pain
Persistent vomiting
Severe, persistent headache
Blurred vision or dizziness
Painful urination
Chills with fever over 38 C
```
52
What is hyperemesis gravidarum?
Nausea and vomiting, which is most common medical condition during pregnancy
Usually begins during the first 10 weeks of pregnancy
53
With a nitrazine test, what colour is the swab when the membranes are ruptured?
Dark green - blue for ruptured membranes
| Yellow to dark orange for intact membranes
54
What are some risk factors for preterm labor?
```
Underweight
Chronic illness
Dehydration
Previous preterm labor or birth
Substance abuse
Chronic stress
Infection
Anemia
Poor nutrition
Poverty
Smoking
```
55
What are some signs of impending preterm labor?
Shortened cervix at 20 week ultrasound
| The presence of fibronectin in vaginal secretions between 22-24 weeks is predictive of preterm labor
56
What are some maternal symptoms of Preterm labor?
Contractions that may be either uncomfortable or painless
Feeling that the fetus is "balling up" frequently
Menstrual like cramps
Constant low backache
A change in vaginal discharge
"Just feeling bad" or "coming down with something"
57
What are some patient teachings for a woman with an infection or in preterm labor?
Report a temp over 38 C
Avoid sexual intercourse or anything in the vagina
Avoid orgasms
Avoid breast stimulation
Note any uterine contractions, reduced fetal activity
Report fewer than 6 fetal kick counts in a 2 hour period
58
What is PLAT?
Preterm Labor Assessment Toolkit
| It is designed to standardize care and assessment of women at risk for preterm labor
59
If PLAT is positive, what will be administered?
Steroids
60
What are some initial measures to stop preterm labor?
Identifying and treating the infection
Activity restriction
Hydration
61
In what type of abortion can sepsis occur?
Missed, because the fetus dies in utero but is not expelled
62
What is placenta previa? What can it cause?
It is when the placenta develops over the lower part of the uterus rather than the upper part
There is a risk of hemorrhage increase as the cervix begins to efface and dilate
63
What are predisposing factors for abruptio placentae?
(Premature seperation of a placenta that is normally implanted)
- Hypertension
- Cocaine use
- Cigarette smoking
- Poor nutrition
- Abdominal trauma
- Folate deficiency
64
What is HELLP syndrome?
A laboratory diagnostic variant of severe pre-eclampsia that involves hepatic dysfunction, characterized by:
H-Hemolysis
EL-Elevated liver enzymes
LP-Low platelets
65
When do glucose levels return to normal with true gestational diabetes?
By 6 weeks postpartum
66
What are the effects on the fetus when the mother has preexisting diabetes mellitus?
```
Congenital abnormalities
Spontaneous abortion
Delayed lung maturation
Neonatal hypoglycemia, hypocalcemia
Jaundice
Organ damage from hyperglycemia
```
67
What is the TORCH acronym?
```
It is used to describe infections that can be devastating to the fetus or newborn
T- Toxoplasmosis
O-Other
R-Rubella
C-Cytomegalovirus
H-Herpes
```
68
What is cytomegalovirus (CMV) ?
Herpes infection that is sexually transmitted
The infant may have seizures, blindness, deafness, dental abnormalities, "blueberry muffin rash"
There is no known effective treatment
69
What are the effects of rubella on an embryo or fetus?
```
Small head size (Microephaly)
Intellectual disability
Congenitial cataracts
Deafness
Cardiac effects
```
70
How can an infant be infected with the herpes virus?
The virus ascends into the uterus after the membranes rupture
The infant has direct contact with infectious lesions during vaginal delivery
71
What is the antiviral given to a mom with herpes to prevent lesions?
Acyclovir, can also be given to baby if infected
72
How is hepatitis B transmitted?
Blood, saliva, vaginal secretions, semen, and breast milk
73
When would an infant be tested for HIV for a true diagnosis (when mom is HIV positive)?
3-6 months old
74
What is toxoplasmosis?
It is a non-viral infection, and it is a parasite that is acquired by contact with cat feces or raw meat. It is transmitted through the placenta
75
Where is the group b streptococcus organism found?
Found in a woman's rectum, vagina, cervix, throat or skin
76
Can group b streptococcus be deadly to the infant?
YES!!
77
What is the birth plan?
It is a series of questions that will give the health care workers information that will enable them to make the mothers birthing experience a more positive experience
78
What are some questions in the birth plan?
Who do you plan on having present to support you while in labor?
Have you attended childbirth classes?
What type of pain management will you prefer?
Which gender of health care provider do you prefer?
What type of infant feeding are you planning?
79
What are the advantages and disadvantages of childbirth in a hospital?
Advantages: Emergency care, medications available, house keeping
Disadvantages:
Not as personalized, not as much privacy, restriction on visiting hours, nosocomial infection
80
What are the advantages and disadvantages of childbirth in the home?
Advantages: Familarity, symbolic for mom, more private, less chance for an infection
Disadvantages: Pain management changes, bleeding complications, complications, cleaning up after, lack of hot water or a birth tub
81
What are the differences between false and true labor?
```
False Labor:
Contractions irregular
Walking relieves contractions
Bloody show usually not present
No dilation of the cervix
True Labor:
Contractions gradually develop a regular pattern
Contractions become stronger/more effective with walking
Discomfort of lower back/abdomen
Dilation of the cervix
```
82
What are some signs of impending labor?
Braxton hicks contractions
Increased vaginal discharge
Bloody show(thick mucous mixed with pink/dark brown blood, it is the dislodgement of the mucous plug)
Rupture of membranes
Weight loss (1-3lb water weight loss)
"Nesting" feeling prior to delivery - energy spurt
83
When should the mom go to the hospital or birth center?
```
Contractions(regular for 1 hour)
Ruptured membranes
Bleeding other than bloody show
Decreased fetal movement
Any other concerns
```
84
What are the 3 major assessments performed promptly on admission?
Fetal condition
Maternal condition
Impending birth
85
What needs to be done on admission to the hospital for a pregnant woman?
Permits and consents
Laboratory tests
Intravenous infusion (only if Group B strep positive or there are bleeding concerns)
Determining the fetal position and presentation
86
What are the 4 P's of the birth process?
Powers - Forces that cause cervix to dilate/move fetus downward
Passage - Boney pelvis, soft tissues
Passenger - Fetus, placenta, amniotic membranes and amniotic fluid
Psyche - Impact of the woman's entire being on the birthing process
87
What is the purpose of fetal heart rate monitoring?
To assess the adequacy of oxygenation and uterine activity during labor to avoid hypoxic injury to the fetus
88
What are some abnormal fetal heart patterns?
```
Tachycardia (above 160bpm)
Bradycaria (below 100bpm)
Decreased or absetn variability; little fluctuation in rate
Late decelerations
Variable decelerations
```
89
What are some nursing interventions if there are abnormal fetal heart rate patterns?
Position change
Administer oxygen
Stop oxytocin or correct tachysystole (decrease uterine contractions)
Correct hypotension
Amnioinfusion
Alerted pushing and breathing techniques in 2nd stage of labor
90
What is amniotomy (AROM)
It is the artificial rupture of membranes that is done to stimulate or enhance contractions. It commits the woman to delivery
91
What are complications of amniotomy (AROM)
Prolapse of the umbilical cord
Infection
Abruptio placentae
92
What should you inspect the amniotic fluid for?
Colour: Normal is clear, may have white flecks
Green stained may indicate fetus passed stool
Odor: Should not smell, if it does there may be an infection
Amount:
Scant: trickle
Moderate: 500mL
Large: 1000mL or more
93
What is meconium?
The fetus's first stool before birth
94
What are the stages and phases of labor?
1st stage - dilation and effacement (4-6 hours)
2nd stage - explusion of fetus (30 min to 2 hours)
3rd stage - expulsion of placenta (5 to 30 min)
4th stage - recovery
95
What are some nursing responsibilities during birth?
```
Preparing the delivery instruments and infant equipment
Administering medications
Proving initial care to the infant
Assessing Apgar score
Assessing infant for obvious abnormalities
Examining the placenta
Identifying mother and infant
Promoting parent-infant bonding
```
96
What are nursing responsiblities during the 4th and final stage of labor(recovery stage)
Identifying and preventing hemorrhage
Evaluating and intervening for pain
Observing bladder function and urine output
Evaluating recovery from anesthesia
Providing initial care to the newborn infant
Promoting bonding and attachment between the infant and family
97
What are some non pharmacologic pain relief measures
```
Relaxation techniques
Skin stimulation
Sacral pressure
Thermal stimulation
Positioning
Diversion and distraction
Breathing
```
98
What is the difference between an analgesic and anesthetic?
Analgesic blocks pain
| Anesthetic blocks both pain and motor responses
99
What are indications for labor induction?
Gestational hypertension
Ruptured membranes without spontaneous onset of labor
Infection within the uterus
Medical problems in the woman that worsen during pregnancy
Fetal death
Fetal problems(slowed growth, prolonged pregnancy)
Placental insufficiency
100
What are risks of forceps or vacuum extraction?
Trauma to maternal or fetal tissues
Mother may have a laceration or hematoma in her vagina
Infant may have bruising, facial, or scalp lacerations or abrasions
Infant may have intracranial hemorrhage
101
What are indications for a C-section (cesarean birth)?
```
Abnormal labor
Inability of the fetus to pass through the mothers pelvis
Active maternal herpes virus
Previous surgery on the uterus
Fetal compromise
Placenta previa
Abruptio placentae
```
102
What are some emergencies during childbirth?
Prolapsed umbilical cord
Placenta accreta-abnormal attachment of the placenta to the uterine wall
Uterine rupture
103
What is the ALARMER Mnemonic?
```
It is used for shoulder dystocia(when one or both shoulder of baby gets stuck)
A-Ask for Help
L-Lift/hyperflex legs
A-Anterior shoulder diimpaction
R-Rotation
M-Manual removal of posterior arm
E-Episiotomy
R-Roll over onto 'all fours'
```
