Scientific Principles of Maternal & Infant Health Exam Qs Flashcards
(40 cards)
Women in their third trimester of pregnancy should be advised to rest on their left side as this will avoid what?
Supine hypotension syndrome which occurs when the weight of the enlarged uterus presses on the inferior vena cava thereby reducing venous return resulting in a drop in cardiac output.
How many more calories should a pregnant woman consume and from when?
An additional 200 kcal/day only in the third trimester
Which of the following crosses a cell membrane by active transport? Water Oxygen Sodium Ions Carbon Dioxide
Sodium Ions
Renal blood flow is known to increase during the first trimester of pregnancy by how much?
60%
The woman may experience increased frequency of micturition during the 1st trimester due to what?
The enlarging uterus remains within the pelvis and therefore compression of the bladder occurs causing frequency.
During pregnancy the cardiovascular system adapts by doing what THREE things?
- Increasing blood volume
- Increasing cardiac output
- Decreasing peripheral resistance.
Name THREE unpleasant symptoms that oestrogen may cause the women?
- Nasal stuffiness
- Hypersecretion of mucus
- Increase in the occurrence of epistaxis
What THREE things increase the risk of a Urinary Tract Infection (UTI) during pregnancy?
- The ureters elongate and lose tone due the effects of progesterone.
- The occurrence of vesico-ureteric reflux increases.
- The influence of compression upon the ureters caused by the enlarged uterus at the pelvic brim
Which hormone stimulates Angiogenesis and what is the result?
Oestrogen
An increase in the number and the length of blood vessels
Progesterone influences the respiratory system during pregnancy by affecting what?
Decreases airway resistance by relaxing the smooth muscles of the bronchioles by up to 50%
Why does lipolysis increase during the third trimester?
Fat acts as an alternative source of energy to conserve glucose for fetal utilisation
Maternal pulmonary ventilation increases by 40 % during pregnancy due to what?
The direct effect of progesterone on respiratory mechanisms within the brainstem
What are the three phases of the ovarian cycle?
Follicular
Ovulatory
Luteal
The hormone MOST associated with childbirth is what?
Oxytocin
During trimesters 1 and 2 fat storage increases due to?
Increased insulin production and the influence of progesterone
Proteins do not pass freely through membranes because?
They are very large molecules
Which of the following transportation mechanisms does NOT obey the "laws of diffusion"? Osmosis Diffusion Active transport Facilitated transport
Active Transport
Human Chorionic Gonadotropin (HCG) is different from other gonadotropins because it does NOT what?
Come from the anterior pituitary
How would you calculate a due date – what information would you require? (4 points)
The pattern of a woman’s menstrual cycle would be investigated with regards to length and regularity (1)
Whether the woman was using contraceptives recently (1)
The first date of the woman’s last menstrual period would be needed: this date is then used in the calculation of her estimated date of delivery (EDD) (1)
Naegele’s Rule would be used taking the first date of the woman’s last menstrual period and for:
• A 28 day cycle: + 7days + 9 months
• A 33 day cycle: + 7 days + 5 days + 9 months
• A 23 days cycle: +7 days – 5 days + 9 months (1)
What further investigation is commonly used to confirm gestational age? (2 points)
The estimated gestational age would be confirmed using an ultrasound booking scan (1), this ideally 10-14 weeks gestation where the crown-rump measurement is assessed (1). If the gestation calculated by the sonographer differs by +/- 5 days from the EDD calculated using Naegele’s rule then the date suggested by the USS is usually adopted
Discuss the actions of Human Chorionic Gonadotrophin, including site of production and the significance of changing levels during pregnancy. (3 points)
HCG is produced by the trophoblast and secreted into the lacunae (pockets) of maternal blood in the syncytiotrophoblast. (1)
Action of the hormone- acts upon the corpus luteum (ovary) maintaining oestrogen and progesterone levels to continue pregnancy. (1)
Changing levels- Levels are high and detected in urine 9 days after fertilisation. HCG levels fall when the placenta becomes fully functioning at 12 weeks gestation. (1)
What is the term used to describe severe nausea or morning sickness?
Hyperemesis
What are the known causes of nausea and vomiting? (3 points)
The cause of nausea and vomiting is unclear however there appears to be a link with increasing levels of Human Chorionic Gonadotrophin (HCG). HCG is produced by the trophoblast of the developing embryo from the point of implantation. (1)
Research has suggested a link between nausea and vomiting and raised levels of T4 and higher levels of Thyroid Stimulating Hormone (TSH) (1)
The effect of progesterone upon the tone of gastric smooth muscle may cause significant symptoms of nausea and vomiting due to the influence upon:
• The patency of the lower oesophageal sphincter.
• The delay in gastric emptying.(1)
What advice would you offer someone with morning sickness?
- Reassurance and Advice: Nausea and vomiting is normal and common during pregnancy and will usually resolve spontaneously by 20 weeks therefore Sumara should not become anxious at this time and there are different options available to ease her symptoms. (1)
- Coping Strategies: Would include having small frequent meals, consuming carbohydrates which are easily digested and a diet which is low in fat, foods which contain ginger may be beneficial. Alternative therapies may be utilised with the aid of a fully qualified therapist. (1)
- Pharmacological / Medication: Anti-histamines or Anti-emetics may be prescribed by a doctor e.g. Cyclizine.(1)
- Hospitalisation: If Sumara does not feel that her symptoms have improved then hospitalisation may be indicated particularly if she becomes unable to tolerate oral fluids and if she becomes ketotic. IV fluids and IM/IV Anti-emetics would be indicated.(1)
