T1 - Advance Directives (Josh) Flashcards by Josh Miller

A surge of —- causes the follicle to be released from the surface of the ovum.

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Product of union b/t normal gamete and a gamete that is missing a chromosome.

Monosomy

***monosomic individuals have only 45 chromosomes

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What time and what amount is sufficient to perform an amnioscentesis?

16 wks and 200-300 mL

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What could cause a decreased fundal height?

Intrauterine Growth Restriction (IUGR)

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What amount of AF is Polyhydramnios?

What conditions does this cause?

> 2000 mL

associated w/ esophageal atresia and severe CNS malformation

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Sperm survive approximately —

Female ova survive approximately —-

48 -72 hrs

12-24 hrs

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What meds can interfere w/ accuracy of EPT?

Anticonvulsants and diuretics can cause a false positive

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Normal fetal HR

110-160 bpm

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What is Goodell’s Sign?

“gooey”

Softening of cervical tip in a normal, unscarred cervix

~6th week

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Teaching regarding early pregancy test (EPT)?

a. first voided urine specimen in AM
b. Meds can interfere with accuracy of test (anticonvulsants, diuretics)
c. Hcg detected 4 days after implantation.
d. If test is done at time of your missed period is negative, repeat in 1 wk if period hasn’t returned

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Cardinal signs of Preeclampsia?

Proteinuria

Edema (periorbital)

Elevated BP (140/90)

Headache/Dizziness

Blurred Vision

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Implantation occurs when estrogen and progesterone, produced by —- are at their peak.

ovaries (6-10 days)

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Baby heart can be heard — by doppler and — by fetoscope (bone conduction.

10-12 wks

18-20 wks

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What else can cause Balottement?

tumor

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Sperm best survive in a — environment.

— is nutritive to sperm.

alkaline

Seminal fluid

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Objective/Subjective signs of ovulation?

Spinnberkeit

increased cervical mucous

breast tenderness

cervix is high, soft, and open

increased sex drive

spotting, cramping and/or pain on one side

bloating

mild nausea

headache

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What BP is a danger signal?

140/90

***absolute value that signifies gestational HTN

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Sex of baby

ovaries and testes distinguishable at 8 WKS

internal and external organs specifically identifiable at 12 WKS

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What days of ovarian cycle does ovulation typically occur?

14 +- 2 days before the next menstrual cycle

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What do Ghonorrhea and Chlamydia increase risk of?

corneal scarring of infant (blind babies)

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Presumptive signs of pregnancy.

Amenorrhea

Fatigue

Breast Changes

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What are positive signs of pregnancy?

Hearing fetal tones

Seeing the fetus

Palpating fetal movements

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— is baby bounces against examiner’s hand (sign that baby is NOT ready to be born b/c he hasn’t come down yet)

Ballottement

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What triggers the ovarian/hypothalamus/pituitary feedback mechanism?

low blood levels of estrogen trigger the hypothalamus to secrete GnRH which simulates the anterior pituitary to release FSH and LH which stimulates a primary follicle to begin maturing

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What is lightening and when does it occur?

Fundal heigh decreases as fetus descends into pelvis 38-40 weeks

What is Chadwick's Sign?

Bluish color of cervix at 6-8 wks

Vessels within Umbilical Cord.

2 arteries (deoxygenated blood and waste) 1 vein (oxygenated blood)

List changes of breasts during pregnancy?

a. Colostrum may leak from nipple b. Size increases c. Nipples and areola darken d. May have striae gravidarum (stretch marks) e. Superficial veins become prominent

What is leukorrhea?

whitish, yellowish mucous discharge from vagina

What is the avg. length of the menstrual cycle?

28 days

What structures of the blastocyst extend into the maternal blood supply in the process of implantation?

Chorionic villi.

At 20 wks, where is the fundal height?

at the umbilicus

S/S of UTI

Urinary frequency Dysuria Hematuria

Can UTI be asymptomatic?

yes

Which individuals are unaffected by Autosomal Recessive Inheritance Disorders?

Heterozygous individuals b/c their normal gene overshadows the variant allele ***clinically normal but they're still CARRIERS

What does an increase in clotting factors place pregnant client at risk for?

blood clots

What amounts of iron is recommended?

27 mg/day ***supplement 30mg daily starting about 12 wks gestation

What else could cause a Positive Pregnancy Test?

Hydatidiform Mole Choriocarcinoma

How long does it take Zygote to reach uterus?

3-4 days

Baby's heart is fully developed at ---

8 wks

When would ovulation likely occur on a 32 day cycle?

day 18 ***32-14 = 18

--- is period from conception to day 14 --- is period from day 15 - 8 weeks --- is peiod from week 9 - week 40

ovum embryo fetal

Implantation occurs --- after conception.

6-10 days

What is the purpose of the corpus luteum?

secretes estrogen and progesterone until the placenta is large enough to take over

After ovulation, the follicle crater is called --- ---

corpus luteum

How long is pregnancy in days, weeks, and months?

280 days 40 wks 10 lunar months

By --- weeks gestation, a female has a lifetime supply of oocytes.

What is a concern when the membranes are ruptured?

umbilical cord caught b/t head and pelvis

Which hormones are released by the Anterior Pituitary?

FSH and LH

What is Spinnbarkeit?

change in cervical mucous during ovulation where it is more thin and stretch

During the Follicular and Proliferation phases (pre-ovulatory), which hormone is dominant?

estrogen *** e before p (estrogen before progesterone)

What is the criteria for viability?

20 wks and 500 g ***looking for CNS function and O2 capacity of lungs

Calculate the date of ovulation for a client who has a 32 day cycle?

14 + - 4 days

With a recessive disorder, what must happen for it to be expressed?

two carriers must each contribute the affected gene to the offspring

What is leukorrhea a possible sign of?

STDs - Gonorrhea - Chlamydia - Syphilis - Herpes

Most inborn errors of metabolism such as PKU, galactosemia, Tay-Sachs disease, sickle cell anemia, and cystic fibrosis (CF) are ----

autosomal recessive inherited disorders.

What is the purpose of the endocervical plug?

aka: operculum seals endocervical canal and prevents ascent of bacteria from vagina to uterus

The FOLLICULAR PHASE of the ovarian cycle corresponds with the ____ of the endometrial cycle.

Proliferation ***both are PRE-ovulatory

In relation to the endometrial cycle, ovulation occurs at the end of the --- phase.

proliferation

The hormone --- causes the primary follicle to mature.

FSH

Which developmental stage is the time when organs are most vulnerable to teratogens?

Embryo (day 15 - 8 weeks)

Which hormone is responsible for milk PRODUCTION? Which hormone is responsible for milk LETDOWN?

Prolactin Oxytocin

What amount of AF is Oligohydramnios? What conditions does this cause?

Which phase of the OVARIAN cylce occurs at the same time as the SECRETORY phase of the ENDOMETRIAL cycle?

Luteal

Meconium in AF places baby at risk for ---

meconium aspiration

Which phase of the endometrial cycle can support an implanted zygote?

secretory

---- shunt blood around fetal liver. ---- shunts blood around fetal lungs. ---is right to left shunt around fetal ventricles.

ductus venosus ductus arteriosis foramen ovale

Which type of chromosomal abnormality is Down's Syndrome?

Trisomic (extra chromosome)

When is L/S ratio proper for lung development?

2:1 36th week

When does the Fundus become palpable?

12 wks

Sperm and Ova meet (fertilization) happens where?

outer 1/3 of FT

Quickening happens at ---- for nulliparous and --- for multips.

18-20 weeks (nulliparous) 14-16 weeks (multip)

How long does the Corpus Luteum secrete Estrogen and Progesterone?

until the placenta can take over at about 3 MONTHS gestation

--- abnormalities are a major cause of reproductive loss and congenital problems.

Chromosomal

Vascular volume increases by --- and peaks at ---

45-50 % 32-34th wk

What else could cause Goodell's Sign?

pelvic congestion

What blood types cannot mix?

Rh+ mom and Rh- baby ***mom's body will attack *** give Rhogam

AF is slightly --- and turns nitrazine paper ---

alkaline blue ***urine (acid) turns it red

Probably signs of pregnancy.

Hegar's Sign Balottment Pregnancy Test Goodell sign

Lay mom on which side to take pressure off of IVC and Aorta?

left side

Which organ of pregnancy takes over work of the liver for the baby?

placenta

When should Rhogam be given?

28 wks and again up to 48-72 hrs after delivery

What hormone is the earliest biochemical marker for pregnancy diagnosis?

hCG ***secreted by the blastocyst to make sure the corpus luteum remains viable and secreting E and P

Where is the hormone estrogen produced?

Ovary Corpus Luteum Placenta

--- are those in which both genes of a pair are forms associated with the disorder to be expressed.

Autosomal recessive inheritance disorders

Product of union b/t normal gamete and a gamete with an extra chromosome.

Trisomy

What is the most common cause of Ophtalmia Neonatorum?

Chlamydia

What else could cause Hegar Sign?

pelvic congestion

Sperm cell development is stimulated by the hormone ---

notes say testosterone google says FSH

What affect does Progesterone have on smooth muscle? What does this lead to in Placenta and GI tract?

relaxes smooth muscle prevents placenta from spontaneous abortion leads to constipation in GI tract due to slowed peristalsis

Nicotine is a --- drug.

vasoconstrictor leads to HTN and tachycardia in baby

Blood cells form at approximately --- gestation.

3 wks

Increase in vascular problem causes which problem?

Physiologic Anemia - Hgb

What could cause an excessive increase in fundal height?

twins polyhydramnios hydatidiform mole

Which hormone is dominant during the secretory phase?

Progesterone ***when the corpus luteum beings picking up the pace

HSV (Herpes Simplex Virus) can --- the placenta.

cross ***baby will look scalded

What is Hegar's Sign?

Softening and Thinning of lower segment of uterus (~ 6th wk)