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OB > Week 1 OB > Flashcards

Week 1 OB Flashcards

1
Q

The most common genetic disease among people of African ancestry.

A

Sickle-cell anemia (R)

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2
Q

Forms rigid crystals that distort and disrupt red blood cells; oxygen-carrying capacity of the blood is diminished

A

Sickle-cell anemia (R)

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3
Q

The most common genetic disease among people of European ancestry.

A

Cystic fibrosis (R)

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4
Q

Production of thick mucus clogs in the bronchial tree and pancreatic ducts. Most severe effects are chronic respiratory infections and pulmonary failure.

A

Cystic fibrosis (R)

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5
Q

The most common genetic disease among people of Jewish ancestry.

A

Tay-Sachs disease (R)

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6
Q

Degeneration of neurons and the nervous system results in death by the age of 2 years

A

Tay-Sachs disease (R)

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7
Q

Lack of an enzyme to metabolize the amino acid phenylalanine leads to severe mental and physical retardation. These effects may be prevented by the use of a diet (beginning at birth) that limits phenylalanine.

A

Phenylketonuria (PKU) (R)

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8
Q

Uncontrollable muscle contractions between the ages of 30 and 50 years, followed by loss of memory and personality. There is no treatment that can delay mental deterioration.

A

Huntington’s disease (Dominant)

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9
Q

Lack of factor VIII impairs chemical clotting; may be controlled with factor VIII from donated blood.

A

Hemophilia (X-linked)

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10
Q

Replacement of muscle by adipose or scar tissue, with progressive loss of muscle function; often fatal before age 20 years due to involvement of cardiac muscle.

A

Duchenne’s muscular dystrophy (X-linked)

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11
Q

Allows for the early detection of genetic disorders such as trisomy 21, hemophilia, and Tay-Sachs disease

A

Prenatal testing

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12
Q

The developing human is most vulnerable to the effects of teratogens during the period of _____.

A

organogenesis, the first 8 weeks of gestation

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13
Q

Give an example of a teratogen

A

Toxoplasmosis

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14
Q

Protozoan parasite found in cat feces and uncooked or rare beef and lamb.

A

Toxoplasma

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15
Q

When an en embryo is exposed to ______, fetal demise, mental retardation and blindness can result.

A

Toxoplasma

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16
Q

Education for women who are pregnant or attempting to conceived should:

A
  • Avoid contact with cat feces, such as cleaning or changing a litter box.
  • Avoid eating rare beef or lamb.
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17
Q

Exposure to teratogens after 13 weeks of gestation may cause

A

Fetal growth restriction or reduction of organ size

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18
Q

Give examples of Drugs and Chemicals (Teratogenic Agents)

A
  • Alcohol
  • ACE
  • Carbamazepine (anticonvulsant)
  • Cocaine
  • Warfarin (Coumadin)
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19
Q

Alcohol - Characteristics of Fetal Alcohol Syndrome (FAS)

A
  • low birth weight
  • microcephaly
  • mental retardation
  • unusual facial features due to midfacial hypoplasia
  • cardiac defects
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20
Q

Increased risk for:
• Renal tubular dysplasia that can lead to renal failure and fetal or neonatal death
• Intrauterine growth restriction

A

Angiotensin-converting enzyme (ACE) inhibitors

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21
Q

Increased risk for:
• Neural tubal defects
• Craniofacial defects, including cleft lip and palate
• Intrauterine growth restriction

A

Carbamazepine (anticonvulsant)

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22
Q

Increased risk for:
• Heart, limbs, face, gastrointestinal tract, and genitourinary tract defects
• Cerebral infarctions
• Placental abnormalities

A

Cocaine

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23
Q 
Increased risk for:
• Spontaneous abortion
• Fetal demise
• Fetal or newborn hemorrhage
• Central nervous system abnormalities
A

Warfarin (Coumadin)

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24
Q

Teratogen examples of Infections/Viruses

A
  • Cytomegalovirus
  • Herpes varicella (chicken pox)
  • Rubella
  • Syphilis
  • Toxoplasmosis
  • Zika
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25
Q 
Increased risk for:
• Hydrocephaly
• Microcephaly
• Cerebral calcification
• Mental retardation
• Hearing loss
A

-Cytomegalovirus

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26
Q

Increased risk for:
• Hypoplasia of hands and feet
• Blindness/cataracts
• Mental retardation

A

-Herpes varicella

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27
Q 
Increased risk for:
• Heart defects
• Deafness and/or blindness
• Mental retardation
• Fetal demise
A

-Rubella

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28
Q

Increased risk for:
• Skin, bone, and/or teeth defects
• Fetal demise

A

-Syphilis

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29
Q

Increased risk for:
• Fetal demise
• Blindness
• Mental retardation

A

-Toxoplasmosis

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30
Q 
Increased risk for:
• Microcephaly
• Blindness
• Hearing defects
• Impaired growth
A

-Zika

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31
Q

Where does fertilization occurs?

A

Fertilization occurs within one of the two fallopian tubes, also called oviducts

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32
Q

Site of implantation

A

Uterus

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33
Q

Inner layer of the uterus is called _____.

A

Endometrium. Each month, estrogen and progesterone stimulate the functional layer to thicken in preparation for egg implantation. If implantation occurs, the endometrium continues to thicken. If implantation does not occur, the functional layer is shed during the menstrual cycle.

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34
Q

Menstrual Cycle 2 Phases

A
  1. Ovarian Cycle, 2. Endometrial cycle
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35
Q

____ cycle pertains to the maturation of the ova and consists of 3 phases ____, ____, _____

A 
Ovarian cycle 
(FOS); 1. follicular phase; 2. ovulatory phase; 3. luteal phase
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36
Q

Phase that begins during the first day of menstruation and lasts 12 to 14 days.

A

-follicular phase

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37
Q

During this phase, the graafian follicle matures under the influence of two pituitary hormones: ____ and ____. The maturing graafian follicle produces what hormone? _____.

A
  • follicular phase
  • 2 pituitary hormones: luteinizing hormone (LH) and follicle-stimulating hormone (FSH).
  • The maturing graafian follicle produces estrogen.
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38
Q

This phase begins when estrogen levels peak and ends with the release of the oocyte (egg) from the mature graafian follicle

A

Ovulatory Phase

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39
Q

The release of the oocyte is referred to as _____.

A

Ovulation

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40
Q

LH levels surge 12 to 36 hours before ovulation. Before this surge, estrogen levels decrease and progesterone levels increase.

A

Ovulatory phase

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41
Q

Begins after ovulation and last approximately 14 days.

A

Luteal Phase

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42
Q

During this phase, the cells of the empty follicle morph to form the corpus luteum, which produces high levels of progesterone and low levels of estrogen.

A

Luteal Phase

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43
Q

If pregnancy occurs, the corpus luteum releases progesterone and estrogen until the placenta matures enough to assume this function. If pregnancy does not occur, the corpus luteum degenerates, resulting in a decrease in progesterone and the beginning of menstruation.

A

Luteal Phase

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44
Q

3 Phases of Endometrial Cycle

A

PSM = 1. Proliferative Phase, 2. Secretory Phase, 3. Menstrual Phase

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45
Q

This phase occurs following menstruation and ends with ovulation. During this phase, the endometrium prepares for implantation by becoming thicker and more vascular. These changes are in response to the increasing levels of estrogen produce by the graafian follicle

A

Proliferative Phase

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46
Q

This phase begins after ovulation and ends with the onset of menstruation. In this phase, the endometrium continues to thicken. The primary hormone during this phase is the progesterone secreted from the corpus luteum.

A

Secretory Phase

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47
Q

If pregnancy occurs, the endometrium continues to develop and begins to secrete glycogen, the energy source for the blastocyst during implantation. If pregnancy does not occur, the corpus luteum begins to degrade and the endometrial tissue degenerates.

A

Secretory Phase

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48
Q

This phase occurs in response to hormonal changes and results in the sloughing off and expulsion of the endometrial tissue.

A

Menstrual phase

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49
Q

Conception aka as _____, occurs when a sperm nucleus enters the nucleus

A

Fertilization

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50
Q

Heart begins to beat during ____.

A

3rd week after conception

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51
Q

3 Fetal Circulation

A
  1. ductus venosus, 2. foramen ovale, 3. ductus arteriosus
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52
Q

It connects the pulmonary artery with the descending aorta.

A

Ductus arteriosus

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53
Q

It connects the umbilical vein to the inferior vena cava. This allows the majority of the highly oxygenated blood to enter the right atrium.

A

ductus venosus

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54
Q

It is an opening between the right and left atria. It may take up to 3 months for full closure.

A

foramen ovale

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55
Q
  • Red blood cells are produced in the liver.
  • Fusion of the palate is completed.
  • External genitalia are developed to the point that sex of fetus can be noted with ultrasound.
  • Eyelids are closed.
  • Fetal heart tone can be heard by Doppler device.
A

Gestational Week 12

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56
Q
  • Lanugo is present on head
  • Meconium is form in the intestines
  • teeth begin to form
  • sucking motions are made with the mouth
  • skin is transparent
A

Gestational Week 16

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57
Q
  • Lanugo covers the entire body
  • Venix caseosa covers the body
  • Nails are formed
  • Brown fats begin to develop
A

Gestational Week 20

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58
Q
  • Eyes are developed.
  • Alveoli form in the lungs and begin to produce surfactant.
  • Footprints and fingerprints are forming.
  • Respiratory movement can be detected.
A

Gestational Week 24

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59
Q

Eyelids are open. Adipose tissue develops rapidly. The respiratory system has developed to a point where gas exchange is possible, but lungs are not fully mature.

A

Gestational Week 28

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60
Q

Bones are fully developed. Lungs are maturing. Increased amounts of adipose tissue are present.

A

Gestational Week 32

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61
Q

Lanugo begins to disappear. Labia majora and minora are equally prominent. Testes are in upper portion of scrotum.

A

Gestational Week 36

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62
Q

Fetus is considered full term at 38 weeks. All organs/systems are fully developed.

A

Gestational Week 40

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63
Q

2 Functions of the placenta

A
  1. Metabolic and gas exchange -In the placenta, fetal waste products and CO2 are transferred from the fetal blood into the maternal blood sinuses by diffusion. Nutrients such as glucose and amino acids and O2 are transferred from the maternal blood sinuses to the fetal blood through the mechanisms of diffuse and active transport.
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64
Q

2 Functions of the placenta

A
  1. Hormone Production: The major hormones the placenta produces are progesterone; estrogen; human chorionic gonadotropin (hCG); and human placental lactogen (hPL), also known as human chorionic somatomammotropin.
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65
Q

4 hormones of the placenta:

A

Progesterone, Estrogen, hCg, hPL

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66
Q

Function of the progesterone in the placenta

A

Progesterone facilitates implantation and decreases uterine contractility.

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67
Q

Function of the estrogen in the placenta

A

Estrogen stimulates the enlargement of the breasts and uterus.

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68
Q

Function of the hCG in the placenta

A

hCG stimulates the corpus luteum so that it will continue to secrete estrogen and progesterone until the placenta is mature enough to do so. This is the hormone assessed in pregnancy tests. hCG rises rapidly during the first trimester and then rapidly declines.

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69
Q

Function of the hPL in the placenta

A

hPL promotes fetal growth by regulating available glucose and stimulates breast development in preparation for lactation.

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70
Q

What can cross the placenta?

A
  • viruses such as rubella and cytomegaloviruses

- drugs/avoid preg category C, D, or X.

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71
Q

Function of the Embryonic Membranes

A

The intact membranes help maintain a sterile environment by forming a barrier that prevents bacteria from entering the amniotic fluid through the vagina.

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72
Q

Contained within the amniotic sac. It is clear and is mainly composed of water. It also contains proteins, carbohydrates, lipids, electrolytes, fetal cells, lanugo, and vernix caseosa.

A

Amniotic fluid

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73
Q

4 Functions of Amniotic Fluid

A

● Cushions the fetus from sudden maternal movements.
● Prevents the developing human from adhering to the amniotic membranes.
● Allows freedom of fetal movement, which aids in symmetrical musculoskeletal development.
● Provides a consistent thermal environment.

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74
Q

2 types of amniotic fluid abnormalities

A
  1. Polyhydramnios or hydramnios

2. Oligohydramnios

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75
Q

Refers to excess amount of amniotic fluid (1,500–2,000 mL). Newborns of mothers who experience polyhydramnios have an increased incidence of chromosomal disorders and gastrointestinal, cardiac, and neural tube disorders.

A

Polyhydramnios or hydramnios

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76
Q

Refers to a decreased amount of amniotic fluid (less than 500 mL at term or 50% reduction of normal amount). This is generally related to a decrease in placental function. Newborns of mothers who experienced oligohydramnios have an increased incidence of congenital renal problems.

A

Oligohydramnios

77
Q

It connects the fetus to the placenta and consists of two umbilical arteries and one umbilical vein (AVA).

A

Umbilical Cord

78
Q

It connects the fetus to the placenta and consists of two umbilical arteries and one umbilical vein. The arteries carry deoxygenated blood while the vein carries oxygenated blood

A

Umbilical Cord

79
Q

A collagenous substance that protects the vessels from compression

A

Wharton’s Jelly

80
Q

Newborns with only two vessels (one artery and one vein) have a 20% chance of having a cardiac or vascular defect.

A

Umbilical Vessels

81
Q

Defined as the inability to conceive and maintain a pregnancy after 12 months (6 months for woman older than age 35 years) of unprotected sexual intercourse.

A

Infertility

82
Q

Male causative factors in 5 categories

A
  1. Endocrine
  2. Spermatogenesis
  3. Sperm antibodies
  4. Sperm transport factor
  5. Disorder of intercourse
83
Q

Infertility causative factor: Endocrine

A

Endocrine causes include pituitary diseases, pituitary tumors, and hypothalamic diseases that may interfere with male fertility. Low levels of LH, FSH, or testosterone can also decrease sperm production.

84
Q

Infertility causative factor: Spermatogenesis

A

Spermatogenesis is the process in which mature functional sperm are formed. Several factors can affect the development of mature sperm. These factors are referred to as gonadotoxins and include:

85
Q

Examples of gonadotoxins

A

● Drugs (e.g., chemotherapeutics, calcium channel blockers, heroin, and alcohol)
● Infections/viruses (e.g., prostatitis, sexually transmitted infections [STIs], and contracting mumps after puberty)
● Systemic illness
● Prolonged heat exposure to the testicles (e.g., use of hot tubs, wearing tight underwear, and frequent bicycle riding)
● Pesticide exposure
● Radiation to the pelvic region

86
Q

Infertility causative factor: Sperm antibodies

A

Sperm antibodies are an immunological reaction against the sperm that causes a decrease in sperm motility. This is seen mainly in men who have had either a vasectomy reversal or who experienced testicular trauma.

87
Q

Infertility causative factor: Sperm transport factor

A

Sperm transport factor includes missing or blocked structures in the male reproductive anatomy that interfere with sperm transport (e.g., vasectomy, prostatectomy, inguinal hernia, and congenital absence of the vas deferens).

88
Q

Infertility causative factor: Disorders of intercourse

A

Disorders of intercourse include erectile dysfunction (inability to achieve and/or maintain an erection), ejaculatory dysfunctions (retrograde ejaculation), anatomical abnormalities (hypospadias), and psychosocial factors that can interfere with fertility.

89
Q

Female causative factors are classified into three major categories

A
  1. Ovulatory dysfunction includes anovulation or inconsistent ovulation 2. Tubal and pelvic pathology factors 3. Cervical mucus factors
90
Q

Female causative factors: Ovulatory dysfunction includes anovulation or inconsistent ovulation.

A

Ovulatory dysfunction includes anovulation or inconsistent ovulation. Causes of ovulatory dysfunction are hormonal imbalances, hyperthyroidism and hypothyroidism, high prolactin levels, premature ovarian failure (menopause prior to age 40), polycystic ovarian syndrome.

91
Q

Female causative factors: Tubal and pelvic pathology factors

A

Tubal and pelvic pathology factors include damage to the fallopian tubes and uterine fibroids. Damage to the fallopian tubes is commonly related to previous pelvic inflammatory disease or endometriosis. Uterine fibroids, benign growths of the muscular wall of the uterus, can cause a narrowing of the uterine cavity and interfere with embryonic and fetal development, causing a spontaneous abortion.

92
Q

Female causative factors: Cervical mucus factors

A

Cervical mucus factors – include infection and cervical surgeries such as cryotherapy, a medical intervention to treat cervical dysplasia. These factors may interfere with the ability of sperm to enter or survive in the uterus.

93
Q

Risk Factors for Infertility in Women (9)

A

autoimmune disorders, diabetes, eating disorders or poor nutrition, excessive alcohol use, excessive exercising, history of cancer treated with gonadotoxic therapy or pelvic irradiation, obesity, older age, STI

94
Q

Risk Factors for Infertility in Men (6)

A
  • Environmental pollutants
  • heavy use of alcohol, marijuana or cocaine,
  • impotence
  • older age
  • STIs
  • smoking
95
Q

Common diagnostic tests to determine the underlying cause of infertility (7)

A
  1. Screening for STI,
  2. Laboratory test
  3. Semen Analysis
  4. Ovulatory dysfunction analysis
  5. Endometrial biopsy
  6. Hysterosalpingogram
  7. Laparoscopy
96
Q

What laboratory test to assess for hormonal levels in infertility?

A

Laboratory tests to assess hormonal levels (thyroid-stimulating hormone [TSH], FSH, LH, anti-Müllerian hormone [AMH], and testosterone)

97
Q

4 types of ovulatory dysfunction analysis

A
  1. Basal Body Temperature
  2. Ovulatory prediction kits
  3. Ovarian reserve testing
  4. Detecting LH surge
98
Q

What is semen analysis?

A

oThe man abstains for 2 to 3 days before providing a masturbated sample of his semen.
oSpecimens are either collected at the site of testing or brought to the site within an hour of collection.
oThe semen analysis includes volume, sperm concentration, motility, morphology, white blood cell count, immunobead, and mixed agglutination reaction test.
oSeveral semen analyses may be required since sperm production normally fluctuates.

99
Q

Female takes temperature each morning before rising using a basal thermometer and records her daily temperature. Ovulation has occurred if there is a rise in the temperature by 0.4 F for 3 consecutive days.

A

Basal Body Temperature (BBT) charting

100
Q

Used more often than BBT

A

Ovulatory prediction kits

101
Q

It is used to determine size of the remaining egg reserve. On day 3 of the menstrual cycle, blood is drawn to evaluate the levels of FSH, estradiol and AMH. The same day, a transvaginal ultrasound is performed to assess ovarian volume and antral follicle amount.

A

Ovarian reserve testing

102
Q

A rapid increase in LH 36 hours before ovulation can be testing with urine or serum. The urine test can be performed at home to assist in identifying the ideal time for intercourse when pregnancy is desired.

A

Detecting LH surge

103
Q

Assess the response of the uterus to hormonal signals that occur during the cycle. The biopsy is performed at the end of the menstrual cycle in the clinical or medical office.

A

Endometrial biopsy

104
Q

Radiological examination that provides information about the endocervical canal, uterine cavity, and fallopian tubes. Under fluoroscopic observation, dye is slowly injected through the cervical canal into the uterus. This examination can detect tubal problems such as adhesions or occlusions and uterine abnormalities such as fibroids, bicornate uterus and uterine fistulas.

A

Hysterosalpingogram

105
Q

It uses an instrument called laparoscope to visualize and inspect the ovaries, fallopian tubes, and uterus for abnormalities such as endometriosis and scarring.

A

Laparoscopy

106
Q

Male infertility patient’s treatment (6)

A
  1. Hormonal therapy for endocrine factors
  2. Lifestyle changes to correct abnormal sperm count: stress reduction, improved nutrition, smoking cessation and elimination of drugs
  3. Corticosteroids to decrease the production of the sperm antibodies
  4. Antibiotics to clear infections of the genitourinary tract
  5. Repair of varicocele or inguinal hernia to facilitate sperm transport
  6. Transurethral resection of ejaculatory ducts to treat disorders related to intercourse.
107
Q

Female infertility treatment (4)

A
  1. Treatment for anovulation: lifestyle changes (stress reduction, improved nutrition, smoking cessation, and elimination of drugs that have an adverse effect on fertility) and drug therapy to stimulate ovulation: clomiphene citrate, letrozole; injectable gonadotropins; the gonadotropin-releasing hormone [GnRH] pump; and bromocriptine.
  2. Surgery to open the fallopian tubes if tubal abnormalities are present.
  3. Removal of uterine fibroids through a surgical procedure called myomectomy
  4. Antibiotics to treat cervical infection.
108
Q

Clomiphene Citrate (Clomid) Indication

A 
Clomiphene Citrate (Clomid)
● Indication: Anovulatory infertility
109
Q

Clomiphene Citrate (Clomid) Action and Common Side Effects (8)

A

● Action: Stimulates release of FSH and LH, which stimulates ovulation

● Common side effects: Hot flashes, breast discomfort, headaches, insomnia, bloating, blurry vision, nausea, vaginal dryness

110
Q

Clomiphene Citrate (Clomid) Route and Dose; Nursing Actions

A

● Route and dose: PO; 50–200 mg/day from cycle day 3–7.

● Nursing actions:

● Provide information on use of medication and its side effects.

Instruct woman not to drive if she is experiencing blurry vision.

111
Q

Common Assisted Fertility Technologies (6)

A
  1. AI
  2. Testicular sperm aspiration
  3. In vitro fertilization (IVF)
  4. Zygote intrafallopian transfer (ZIFT)
  5. Gamete intrafallopian transfer (GIFT)
  6. Embryo transfer (ET)
112
Q

Procedure: sperm that has been removed from semen is deposited directly into the cervix or uterus using a plastic catheter. The sample is collected by masturbation, and the sperm are separated from the semen and prepared

A

Artificial insemination (AI):

113
Q

Examples of fertility conditions where artificial insemination is used (4)

A

(1) poor cervical mucus production as a result of previous surgery of the cervix, (2) anti-sperm antibodies, (3) diminished amount of sperm, and (4) diminished sperm motility.

114
Q

Sperm are aspirated or extracted directly from the testicles. Sperm are then microinjected into the harvested eggs of the female partner. This is also referred to as intra-cytoplasmic injection.

A

Testicular sperm aspiration

115
Q

Examples of fertility conditions where Testicular sperm aspiration is used (3)

A

(1) had an unsuccessful vasectomy reversal, (2) have an absence of vas deferens, or (3) have an extremely low sperm count or no sperm in their ejaculated semen.

116
Q

A procedure in which oocytes are harvested and fertilization occurs outside the female body in a laboratory.

A

In vitro fertilization (IVF)

117
Q

Zygote is placed into the fallopian tube via laparoscopy 1 day after the oocyte is retrieved from the woman and IVF is used.

A

Zygote intrafallopian transfer (ZIFT)

118
Q

Sperm and oocytes are mixed outside the woman’s body and then placed into the fallopian tube via laparoscopy. Fertilization takes place inside the fallopian tube.

A

Gamete intrafallopian transfer (GIFT)

119
Q

When is GIFT procedure used?

A

This procedure is used when there has been (1) a history of failed infertility treatment for anovulation, (2) unexplained infertility, and (3) low sperm count.

120
Q

An embryo is placed in the uterine cavity via a catheter. Example of fertility condition in which this procedure is used is when the fallopian tubes are blocked.

A

Embryo transfer (ET)

121
Q

Breast Changes: due to stretching of skin to accommodate enlarging breast tissue

A

Striae

122
Q

Softening of the cervix

A

Goodell’s sign

123
Q

Softening of the lower uterine segment

A

Hegar’s sign

124
Q

bluish coloration of cervix, vaginal mucosa, and vulva

A

Chadwick’s sign

125
Q

Cardiovascular changes during pregnancy

A
  • Decrease in peripheral vascular resistance = decrease BP
  • Increase blood volume 40-45%= hypovolemia
  • Increase in cardiac output = increase HR
  • increase WBC = up to 16, 000 mmm in the absence of infection
126
Q

What is Supine hypotensive syndrome?

A

In supine position the enlarged uterus compresses the inferior vena cava, causing reduced blood flow back to the right atrium and a drop in cardiac output and blood pressure.

127
Q

Physiological Changes in GI system during pregnancy

A

Increased levels of hCG and altered carbohydrate metabolism

128
Q

Altered Gait

A

Waddle Gait

129
Q

Abdominal muscles stretch due to enlarging uterus

A

Diastasis recti

130
Q

Integumentary System Physiological Changes in pregnancy

A
  • Linea nigra
  • Melasma (chloasma)
  • Increased pigmentation of nipples, areola, vulva, scars, and moles
131
Q

3 parts of the uterus

A
  • Fundus or upper portion
  • isthmus or lower segment
  • cervix - lower narrow part
  • the cervical ox - opening of the cervix that dilates during labor to allow passage of the fetus
132
Q

Intermittent, painless, and physiological uterine contractions,

A

Braxton-Hicks contractions

133
Q

It begin in the second trimester, but some women do not feel them until the third trimester. These contractions are irregular with no particular pattern. As the uterus enlarges, they are more noticeable

A

Braxton-Hicks contractions

134
Q

It is a hypotensive condition result from a woman lying on her back in mid to late pregnancy. In a supine position, the enlarge uterus compresses the inferior vena cava, leading to a significant drop in cardiac output and blood pressure that results in the woman feeling dizzy and faint.

A

Supine Hypotensive Syndrome

135
Q

Body Mass Index Categories

A
  • Underweight: Less than 18.5
  • Normal weight: 18.5–24.9
  • Overweight: 25–29.9
  • Obesity class I: 30–34.9
  • Obesity class II: 35–39.9
  • Obesity class III: 40 or greater
136
Q

Decrease risk of neural tube defects

A

Folic acid supplementation

137
Q

All subjective signs of pregnancy (i.e., physiological changes perceived by the woman

A

Presumptive signs of pregnancy

138
Q

Amenorrhea: absence of menstruation

A

Presumptive signs

139
Q

A woman’s first awareness of fetal movement; occurs around 18 to 20 weeks’ gestation in primigravidas (between 14 and 16 weeks in multigravidas)

A

Quickening

140
Q

Quickening: A woman’s first awareness of fetal movement; occurs around 18 to 20 weeks’ gestation in primigravidas (between 14 and 16 weeks in multigravidas)

A

Presumptive signs

141
Q

Objective signs of pregnancy and include all physiological and anatomical changes that can be perceived by the health care provider

A

Probable signs of pregnancy

142
Q

Chadwick’s sign: Bluish-purple coloration of the vaginal mucosa, cervix, and vulva seen at 6 to 8 weeks

A

Probable signs of pregnancy

143
Q

Goodell’s sign: Softening of the cervix and vagina with increased leukorrheal discharge; palpated at 8 weeks

A

Probable signs of pregnancy

144
Q

Hegar’s sign: Softening of the lower uterine segment; palpated at 6 weeks

A

Probable signs of pregnancy

145
Q

Also referred to as the mask of pregnancy: brownish pigmentation over the forehead, temples, cheek, and/or upper lip

A

Melasma (chloasma) / Probable signs of pregnancy

146
Q

Dark line that runs from the umbilicus to the pubis

A

Linea nigra / Probable signs of pregnancy

147
Q

Become darker; more evident in primigravidas and dark-haired women

A

Nipples and areola / Probable signs of pregnancy

148
Q

A light tap of the examining finger on the cervix causes fetus to rise in the amniotic fluid and then rebound to its original position; occurs at 16 to 18 weeks

A

Ballottement / Probable signs of pregnancy

149
Q

Positive pregnancy test results

A

Probable signs of pregnancy

150
Q

Objective signs of pregnancy (noted by the examiner) that can only be attributed to the fetus

A

Positive signs of pregnancy

151
Q

Give 3 positive signs of pregnancy

A

● Auscultation of the fetal heart, by 10 to 12 weeks’ gestation with a Doppler
● Observation and palpation of fetal movement by the examiner after about 20 weeks’ gestation
● Sonographic visualization of the fetus: Cardiac movement noted at 4 to 8 weeks

152
Q

First day of LMP through 14 completed weeks

A

First trimester

153
Q

15 weeks through 28 completed weeks

A

Second trimester

154
Q

29 weeks through 40 completed weeks

A

Third trimester

155
Q

Begins with the first day of last menstrual period (LMP) and ends with the onset of labor

A

Antepartum (antepartal) period aka prenatal period

known as intrapartal period

156
Q

EDD meaning

A

Estimated due date

157
Q

Naegele’s Rule

A

Naegele’s rule is the standard formula for determining an EDD based on the LMP: First day of LMP – 3 months + 7 days.

158
Q

Classification of Deliveries From 37 Weeks of Gestation

A

Early term: 37 0/7 weeks through 38 6/7 weeks
Full term: 39 0/7 weeks through 40 6/7 weeks
Late term: 41 0/7 weeks through 41 6/7 weeks
Post term: 42 0/7 weeks and beyond

159
Q

refers to the number of completed weeks of fetal development, calculated from the first day of the last normal menstrual period

A

Gestational age

160
Q

It refers to the total number of times a woman has been pregnant, without reference to how many fetuses there were with each pregnancy or when the pregnancy ended. Twins counted as 1 and it includes current pregnancy

A

Gravida

161
Q

Refers to the number of births after 20 weeks’ gestation were live birth or stillbirths.

A

Para

162
Q

GTPAL

A

(gravida, term, para, abortion, living)

163
Q

GTPAL

A

● G = total number of times pregnant (same as G/P system)
● T = number of term infants born (between 38- and 42-weeks’ gestation)
● P = number of preterm infants born (between 20 and 37 6/7 weeks)
● A = number of abortions (either spontaneous or induced) before 20 weeks’ gestation (or less than 500 grams at birth)
● L = the number of children currently living

164
Q

It is the entire period a woman is pregnant, through the birth of the baby.

A

Prenatal period

165
Q

A woman who has never been pregnant or given birth.

A

Nulligravida

166
Q

A woman who is pregnant for the first time

A

Primigravida

167
Q

A woman who is pregnant for at least the second time.

A

Multigravida

168
Q

An entire period a woman is pregnant, through the birth of the baby.

A

Prenatal period

169
Q

First Trimester Lab/Diagnostic studies - Initial Visit

A
  • Blood type and Rh Factor
  • Antibody screen
  • CBC (Hemoglobin, Hematocrit, RBC count, WBC count, Platelet count)
  • RPR, VDRL (syphilis serology)
  • HIV screen
  • Hepatitis B screen (surface antigen)
  • Genetic screening may be done between 10 0/7 weeks and 13 6/7 weeks
  • Rubella titer
  • PPD (tuberculosis screen)
  • Urinalysis
  • Urine culture and sensitivity
  • Pap smear
  • Gonorrhea and chlamydia cultures
  • Ultrasound
170
Q

First Trimester Lab/Diagnostic studies - Return visits (every 4 weeks)

A
  • Triple screen, quad screen, or penta screen
  • Ultrasound
  • Screening for gestational diabetes at 24–28 weeks
  • Hemoglobin and hematocrit
  • Antibody screen if Rh negative
  • Administration of RhoGAM if Rh negative and antibody screen negative
171
Q

Third Trimester Lab/Diagnostic studies

A

Group B streptococcus screening: Vaginal and rectal swab cultures done at 35–37 weeks’ gestation to determine presence of GBS bacterial colonization before the onset of labor in order to anticipate intrapartum antibiotic treatment needs
Additional screening testing:
• H&H if not done in second trimester
• Repeat GC, chlamydia, RPR, HIV, HBsAg (if indicated and not done in late second trimester)
• 1-hour glucose challenge test at 24–28 weeks

172
Q

AWHONN advocates for universal screening for all pregnant women and recommends the _ _ _s of patient care to guide nurses caring for victims of abuse

A 
A- Alone
B- Beliefs
C- Confidentiality
D- Documentation
E- Education
S- Safety
173
Q

Warning/Danger Signs of the First Trimester (6)

A
  • Abdominal cramping or pain indicates possible threatened abortion, UTI, or appendicitis.
  • Vaginal spotting or bleeding indicates possible threatened abortion.
  • Absence of fetal heart tone indicates possible missed abortion.
  • Dysuria, frequency, and urgency indicate possible UTI.
  • Fever or chills indicate possible infection.
  • Prolonged nausea and vomiting indicate possible hyperemesis gravidarum, increased risk of dehydration.
174
Q

Warning/Danger Signs of the Second Trimester (6)

A
  • Abdominal or pelvic pain indicates possible preterm labor (PTL), UTI, pyelonephritis, or appendicitis.
  • Absence of fetal movement once the woman has been feeling daily movement indicates possible fetal distress or death.
  • Prolonged nausea and vomiting indicate possible hyperemesis gravidarum, at risk for dehydration.
  • Fever and chills indicate possible infection.
  • Dysuria, frequency, and urgency indicate possible UTI.
  • Vaginal bleeding indicates possible infection, friable cervix due to pregnancy changes, placenta previa, abruptio placenta, or PTL.
175
Q

Signs and symptoms of PTL (6)

A 
● Rhythmic lower abdominal cramping or pain
● Low backache
● Pelvic pressure
● Leaking of amniotic fluid
● Increased vaginal discharge
● Vaginal spotting or bleeding
176
Q

Signs and symptoms of hypertensive disorders (3)

A

● Severe headache that does not respond to usual relief measures
● Visual changes
● Facial or generalized edema

177
Q

Warning/Danger Signs of the Third Trimester

A
  • Abdominal or pelvic pain (PTL, UTI, pyelonephritis, appendicitis)
  • Decreased or absent fetal movement (fetal hypoxia or death)
  • Prolonged nausea and vomiting (dehydration, hyperemesis gravidarum)
  • Fever, chills (infection)
  • Dysuria, frequency, urgency (UTI)
  • Vaginal bleeding (infection, friable cervix due to pregnancy changes or pathology, placenta previa, placenta abruptio, PTL)
  • Signs/symptoms of PTL: Rhythmic lower abdominal cramping or pain, low backache, pelvic pressure, leaking of amniotic fluid, increased vaginal discharge
  • Signs/symptoms of hypertensive disorders: Severe headache that does not respond to usual relief measures, visual changes, facial or generalized edema.
178
Q

Nursing Action: Emotional lability (throughout pregnancy)

A

Reassure the woman of the normalcy of response.
Encourage adequate rest and optimal nutrition.
Encourage communication with partner/significant support people.
Refer to pregnancy support group.

179
Q

Nursing Action: Tenderness, enlargement, upper back pain (throughout pregnancy; tenderness mostly in the first trimester)

A

Encourage the woman to wear a well-fitting, supportive bra.

Instruct woman in correct use of good body mechanics.

180
Q

Nursing Action: Braxton-Hicks contractions (mid-pregnancy onward)

A

Reassure the woman those occasional contractions are normal.
Instruct the woman to call her provider if contractions become regular and persist before 37 weeks.
Ensure adequate fluid intake.
Recommend a maternity girdle for uterus support.

181
Q

Nursing Action: Supine hypotension (mid-pregnancy onward)

A

Instruct the woman to avoid supine position from mid-pregnancy onward.
Advise her to lie on her side and rise slowly to decrease the risk of a hypotensive event.

182
Q

Nursing Action: Orthostatic hypotension

Anemia (throughout pregnancy; more common in late second trimester)

A

Advise woman to keep feet moving when standing and avoid standing for prolonged periods.
Instruct to rise slowly from a lying position to sitting or standing to decrease the risk of a hypotensive event.
Encourage the woman to include iron-rich foods in daily dietary intake and take iron supplementation.

183
Q

Nursing Action: Diastasis recti (later pregnancy)

A 
Diastasis recti (later pregnancy)	Instruct the woman to do gentle abdominal strengthening exercises (e.g., tiny abdominal crunches, may cross arms over abdomen to opposite sides for splinting, no sit-ups).
Teach proper technique for sitting up from lying down (i.e., roll to side, lift torso up using arms until in sitting position).
184
Q

Ambivalent Feelings Toward Pregnancy

A

It is common for women to experience ambivalent feelings toward pregnancy during the first trimester. These feelings decrease as pregnancy progresses.

185
Q

Paternal Developmental Taks (3)

A
  1. Announcement Phase
  2. Moratorium Phase
  3. Focusing Phase
186
Q

Announcement phase

A
  • Occurs when pregnancy is revealed
  • Common if men to feel ambivalence
  • accept the biological fact of pregnancy
  • Men will begin to take the expectant father role
187
Q

Moratorium Phase

A

Men’s main developmental task during this phase is to accept the pregnancy. This includes accepting the changing body and emotional state of his partner, as well as accepting the reality of the fetus, especially when fetal movement is felt.

188
Q

Focusing Phase

A
  • Men will be actively involved in the pregnancy and their relationship with the child.
  • think of themselves as father
  • men participate in L & D and newborn

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