Wk 13 Obstetrics: antepartum

Question 1

Define: Braxton Hicks contractons

Answer 1

irregular, usually mild uterin contractions that occur through out preg and become stronger in the last trimester. May be confused with true or false labor

Question 2

Define: Chadwick’s sign

Answer 2

bluish purple color of the the cervix, vagina and labia during pregnancy, increased vascular congestion

Question 3

Define: Chloasma

Answer 3

A condition in which brown patches appear on the face due to hormonal changes during pregnancy

Question 4

Define: Goodell’s signs

Answer 4

softening of cervix during pregnancy

Question 5

Define: quickening

Answer 5

first movements of fetus mother feels

Question 6

Define: striae gravidarum

Answer 6

irregular pink to purple streaks on the abdomen, breasts or buttocks resulting from tears in the connective tissue (stretch marks)

Question 7

Define: trimester

Answer 7

division of pregnancy one of three equal parts of 13 weeks each

Question 8

process of fertilization

Answer 8

spermatozoon enters the ovum and the two nuclei containing the parents chromosomes merge. 23 from the sperm and 23 from chromosomes from the ovum. Ovum now called zygote is ready for the first mitotic cell divison

Question 9

process of implantation

Answer 9

upper uterus (fundus)
rich supply of blood and optimal gas exchange and nutrition
uterine lining is thick in fundus preventing placenta from attaching so deeply that it does not easily detach
upper uterus limits blood loss after birth due to strong interlacing muscle fibers

Question 10

role of the following in pregnancy and labor:

Human chorionic somatomammotropin (hCS)

Answer 10

Promotes normal nutrition and growth for the fetus, maternal breast development, decrease insulin sensitivity making more glucose available for the fetus

Question 11

role of the following in pregnancy and labor:

Progesterone

Answer 11

causes the endrometrium to change into the decidua (the thick layer of modified mucous membrane which lines the uterus during pregnancy and is shed with the afterbirth), reduces uterine contractions, suppresses maternal reactions to fetal antigens, with other hormones causes growth of the breast

Question 12

role of the following in pregnancy and labor:

Estrogen

Answer 12

causes infringement of the uterus and breasts, enhances uterine activity as term approaches

Question 13

role of the following in pregnancy and labor: pelvic shape and size

Answer 13

??

Question 14

Differentiate between the hormonal levels of a pregnant and nonpregnant woman

Answer 14

Pregnant:
Nonpregnant:

Question 15

Identify the functions of the amniotic fluid

Answer 15

protects growing fetus and promotes normal prenatal development by:
cushioning
stable temp
symmetric development of fetus as body surfaces fold toward midline
keeping membranes from adhering to fetal parts
providing room and buoyancy for movement

Question 16

Explain the functions of the placenta

Answer 16

metabolic
transfer of substances between mother and fetus
endocrine

Question 17

Describe the physical development of the fetus given a specific time during normal pregnancy
Embryonic period

Answer 17

Embryonic period: beginning of 3rd week through 8th week after conception ?????

Question 18

Describe the physical development of the fetus given a specific time during normal pregnancy
Fetal period

Answer 18

Fetal period: begins 9 weeks after conception. 9th-38th weeks

Question 19

Fetal period: 9-12 weeks

Answer 19

begins to produce urine
fetal sex is apparent
intestines enter abdomen

Question 20

Fetal period: 13-16 weeks

Answer 20

Fetus grows rapidly in length, head becomes smaller, “quickening” movements felt
face looks human

Question 21

Fetal period: 17-20 weeks

Answer 21

vernix and lanugo cover skin

eyebrows and head appear

Question 22

Fetal period: 21-24 weeks

Answer 22

lungs produce surfactant

may survive if born now

Question 23

Fetal period: 25-28 weeks

Answer 23

subcutaneous fat is deposited under skin.

Usually head down.

Question 24

Fetal period: 29-32 weeks

Answer 24

Toenails are present, finger nails extend to tips. more subcutaneous fat. survival rate good with neonatal care

Question 25

Fetal period: 33-38 week

Answer 25

growth of all body systems. full term is 38-42 weeks gestational age

Question 26

Identify the physiological changes that occur in the various body systems during pregnancy Uterus

Answer 26

``` Weight and size increase Fibrous connective tissue Cervical softening Mucus plug Under goes Braxton Hicks Blood flow rises ```

Question 27

Identify the physiological changes that occur in the various body systems during pregnancy Cerix

Answer 27

Color and consistency Estrogen causes hyperema Collagen fibers decrease causing softening (Goodell's) mucus plugs cervical canal and blocks the ascent of bacteria Bloody show- disruption of cervical capillaries

Question 28

Identify the physiological changes that occur in the various body systems during pregnancy Vagina and Vulva

Answer 28

Estrogen influence Hypertrophy Hyperplasia of lining Thick white secretions

Question 29

Identify the physiological changes that occur in the various body systems during pregnancy Cardiovascular

Answer 29

``` Increase heart rate Blood volume increases Cardiac output increases up to 50% Palpitations Murmurs lower serum plasma protein Diastolic BP decrease by 24 weeks but returns by term Supine hypotension ```

Question 30

Distinguish between positive, probable, and presumptive signs of pregnancy PRESUMPTIVE

Answer 30

``` Amenorrhea N/V Fatigue Urinary frequency Breast/skin changes Vaginal/cervical color changes Fetal movement ```

Question 31

Distinguish between positive, probable, and presumptive signs of pregnancy PROBABLE

Answer 31

``` Abdominal enlargement Cervical softening (Goodell's) Bluish vagina (Chadwick's) Softening of uterus (Hegar's) Fetus rebound (Ballottement) Braxton Hicks contractions Pregnancy test ```

Question 32

Distinguish between positive, probable, and presumptive signs of pregnancy POSITIVE

Answer 32

Auscultation of fetal heart sounds Fetal movement felt by examiner Visualization of the fetus, ultrasound

Question 33

Compute the expected date of delivery using Naegel’s Law

Answer 33

First day of last period, subtract 3 months, add one year, add 7 days

Question 34

Define: Gravida

Answer 34

refers to a woman who is or has been pregnant regardless of the duration of pregnancy

Question 35

Define: Primigravida

Answer 35

woman who is pregnant for the first time

Question 36

Define: Multigravida

Answer 36

woman who has been pregnant more than once

Question 37

Define: Para

Answer 37

Number of pregnancies that have ended at 20 or more weeks regardless of whether the infant was born alive or was stillborn

Question 38

Define: Nullipara

Answer 38

woman who has never completed a pregnancy beyond 20 weeks of gestation because she has never been pregnant or has had a spontaneous or elective abortion

Question 39

Define: Primipara

Answer 39

woman who has delivered one pregnancy at 20 or more weeks of gestation

Question 40

Define: Multipara

Answer 40

woman who had delivered two or more pregnancies at 20 or more weeks of gestation

Question 41

Assess the prenatal patient for appropriate weight gain

Answer 41

general recommendation of increments of 1.1-4.4 lbs during the first trimester. 2nd and 3rd trimester 0.8-1 lb weekly

Question 42

Three germ layers: developing structures | ECTODERM

Answer 42

``` brain/spinal cord peripheral nervous system pituitary gland sensory epithelium of eye/ear/nose epidermis hair nails subcutaneous glands mammary gland tooth enamal ```

Question 43

Three germ layers: developing structures | MESODERM

Answer 43

``` cartilage bone connective tissue muscle tissue heart blood vessels blood cells lymphatic system spleen kidneys adrenal cortex ovaries testes reproductive system lining membranes (pericardial, pleural, peritoneal) ```

Question 44

Three germ layers: developing structures | ENDODERM

Answer 44

``` gastrointestinal/respiratory tracts lining tonsils thyroid parathyroid thymus liver pancreas urinary bladder/urethra lining ear canal lining ```

Question 45

two fetal membranes of the amniotic sac

Answer 45

Amnion is the inner membranes | Chorion is the outer membrane

Question 46

Nutrition during pregnancy

Answer 46

Energy: carbs, fats, nutrient density calories Protein Vitamins Folic Acid: neural tube deficit preventative Minerals: iron, sodium, calcium (lactose intolerance) Nutritional supplements (disadvantages/dangers) Water

Question 47

Foods to avoid

Answer 47

``` Raw fish Under cooked eggs Under cooked meat Excessive amounts of caffeine Alcohol Certain types of fish ```

Question 48

Foods to eat

Answer 48

``` Oatmeal Approved tatty fish Leafy greens Nuts Beans/Lentils Yogurt Avocados Lean meats ```

Question 49

Adaptations to pregnancy | FIRST TRIMESTER

Answer 49

Uncertainty Ambivalence Self as primary focus Focus on mom

Question 50

Adaptations to pregnancy | SECOND TRIMESTER

Answer 50

``` Physical evidence of pregnancy Fetus as primary focus Narcissism and introversion Body image Changes in sexuality ```

Question 51

Adaptations to pregnancy | THIRD TRIMESTER

Answer 51

Vulnerability Increasing dependence Preparation for birth

Question 52

Family adaptation | FATHER

Answer 52

Struggling for recognition as a parent | Creating role of involved father

Question 53

Family adaptation | SIBLINGS

Answer 53

Toddlers unaware of changes Older children realize a baby is being born benefit from being included in preparation Adolescents some are embarrassed, others may be indifferent unless it affects them

Question 54

Family adaptation | GRANDPARENTS

Answer 54

Age: older grand parents react with joy | Relationships with grand parents second in importance only to their parent child relationship

Question 55

Erickson's stage | INFANCY

Answer 55

Trust VS Mistrust Development of a sense that the self is good and the world is good when consistent, predictable, reliable car is received; characterized by hope

Question 56

Erikson's stage | ADOLESCENCE

Answer 56

Identity VS Role confusion Begins to develop a sense of "I"; this process is lifelong; peers become of paramount importance; child gains independence from parents; characterized by faith in self

Question 57

Erkson's stage | ADULTHOOD

Answer 57

Intimacy VS isolation | development of the ability to lose the self in genuine mutuality with another; characterized by love