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TEST 2 > Antepartum/Maternal > Flashcards

Antepartum/Maternal Flashcards

1
Q

DEFINE:

  • Fusion of ovum and sperm
  • In fallopian tubes.
A

FERTILIZATION

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2
Q

When does FERTILIZATION occur.

A

Occurs around 2 wks. after last normal menstrual period in a 28-day cycle.

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3
Q

DEFINE:

Occur about 7-10 Days after conception.

A

IMPLANTATION

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4
Q

What happens during IMPLANTATION?

A

Fertilized egg attaches to endometrium.

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5
Q

DEFINE:

  • When fertilized egg cell divides MANY TIMES to produce specialized cells.
A

CELL DIFFERENTIATION

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6
Q

Pregnant period time.

A
  • 40 weeks
  • 90 months
  • 266-280 days
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7
Q

Name the THREE stages of FETAL DEVELOPMENT.

A
  1. Pre-embryonic stage
  2. Embryonic stage
  3. Fetal Stage
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8
Q

Pre-embryonic stage INCLUDES 2 stages of the human development.
1.
2.

A
  1. Zygotic stage
  2. Blastocyst stage
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9
Q

define:

fertilization of sperm & egg through second week.

A

Zygote stage

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10
Q

define:

Zygote divides IN ball of cells then attaches to uterus

A

Blastocyst stage

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11
Q

Stage after Blastocyst.

A

Embryonic stage

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12
Q

Embryonic stage lasts ____ weeks.

A

3-8 weeks.

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13
Q

Stage AFTER EMBRYONIC stage

A

FETAL STAGE

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14
Q

FETAL STAGE LASTS

A

9 weeks till Birth

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15
Q

The babies SEX is determined by which parents dna?

A

FATHER.

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16
Q

Begins day 15 post conception - week 8

A

Embryonic stage.

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17
Q

The Embryonic membranes are
1.
2.

A
  1. Amnion-Inner layer
  2. Chorion-Outer layer
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18
Q

What is the job of the EMBRYONIC MEMBRANES?

A

surround and protect embryo (future baby)

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19
Q

Embryonic membrane that:

  1. contains amniotic fluid
  2. From ectoderm germ layer
  3. WIth time it expands and touches Chorion
A

Amnion-Inner Layer

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20
Q

Embryonic membrane that:
1. has fingelike projections “chorionic villi”
2. From trophoblast cells and mesodermal lining.

A

Chorion-Outer Layer.

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21
Q

These two fetal membranes form

A

fluid-filled amniotic sac, or bag of waters (BOW)

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22
Q

What happens if the embryonic membranes has ruptured for a long time?

A

INFECTION.
Becomes chorioamnionitis

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23
Q

Which of the Fetal Development Stages is MORE SUSCEPTIBLE TO TERATOGENS?

A

Embryonic Stage

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24
Q

What are TERATOGENS

A
  • A teratogen is a substance that **interferes with normal fetal development and causes congenital disabilities. **
  • Drugs, alcohol, chemicals and toxic substances are examples of teratogens.
  • Teratogens can also increase the risk for miscarriage, preterm labor or stillbirth.
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25
Q

What week of the embryonic development will show HEARTBEAT- REGULAR RHYTHM?

A

Week 5

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26
Q

What week of the embryonic development will begin formation of LUNGS.

A

week 6

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27
Q

What week of embryonic development can the fetal heartbeat be HEARD?

A

WEEK 7

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28
Q

What week of the embryonic develpment will the embryo resemble a human being?

A

Week 8

Once it becomes human looking its called a fetus.

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29
Q

Which stage is this:

  • From 9th week until birth
  • Longest period of dev.
A

FETAL STAGE

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30
Q

IN the fetal stage the embryo is now called

A

FETUS

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31
Q

What does the fetus have/show during the fetal stage?

A
  • All major organ systems in BASIC form
  • Dramatic growth & refinement
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32
Q

Week where Gender can be determined

A

Week 12

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33
Q

Weeks 9-12 the fetus has

A
  • 20 temporary teeth
  • Urine produced & excreted
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34
Q

What is happening in weeks 13-16

A
  1. lanugo (hair around body
  2. Fetus MOVES (Quickening)
  3. Sucking & Swallow
  4. Nails present
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35
Q

What is happening in weeks 17-20

A
  1. Rapid brain growth
  2. FHR with stethoscope
  3. Vernix caseosa: white, creamy, naturally occurring biofilm covering the skin of the fetus during the last trimester of pregnancy
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36
Q

What happens in WEEKS 21-24

A
  1. Hand grasp & startle reflex
  2. Alveoli formation & surfactant - LUNGS
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37
Q

What week will show:

  1. Eyelids open & close
  2. Fingerprints are set
A

week 25-28

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38
Q

Weeks where LUNGS are NOT fully mature.

A

weeks 29-32

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39
Q

Weeks where:

  1. Testes descend
  2. transport of antibodies from MOM -> FETUS occur
A
  • Weeks 33-38
  • Considered **FULL TERM **now.
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40
Q

What organ provides FETAL oxygenation?

A

placentA

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41
Q

in FETAL CIRCULATION are the lungs involved?

A

No- fetus lungs are NOT FUNCTIONAL.

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42
Q

Explain fetal circulation in basic terms

A

PLACENTA —> FETUS —> PLACENTA

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43
Q

Does the fetus perform any metabolic functions?

A

NO.
Mothers body performs these functions.

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44
Q

In fetal circulation there are small passages that direct blood that needs to be OXYGENATED.

what are these passages called?

A

Shunts.

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45
Q

WHat are the 3 SHUNTS in fetal circulation?

A
  1. Ductus Venosus
  2. Ductus Arteriosus BYPASSES L. Lungs
  3. Foramen Ovale BYPASSES L. Ventricle & Lungs
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46
Q

Which sHUNT bypasses LIVER

A

DUCTUS VENOSUS

THINK: VENOUS DELIVERY FROM PLACENTA

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47
Q

WHICH SUNT bypass L. LUNGS

A

DUCTUS ARTERIOSUS

THINK: DEOXYGENATED BLOOD CARRIED AWAY

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48
Q

WHICH SHUNT BYPASSES Right VENTRICLE AND LUNGS.

A

FORAMEN OVALE
** THINK OPENING (OVALE)**

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49
Q

MAIN function of fetal shunts

A

Ensures oxygenated blood is received in heart and brain.

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50
Q

So, during fetal stage oxygen is received via ______.

After birth, oxygen is received via _______.

A
  1. placenta
  2. lungs.
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51
Q

Circulatory Changes AT BIRTH

A
  1. shunts no longer needed
  2. Newborn takes 1st breath
  3. Clamping of cord changes circulation.
  4. circulation and blood flow functions like an adult.
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52
Q

What is FUNCTIONAL MURMUR

A

Delay shunt closure can be benign or innocent (no damages)

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53
Q

Define:

  1. Surrounds EMBRYO for protection.
  2. embryo swallows and voids in this fluid.
  3. Includes Maternal BLOOD also.
  4. Formed by the amnion (inner layer) and chorion (outer layer) membranes
A

Amniotic fluid

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54
Q

How much amnioitic fluid is accumulated in a FULL TERM?

A

1 Liter

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55
Q

Whats in the amniotic fluid?

A

98% water
2% organic matter

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56
Q

Functions of the Amniotic fluid include:

A
  • Thermoregulation for fetus
  • Permit symmetric growth & development
  • Cushion fetus from trauma
  • prevents umbilical cord from compression
  • Promote fetal movement
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57
Q

too little amniotic fluid
<500 mL at TERM is called

A

oligohydramnios

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58
Q

oligohydramnios is associated with

A
  • Renal abnormalities
  • Risk of surgical births
  • Low-birth-weight infants
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59
Q

Too much amniotic fluid
<2000 mL at term.

A

Hydramnios

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60
Q

Hydramnios is associated with

A
  • Maternal DM
  • Neural tube defects
  • Chromosomal deviations
  • Malformations of CNS &/or GI tract
  • May CAUSE premature rupture of membrans related to over distention
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61
Q

AMniotic fluid that is

Colorless with slight to moderate turbidity

A

normal

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62
Q

amniotic fluid that is bLOOD-STREAKED

A

trauma tap, abdominal trauma, intra-amniotic hemorrage

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63
Q

amniotic fluid that is DARK GREEN

A

MECONIUM:

Babies poop- indicates fetal hypotension or distress.

64
Q

amniotic fluid that is YELLOW

A

HDN
(hemolytic disease of the newborn)

65
Q

AMniotic fluid with dare red-brown appearance

A

fetal death.

66
Q

What forms the umbilical cord?

A

AMnion membrane

67
Q

Describe Umbilidcal cord

A
  1. ONE large blue vein
  2. TWO small red arteries
  3. surounded by WHARTON JELLY
  4. length at birth: 22 in and 1 in Wide
68
Q

Whos job is this?

Vital passage for nutrients, oxygen & waste products to and from the fetus

A

UMBILICAL CORD

69
Q

PLACENTAs function depends on

70
Q

Functions of the PLACENTA

A
  • Serves as interface between mother & fetus (barrier)
  • Protects fetus from immune attack by mother
  • Removal of fetal waste products
  • Induces mother to bring more food to placenta
71
Q

HORMONES produced by PLACENTA necessary for normal pregnancy

A
  1. hCG: human Chorionic Gonadotropin-progesterone release
  2. Prolactin- contractions
  3. Human placental lactogen (hPL)
  4. Estrogen (estriol)
  5. Progesterone (progestin)
  6. Relaxin
  7. Adrenal hormones
  8. **thyroid hormones **

Prepare fetus for life OUTSIDE uterus and builds moms energy reserves

72
Q

does the maternal blood and fetal blood mix?

A

No- thanks to placental barrier.

73
Q

What am I?

allows for close enough contact for exchange but AVOIDS mixing of fetal & maternal blood

A

Chorionic villi.

74
Q

Cause harm, defects, or death in fetus

A

Teratogens

75
Q

When are TERATOGENS MOST HARMFUL?

A

During EMBRYONIC STAGE

(DAY 15 of conception to WEEK 8)

76
Q

Genetic Disorder:

  • Increased levels -neural tube, Turner Syndrome, omphalocele
  • Decreased levels- Down Syndrome
A

Alpha-Fetoprotein (AFP)

tests maternal blood

77
Q

Alpha-Fetoprotein is tested during what weeks?

A

15-18 weeks
-blood test

78
Q

transabdominal puncture of the amniotic sact to obtain a sample of amniotic fluid for analysis.

A

Amniocentesis

79
Q

Safety concerns for Amniocentesis

A
  • Infection
  • pregnancy loss
  • fetal injuries
80
Q

Amniocentesis is tested during what weeks of pregnancy?

A

15-20 weeks.

81
Q

What is tested in Amniocentesis

A
  • Chromosome analysis
  • DNA markers
  • Viral studies
  • Metabolism errors
82
Q
  • Invasive procedure involving 18 gauge needlestick through abdomen through the vervix under ultrasound guidanc.
  • obtains sample of chorionic villi from placenta for prenatal eval.
A

Chorionic villus sampling

83
Q

Safety concerns for Chorionic villus sampling

A
  • Severe limb defects
  • Pregnancy loss
84
Q

Chorionic villus sampling tests for

A
  • Sickle cell anemia
  • Phenylketonuria
  • Down Syndrome
85
Q

when is Chorionic villus sampling tested?

A

10-12 weeks.

86
Q

insertion of a needle directly into a FETAL umbilical vessel under ultrasound guidance.

A

Percutaneous umbilical blood sampling.

87
Q

safety concerns with Percutaneous umbilical blood sampling.

A
  1. Infection
  2. Fetal Hemorrhage
88
Q

safety concerns with Percutaneous umbilical blood sampling tests for

A
  • Inherited blood disorders
  • Fetal infection
  • Acid-base status
  • Isoimmunization
89
Q

safety concerns with Percutaneous umbilical blood sampling tests for tested during which week?

90
Q

Sign and symptoms of pregnancy are grouped into 3 categories.

A
  1. presumptive signs
  2. probable signs
  3. positive signs
91
Q

Signs a mother can PERceive such as :

  • absence of menstruation.
  • N/V, FATIGUE, URINARY FREQ., BREAST CHANGES
  • least reliable indicator of pregnancy- can be caused by other factors (amenorrhea)
A

Presumptive signs

92
Q
  • Signs of pregnancy detected on physical examination by HCP
  • Vaginal mucousa and cervix changes.
  • Changes in uterus.
A

PROBABLE signs

(bc other conditions can elevate pregnancy levels (hCG) levels

93
Q
  • enough subjective symptoms are present so that a woman can be reasonably sure she is pregnant.
  • Confirm fetus is growing in uterus.
  • POS Ultrasounds, fetal heartbeat
  • Hear & See baby
A

POSITIVE signs.

94
Q

Pregnancy test:

  • 99%
  • blood serum or urine
  • over the counter purchase
  • 4 days AFTER implantation
95
Q

Pregnancy Test:

Return of fetus when cervix is tapped

“BOUNCE”

A

ballottement

96
Q

Pregnancy Test:
* A softening of the cervix
* 6-8 weeks
* due to Estrogen

A

Goodells sign

97
Q

Pregnancy TEst:

  • Bluish color to the CERVIX (increased vascularity)
A

CHADWICKS sign

98
Q

Prego test:

  • Lower uterine segment softens (isthmus)
  • 6-8 weeks
A

hegar’s sign

hegars test is done same way as Goodell’s

99
Q

Fetal movements

A

20 weeks
detected by HCP

100
Q

Visualization of embryo or fetus

101
Q

What hormone stimulates UTERUS groth

102
Q
  • Uterine contractility is enhanaced
  • Starts 1st trimester - throughout pregnancy.
  • False labor pain
A

Braxton Hicks Contractions

103
Q

Explain Fundal Height measurement

A
  • Height of top of uterus in cm
  • corresponds to # of gestational wks.
  • +/- 2
104
Q
  • HIGHEST fundal height
  • Mom shortness of breath
105
Q
  • fundal height drops
  • Fetus descends into pelvic canal (lightening)
  • Breathing easier
  • increased bladder pressure
A

38-40 weeks

106
Q

Recommended sleeping position for pregnant women

A

right lateral position

107
Q

changes in Cervix:

  • occurs 6-8 weeks
  • R/T vasocongestion and estrogen
A

Goodell’s sign

softening of cirvix

108
Q

changes in Cervix:

Softening, increased elasticity & effacement
Begins about 4 wks. before birth

A

Cervical ripening

109
Q

VAginal changes

A
  • Connective tissue loosens
  • More acidic, thick, white
  • Increase in white, vaginal discharge (leukorrhea)
  • Vaginitis, candida infections
110
Q

Overies produce hormones until

A

6-7 weeks gestation then placenta takes over

111
Q

Colostrum production during

A

3rd trimester
- creamy, yello breast fluid
- Nourishment for breattfeeding newborn during 1st few days of life.

112
Q

Colostrum is full of

A

immunoglobulins (antibodies) and proteins

113
Q

GI SYSTEM during pregnancy

A
  • smooth muscle relaxation
  • DECREASED peristalsis (constipation)
114
Q

MOUTH during pregnancy

A
  • guyns- hyperemic, swollen, bleed easy
  • Gingivitis, periodontitis.
115
Q

Stomach and intestines during pregnancy

A
  • Delayed Gastric Emptying
  • Nausea & Vomiting (Ginger & antiemetics- antinausea meds)
  • Bloating & Constipation
  • Hemorrhoids
  • GERD
  • Heartburn (pyrosis)
116
Q

Gallblader during pregnancy

A
  • Prolonged emptying
  • Hypercholesterolemia
  • Increased risk of gallstone formation
117
Q

When should pregnant mom call HCP

A
  • Signs of dehydration
  • Infrequent urination
  • Dark-colored urine
  • Dizziness with standing
  • Vomiting repeatedly throughout day
  • Any blood in the vomit
  • Abdominal or pelvic pain or cramping
  • Unable to keep food or drinks DOWN for >12 hrs
  • Weight loss >5 pounds (2.3 kg)
  • Fever or diarrhea WITH N/V
118
Q

INCREASE plasma volume during pregnancy (dilution of RBC’s) is called

  • plasma volume increases FASTER than RBCs
A

physiologic anemia of pregnancy .

119
Q

Hgb and RBC levels with Physicologic anemia will show:

A

hgb: 10g or less
RBC: 3.5 or less

(lowerd levels)

Norms are:
* Hgb: 12-17g/dl
* RBC: 4.0-5.5 M/ul

120
Q

Can givin IRON supplements fix the low levels of hgb and RBC in PHYSIOLOGIC ANEMIA?

A

No. these changes cannot be prevented by giving iron supplement.

121
Q

Is physiologic anemia dangerous?

A

No, considered a normal adaptation of pregnancy. It is needed to meet other organ function for her and baby.

122
Q

What are the VS during pregnancy?

A
  • Incr. CO
  • low BP
  • incr. HR
  • low systemic vascular resistance
  • Incr blood /plasma volume.

to meet demands of enlarging uterus and placenta- heart works harder and pumps more blood for both humans.

123
Q

If BP INCREASES during pregnancy, what should be done?

A

Must be investigated.
Not a norm.

124
Q

Blood components during pregnancy:

What happens to RBCs?

A
  • Increase by 20-30%
  • support additional O2 & iron requirements
125
Q

Blood components during pregnancy:

Hypercoagulable state DURING pregnancy shows:

A
  • Increase in fibrin, plasma fibrinogen, & clotting factors
  • Venous Stasis – pressure from uterus
  • Risk for venous thrombosis
126
Q

Respiratory Changes include:

A
  • O2 consumption increase 20% to 30%
  • HYPERVENTILATION & HYPOCAPNIA
  • Breathing DIAPHRAGMATIC than abdominal
  • Breathes faster & more deeply
  • Congestion (Increased estrogen, sex hormones & sensitivity to allergens)
  • changes tone and quality of voice
127
Q

Renal and urinary changes include

A
  • Increase waste & blood volume
  • Increased blood flow to kidneys (50-80%)
  • HYPERfiltratoin
  • Drugs excreted VIA kidneys
  • Require higher doses- More frequent administration

like heart, kidneys also work harder

128
Q

Kidney activity is even GREATER when mom lies on

A

her side.

but lying on back puts pressure on back and vena cava

129
Q

When mom lies on her side what happens?

A
  • Relieves pressure FROM vena cava
  • Venous return to heart increases
  • Increased cardiac output
  • Increased renal perfusion & glomerular filtration
130
Q

Musculoskeletal system changes include:

A
  • Changes in posture & gait
  • Ligaments soften & change
  • Joints widen & more moveable
  • Center of gravity shifts forward
  • Lumbar lordosis
  • Waddle gait
131
Q

Integumentary Changes include:

A
  • 90% hyperpigmentation r/t INCREASE estrogen, progesterone, melanocyte-stimulating hormone
  • Linea nigra (pigmented line mid abdomen from umbilical to pubis)
  • Stretch marks (stria gravidarum)
  • ** Palmar erythema**
  • Malasma : pregnancy. mask
132
Q

Hair and nail changes

A
  • Decline in hair growth
  • Follicles undergo a resting phase
  • Nails grow faster
133
Q

vascular changes

A
  • Varicose Veins
  • Distention, Poor circulation, Uterine pressure on vessels
  • Risk Reduction OR Prevention
134
Q

Thyroid gland changes

A

TSH decrease 1st trimester

135
Q

Anterior pituitary lobe activity during pregnancy include

A

Prolactin is secreted in response to baby suckling

136
Q

What causes morning sicknes and N/V in 1st trimester

A
  • Decrease TSH (pituitary hormone)
  • Elevated hCG (placenta hormone)
137
Q

After Birth what happens with Anteriror Pituitary lobe activities?

A
  • AFTER placenta DELIVERY —- **drop in progesterone **—– lactogenesis
  • Prolactin IS secreted from Anterior Pituitary in response to suckling by BABY
  • Melanocyte-stimulating hormone (MSH) increases
138
Q

2 hormones made in the POSTERIOR PITUITARY LOBE

A

Oxytocin & Antidiuretic Hormone (ADH)

139
Q

During pregnancy Oxytocin is responsible for

A
  • Uterine contractions, before & after delivery.
  • Contractions are more frequent & stronger
  • Contractions lead to:
    1. Cervical thinning and dilation
    2. Exert pressure, & help fetus to descend in pelvis
140
Q

After delivery, oxytocin cause

A
  • Myometrium to contract & decrease vaginal bleeding
  • Responsible for milk ejection
  • Breastfeeding signals the release of oxytocin, which stimulates the uterus to contract and increases the severity of after birth pains.
141
Q

Pancreas during pregnancy

A
  • Insulin Resistance can occur–> gestational diabetes
  • Glucose & other nutrients easily cross placenta
  • Insulin does NOT cross placenta.
  • Fetus must produce its own insulin
142
Q

Adrenal glands during pregnancy

A
  • Increased amounts of Aldosterone BY 15 wks. of pregnancy (regulates absorption of sodium)
  • During pregnancy, progesterone allows salt to be wasted (or lost) in urine
  • So, Aldosterone regulates -
    1. Electrolyte & water homeostasis
    2. Blood pressure
143
Q

Immune System during pregnancy

A

Alterations help -
* Prevent mother’s immune system from rejecting fetus
* Increase her risk of developing certain infections (UTI)

144
Q

Psychosocial Adaptations include:

Reality & acceptance occur during

A

(2nd trimester)
Brought on by physical changes, fetal movement, hearing heartbeat

145
Q

an emotional roller coaster is considered

A

normal during pregnancy.

146
Q

The importance of ENFACE POSITION

A
  • eye-to-eye contact .
  • promotes relationship
147
Q

Diet recomendation during pregnancy

A
  • Avoid hydrogenated or partially hydrogenated fats
  • Use reduced fat spreads & dairy products
  • Eat at least 2 servings of fish/week
  • Consume at least 2 quarts of water daily
  • Include variety from all food groups
  • Gluten-free
148
Q

a serious infection usually caused by eating food contaminated with the bacterium Listeria monocytogenes

A

Listeriosis

149
Q

LISTERIOSIS causes

A
  • miscarriages
  • stillbirths
  • newborn deats

**Bacteria is passed by mom to fetus. **

150
Q

How to avoid LISTERIOSIS

A
  • Don’t eat soft cheeses
  • Don’t eat refrigerated pâté or meat spreads.
  • Don’t eat refrigerated smoked seafood: “nova-style,” “lox,” “kippered,” “smoked,” or “jerky.
  • Don’t eat salads made in store
  • Clean refrigerator regularly
151
Q

INTENSE craving & eating of Nonfood items FOR at least 1 M is called

152
Q

A pregnant women who craves AMYLOPHAGIA

A

laundry starch

IRON DEFICIENCY

153
Q

A pregnant women who craves Geophagia

A

dirt, sand, clay

IRON DEFICIENCY

154
Q

a women who craves PAGOPHAGIA

A

ICE, FREEZER SOFT

IRON DEFICIENCY

155
Q

WHAT FOODS WILL YOU HAVE A PREGNANT MOM FOCUS ON

A
  • On Protein, Iron, Calcium, & Vit B12.
  • Protein: Soy , beans, lentils, nuts, grains, seeds
  • Iron: Meat alternate with vit. C–rich foods
  • Calcium: Soy, ca.-fortified OJ, tofu.
  • B12: Fortified soy foods & supplement.
156
Q

Weight Gain During Pregnancy

A
  • Recommended wt. gain is **dependent on
  • pre-pregnancy BMI**
  • First trimester, weight gain should be 3.5-5 lbs - DEPENDS on N/V
  • Second & third trimester: 1 lb per week
157
Q

Heart and blood volume changes during pregnancy

A

Heart works harder
And pumls More blood.

TEST 2 (6 decks)

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