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Maternity > chapter 14 > Flashcards

chapter 14 Flashcards

1
Q

Is it possible for ova to be fertilized up to 5 days after release into the fallopian tubes

A

FALSE

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2
Q

____________ is secreted by the ovaries after ovulation

A

estrogen

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3
Q

the formation of fetal organs, or _________, is a critical period of fetal development that occurs between 3 and 10 weeks of gestation

A

organogenesis

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4
Q

Amenorrhea is a(n) ______ sign of pregnancy

A

presumptive

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5
Q

Gravidity (G) is the number of pregnancies a woman has had in her lifetime regardless of outcome

A

True

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6
Q

A pregnancy that is 37 0/7 weeks through 38 6/7 weeks is referred to as a(n) __________ term pregnancy

A

early

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7
Q

Good __________ and having an open mind are essential for cultural competence

A

communication

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8
Q

It is not necessary to seek early prenatal care if a woman is healthy

A

false

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9
Q

Luteinizing hormone is the hormone responsible for the release of the mature egg from the follicle

A

True

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10
Q

To be a culturally competent nurse, one must understand all aspects of a person’s culture

A

false

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11
Q

which weeks of gestation does organogenesis occur

A

between 3 and 10 weeks of gestation

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12
Q

what pregnancy ages are considered high risk

A

34 years and older. but also, pregnancies under the age of 20 years old

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13
Q

the likelihood of getting pregnant spontaneously (fecundity) begins to reduce at the age of _____ years

A

32

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14
Q

what ages are at higher risks for fetal abnormalities, spontaneous abortion, hypertension, neonatal morbidity, and complications in labor and delivery

A

woman over 35 + and 50 +

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15
Q

What does the acronym GTPA stand for

A

G: the number of pregnancies a woman has had in her lifetime
T: The number of pregnancies that have ended at term (37 wk plus)
P: The number of pregnancies that end by spontaneous of elective abortion before 20 wk.
L: The number of living children

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16
Q

39 0/7 wk through 40 6/7 wk is considered ______ _______

A

full term

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17
Q

41 0/7 wk through 41 wk 6/7 is considered ______ ______

A

late term

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18
Q

42 0/7 wk and beyond is considered _________

A

Postterm

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19
Q

_______ is a pregnancy should be counted as preterm if it ends between 20 and 36 weeks 6 days. As with term, a twin pregnancy would still be counted as one, not two.

A

Preterm

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20
Q

_________ is any pregnancy ending prior to 20 weeks should be accounted for as this, regardless of the number of fetuses included in a pregnancy

A

abortion

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21
Q

__________ is any substance a woman may be exposed to that causes damage to pregnancy, leading to physical or functional birth defects

A

teratogen

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22
Q

date of MP refers to

A

the first day of the most recent menses. this helps us predict when a woman may be most likely to conceive

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23
Q

These two STI’s may cause permanent mechanical damage to the fallopian tubes, impairing fertility

A

Gonorrhea and chlamydia

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24
Q

A woman with hepatitis ___ may pass the infection onto her child

A

C

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25
Q

surgery on the _____ may make it less likely to dilate

A

cervix

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26
Q

surgery on the ____ may make it more likely to rupture during labor

A

uterus

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27
Q

surgery for a woman with endometriosis may ______ her chances of getting pregnant

A

improve

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28
Q

endometriosis can make it more ______ to get pregnant

A

difficult

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29
Q

a malformed uterus may make it ______ likely that a pregnancy can be successfully carried to term

A

less

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30
Q

poorly controlled diabetic is at higher risk for a pregnancy with

A

congenital defects

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31
Q

uncontrolled hypothyroidism can compromise

A

neurologic development in the fetus

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32
Q

some medications used to control hypertension are ____ recommended in pregnancy

A

not

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33
Q

many healthcare providers will recommend that a woman seeking to conceive abstain from alcohol completely, or at least during the last ___ days of their menstrual cycle when a pregnancy may not have begun but is not yet detectable

A

14

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34
Q

vaccinations containing live virus are contraindicated because of a theoretical chance of

A

fetal harm

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35
Q

patients are strongly encouraged to reach and maintain a goal weight between the BMIs of ___ and ____ prior to seeking pregnancy

A

18.5; 30

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36
Q

obesity in pregnancy is associated with

A

birth defects, infertility, gestational diabetes, and other implications

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37
Q

a maternal BMI below 18.5 is correlated with

A

low birth weight and preterm birth

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38
Q

how much of folic acid daily in advance to conception is advised

A

at least 400 to 800 ug

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39
Q

the neural tube closes between _____ and ____ days post conception

A

18; 26

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40
Q

adequate folic acid intake could eliminate approximately ____% of neural tube defects such as spina bifida

A

70%

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41
Q

What kind of diet is encouraged

A

lean protein, fruits, vegetables, and a minimum of processed foods and simple sugars

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42
Q

Vaccinations that may be administer during pregnancy

A

annual influenza vaccine, Tdap during each pregnancy (27-26wk), and Hep. B virus

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43
Q

Vaccinations that should be administered preconception or postpartum if indicated

A

MMR, Varicella virus, Hep. A virus, Pneumococcal virus, Polio virus, Human papillomavirus

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44
Q

environmental toxins may also be teratogens and cause

A

birth defects, childhood cancer, impaired brain development, miscarriage, and stillbirth

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45
Q

women should limit their exposure to

A

large fish with high mercury content, pesticides, solvents, dietary animal fat, BPA-containing plastics, processed foods, and fruits and vegetables that have not been thoroughly washed

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46
Q

many toxin pass the ______ to impact the fetus, and toxins may also be found in ______ ______

A

placenta; breast milk

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47
Q

How does the Zika virus affect pregnancy

A

fetal abnormalities including microcephaly, spontaneous abortion, stillbirth, fetal growth restrictions, and other complications

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48
Q

Which test should be done only at the time of a preconception visit if a woman was due for one per the standard screening or follow-up schedule

A

Pap test

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49
Q

periodontal disease (oral disease) has been associated with

A

poor pregnancy outcomes, including preterm birth

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50
Q

Glands on either side of the vaginal vestibule that secrete mucus for vaginal lubrication

A

Barholin’s glands

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51
Q

the visible portion of the clitoris and the most sensitive erogenous zone of the female body

A

clitoris glans

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52
Q

the skin at the posterior of the vulva

A

fourchette

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53
Q

a membrane partially covering the opening of the vagina

A

hymen

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54
Q

the exterior skin folds, which are hair-bearing in mature females and extend from the mons pubis to the perineum

A

labia major

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55
Q

the inner mucosal skin folds, which extend from the mons pubis to the perineum

A

labia minora

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56
Q

a rounded area, padded with fat, that is anterior to the pubic symphysis; hair-bearing in mature females

A

mons pubis

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57
Q

the opening to the urethra

A

urethra meatus

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58
Q

the area between the vulva and the anus

A

perineum

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59
Q

glands at the anterior of the vulva that drain into the urethra

A

Skene’s glands

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60
Q

the opening into the vagina. when referred to as the vulvar vestibule, the term includes the urethral meatus

A

vaginal vestibule

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61
Q

the vaginal orifice

A

introitus

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62
Q

paired reproductive organs that produce ova, estrogen, testosterone, and progesterone, and are approximately that size and shape of walnuts

A

ovaries

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63
Q

also called the “womb”; the site of implantation of fetal growth and development

A

uterus

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64
Q

three layers of the uterus

A

endometrium, myometrium, serosa/perimetrium

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65
Q

which layer of the uterus sheds with menstruation

A

endometrium (innermost layer)

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66
Q

a pregnancy implants in the ______

A

endometrium

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67
Q

the endometrium is referred to as the _______

A

decidua

68
Q

myometrium is primarily

A

smooth muscle

69
Q

non pregnant uterus is approximately the size and shape of an

A

upside down pear

70
Q

the uppermost, rounded part of the uterus, which contains the greatest volume of smooth muscle

A

fundus

71
Q

the main body of the uterus, located between the isthmus and the fallopian tubes

A

corpus

72
Q

the area of the uterus between the cervix and the corpus, which has thinner, more narrow musculature

A

isthmus

73
Q

a muscular tube that extends from the vestibule to the cervix and that accommodates penetrative sex and childbirth

A

vagina

74
Q

the lowest portion of the uterus, which extends into the vagina. it is approximately an inch in diameter and has a small opening at its center called the os

A

cervix

75
Q

the opening between the cervix and the body of the uterus

A

internal os

76
Q

the canal between the internal os and the outer os

A

cervical canal

77
Q

the opening between the cervix and the vagina

A

outer os

78
Q

a pair of cilia-lined tubes between the uterus and the ovaries, also referred to as the uterine tubes

A

fallopian tubes

79
Q

the portion of the tube that travels through the musculature of the uterus

A

interstitial

80
Q

the portion of the tube between the interstitial and the ampulla

A

isthmus (fallopian tubes)

81
Q

the distal portion of the tube, located between the isthmus and the infundibulum, where fertilization most often occurs

A

ampulla

82
Q

the funnel-shaped part of the tube, located between the fimbriae and the ampulla

A

infundibulum

83
Q

a fringe of tissue at the end of the fallopian tube, not attached to the ovary, that gently draws the ovum into the fallopian tube with a sweeping motion

A

fimbriae

84
Q

a pair of ligaments attaching the ovaries to the uterus

A

ovarian ligaments

85
Q

a pair of ligaments starting where the fallopian tubes join the uterus (“the uterine horns”) and ending deep in the pelvis. stretching of these ligaments in pregnancy can cause pain

A

round ligaments

86
Q

a wide ligament connective the uterus to the pelivs

A

broad ligaments

87
Q

the hypothalamus releases

A

gonadotropin-releasing hormone (GnRH).

88
Q

in response to the release of GnRH, the anterior pituitary secretes

A

LH and FSH

89
Q

the primary hormone responsible for maturation of the follicles of the ovary that will subsequently release eggs for fertilization

A

FSH

90
Q

___ is responsible for the final maturation and release of the egg from the follicle

A

LH

91
Q

levels of ____ peak approximately 12 to 24 hours prior to follicle rupture (ovulation)

A

LH

92
Q

after follicle rupture, ____ stimulates the ruptured follicle, free of its ovum. this process is called ________

A

LH; luteinization

93
Q

after luteinization, the follicle is now called the _____ _______

A

corpus luteum

94
Q

corpus luteum produces

A

large amounts of progesterone and a smaller amount of estrogen

95
Q

progesterone is responsible for the

A

secretory phase of the endometrial cycle, during which the lining of the uterus is nourished and maintained in the event of a fertilized embryo and implantation

96
Q

GnRH from the hypothalamus regulates

A

gonadotropin (luteinizing and FSH) release from the anterior pituitary

97
Q

the corpus luteum begins to lose its secretory function approximately a week after ovulation, this lowers levels of both ________ and _______

A

progesterone and estrogen

98
Q

When progesterone and estrogen levels are lowered, it stimulates the hypothalamus to produce _______, thus cueing the anterior pituitary to produce ____ and ____, thus restarting

A

GnRH, FSH and LH

99
Q

if conception occurs, the pregnancy cues the continuation of the corpus luteum and the maintenance of the endometrium/decidua by producing _______ , thus inhibiting GnRH

A

hCG

100
Q

Estrogen hormone is primarily responsible for

A

female patterns of fat distribution, development of breasts

101
Q

estrogen is the dominant hormone in the ____ half of the menstrual cycle

A

dominant

102
Q

estrogen is secreted by the

A

ovaries, and to a smaller degree, by the corpus luteum

103
Q

progesterone is produced by the ______ ______ after rupture of the ovarian follicle

A

corpus luteum

104
Q

in the second half of the menstrual cycle after ovulation, ________ helps maintain the uterine lining as well as relaxing the smooth muscle of the uterus, causing vasodilation (this all supports the implantation of pregnancy)

A

progesterone

105
Q

which hormone creates the small rise in body temperature after ovulation

A

progesterone

106
Q

what are the two phases of the ovarian cycle

A

follicular phase and the luteal phase

107
Q

the ____ phase is prior to ovulation and may be as short as 8 days. however, the average phase lasts 14-21 days. this phase concerns maturation of the follicles and the associated oocytes. at the end of this phase, the now mature follicle is called the graafian follicle.

A

follicular

108
Q

the _____ phase is 12 to 14 days for most women. as women approaches menopause, this phase shortens, making successful implantation and maintenance of a pregnancy less likely.

A

luteal

109
Q

what are the cells that line the follicle, that produces progesterone after ovulation when the empty follicle becomes the corpus luteum

A

granulosa cells

110
Q

what helps move the egg towards the uterus

A

the cilia within the fallopian tubes

111
Q

the ______ cycle refers to the period of time between the start of one meses to the start of the next. this cycle is usually 21 to 35 days long. this cycle can be broken down into four phases: ______, _______, ______, and _______

A

menstrual; menstrual, proliferative, secretory, and ischemic

112
Q

_______, or the creation of gametes (ova and sperm), occurs by a process called meiosis

A

gametogenesis

113
Q

spermatogenesis: one spermatogonium gives rise to _____ spermatozoa

A

four

114
Q

oogenesis. from each oocyte, ____ mature ovum and ____ polar bodie(s) are produced

A

one; three

115
Q

presumptive signs of pregnancy include

A

amenorrhea, fatigue, nausea, vomiting, breast changes, quickening, uterine enlargement, urinary frequency

116
Q

proable signs of pregnancy are primarily related to the

A

physical changes of the uterus

117
Q

proable signs of pregnancy includes

A

abdominal enlargement, Hegar’s sign, Chadwick’s sign, Goodell’s sign, Ballottement, Braxton Hicks contractions, positive pregnancy test, fetal outline `

118
Q

Hegar’s sign

A

softening and compressibility of the lower uterus

119
Q

Chadwick’s sign

A

deepened violet-bluish color of the cervix and vaginal mucosa

120
Q

Goodell’s sign

A

softening of the cervical tip

121
Q

Ballottement

A

rebound of unengaged fetus

122
Q

Braxton Hicks contractions

A

false contractions that are usually painless, irregular, and usually relieved by walking

123
Q

hCG productions starts as early as the day of implantation and detected as early as __ to ___ days before expected menses

A

7 to 8

124
Q

after the day of implantation, when do hCG levels start to peak

A

60 to 70 days

125
Q

after the peak of hCG levels, when does the levels of hCG start to decrease and level out for the remainder of the pregnancy?

A

100-130 days after implantation

126
Q

____ levels of hCG indicated multifetal pregnancy, ectopic pregnancy, hydatidiform mole (gestational trophoblastic disease), or a genetic abnormality such as Down syndrome)

A

increased

127
Q

_____ levels of hCG might suggest miscarriage or ectopic pregnancy

A

decreased

128
Q

meds such as anticonvulsants, diuretics, and tranquilizers can cause a false-positive pregnancy test

A

true

129
Q

for the most accurate results of a urine pregnancy test, urine sample should be

A

first-voided morning specimen

130
Q

this rule tells you to take the first day of the clients last menstrual cycle, subtract 3 months and then add 7 days and one year

A

Nagele’s rule

131
Q

to measure the ______l height, in cm from the symphysis pubis to the top of the uterine _____ (between 18-32 weeks gestation). approximately the gestational age, plus or minus 2 gestational weeks.

A

fundal; fundus

132
Q

Gravidity is the

A

number of pregnancies

133
Q

nulligravida means

A

the client has never been pregnant

134
Q

primigravida means the

A

client is in their first pregnancy

135
Q

multigravida means

A

the client has had two or more pregnancies

136
Q

the parity is the

A

number of pregnancies where the fetus reaches 20 weeks, NOT the number of fetuses. (this is not affected whether the fetus is born stillborn or alive)

137
Q

nullipara means

A

no pregnancy beyond the stage of viability

138
Q

primipara means

A

they have completed one pregnancy to the stage of viability

139
Q

multipara means

A

they completed two or more pregnancies to viability

140
Q

viability is the

A

point in time when an infant has the capacity to survive outside the uterus. infants born between 22-25 weeks are considered on the threshold of viability

141
Q

the uterus ____ in size and ovulation and menses cease during pregnancy

A

increases

142
Q

O2 needs ______. in the last trimester the size of their chest may ______. this allows for lung expansion as the uterus pushes upward. thus, the respiration rates ____ and the total lung capacity _______

A

increases; enlarge; increase; decrease

143
Q

nausea and vomiting are symptoms due to

A

hormones and or increased pressure with abdominal cavity

144
Q

constipation is due to _______ transit of time and food through the gastrointestinal tract. therefore ______ water absorption

A

increase; increase

145
Q

filtration rate _______ secondary to the influence of pregnancy hormones and _______in blood volume and metabolic demands

A

increases; increases

146
Q

the _______ becomes an endocrine organ

A

placenta

147
Q

the placenta produces large amounts of which hormones

A

hCG, progesterone, estrogen, human placental lactogen, and prostaglandins

148
Q

cardiac output _______ and blood volume _______ to meet greater metabolic demands

A

increases; increases

149
Q

HR ______ during pregnancy beginning around week 5, and reaches a peak around ____ weeks

A

increases; 32

150
Q

when do BP measurements start to change during pregnancy

A

diastolic BP slightly decreases around 24-32 weeks

151
Q

what position can affect the BP

A

supine position

152
Q

a supine position can affect BP due to

A

the weight and pressure of the gravid uterus on the vena cava. this decreases venous blood flow to the heart. this can lead to maternal hypotension and fetal hypoxia. this is also called supine hypotensive syndrome or supine vena cava syndrome

153
Q

what are manifestations of supine hypotensive syndrome or supine vena cava syndrome

A

dizziness, lightheadedness, pallor, clammy skin

154
Q

if a patient has supine hypotensive syndrome or supine vena cava syndrome manifestations, what should you encouragethem to do

A

encourage the client to engage in maternal positioning on the left lateral side, semi fowler’s, or, if supine, with a wedge placed under one hip to alleviate pressure to the vena cava

155
Q

ones pulse increase 10-15/min around ____ weeks, and remains elevated throughout the remainder of pregnancy

A

32

156
Q

what indicates an intact fetal CNS

A

fetal heart tones are heard at a normal baseline rate of 110 to 160/min with reassuring FHR accelerations noted

157
Q

does a pregnant womans heart change in size and shape?

A

yes, this also means the heart sounds also change

158
Q

why does a pregnant womans heart change in size and shape?

A

to accommodate with increased input and volume

159
Q

which heart sounds are more distinguishable in a pregnant woman?

A

splitting of S1 and S2, with S3 more easily heard following 20 weeks

160
Q

is it common to hear murmurs in a pregnant woman

A

yes

161
Q

uterine size will start to weigh of _____ to _____g

A

50-1000g (0.1 to 2.2 lbs)

162
Q

at _____ weeks, the top of the uterus and fundus will reach the ______ process, which can contribute to having shortness of breath

A

36 weeks’ xiphoid process

163
Q

breast changes include

A

increased size, darkening of the areola

164
Q

skin changes include

A

chloasma, linea nigra, and striae gravidarum

165
Q

chloasma is the

A

increase of pigmentation on the face

166
Q

linea nigra is the

A

dark line of pigmentation from the umbilicus extending to the pubic area

167
Q

striae gravidarum are

A

stretch marks most notably found on the abdomen and thighs

Maternity (2 decks)

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