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Maternal- Newborn & Women's Health Nursing > Chapter 6 & 8 > Flashcards

Chapter 6 & 8 Flashcards

Exam 1

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1
Q

What causes uterine muscle fibers to grow in length and width?

A

estrogen

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2
Q

By 12 wks gestation, what can be palpated above the symphysis pubis?

A

the uterus

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3
Q

Where is the fundal height at 20 wks gestation?

A

at level of umbilicus- 20 cm

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4
Q

What is a reliable determination of gestational age until 36 wks gestation?

A

fundal height

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5
Q

After 36 wks gestation, why isn’t fundal height a reliable determinator of gestational age?

A

the uterus begins descending into the pelvis (the baby drops)

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6
Q

Where is the fundal height at 36 wks gestation?

A

at the xiphoid process

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7
Q

irregular, not real labor

A

Braxton Hicks contractions

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8
Q

softening of the cervix is called

A

Goodell sign

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9
Q

formation to prevent ascent of bacteria from vagina into the uterus

A

mucus plug

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10
Q

What is the increased vascularization of the cervix called and what does it look like?

A

Chadwick signs; bluish- purple in color

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11
Q

What happens to the vagina during pregnancy?

A

*Increased vascularity with thickening, vulva is thicker
*leukorrhea- secretions more acidic, white, and thick

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12
Q

What do the ovaries release to maintain pregnancy & to relax smooth muscle?

A

Progesterone

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13
Q

The cessation of ovulation is an inhibition of what?

A

FSH and LH

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14
Q

What increases in size and nodularity to prepare for lactation?

A

Breasts

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15
Q

What increases in size, becomes more erect and pigmented?

A

nipples

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16
Q

antibody-rich, yellow fluid that can be expressed after the 12 wk of pregnancy

A

colostrum

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17
Q

Conversion from colostrum to mature milk happens when?

A

after delivery

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18
Q

An adaption of the cardiovascular system during pregnancy is an increase in blood volume. What percentage above pre-pregnancy levels are seen?

A

50% above pre-pregnancy levels

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19
Q

An adaption of the cardiovascular system during pregnancy is an increase in venous return and an increase in HR which leads to an increase in what?

A

cardiac output

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20
Q

What cardiovascular abnormality is normal in pregnancy?

A

a murmur

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21
Q

An adaption of the cardiovascular system during pregnancy is an increase in the number of RBCs which can lead to what?

A

plasma volume > RBC; leading to hemodilation (physiologic anemia)

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22
Q

An adaptation of the cardiovascular system during pregnancy may be an increase in IRON demands, fibrin and plasma fibrinogen levels, and some clotting factors leading to what?

A

hyper-coagulable state- clots block perfussion that can be fatal to fetus
(increase in IRON demand may drive PIKA)

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23
Q

BP drops when woman lies down due to pressure of uterus on vena cava leading to what?

A

Vena Cava Syndrome

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24
Q

An adaption of the respiratory system during pregnancy may be breathing more from where?

A

diaphragm/ diaphragmatic breathing

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25
Q

The uterus pushes the diaphragm up how many centimeters during pregnancy?

A

4cm

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26
Q

What can cause pregnant women to be more susceptible to early decompensation?

A

asthma and other respiratory conditions

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27
Q

Which hormone relaxes smooth muscles in the airway?

A

Progesterone

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28
Q

Which hormone leads to nasal stuffiness?

A

estrogen

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29
Q

What happens with the gums during pregnancy?

A

hyperemic, swollen, and friable from estrogen

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30
Q

What is excessive salivation?

A

Ptylalism

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31
Q

A decrease in peristalsis is caused by what and what can be a result?

A

from smooth muscle relaxation (progesterone); constipation

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32
Q

What factors cause hemorrhoids in pregnancy?

A

constipation + increased venous pressure + pressure from uterus

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33
Q

What is the result of slow gastric emptying?

A

heartburn

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34
Q

Why does renal plasma flow increase in pregnancy?

A

to remove metabolic wastes from patient and fetus

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35
Q

What happens with the kidneys when pregnant women lie down and is greater with the left-lying position?

A

an increase in activity

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36
Q

monitored during pregnancy (in urine)

A

protein

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37
Q

hyperpigmentation is from what hormone?

A

melanocyte-stimulating hormone

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38
Q

“mask of pregnancy”

A

facial melasma

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39
Q

dark line on abdomen

A

linea nigra

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40
Q

stretch marks

A

striae gravidarum

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41
Q

varicose veins

A

varicosities

42
Q

caused by darkening of the blood flow

A

vascular spiders

43
Q

The circulation to skin increases making the patient feel what?

A

warmer and perspire more

44
Q

What happens to the ligaments holding sacroiliac joints and pubis symphysis?

A

softening and stretching

45
Q

What happens when there is increases of swayback and upper spine extension?

A

postural changes

46
Q

What happens to the center of gravity in someone who is pregnant?

A

their center of gravity shifts forward

47
Q

increase in lumbosacral curve

A

lordosis

48
Q

What happens with the spine column during pregnancy?

A

an increase in lumbosacral curve (Lordosis); compensatory curve in cervicodorsal area

49
Q

Relaxation and increased mobility of joints due to the hormone Relaxin causes what type of gait in pregnancy?

A

waddle gait

50
Q

What happens to the thyroid gland during pregnancy?

A

a slight enlargemen; increased activity nec for fetal neurologic function

51
Q

What happens in the pituitary gland during pregnancy?

A

an increase in Prolactin, inhibition of FSH and LH; gradual increase in oxytocin with fetal maturation

52
Q

What happens with the pancreas during pregnancy?

A

the fetus makes demands on maternal glucose stores (glucose levels will be monitored)

53
Q

What happens in the adrenal glands during pregnancy?

A

there is an increase in cortisol

54
Q

Cortisol regulates what?

A

carbohydrates and protein metabolism

55
Q

What does the placenta secrete?

A

hCG, hPL (human placental lactogen), relaxin, progesterone, estrogen

56
Q

Presumptive Signs

A

*fatigue
*breast tenderness
*n/v
*amenorrhea
*urinary frequency

57
Q

Presumptive signs are…..

A

subjective

58
Q

Probable signs are…..

A

objective

59
Q

Probable signs

A

*Braxton Hicks contractions
*Positive pregnancy test
*Abdominal enlargement
*Ballottement
*Goodell sign
*Chadwick sign
*Hegar sign

60
Q

bluish- purple coloration of the vaginal mucosa and cervix

A

Chadwick sign

61
Q

softening of the cervix

A

Goodell sign

62
Q

softening of the lower uterine segment or isthmus;
Softening of the lower uterine segment that allows it to be easily compressed at 6 to 8 weeks of pregnancy.

A

Hegar sign

63
Q

human chorionic gondadotropin

A

hCG

64
Q

What usually doubles every 48- 72 hrs in normal pregnancy until they peak at 60- 70 days after fertilization?

A

hCG levels

65
Q

What is used a marker to see how the pregnancy is progressing and help differentiate normal pregnancy from abnormal?

A

hCG

66
Q

Positive signs

A

*ultrasound verification of embryo or fetus
*fetal movement felt by experienced clinician
*auscultation of fetal heart tones via doppler

67
Q

Psychological Responses during the 1st Trimester

A

*Uncertainty (seeks to confirm pregnancy)
*Ambivalence (conflicting feelings)
*Introversion (thoughts are of themselves)

68
Q

Psychological Responses during the 2nd Trimester

A

*Physical changes happen that make it “real”
*Fetus becomes primary focus
*Introversion remains
*Change in body image
*Change in sexuality

69
Q

Psychological Responses during the 3rd Trimester

A

*Feelings of vulnerability
*Increased dependence on partner
*Preparation for birth

70
Q

The patient must accept what and the changes that will result from it?

Then they must develop what with the unborn child?

A

the pregnancy; a relationship

71
Q

Parental role transition is the realization that they must give up what in order to do what?

A

certain aspects of their life, take on a new identity as a parent (stages of grief)

72
Q

Parental tasks of pregnancy

A

1) seek safe passage for oneself and baby
2) gain acceptance of the baby and oneself from partner and family
3) learning to give of oneself
4) developing attachment and connection with the unknown child

73
Q

Although partners do not experience biologic processes of pregnancy they must do what?

A

must make major psychosocial changes to adapt to new role

74
Q

Partner Adaptations to pregnancy:

they can be _______ invested and _______ involved in pregnancy, labor, and parenting

A

emotionally; actively

75
Q

What are some questions the partner/ mother could be asking in regards to readiness for parenthood?

A

-financial security
-stable relationship between partners

76
Q

An unplanned pregnancy could cause what in the relationship?

A

distress

77
Q

To help the expected parents during the adaption to pregnancy phase, offer what to them?

A

-support groups for expected parents
-parenting classes

78
Q

Siblings reactions are…

A

age- dependent

79
Q

There may be what between the siblings with the introduction of the new infant into the famly?

A

rivalry

80
Q

What is imperative especially for toddlers before the new baby is born or introduced?

A

sibling preparation

81
Q

Adolescent siblings may exhibit what towards their parents?

A

embarrassment that their parents are sexually active

82
Q

Adolescent siblings may only care about themselves unless it what?

A

affects them or their activities

83
Q

Can adolescent siblings take an active role and want to help with the new baby?

A

yes

84
Q

Teenage pregnancies can be a challenge due to what psychosocial factors?

A

identity vs confusion

85
Q

multiple pregnancies

A

multiparity

86
Q

Descent of the fetal head into the pelvic cavity before labor.

A

lightning

87
Q

The first movements of the fetus felt by the pregnant client.

A

quickening

88
Q

:a sudden tap on the cervix during vaginal examination may cause the fetus to rise in the amniotic fluid and then rebound to its original position
;a strong indication of pregnancy, but it may also be caused by other factors such as uterine or cervical polyps.

A

ballottement

89
Q

healthy weight BMI

A

25 to 35 lbs

90
Q

What is a healthy average of weight gain through the 2nd and 3rd trimesters?

A

1lb/ wk

91
Q

If a patient has a BMI <18.5, then how much weight are they recommended to gain?

A

28- 40 lbs

92
Q

If a patient has a BMI <18.5, what is the average amount of weight gain per week?

A

+1lb/ wk

93
Q

If a patient has a BMI >25, then how much weight are they recommended to gain through the 2nd and 3rd trimesters?

A

<1 lb/ wk

94
Q

What kind of effect does nutritional intake have on fetal well-being and birth outcome?

A

direct effect

95
Q

What should the mother take from the beginning of the pregnancy until after delivery?

A

vitamin and mineral supplement/ daily

96
Q

What are the dietary recommendations for expected mothers?

A

*prenatal vitamins (iron and folic acid)

97
Q

What is the prenatal vitamins needed for?

A

fetal growth and brain development

98
Q

Prevents neural tube defects (spina bifida and anencephaly)

A

Folic acid

99
Q

The use of artificial sweeteners such as stevia, aspartame, saccharin should be what?

A

what to the MD, as it is debated

100
Q

What foods should woman avoid in preganancy?

A

*some fish due to mercury content (shark, swordfish, king mackerel, ahi tuna)
*foods causing Listeriosis (soft cheeses- brie, feta, blue-veined cheese; hotdogs, lunch meats; smoked seafood

101
Q

cause miscarriage

A

Listeriosis

102
Q

daily Caffeine intake recommendation

A

300mg

Maternal- Newborn & Women's Health Nursing (16 decks)

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