exam 1 Flashcards
total fertility rate
average number of children born if all women lived through childbearing years and bore children according to their fertility
numerical total fertility rate
> 2 population is growing
<2 population is declining
what affects total fertility rate
level of education, economy, religion, contraception, family planning programs
birth rate
number of live births per 1,000 people
what affects the birth rate
OCP, delayed child birth, legal elective abortions, cost to raise children
very premature
<32 weeks
moderately premature
32-33 weeks
late premature
34-36 weeks
complications of preterm births
leading cause of death under the age of 5
long term effects of preterm births
respiratory disorders, cerebral palsy, vision and hearing deficits, developmental delays
neonatal birth weight
predictor of mortality and morbidity
high birth weight
4000g and higher
lowest mortality rates in year 1 of life
normal birth weight
2500-3999g
low birth weight
<2500g
very low birth weight
<1500g
significantly higher mortality rates in year 1 of life
birth weight formula
weight (g)/ 454
maternal death
occurs during pregnancy or within 42 days of pregnancy termination caused by pregnancy related issues
direct obstetric death
a direct result from complications during pregnancy, labor, birth, or postpartum
indirect obstetric death
caused by preexisting or non-obstetrical disease exacerbated by pregnancy
late maternal death
more than 42 days after pregnancy termination from direct or indirect obstetrical cause
pregnancy-related death
during or up to 1 year after pregnancy ends due to pregnancy complication
(umbrella term)
direct obstetric death example
pp hemorrhage, DIC
indirect obstetric death
type 1 DM, SLE, HIV, CVD, renal disease, autoimmune disease
weight gain recommendations for BMI 18.5
gain 28-40 lbs
weight gain recommendation for BMI 18.5-24.9
gain 25-35 lbs
weight gain recommendation for BMI 25-29.9
gain 15-25 lbs
weight gain recommendations for BMI >30
gain 11-20
ethics
disciplined study of mortality expressed in systematic norms
what code of ethics do nurses use
ANA- American Nurses Association code of ethics
what is the ANA used for
a resource for nurses during an ethical delimma
beneficence
obligation to do good
doing what is best for the patient
Non-Maleficence
obligation to do no harm
informing patient of harmful effects for drugs on fetus
Fidelity
keep your promise
being loyal
Veracity
being truthful
Autonomy
involve individuals in decision-making process
not applicable to fetus, only mother
justice
to allow fairness in the healthcare industry
Utilitarianism
do what is best for most
Libertarianism
give to the most deserving
ex- organ transplant
Egalitarianism
everything should be equal
ex- every nurse would have 4 patients and some patients don’t have a nurse
4 obligations of a nurse when refusing an assignment
1- do not abandon pt or refuse care due to bias or prejudice
2- provide emergency care
3- inform the employer in advance
4- inform the provider of the situation when an ethical dilemma is identified
carrier testing
detect genetic mutations in family history
preimplantation testing
embryo is tested prior to implantation
prenatal testing
early detection
newborn screening
state-mandated heel stick
phenlyketouria
menstrual cycle- follicular phase
begins with day 1 of menstruation and lasts 12-14 days. Follicle develops under influence of LH and FSH. the follicle produces estrogen (dominant in the first half of cycle)
menstrual cycle- ovulatory phase
begins with the estrogen level peak and the oocyte is released from the ovary LH levels surge 12-36 hours prior to ovulation.
menstrual cycle- luteal phase
begins after ovulation and lasts 14 days. progesterone levels are high during the second half of cycle.
menstrual cycle- failed implantation
the cycle restarts because corpus luteum sloughs resulting in decreased progesterone and menstruation
zygote
fertilized oocyte
contains 46 chromosomes
progresses to 16 cell morula
blastocyte
implants in endometrium on days 5-6
hCG is detectable
implantation in upper posterior wall of uterus
embryonic stage
implantation to 8 weeks gestation
germ layers
ectoderm
forms epidermis, hair, nails, lens, cornea, and mucosa of cavities
mesoderm
forms dermis, bone, cartilage, skeletal muscles, and kidneys
endoderm
forms mucosa of esophagus, stomach and lungs, liver, GB, pancreas, and thyroid
fetal stage
9 weeks gestation to birth
organ system growth and maturation
fetal cardiovascular system
develops within weeks of conception
heart beats after 3 weeks
oxygenated blood enters fetus via umbilical vein
ductus venosus
connects umbilical vein to inferior vena cava
oxygenated blood enters right atrium
foramen ovale
opening between the right and left atrium
oxygenated blood is shunted to the left atrium and closes at delivery due to increased blood returning to the left atrium after birth
ductus arteriosus
connects pulmonary artery with descending aorta
oxygenated blood is shunted to aorta via DA
constricts after birth due to blood levels and prostaglandins
placenta
formed from maternal and fetal tissue
provides nutrients, hormones, and metabolic gas exchange
fully functioning 8-10w gestation
embryonic membrane
create sterile environment
amniotic- inner layer
choronic- outer layer
amniotic fluid
cushioning, protection, warmth
normal 1000 ml
polyhydramnios
> 1500 ml amniotic fluid
oligohydramnios
<500 ml amniotic fluid
umbilical cord
nutrition and gas exchange
wrapped in Wharton’s jelly
2 arteries 1 vein (AVA)
2 umbilical vessels
indicated cardiovascular defect
infertility female causative factors
ovulatory dysfunction (hormonal imbalance, thyroid dysfunction, premature ovarian failure)
tubal or pelvic pathology (damage or fibroids)
cervical mucous factors (infection or cryotherapy)
infertility male causative factors
endocrine disorders, spermatogenesis issue, sperm antibodies, sperm transport factors, disorders of intercourse
infertility (definition)
inability to conceive despite engaging in unprotected sex x12 months
6 months if over 35 y/o
fertility associated factors
decreased sperm production, endometriosis, ovulation disorders, tubal occlusions
expense, feelings of stress, and effect on couples’ relationship, lack of family support
assessment of infertility
medical history
surgical history (female)
obstetric history (female)
gynecologic history (female)
sexual history
occupational/ environmental exposure risk
nutrition status (female)
female-specific infertility assessment
endocrine disorders, history of pelvic and abdominal surgeries, spontaneous abortions, hormonal abnormalities (anovulation), abnormal uterine contours, exposure to teratogenic substances, over or underweight, substance use
male-specific infertility assessment
history of mumps, genetic disorders, history of STIs, exposure to teratogenic substances
infertility diagnostic procedures- female
pelvic exam
hormone analysis
postcoital test
ultrasound
hysterosalpingography
hysteroscopy
laproscopy
infertility diagnostic procedure- male
semen analysis
ultrasound
intrauterine insemination
sperm placed in uterus
In Vitro Fertilization
fertilization of client’s egg which is the implanted into the clients uterus
In Vitro Fertilization
egg fertilized outside the uterus and implanted
gamete intrafallopian transfer
egg retrieved and placed in sperm which is then injected into fallopian tube
donor oocyte
use of donor egg
donor embryo
donated embryo implanted in recipient uterus
gestational carrier
IVF process but implanted in a carrier (no genetic relation)
surrogate mother
inseminated with semen and carries fetus until birth
donor insemination
donor sperm
