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WOMENS > EXAM 1 > Flashcards

EXAM 1 Flashcards

1
Q

DEFINE BALLOTTMENT

A

When provider pushes in mom’s cervix the cervix rebounds as if there is a fetal head on other side

PROBABLE SIGN

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2
Q

What is Goodells sign

A

Softening of cervix indc pregnancy

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3
Q

What is Chadwick’s sign

A

bluish color of the vulva, vagina, and cervix

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4
Q

What is Hegar’s sign

A

the lower part of the uterus is soft (can squeeze the uterus through insertion of fingers through vaginal pushed against hand up top

PROBABLE SIGN

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5
Q

what are the positive signs of fetal presence

A

doc/nurse sees’feels visible movment

on ultrasound

fetal hr

baby is delivered

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6
Q

Describe the function of hormones’ w/ in the 1st trimester (0-13 weeks)

A

the corpus luteus (follicle that just released an egg, will die if their egg isn’t fertilized) in the ovaries secretes estrogen and progesterone to support the fetus and creation of placenta. Also decreased GnRH to stop cycle

estrogen’s steadily rises until week 38.5: suppresses FSH and LH, grows the fetus’s organs, increase’s maternal tissue growth (mammary glands and uterus)

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7
Q

Describe the function of hormones’ w/ in the 2nd trimester (14-26 weeks)

A

the placenta takes over for the corpus luteum in the ovaries and secretes estrogen and progesterone to support the fetus and creation of placenta

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8
Q

What is the effect of estrogen on mom’s body?

A

mask of pregnancy (hyperpigmentation around face)

suppresses FSH and LH (except at high levels such as during ovulation)

grows the fetus’s organs

increase’s maternal tissue growth (mammary glands and uterus)

increase blood volume

increase Na and water retention

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9
Q

What is the effect of progesterone on mom’s body?

A

secreted by corpus luteus

maintains endometrium (no early miscarriages), makes period lining during luteal phase

inhibits contractions

aids in duct development

decreases smooth muscle tone which can turn into constipation and heartburn and varicose veins

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10
Q

What does HCG do?

A

Stimulates the corpus luteum in the ovaries to secrete estrogen and progesterone to support the fetus and create the placenta

eventually taken over by placenta by beginning of 2nd trimester

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11
Q

How do you measure the position of the fundus?

A

The relationship between the symphysis pubis (cartilage between anterior pelvis) and the fundus (top, meaty part of the uterus)

  1. Have pt lay on back
  2. use taper measure to measure the distance between the symph pub and fundus

See if length matches the gestational age of the pregnancy

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12
Q

the fundus is positioned just above the symphysis pubis. About hoe many weeks gestation is she?

A

12 weeks (+/-2cm)

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13
Q

the fundus is positioned at the belly button. About how many weeks gestation is she?

A

20 weeks (+/-2cm)

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14
Q

the fundus is positioned at the xiphoid process. About how many weeks gestation is she?

A

36 weeks (+/-2cm)

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15
Q

where do you expect the fundus to be at 36-40+ weeks?

A

down about 4cm from the xiphoid process

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16
Q

How do you calculate a woman’s estimated due date

A

add 7 days to LMP and count forward 9 months

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17
Q

what is the fertile pd for a 28 day cycle

A

days 9-16

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18
Q

high levels of estrogen can cause
_____ on microscope slide

A

ferning

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19
Q

what would the characteristics of a woman’s cervical mucus be during their early follicular phase, ovulation, and luteal phase?

A

follicular phase: Spinnbarkeit 6cm (white)

ovulation: Spinnbarkeit 12cm (clear)

luteal: Spinnbarkeit 3cm

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20
Q

define menarche

A

occurrence of first menstrual period

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21
Q

define menorrhagia

A

Regularly occurring bleeding excessive in
duration and flow (longer than 7 days)

Soaking through pad/tampon in 1 hour, clots, gush

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22
Q

define metrorrhagia

A

Bleeding at irregular intervals

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23
Q

define oligomenorrhea

A

infrequently occurring menses at intervals
greater than 35 days

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24
Q

polymenorrhea

A

Menses at intervals of 21 to 24 days or fewer

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25
Q

hypomenorrhea

A

Regular bleeding in less than normal amount

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26
Q

primary Amenorrhea

A

 No menses by age 14 in the absence of secondary sex
characteristics
 No menses by age 16 in the presence of secondary sex
characteristics

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27
Q

secondary Amenorrhea

A

Absence of menses for 3 cycles or 6 months in women who have
previously menstruated

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28
Q

labs for Amenorrhea

A

 Amenorrhea workup:
ßHcG, TSH, prolactin,
FSH & LH may be ordered
if ovarian failure
suspected
 Progesterone challenge
test

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29
Q

what are some lifestyle habits that may cause dysmenorrhea

A

smokers, and women who are obese

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30
Q

primary vs. secondary dysmenorrhea

A

Primary - when ovulation is established
 excess prostaglandins
 Usually starts 6-12 months following 1st pd
 Lasts 48-72 hours

Secondary - usually with underlying pelvic pathology

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31
Q

What are the trimesters of pregnancy

A

 First: week 1 through 13
 Second: weeks 14 through 26
 Third: weeks 27 through 40

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32
Q

what are the sounds made by uterine arteries called

A

Uterine souffle. Should be the same as the maternal pulse

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33
Q

when would Quickening-first recognition of fetal movement expected to be present

A

14 to 16 weeks for multips (already has a kid)
18-20 weeks for primips

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34
Q

what are Montgomery’s tubercles

A

hypertrophied sebaceous glands on areolas (lubricate things for breastfeeding)

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35
Q

Blood volume and composition increases by

A

30-50% = dilution of iron causes anemia

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36
Q

what is a Daily fetal movement count (DFMC)

A

count number of kicks in 1 hr

Further evaluation needed: mom reports decreased activity or no FM in 12 hours

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37
Q

how do you use Ultrasonography to determine baby’s gestation

A

CROWN TO RUMP LENGTH CAN INDICATE GESTATIONAL AGE

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38
Q

how do you use Ultrasonography to determine 5 fetal variables

A

breathing movement
body movement
tone
amniotic fluid volume (all found via ultrasound)

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39
Q

what is IUGR

A

Intrauterine growth restriction, or IUGR, is when a baby in the womb (a fetus) does not grow as expected.

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40
Q

What are the scores for the Biophysical Profile of a fetus

A

0-2 strongly suspect chronic asphyxia

10: normal

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41
Q

There difference between reactive, nonreactive, and unsatisfactory NST (non-stress test to determine fetal activity)

A

reactive NST
at least 2 15-bpm FHR accelerations lasting 15 seconds or more with fetal movements over 20 minutes (over 32 weeks gestation)

nonreactive NST
reactive criteria not demonstrated or met (flat-ish line despite contractions)

unsatisfactory NST
inadequate external monitor tracing of FHR

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42
Q

why would you perform a Contraction stress test (CST)

A

Indicated for pregnancies at risk for placental insufficiency or fetal compromise as a result of
IUGR
diabetes mellitus
Post term or 42 week’s gestation or more
nonreactive NST
abnormal or suspicious BPP

do it by Nipple-stim or Oxytocin-stimulated contraction test

don’t do if there is a risk of bleeding/infection

43
Q

Why do an Amniocentesis

A

genetic concerns (16-18w) and lung maturity (30-35 weeks)

44
Q

2 most frequent tests to test Fetal lung maturity

A

L/S (lecithin / sphingomyelin) ratio: 2 components of surfactant

Phosphatidylglycerol (PG)

lungs are mature if PG is present in conjunction with L/S ratio of 2:1 expected at at about 32-35 weeks’ gestation

45
Q

when are fetus’ lung mature

A

32-35 weeks’ gestation

46
Q

Preterm labor is defined as

A

cervical changes and uterine contractions occurring between 20 and 37 weeks gestation (when birth is considered a miscarriage)

characterized by uterine activity, discomfort, and vaginal discharge

Fix by Decrease activities that result in PTL symptoms or bed rest

47
Q

what threshold is considered a Low birth weight:

A

less than 2500 grams at birth

48
Q

when would you use betamethasone on L/D

A

Suppression of preterm birth by decreasing uterine activity: Tocolytics (Mag, nifedipine, terbutaline, indomethacin)

its an antenatal glucocorticoids that Accelerates fetal lung maturity & Reduces severity of respiratory distress in preterm births

Effective for 24-34 week gestation pregnancies

49
Q

Tocolytic drugs

A

Terbutaline (Brethine)-beta adrenergic receptor
Nifedipine (Procardia)-calcium channel blocker
Indomethacin (Indocin)-prostaglandin inhibitor NSAID
Magnesium sulfate-calcium antagonist

50
Q

at what point would pre-term labor inevitably become preterm birth?

A

Labor progressed to cervical dilation of 4 cm

51
Q

How can you tell if a pt is Premature Rupture of Membranes (PROM)

A

test discharge for amniotic fluid

Nitrazine: amniotic fluid will be higher than 6.5-alkaline (rub paper on soaked pad to test PH)

Fern test: fluid on slide and let dry-fern pattern

52
Q

When would PROM pts have to be induced if no labor starts?

A

If no labor in 12 hours, usually will induce-some will wait 24 hours

53
Q

when is testing for Group B Streptococcus (GBS)

A

Testing routinely done between 35-37 weeks

Results valid for 5 weeks

Prophylactic antibiotics: 4 hours prior to delivery
Ampicillin or cephalexin

54
Q

what is the Cullen sign

A

Ectopic pregnancy
Note @ 5-6 weeks: BRUISED BELLY BUTTON

55
Q

what are the types of hydatidiform moles

A

Complete (or classic) mole, which results from fertilization of egg with lost or inactivated nucleus

Partial mole, a result of two sperm fertilizing normal ovum

56
Q

Prophylactic cerclage is placed at _______ weeks of gestation

A

11 to 15

57
Q

A Miscarriage is _____

A

Pregnancy ending before 20 weeks
most common cause is chromosomal abnormalities
Some r/t hormonal deficiency (progesterone)

58
Q

Difference in pain between placenta previa and placenta abrupta

A

previa painless, abruption painful

59
Q

Diabetes during pregnancy affects on baby

A

BABY STARTS TO PRODUCE INSULIN ON THEIR OWN TO COMPENSATE FOR MOM’S HYPERGLYCEMIA, CAUSING THEM TO BECOME LARGER AND OFTEN HAVE CARDIAC ISSUES.

(CHECK GLUCOSE X3, NORM RANGE 45)) baby at risk of crashing

60
Q

will a breastfeeding mom or a non-breast feeding mom make more insulin?

A

non-brest feedin mom makes more insulin

61
Q

gestational diabetes is when

A

perform 1hr oral glucose screening, positive if greater than 130-140

Unable to meet increased insulin demand during 2nd & 3rd trimester

Insulin either not produced by pancreas or not utilized by cells appropriately

62
Q

medications for gestational diabetes

A

Oral hypoglycemics (glyburide, glipizide, metformin)
Insulin therapy-only option in the past

63
Q

Difference between chronic and gestational hypertension

A

chronic (hypertension before 20 weeks) gest (hypertension after 20 weeks)

64
Q

Difference between chronic/gestational hypertension and pre-e

A

new onset proteinuria & pathologic edema

BABY ISNT GETTING ENOUGH NUTRIENTS D/T POOR PERF FROM VASOSPASM SO PLACENTA TELLS MOM’S BODY TO DECREASE THE DIAMETER OF VASCULATURE TO INCREASE PRESSURE OF FLOW THROUGH PLACENTAL VASCULATURE

65
Q

Eclampsia vs. pre-e

A

eclampsia is Seizure activity in preeclamptic woman

66
Q

what 3 things cause gestational hypertension

A

VASOSPASM, INTRAVAS COAG OF BLOOD, AND INCREASED PERMEABILITY OF VASCULATURE (PROTEINURIA) CAUSE HYPERTENSION

67
Q

Mild Preeclampsia parameters

A

BP greater than 140 systolic or 90 diastolic (>20 weeks gest.)
≥0.3 urine protein/creatinine ratio300mg proteinuria in 24 hour specimen

68
Q

Severe preeclampsia parameters

A

BP greater than 160 systolic or 110 diastolic

Oliguria (less than 500cc in 24 hours) & elevated serum creatinine
Altered LOC or visual changes

Hepatic involvement: lab changes, epigastric and/or RUQ pain
Thrombocytopenia: platelets <100,000

Pulmonary edema or cyanosis

Fetal growth restriction

69
Q

Eclampsia can happen up to ____ hours post partum

A

72

Later eclampsia can occur after 48 hours and up to 4 weeks post partum

70
Q

what is HELLP syndrome

A

variant of severe preeclampsia involving hepatic dysfunction and characterized by:
(H)Hemolysis
(EL)Elevated liver enzymes
(LP)Low platelets

Can develop HELLP syndrome up to 72-96 hours post partum

May continue Magnesium for 24 hours as this is most critical period

71
Q

MAGNESIUM _____________ REFLEXES. ALSO A _____________. CAN _________BP, BUT OFTEN WON’T AND WILL NEED BP MEDS ON TOP.

A

DEPRESSES

TOCOLYTIC

DECREASE

72
Q

Oligohydramnios:

A

<300 mL of amniotic fluid (which can cause some renal issues)

73
Q

Hydramnios

A

> 2000 mL of amniotic fluid (which can cause GI problems

74
Q

amniotic fluid 32-39 weeks

A

700- 800 mL

75
Q

amniotic fluid 41 weeks

A

500 mL

76
Q

difference in amniotic fluid at 8 weeks vs. 16 weeks

A

8 weeks- less than 10 mL

16 weeks- 250 mL

77
Q

umbilical cord length at term

A

40 to 70 cm

78
Q

vasculature of umbilical cord

A

2 arteries carry DEOXYGENATED blood from the fetus to the placenta

1 vein carries OXYGENATED blood from the placenta to the fetus

79
Q

3rd week of gestation

A

formation of blood occurs in the yolk sac

80
Q

By 6th week

A

Blood type develops in the fetus

81
Q

By 5th month

A

swallowing and peristalsis begins

82
Q

8 weeks:

A

can detect EEG waves (brain waves

83
Q

By 11 to 12 weeks

A

baby makes respiratory movements and extremity movements

84
Q

By 16 to 20 weeks

A

mom can feel fetal movement

85
Q

24 weeks:

A

babies start to respond to sound and they can see and taste

86
Q

At about 20 weeks:

A

Baby produces insulin, but it’s still affected by mom glucose level

87
Q

By week 7:

A

Sex differentiation occurs

88
Q

what is the First organ system to develop

A

fetal circulation

89
Q

normal fetal heart rate is

A

110 to 160 bpm

90
Q

when in gestation do fetal lungs mature?

A

32-35 weeks’ gestation

91
Q

contractions that are felt as early as 4 months

A

Braxton Hicks sign

92
Q

Leukorrhea is

A

a white vaginal discharge in response to stimulation by estrogen and progesterone – eventually forms mucus plug which is kind of a barrier against bacteria in the neck of the cervix

93
Q

Differentiation of alveolar epithelial cells into lactocytes (produce colostrum) is caused by

A

prolactin, progesterone, and human placental lactogenstimulate

94
Q

TBV increases by ____%

A

40- 45

95
Q

Norm BP/HR for pregnant person

A

BP remains the same or slightly decreases due to reduced systemic vascular resistance

HR increases 10- 20 bpm

96
Q

What physiologic functions increase during pregnancy

A

Cardiac output increases by 30- 50%

Increase in RBC mass of (20-30%)

Increase in WBCs

Increases in clotting factors and decreases in coagulation inhibition

Maternal oxygen consumption increases by steadily (40% by term)

Tidal volume, the amount of air exchanged during normal inspiration and expiration, increases by 40%

Chronic mild hyperventilation (pH increases slightly- respiratory alkalosis)

renal ureters dilate more during pregnancy

More urine is stored and stagnant

Tubular reabsorption of sodium increases to meet those demands

Reabsorption of glucose occurs at a fixed rate – increased volume

97
Q

food w/ mg

A

Magnesium: whole grains, dark green leafy vegetables

98
Q

food w/ Zinc

A

oysters, red meat, poultry

99
Q

food w/ Vitamin B

A

liver, seafood, poultry, eggs

100
Q

what is Chorioamnionitis

A

a bacterial infection of the amniotic cavity

101
Q

what is Funneling

A

the cervix stretches and gets thinner

102
Q

difference between Shirodkar, McDonald cerclages

A

. Shirodkar – higher in cervix and more involved2. McDonald (purse string) – opening of cervix – easy to access procedure

103
Q

What is the difference between asymptomatic bacteriuria, cystitis, and pyelonephritis?

A

bacteruira: no sx

cystits: sx

Pyelonephritis: kidney infection

104
Q

the Gonadotropin-releasing hormone is released in the ______

A

Hypothalamus

WOMENS (5 decks)

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