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Maternal Health > EXAM #1 > Flashcards

EXAM #1 Flashcards

1
Q

What is climacteric & when does it begin?

A

A transitional time in a woman’s life marked by declining ovarian function and decreased hormone production.
-Begins at the onset of ovarian decline and ends with the cessation of postmenopausal symptoms.

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2
Q

What is menopause? When is it certian?

A

Refers to the last menstrual
period and can be dated with certainty when there has been
at least 1 whole year without menstruation

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3
Q

Define Premenopause

A

The time up to the beginning of perimenopause, but the term is also used to define the time up to the last menstrual period.

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4
Q

Define perimenopause

A

Perimenopause is the time preceding menopause, usually starting between 2 and 8 years before menopause and lasting an average of 4 years

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5
Q

Postmenopause

A

Begins when ovarian estrogen terminates, ovulation ceases, and menstrual periods have stopped for 12 consecutive months

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6
Q

Where is estrogen produced during postmenopause?

A

The Adrenal Glands

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7
Q

During perimenopause, what happens to the ovarian follicles?

A

The responsiveness to gonadotropins are decreased and responsive follicles do not develop as quickly as before.

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8
Q

During perimenopause the cycles can become anovulatory (no ova released) which leads to:

A

-Irregular bleeding
-Skin changes & decrease in hair distribution
-Vasomotor instablility leads to night sweats and hot flashes.

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9
Q

How long should Hormone Therapy be prescribed for and what does it help?

A

A short period of time for the reduction of menopause symptoms

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10
Q

What does Estrogen-progestin therapy increase the risk of?

A

VTE, Factor V Leiden, and Breast Cancer when used for longer than 3 to 5 years

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11
Q

What kind of Hormone Therapy is used after a hysterectomy & why?

A

Estrogen with NO progesterone facilitates the shedding of the endometrial lining (reduces the risk of endometrial cancer)

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12
Q

Patient education for hormone therapy

A
  • Vaginal bleeding and spotting are most likely to
    occur in the first 3 months after initiation of therapy.
  • Follow-up visits should be scheduled at 1 and
    3 months—and improvement in symptoms should
    be noted at that time.
  • It is important to promptly report the following
    symptoms: persistent bleeding; bleeding that stops
    but then starts again; or the presence of blood clots
    in the vaginal discharge
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13
Q

Contraindications for patients who are on estrogen therapies

A
  • Known or suspected estrogen-dependent cancer
  • Known or suspected history of breast cancer except
    in appropriately selected patients being treated for
    metastatic disease
  • Undiagnosed abnormal genital bleeding
  • Active or history of deep venous thrombosis,
    pulmonary embolism
  • Active or recent (within the past year) arterial
    thromboembolic disease (e.g., stroke, myocardial infarction)
  • Liver dysfunction or disease
  • Known or suspected pregnancy
  • Known hypersensitivity to ET/EPT
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14
Q

What hormone affects secondary sexual characteristics such as linear growth spurts?

A

Testosterone (androgen)

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15
Q

What is the ouside of the womens’ reproductive part called?

A

Vulva

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16
Q

What hormones are released from the Anterior pituitary gland?

A

Gonadotropins (LH & FSH)

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17
Q

What hormones do the ovaries produce?

A

Estradiol (estrogen) & Progesterone

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18
Q

What is the function of FSH (folicle stimulating hormone)?

A

-Initiates development of ovarian follicles & causes it to mature
-Stimulates secretion of estrogen by follicle cells

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19
Q

What is the function of LH (Luteinizing hormone)?

A

-Causes the release of the ovum for ovulation
-Converts the ruptured ovarian follicle into the corpus luteum
-Stimulates secretion of progesterone by the corpus luteum

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20
Q

What is the function of Estrogen?

A

-Promotes maturation of ovarian follicles
-Promotes growth of blood vessels in the endometrium
-Initiates development of the secondary sec characteristics (breast development, widening of hips, and deposition of fat onto hips)

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21
Q

What is the function of Progesterone?

A

-Promotes successful implantation of the embryo in the endometrium
-Promotes further growth of blood vessels in the endometrium and storage of nutrients

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22
Q

What occurs during the menstrual phase?

A

The beginning of the follicular phase
-Menstruation is triggered by the declining levels of estrogen & progesterone produced by corpus luteum
-Leads to a decrease of nutrients and oxygen leading to sloughing off of the endometrial lining

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23
Q

What occurs during the proliferative phase?

A

-The end of menses through ovulation
-Estrogren levels are low but gradually increase
-Uterine smooth muscle grows
-Endometrial receptor sites for progesterone are developed

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24
Q

What occurs during the secretory phase?

A

-The time of ovulation to just before menses
-Increasing amounts of progesterone (creates highly vascular secretory endometrium that is suitable for implantation)
-Endomertial growth ceases
-Progesterone also causes: thining of vaginal mucosa, increased thickness of cervical mucosa, increase in glandular growth of the breast.

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25
Q

What occurs during the ischemic phase?

A

-From the end of the secretory phase to onset of menstruation.
-Estrogen and progesterone are low & uterine spiral arteries constrict
-Endometrium becomes pale and blood vessels rupture (1st day of next cycle)

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26
Q

What type of discharge is best for getting pregnant during ovulation?

A

Clear phase (10-14 days) appears as raw eggwhite stretchy and slippery

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27
Q

How is chlamydia transmitted?

A

Bacterial through sexual activity and birth

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28
Q

Signs and symptoms for Chlamydia

A

Asymptomatic; mucopurulent drainage

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29
Q

How do we treat Chlamydia?

A

Penicillin or Erythromycin.

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30
Q

How is Gonorrhea transmitted?

A

Bacterial, through sexual activity and birth

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31
Q

What are signs and symptoms of Gonorrhea?

A

Asymptomatic; greenish/yellow discharge

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32
Q

What is the treatment for Gonorrhea?

A

Ceftriaxone IM, doxycycline PO, cefixime PO

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33
Q

How is Syphilis transmitted?

A

-Bacterial, through sexual activity
-If not tx before the 18th week of pregnancy it can infect the fetus

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34
Q

What are signs and symptoms of Syphilis?

A

Chancre sores (10-90 days), palmer/pedal rashes, multi-organ involvement

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35
Q

What is the tx for Syphilis?

A

Penicillin

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36
Q

How is HPV (human Papillomavirus) transmitted?

A

Viral, through sexual activity and transplacentally to the fetus

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37
Q

What are signs and symptoms of HPV?

A

Genital warts

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38
Q

What is the tx for HPV?

A

No cure, management of warts with trichloroacetic acid or dichloroacetic acid, cryotherapy; surgery.

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39
Q

How is HIV/AIDS transmitted?

A

Viral, through unprotected sex, transplacentally to the fetus late in pregnancy or at birth and through breast milk

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40
Q

What are signs and symptoms of HIV/AIDS?

A

Flu-like symptoms, fatigue, weight loss, night sweats

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41
Q

What is the tx for HIV/AIDS?

A

No cure, HAART highly reactive antiretroviral therapy, and c section to reduce transmission to the infant.

42
Q

What are presumptive signs of pregnancy?

A

Amenorrhea
Fatigue
Nausea and vomiting
Breast tenderness
Urinary frequency
Quickening: 1st fetal movement

43
Q

What are Probable signs of pregnancy?

A

Hegar’s sign
Goodell’s sign
Chadwick’s sign
Positive pregnancy test
Braxton hicks contractions or ballotmen

44
Q

What are positive signs of pregnancy?

A

Hearing fetal heart tones
Visualization of the fetus
Palpation of fetal movements by examiner

45
Q

Chadwick’s Sign:

A

Pregnant woman’s cervix will be dark-bluish cervix due to increase in vascularity

46
Q

Hegar’s Sign:

A

Compressibility & softening of cervical ISTHMUS in first 4-6w

47
Q

Goodell’s Sign:

A

Softening of the cervix in the first 4-8w

48
Q

Ballottement:

A

Fetus can float up and back down. Found in EARLY pregnancy

49
Q

T or F? Fundus height in cm is consistent with # of weeks?

A

True. May be +/-2 after 20 weeks (normal)

50
Q

What week of pregnancy is the top of the fundus at the umbilicus?

A

20w

51
Q

How to measure the fundal height:

A

-From symphysis pubis to fundus
-Measured in centimeters
-Indicative of fetal growth
-Measurement of + or – cms compared to gestational age requires further assessment
- Magic number is 2, +2 or -2 compared to expected weeks gestation is a concern

52
Q

What findings or changes occur to the integumentary system during pregnancy?

A
  • Change in pigmentation
  • Linea nigra
  • Chloasma: pregnancy mask
  • Hyperactive sweat and sebaceous glands
  • Striae gravidarum: stretch marks
  • Angiomas; palmar erythema
  • New hair growth
  • Stronger nails
53
Q

What changes occur to the neurological system during pregnancy?

A

-Decreased attentions, concentration, memory
-Carpal tunnel syndrome
-Syncope
-Altered sleep pattern

54
Q

What changes occur to the cardiovascular system?

A

-Supine Hypotension: no perfusion to the uterus=no perfusion to the placenta
-B/P should stabilize around 20W. Monitor for pre-eclampsia.
-Increased cardiac output/volume
-Diluted blood: increased need for iron
-Varicose veins

55
Q

What changes occur with the respiratory system during pregnancy?

A

-Decreased lung capacity (exacerbation of asthma)
-Increased mucus production: postnasal drip & sore throat

56
Q

What changes occur to the GI system during pregnancy?

A

-Constipation
-Decreased motility
-Increased risk for periodontal disease: infection, plaque, and carries
-Increasd urination
-N/V
-Increased saliva production
-Pyrosis (heartburn)

57
Q

What changes occur to the endocrine system during pregnancy?

A

-Decreased TSH
-Prolactin
-FSH & LH
-Oxytocin
-

58
Q

What changes occur to the musculoskeletal system during pregnancy:

A

-Relaxation
-Diastasis recti
-Lumbar lordosis
-Separation of pubis symphysis

59
Q

How to differentiate ligament pain Vs contractions:

A

-Ligament pain is constant
-Contractions come and go

60
Q

What maternal tasks are experienced during pregnancy?

A

-Acceptance of pregnancy & child
-Reordering relationships
-Seeking safe passage

61
Q

What paternal tasks are experienced during pregnancy?

A

-Announcement phase
-Moratorium phase: relaxation
-Focusing phase

62
Q

How often should a mother go to their prenantal appointment for 28-32 weeks pregnant?

A

Monthly

63
Q

How often should a mother go to their prenantal appointment for 28-32 to 36 weeks pregnant?

A

Q 2 weeks

64
Q

How often should a mother go to their prenantal appointment for 36 weeks until delivery?

A

Weekly

65
Q

How to calculate Nagele”s Rule:

A

-Add 7 days, subtract 3 months from the date of the patient’s first day of their last manstural (LMP)
-Add a year

66
Q

Gravida:

A

Number of pregnancies

67
Q

Para:

A

Number of deliveries of 20 weeks and beyond no matter the outcome

67
Q

Term:

A

Number of babies born 37 weeks and beyond

68
Q

Preterm:

A

Number of babies born 24 week to 36/37w

69
Q

Abortion

A

Any pregnancy that occurs before 20 weeks

70
Q

Living:

A

Number of living children

71
Q

Chemical pregnancy:

A

Positive test followed by late menstrual period with heavy bleeding probably indicates brief, nonviable pregnancy

72
Q

Which vaccine should be avoided during pregnancy that has not been given before?

A

Rubella

73
Q

What tests are done during pregnancy?

A

-Blood type & RH factor
-VDRL (Syphilis)
-CBC
-HIV
-Sickle Cell
-STIs
-Cervical cancer

74
Q

How many more calories are needed per day during pregnancy?

A

300

75
Q

How much folic acid is needed per day during pregnancy?

A

400mcg

76
Q

What position should a pregnant person lay on during breast exam?

A

Recumbent/left side

77
Q

What is considered normal on a breast examination during pregnancy?

A

-Nodularity, striae, enlargement, and hyperpigmentation

78
Q

What is considered advanced maternal age?

A

Over 35 years of age, can cause chromosomal abnormalities

79
Q

triple screening

A
80
Q

Quadruple screening

A
81
Q

What is an essential macronurtient during pregnancy?

A

Protien is essential for growth and repair

82
Q

What vitamins are essential for pregnancy? Include examples of foods

A

-Calcium & Vitamin D: diary
-Iron: Liver
-Vitamin C: Citrus
-Folic Acid: Peas (legumes)
-Protein

83
Q

Common complaints for pregnant women?

A

-N/V
-Dyspepsia
-Flatulence
-Constipation
-Nasal Congestion
-SOB
-Backache
-edema
-Vaicosities
-Leg cramps

84
Q

Dangerous sign and symptoms to report during the first trimester:

A

-N/V
-Bleeding-spontaneous abortion, pain, emotional support
-Infection

85
Q

Dangerous sign and symptoms to report during the second trimester:

A

-Preeclampsia
-PROM
-Pre-term labor

86
Q

Dangerous sign and symptoms to report during the third trimester:

A

-Preeclampsia
-PROM
-Pre-term labor
-Gestational Diabetes
-Bleeding

87
Q

Signs and symptoms of ectopic pregnancy:

A

-Unilateral pain
-Abdominal tenderness
-Referred shoulder pain
-Bleeding

88
Q

Diagnosis for ectopic pregnancy

A

-+ HCG but low for gestation
-Increased WBC
-US

89
Q

Surgical mangement of ectopic pregnancy

A

Laparoscopic surgery & Methotrexate = termination

90
Q

What change happens to blood pressure during first trimester?

A
91
Q

True or False, any bleeding beyond first trimester is an emergency

A

True

92
Q

What is Clomiphene citrate used for?

A

Infertility, increases growth of folicles

93
Q

Clomiphene citrate How is it administered and what are the signs and symptoms?

A

Subq injection
-Irritability, mood swings, multiple babies.

94
Q

What are signs and symptoms of ectopic pregnancy?

A

-Unilateral pain
-Refered shoulder pain
-Bleeding
-Positive but low HCG gestation

95
Q

Education for molar pregnancy (gestational trophoblastic disease)

A

Do not get pregnant for 1 year

96
Q

signs and symptoms of placenta previa

A

-Bright, red painless bleeding

97
Q

Management for placenta previa and placental abruption:

A

Patient must have may an immediate c section and no vaginal exams

98
Q

Signs and symptoms for placental abruption:

A

-Painful, dark red bleeding in the 3rd trimester

99
Q

What is DIC (Disseminated intravascular Coagulation)?

A

Secondary disorder of coagulation that occurs as a complication of abruption, previa and trauma.

100
Q

Signs and symptoms of DIC (Disseminated intravascular Coagulation):

A

Petchiae, purpura, bleeding from openings in skin (IV & Surgical site), GI bleed, hypotension

Maternal Health (4 decks)

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