Exam 1 OB/peds Flashcards
Nuclear Family
“traditional family”: Consists of a husband, wife and their children.
Extended Family
“multigenerational family” includes at least one parent, a child or children, and any combination of grandparents, aunts, uncles, etc.
Single-Parent Family
One parent living at home with a child/children.
Blended Family
Father with a child or children from a previous relationship and a mother from a previous relationship, who marry and live together.
Cohabitating Family
A man and woman with or without child live together but unmarried
Gay or Lesbian Family
Same sex adults with or without children.
Infant mortality Rate
number of infant deaths per 1000 live births in any given year
Infancy
Birth-1 year
Toddlerhood
1year- 3 years
Preschool
3-6 years
School age
6-12 years
Adolescent
12-18 years
Cephalocaudal growth
From head to toe
Proximodistal growth
From trunk to tips of extremities
Trust vs mistrust age
infant (birth -1yr)
Autonomy vs shame and doubt age
Toddlerhood (1-3 yrs)
Initiative vs guilt
Preschool (3-6 yrs)
Industry vs inferiority
School age (6-12 yrs)
Identity vs role confusion
Adolescence (12-18yrs)
Sensorimotor age
Birth-2yrs
Preoperational stage age
2-7yrs
Concrete Operational stage age
7-11 yrs
Formal Operational Stage age
11-15 yrs
which stage is “the child develops trust as the primary caregiver meets the needs”
Trust vs mistrust
what stage is “the child learns to control his body functions and becomes increasingly independent, preferring to do things himself”
Autonomy versus shame and doubt
What stage is “the child learns about the world through play and develops a conscience”
Initiative versus guilt
What stage is “the children enjoys working on projects and with others, and tends to follow rules”
industry vs inferiority
what stage is “changes in the childs body rapidly take place and the child is preoccupied with how they look.”
Identity versus role confusion
Accomodation
draws on past experiences that are closest to his current problem to fix it. Learning and growing from your mistakes or experiences.
During what stage does object permanence occur?
Sensorimotor stage
Object permeneance
the understanding that objects and events continue to exists even when they cant be seen or heard or touched directly
This stage is marked by egocentricity….
Preoperational stage (age 2-7)
What is egocentrism
the child cant comprehend a point of view different from his own.
Transducive reasoning
generalization to the extent that items that share characteristics are labeled the same; (For example-if child gets scolded for being bad-then gets hurt-may put these two together)
During this Piaget stage, the childs thought process becomes more logical and coherent.
Concrete operational stage
they can think abstractly in this Piaget stage
Formal operational stage
when does the anterior fontanel close!?
18 months
When does the posterior fontanel usually close?!
2 months,
When does the first tooth erupt?
6 months
When does the first tooth lost?!
6 years
When do you measure head circumference?
From birth to 2 years
What is important in newborn/infant formula for first 12 months?
Iron fortified formula
What to do to prevent flat spots on head
Supervised tummy time
What can cause dental caries in newborns?
Bottle proppeing
what position for the baby to sleep?
ON back
What is a major component of health promotion?
Anticipatory guidance
Hematocrit and hemoglobin generally performed by what age
9-12 months
Baby doubles weight by when
5 months
Baby triples weight by when
12 months
Oral health of infant
wipe the infants gum with soft moist gauze once or twice daily.
When does the baby identify parents
6 months
infant cry or protests when another person holds them is called what
Stranger anxiety
when is BMI checked ?
2years of age
Limit fast food for toddlers to how often
1-2x a week
toddlers- how many servings of fruit and vegetables
5
toddlers- how many servings of dairy
3
Amount of physical activity for a toddler
60 minutes
Limit television for how long for toddlers and preschoolers
2 hrs
Milk up to 2 years is what kind
whole milk
After 2 yrs of age, what kind of milk do we switch them to?
Skim milk
parent teaching for sleepwalkers
Parents should quietly talk and comfort the child, lead the child back to bed and allow child to return to sleep .
Car seats for 20-40 pounds
use a convertible forward facing seat with full harness that has been placed in the back seat. HAve harness straps at or above shoulders
Car seat for 40 lbs and over 4 years of age
Belt positioning booster seat, in the back seat, uses both lap and shoulder belts, the lap belt positioned low and tight across the lap/upper thigh,and the shoulder belt is snug across the shoulder and chest.
Self-esteem
reflects feelings of self worth or value
Self-concept
refers to evaluations of the self in certain specific areas, such as those related to academic achievements, athletic ability, physical appearance.
Body image
The ideat that forms about ones body
The persons view of self as a sexual being
sexuality
limit what to prevent dental caries and excessive calories
Fruit juices
What becomes important during preschool years?
Coordination (hand-eye)
What becomes important during toddler years
activities that encourage future motor development
when should the childs first dental appointment be
once first tooth erupts, no later than 1 year of age
For toddlers and preschoolers, what can the nurse do to make it easier to get vitals/proceures
Let the child play with the medical equipment, play games for the assessment, leave intrusive procedures last. Preschoolers are interested in body so teach them about their body parts.
What does eye prophylaxis of newborn protect against and when do you give it
within first hour after birth. Try to do it when baby is calm. It protects against opthalmia neonatorum caused by chlamydia and gonorrhoeae.
Vitamin k injection procedure to help the baby stay calm
place newborn on firm surface and have the parent gently hold the newborns arm across the newborns chest.
Handling newborn directly after birth
wear gloves!!!!! Wash hands immediately before gloving and after gloves have been used.
Signs of potential developmental delay in newborn
sucks poorly or feeds slowly, doesnt blink when shown bright light, doesnt focus and follow a nearby object moving side by side, rarely moves arms and legs, movements arent symmetrical, lacks muscle tone, limbs are consistetnly stretched out rather than flexed, and doesnt respond to loud sounds
How far away can a newborn see?
8-12 inches
The state of complete physical, mental, social, and physical well-being and not merely the absence of disease or illness (WHO
Health
Activities that preserve an individual’s present state of health and/or that prevent disease or injury
Health Maintenance
When and where are routine pediatric care provided
Clinics, physician office, school and mobile units. **Some children may not receive routine care so this should be assessed even on sick visits.
Components of well child visit
Oral Health (Dental Caries are the most common chronic childhood problem). Mental & Spiritual Health. Disease Prevention (B/P, Vision). Contact with Family. General Observations. Growth & Development Surveillance. Nutrition. Physical Activity. Injury Prevention (Child Abuse, STD’s, Sports)
How do you do a physical assessment on child
Sequencing-to accomodate to childs developmental need. No head to toe order, do what you can first, least invasive first.
Assessment technique for infant
lie flat/parent’s arms; moro reflex last
Assessment technique for toddler
minimal; contact initially; eyes, ears, mouth last
Assessment technique for preschool
allow to handle equipment; head-2-toe, if cooperative
Assessment technique for school-aged
respect privacy; explain procedures
Assessment technique for adolescent
explain findings, respect privacy
Growth measurements for infants
Recumbent length for infants up to 36 mo; ht, wt, head circumference
Growth measurements for toddlers after 37 months
Standing ht and wt after 37 mos or when able to stand easil
Outside expected parameters for growth chart
95th percentile
Vital sign measurements for todlers/infants
1 - Count respirations before disturbing child
2 - Count AP HR for a full minute
3 – Measure BP, if applicable
4 – Measure temperature last
In children 1 year or older, easy rule of thumb to determine normal systolic BP
80 + (2 x age in yrs)
Normal diastolic BP is generally 2/3 of systolic BP
Determining cuff size
Cuff bladder width 40% of arm’s circumference measured midway between olecranon and acromion
Cuff bladder covers 80-100% of arm circumference
Purposes for developmental assessment
- Validation that a child is developing normally
- Early detection of problems
- Identification of concerns of caregivers and child
- Opportunity for anticipatory guidance and teaching about age-appropriate expected behaviors
Age of Denver developmental assessment
Birth- 6years at latest
When do you repeat the denver screening if the behavior is outside of the norm
1 month later
When do you do BP?
between 2-3 years of age.
Newborn care….
first bath, Cord care Vit K (Insufficient amount at birth) & Hep B Injections Screenings (Hearing, metabolic) Parent bonding Feeding
When do parents follow up with pediatrician after birth?
3-5 days and 1-2 months
A weight loss of how much in the first week of life is considered normal for the bottle fed infant
5%
A loss of how much is average in the first week for the breastfed infant
7%
Maximum weight loss percentage in the first week for newborns is normal?
10%
Why do newborns lose weight?
the use of dry heat from radiant warmers and isolettes (incubators) causes insensible fluid loss, and babies are born with extra weight to help with the stress with transition. The use of I.V. fluids in labor causes a large shift of fluid from the mother to the fetus especially when D5W or Lactated Ringer’s is used
How long does it take for mothers mature milk to come in?
3-5 days
Newborns are farsighted or nearsighted
Nearsighted
A baby’s vision is between what?
between 20/200 and 20/400
Best vision for a newborn is how far away
Best vision is about 8 to 12 inches away.
Health promotion for infants
Supervised “Tummy Time”
Allow free movement of hands & arms
Appropriate Toys (Mobile, Music Box, Mirror)
Turn baby’s head to prevent flat spots
Feeding-Alternate sides to encourage muscle tone
Well checks for infants when?
1, 2, 4, 6, 9 and 12 months
WHen does the baby get lead screening
9-12 months
When does stranger and seperation anxiety occur
After 6 months
What is self regulation
The ability of the baby to comfort itself
Why dont we need to do head on children older than 2?
Fontanels have closed by then
What is ECC
Early childhood caries; one or more decayed, missing, or filled tooth surfaces in a child less than 6 years
Nightmare vs night terrors
Night mares are frightening dreams that awaken the child who is often crying and upset. Night terrors are characterized by a child who cries out and appears frightened but theyre not fully awake
How often for school age children and adolescents need dental visits?
Every 6 months
Risk factor for multiple dental caries
low income and lack of dental insurance, sugary snacks and soda, no proper teeth brushing, no flouride
Techniques for assessment of adolescent
Allow for private time. May want parent or friend present or may prefer to be alone
Screening for adolescent
Height/Weight/Scoliosis/Breast or Testicular Sexually Active: STD/Pap/Pelvic If Menstruating may need CBC BP Annually If high risk-May need lipid panel
What age do you stop flouride supplements
Age 14
Hrs of sleep required for adolescents
9 hrs
Immunizations for adolescent
Tdap MCV4 HPV for girls (8-26) Flu Hep A & B
Role of the pediatric nurse
direct care to children and their families, case management, education to family and child, research, patient advocate
Purpose of family centered care
Family is a constant that supports and influence the childs life
Main causes of mortality in neonates
LBW, congenital malformations, and short gestations
Main causes of mortality in Infants
Congenital defects and SIDS
Main causes of mortality in children
Most common cause is unintentional injury, medical causes are congenital problems, cancer, and heart diseases
What is morbidity
Illness or injury that limits activity, requires medical attention or hospitalization, or can result in a chronic condition
What is the leading cause of hospitalization in kids ages 1-9
Repiratory illness
What is the leading causes of hospitalization in adolescents
mental illness and pregnancy
What can mature minors consent to? (ages 14-18)
May consent to certain procedures birth control, STD checks, mental health, blood transfusion
Parent may make decision except when….
When the child and parent do not agree on major treatment options; the parents do not permit life-saving treatment; Child abuse
“Baby Doe Regulation”
Defines the withholding of medically indicated treatment as child abuse; except when such care is futile
2 or more individuals that are joined by marriage, birth, or adoption and live together
Definition of family
Authoritarian parenting style
Controlling and cold; dictator; military type
Authoritative parenting style
firm control and limits but more open and warm; boundaries but love;
Permissive parenting style
warm and loving but sets few limits and boundaries; love but no boundaries
Indifferent parenting style
Forgets about kids; may be busy with work or other concerns.; too busy or not caring
Most accepted/wanted parenting style
Authoritative
Child outcome in Authoritarian parenting style
no negotiation skills, no ability to direct and initiate own activities, may become fearful, withdrawn and unassertive, girls often passive and dependent during adolescents, boys often rebellious and aggressive, frustrated in efforts to achieve autonomy
Child outcome in Authoritative parenting style
more willingly accepts restrictions, tends to be more self reliant, self controlled, and socially competent, higher self esteem, better school performance
Child outcome in Permissive parenting style
may becomes rebellious, aggressive, socially inept, self indulgent, or impulsive. May be creative, active and outgoing
Child outcome in INdifferent parenting style
May show high expression of destructive impulses and delinquent behavior
Appropriate time out…
1 minute per 1 year of age
Effects of divorce on children aged 3-5
fear, anger, worry, sorrow, anxiety, regression, searching and questioning, temper tantrums, increased crankiness and aggression, self-blame, loneliness, unhappiness, and depression
Effects of divorce on children aged 6-8
worry, anxiety, depression, fantasy, self-blame, inability to concentrate on schoolwork, regression, confusion, grief, anger, aggression, resentment, behavioral problems at school and home
Effects of divorce on children aged 9-10
anger, anxiety, depression, grief, manipulation of parents, withdrawn from friends and activities, resentment, behavioral problems at school and home
Effects of divorce on children aged 11-13
Panic, fear, depression, guilt, risk taking, fear of loneliness and abandonment, and denial
Effects of divorce on children aged 14-17
struggle with morality, loneliness, anger, fear, depression, guilt, truancy, use of drugs and alcohol, and sexual acting out.
Culturally sensitive communication in peds
Avoid professional jargon Let family choose sit/stand position Offer service of interpreter Repeat important info more than 1x Learn basic words of family’s language
THe posterior fontanel closes….
2-3 months
Anterior fontanel and open sutures palpable until….
18 months
The body surface area is large for weight, making baby susceptible for what
Hypothermia
Short trachea under 5 making children susceptible to what
Foreign body obstruciton
Primary breathing muscle up to 4-5 years
Diaphragm
Pediatric assessment technique in infant > 6 months
Stranger Anxiety (Examine in parent’s lap) May start with feet/hands to ease fear
Assessment technique in Toddlers
Stranger anxiety
Let child have control/choices
Sequencing
Assessment technique in preschoolers
Touch and play with equipment
Positive feedback
Distraction
Assessment technique for school age
Modesty/Privacy
Head-to-toe can now be used
Offer explanations/tell child what you are doing
Choices
Include child in care-let them listen to heart, lungs
Assessment technique for adolescents
Privacy/Modesty
Head-to-toe sequence
Reassurance about changes such as puberty, etc
Proper weighing for infants and toddlers
Remove all clothing/needs to have dry diaper on. Record in pounds & ounces
Baby scale” either sitting/lying on scale
Measure head circumference in what
Centimeters
Proper length assessment for toddlers and infants
Under 2 yr. old-measure length lying down. Record in inches
Proper height assessment for preschool and school aged
Stadiometer to measure height-make sure child does not have shoes on.
Proper weight assessment for preschool and school aged
Standing scale. Younger kids in underwear, older in street clothes with shoes and other heavy clothing off
Coronal suture
Across at the front of head
Sagittal suture
Runs down the middle
Lambdoid suture
across at the back of head
What could be important to teach a child/family about hospitalization??
Do not play with IV pump, lines, cords
Do not chew on lines, cords
Bedrails/crib rails up when parent is not present
Remove all syringe caps and other items that kids could choke on
Safety measures for hospitalized child
Box 11- 3
Can help care for the child, provide a sense of security, for a hospitalized child?
Rooming- in. The parent staying the night with them
Who plans activities and age-appropriate care for a child that is hospitalized; Great resource to use
Chil-life specialist
Instead of saying “We will give you some dye in your arm”
Say “We will put some warm medicine into your arm.”
Instead of saying “I will give you a shot”
Say “I will give you some medicine through a small needle”
Instead of saying “This will hurt or burn”
Say “It might feel sore or very warm.”
Instead of saying “The doctor will make a small cut/incision”
Say “The doctor will make a small opening”
Instead of saying “You are going to have some anesthesia”
say “You will get some medicine that you breathe or get through your arm to make you sleep.”
Instead of saying “The medicine tastes bad”
“Some children say the medicine tastes different to them.”
What is growth:
Quantitative-refers to the increase in physical size such as height, weight, head circumference, number of words in vocabulary
What is development
Refers to an increase in capability or function (ability to sit up by self, throw a ball)
Example of Assimilation
Child uses reflexes to suck on things that touch lips (Ex. Pacifier, Bottle)
Example of Accomodation
Child learns that not all things that touch lips are pleasant to suck
Conservation is learned in this piaget stage
Concrete Operational
What is conservation
(Matter does not change when it’s form is altered)
Example-putting a drink in a small container and then into large container is still the same amount of drink
Ecologic Theory
Theory that believes that each child brings a certain set of genes to a certain environment in which he or she interacts; Nature vs Nurture; Mesosystem, microsystem, macrosystem, chronosystem, Exosystem
MIcrosystem
Level of daily constant relationships
Home, daycare, school, friends, neighbors
Reciprocal Relationship
Meosystem
Relationship of microsystems together
Exosystem
Settings that influence the child although the child is not in daily contact with this setting
Example: Parent’s work may influence the child (Overtime, inflexible hours, demanding schedule)
Macrosystem
Beliefs, values, and culture which the child is brought up in
Example: Politics and religion
Chronosystem
The time period in which the child grows up
Example: How would a child that grew up in the 1950’s differ from a child today?
Goodness of Fit
Occurs when parents expectations meet with child’s type of temperament
Nursing intervention for short attention span temperment
Provide projects that can be completed in short periods and gradually work up
Shy child temperament nursing intervention
Allow time to adjust
Nursing intervention for easily stimulated temperament
Place in quiet room to sleep; quite room to do homework
Resiliency Theory
Examines the individuals characteristics and interaction with the environment.
Family/Child experience a crisis that produces stress.
Family/child deals with crisis based on resources available.
Each family has protective factors and risk factors.
Height increases by how much in first year after birth?
1 foot
What is growth closely associated with
Type and quality of feeding/nutrition
Kidneys and livers in infant
Not fully mature at 12 months but are have matured-this helps child excrete drugs or toxic substances better than at birth
Type of play for infant
solitary play; Primarily alone, but enjoys having others present
Communication for infant; what is higher…understanding or what they can say
Understanding (Receptive speech)
receptive speech
WHat they can understand
Expressive speech
What they can say
What could abnormalities in commuication mean…
Abnormalities in communication could indicate a hearing problem, developmental delay, or lack of stimulation
Type of play for toddlers
Parallel play- May play next to each other-may occasionally speak or trade toys but not really interact
Copy things seen at home-cook, use hammer
Temper tantrums normal age.
Toddlers
NUrsing care for toddler
Speak frequently and use simple terms, give short clear insructions, dont perform treatment in toddler bed or room, allow for rewards, praise toddler
Play for preschoolers
Associative play-interact with others- one cuts paper, one pastes. Dramatic play too! Fantasy is ver bid.
Vocaublary amount for preschoolers
2000 words, uses complete sentences, knows lots of words but only understands literal meaning.
Egocentrism is seen in what age
Preschoolers
Implications for Preschool age
Let them play will medical equipment, use pictures that are concrete
Growth spurts or girls
9-10 years old
Growth spurt age for boys
1 year after girls or age 13
Typ of play for school age
Cooperative
Communication for School aged kid:
Grammar and pronunciation, understands conservaton.
Puberty for girls
Develop breasts and pubic hari, then begin menstrual cycle,
Puberty for boys
Voice deepens, penis and testicles get larger and facial hair and pubic hair growth
Type of play for toddlers
Parallel play- May play next to each other-may occasionally speak or trade toys but not really interact
Copy things seen at home-cook, use hammer
Temper tantrums normal age.
Toddlers
NUrsing care for toddler
Speak frequently and use simple terms, give short clear insructions, dont perform treatment in toddler bed or room, allow for rewards, praise toddler
Play for preschoolers
Associative play-interact with others- one cuts paper, one pastes. Dramatic play too! Fantasy is ver bid.
Vocaublary amount for preschoolers
2000 words, uses complete sentences, knows lots of words but only understands literal meaning.
Egocentrism is seen in what age
Preschoolers
Implications for Preschool age
Let them play will medical equipment, use pictures that are concrete
Growth spurts or girls
9-10 years old
Growth spurt age for boys
1 year after girls or age 13
Typ of play for school age
Cooperative
Communication for School aged kid:
Grammar and pronunciation, understands conservaton.
Puberty for girls
Develop breasts and pubic hari, then begin menstrual cycle,
Puberty for boys
Voice deepens, penis and testicles get larger and facial hair and pubic hair growth
The effectiveness of oral contraceptives is decreased when the following medications:
Barbiturates Anticonvulsant Antifungals (griseofulvin) Antibiotics (ampicillin, tetracycline,rifampin Oral hypoglycemics Anticoagulants
ACHES meaning of each Letter
Abdominal Pain (r/t gallbladder or liver problem)
Chest Pain (r/t blood clot in heart or lung)
Headaches (r/t HTN or cardiovascular accident)
Eye Problems (r/t HTN or vascular accident)
Severe Leg Pain (r/t thromboembolics)
PAINS meaning of each letter
Period late, abnormal bleeding or spotting
Abdonimal pain, pain with coitus
Infection exposure, abnormal vaginal discharge
Not feeling well, fever or chills
String missing, shorter or longer
What is ACHES acronym for?
Potential complications of Oral Contraceptions
What is PAINS acronym for?
Potential complications of IUD
How long is copper IUD good for?
10 years
How long is the mirena good for?
5 years
Recommendations for IUD
Clients with at least one child
Have no history of PID
Stable, mutually monogamous relationship
Client teaching of IUD
Check string once a week for the first month after insertion, then once after each menses.
Name for a transdermal hormonal contraception
Ortho Evra
Benefits of oral contraceptives
Reduction in ectopic pregnancy, PID, ovarian cancer, endometrial cancer, colorectal cancer, iron deficiency anemia, benign breast disease
Reduction in perimenopausal s/s
Estrogen effects
Alterations in lipid metabolism Breast tenderness, engorgement, increased breast size Cerebrovascular accident Changes in carbohydrate metabolism Chloasma Fluid retention; cyclic weight gain Headache Hepatic adenomas Hypertension Leukorrhea, cervical erosion, ectopia Nausea Nervousness,irritatibility Telengiectasia Thromboembolic complications- Thrombophlebitis, pulmonary embolism
What is norplant
subdermal implant
Norplant effective for how long
5 years
Norplant isnt effective in women…
who weigh more than 154lbs
Depot-Medroxyprogesterone Acetate(DMPA) (Depo-Provera)
fertility wont come back till after 9 months from stopping, take calcium supplements, not recommended for more than 2 years, suppresses ovulation and thickens mucus
NUrsing care for depot shot
the site should NOT be massaged after the injection because this action can hasten the absorption and shorten the period of effectiveness
After vasectomy, what does it take to clear sperm?
6-36 ejaculations, or 4-6 weeks
Side effects of vasectomy
Pain, infection, hematoma, sperm granulomas, reconnecting
Safer than Tubal Ligation
Patient teaching for vasectomy
Use another form of BC
Bring in 2 or 3 semen samples for sperm count
Recheck at 6 and 12 months to ensure that fertility has not been restored.
What is done after Essure
3 months after placement, tubal occlusion is confirmed by hysterosalpingogram
Contraindications for Essure
allergic to nickel
Culture that believes in IUD and sterilization
Chinese
Who uses oral contraceptions but apposed to abortions
African Americans
who uses Abstinence, Rhythm, believes abortion is seen as morally wrong and has Prolonged breastfeeding
Mexicans
WHo Value large families and Birth control is NOT used
American Indians and Native Alaskins
Example of Alternative Therapy
A childbearing mother will replace medication that will induce labor for herbs, that she believes will induce her. (or casterol will give contractions)
Example of Complementary therapy
Therapy used along side conventional medicine; A woman uses aroma therapy post cesarian birth to help her with pain. Indian spices used have an antimicrobial effect.
is an excellent choice for women desiring long-term contraception who cannot take estrogen
Implanon
available for lactating women, or those who cannot take estrogen
Long acting depo injection
A nurse is explaining to a female client about the advantages and disadvantages of using an intrauterine device. Which of the following is a disadvantage of intrauterine devices?
Increased bleedig during mesese
s/sx of tss
high fever, sore throat, weakness, fainting, diarrhea/vomiting, muscle aches, and a rash.
The lifespan of sperm is
2-7 days
Studies show that what reduces the incidence of neural tube defects such as anencephaly and spina bifida
folic acid supplementation of at least 400 mcg/day taken 1 to 3 months preconceptually and continues through the first trimester
The average time between breast development and menarche is
2.3 yrs
Studies show that what reduces the incidence of neural tube defects such as anencephaly and spina bifida
folic acid supplementation of at least 400 mcg/day taken 1 to 3 months preconceptually and continues through the first trimester
used as the first line therapy to induce ovulation if the woman has normal ovaries, intact pituitary gland and normal prolactin levels
Clomiphene citrate
when does ovulation occur when taking clomiphene citrate
5-9 days after the last dose
After the first treatment cycle with clomiphene citrate, what should happen?
A pelvic ultrasound should be done to rule out ovarian enlargement, ovarian cysts, or hyperstimulation
Side effects of clomiphene citrate
Side effects include hot flashes, abdominal distention, bloating, breast discomfort, nausea and vomiting, vision problems, headache, and dryness or loss of hair.
The woman can do what to relieve side effects of clomphene citrate
The woman can increase her fluids and use fans to obtain relief from side effects
How many cycles of clomiphene citrate can you do
It can be taken no more than 6 ovulatory cycls.
What can induce ovulation in women with PCOS.
oral hypoglycemia agents (e.g. metformin and rosiglitazone)
They are indicated as a first line therapy for the anovulatory infertile woman with low to normal levels of FSH and LH
Gonadotropins (Including menotropin and urofollitropin)
The only monosomy of an entire chromosome that is compatilble with life is what
45, X (Turner Syndrome).
Herbs frequently recommended to treat infertility include what
ginseng and astragalus—watermelon.
Examples of Autosomal Dominant Inheritance:
Huntington’s disease, myotonic dystrophy. polycystic kidney disease, neurofibromatosis, achondroplastic dwarfism
examples of Autosomal Recessive Disorder
PKU, Tay-Sachs, Cystic Fibrosis, galactosemia, sickle cell anemia.(SCD)
Examples of Autosomal Dominant Inheritance:
Huntington’s disease, myotonic dystrophy.
Examples of X- Linked Dominant
Vitamin D-resistant rickets–both males & females are affected
examples of X-Linked Recessive
Hemophilia, duchenne muscular dystrophy, some forms of color blindness and fragile X syndrome, which is the most common form of inherited intellectual disability (mental retardation) second to down syndrome.
Examples of X- Linked Dominant
Vitamin D-resistant rickets `
The outermost membrane to form
chorion
WHen can chorionic villi be used for testing of the embry
8-11 weeks
At 10 weeks, how much amniotic fluid do you have
30 mL
At 20 weeks, how much amniotic fluid do you have
350 mL
After 20 weeks, how much amniotic fluid do you have
700-1000 mL
Baby swallows how much amniotic fluid every 24 hrs
600 mL
How much Amniotic fluid flows from the lungs
400 mL
Oligohydramnios
less than 400 mL of amniotic fluid;
Abnormalities of fetal urine
Obstruction of urine flow (Potter’s syndrome)
Hydramnios, polyhydramnios
> 2000 mL amniotic fluid... Bartter’s syndrome If the fetus does not swallow AF.... Esophageal atresia anencephalus
What happens in cord with 2 vessels…
Cardiac and GI congenital abnormalities
Produce RBCS for the first 6 weeks until the liver takes over
Yolk Sac
What happens in cord with 2 vessels…
Cardiac and GI congenital abnormalities
Average cord size
2 cm wide and 55 cm long
cord that encircles the fetal neck
Nuchal cord
Funic souffle
Synchronous with the fetal heartbeat and the flow of fetal blood through the umbilical arteries
Uterine Souffle
Synchronous with the mother’s pulse and heard above the mother’s symphysis pubis and is caused by blood flow entering the dilated uterine arteries
fetus skin thickens at what weeks
23-25 weeks
Major mechanism by which amniotic fluid is removed in the last half of pregnancy is
fetal swallowin
