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PRNU 129 > Exam 1 Study > Flashcards

Exam 1 Study Flashcards

1
Q

What are the signs of a spontaneous abortion or miscarriage?

A

Vaginal bleeding
uterine cramping
partial or complete expulsion of products of conception

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2
Q

What are the signs of an ectopic pregnancy?

A

Abrupt unilateral lower-quadrant abdominal pain with or without vaginal bleeding

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3
Q

how is ectopic pregnancy resolved

A

methotrexate can be given to inhibit cell division and embryo enlargement

salpingostomy - removing embryo through hole can save fallopian tube

laparoscopic salpingectomy - removal of the tube is performed when the tube has ruptured.

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4
Q

What is gestational trophoblastic disease?

A

proliferation and degeneration of trophoblastic villi in the placenta that becomes swollen, fluid‐filled, and takes on the appearance of grape-like cluster

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5
Q

risk factors for gestational diabetes - MOMMA

A

Maternal age over 25
Obese/overweight BMI >25
Macrosomia - babies greater than 9 lbs
Multiple Pregnancies
A history of familial type 2 diabetes

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6
Q

signs of gestational trophoblastic disease

A

Uterine size increasing abnormally fast
abnormally high levels of hCG
nausea and increased emesis
no fetus present on ultrasound
scant or profuse dark brown or red vaginal bleeding

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7
Q

why is gestational trophoblastic disease dangerous?

A

the mass can become cancerous

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8
Q

What is a placenta abruption or abruptio placenta?

A

Premature separation of placenta from uterus, can be partial or complete

occurs after 20 weeks, usually 3rd trimester

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9
Q

signs of placental abruption

A

Tenderness, painful bleeding, abdominal pain

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10
Q

why is placental abruption dangerous?

A

can cause anemia, hemorrhage, clotting complications: disseminated intravascular coagulopathy

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11
Q

what is placental previa?

A

cervical os is covered by placenta

can be complete, partial, marginal

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12
Q

sign of placenta previa

A

painless bleeding

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13
Q

why is placenta previa dangerous?

A

Can cause death by hemorrhage, fetal anemia, and preterm birth

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14
Q

why is ectopic pregnancy dangerous?

A

fallopian tube rupture can cause fatal hemorrhage

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15
Q

What is a vasa previa?

A

fetal umbilical vessels implant into the fetal membranes rather than the placenta and lie over the cervix

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16
Q

why is vasa previa dangerous?

A

vessels are at risk of rupturing which can cause the fetus to bleed out

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17
Q

Disseminated intravascular coagulation

A

activation of coagulation throughout the mother’s body

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18
Q

Signs of hypovolemic shock

A

Low BP
Tachycardia
Tachypnea
Confusion
Decreased urine output – 30 mL per hour
Palor
Diaphoresis - sweating

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19
Q

endometrial phases

A

Menstruation - day 1-7 endometrium sheds
Proliferative - day 7-14 endometrium grows
Secretory - day 15-28 corpus luteum secretes hormones to stimulate more development of stratum functionalis

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20
Q

Ovarian phases

A

Follicular phase occurs day 1-14, during which the follicle grows
Ovulation occurs around day 14
Luteal phase occurs day 15-28

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21
Q

when are hormones highest and lowest?

A

Decline in progesterone before menstruation - restricts blood flow and endometrium sloughs off

Estrogens secreted by maturing ovarian follicles cause endometrium to grow during proliferative phase

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22
Q

What is the graafian follicle?

A

Most mature follicle at time of ovulation

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23
Q

When and where are FSH and LH released?

A

released from anterior pituitary
FSH released during first week of menstrual cycle to help mature the ovarian follicle
LH released day before ovulation to finalize maturity

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24
Q

What purpose does the corpus luteum serve in pregnancy?

A

Releases progesterone, estrogen, and inhibin to stimulate growth of stratum functionalis

inhibiin prevents maturation of another follicle since it’s not needed

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25
Q

When does ovulation occur in relation to menses?

A

12 to 14 days before menses

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26
Q

how long does the ovum last?

A

12-24 hours

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27
Q

what is cervical mucus like during ovulation?

A

watery and slippery

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28
Q

what is cervical mucus like when not fertile?

A

thick

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29
Q

meiosis vs mitosis

A

Meiosis uses 2 rounds of division to produce 4 haploid cells that are gametes for sexual reproduction

Mitosis divides a cell into two identical daughter cells with a full set of chromosomes for body cells

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30
Q

What are the 3 stages of prenatal development?

A

germinal - week 1-2
embryonic - week 3-8
fetal - week 9-birth

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31
Q

What is the morula and Blastocyst?

A

The morula is a cluster of 16 cells that develops from a fertilized egg, usually on day 4
A blastocyst is a collection of 32 or more cells on day 5

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32
Q

When does implantation occur?

A

day 7, blastocyst sheds zona pellucida

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33
Q

What are the germ cell layers and what do they form?

A

Ectoderm - skin and nervous system
Mesoderm - bones, muscles, cardiovascular system, connective tissue
Endoderm - gut and lungs

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34
Q

What is the purpose/function of the placenta?

A

acts as liver and lungs for the fetus

nutrients, oxygen exchange, remove waste from blood

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35
Q

What hormones does the placenta produce?

A

hCG, lactogen, progesterone, estrogen

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36
Q

ductus venosus

A

shunts blood away from liver
continuation of the umbilical vein, allowing a large part of the oxygenated blood from the placenta to join the supradiaphragmatic inferior vena cava

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37
Q

ductus arteriosus

A

shunts blood away from lungs
permits the transfer of the blood from the pulmonary artery to the aorta

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38
Q

foramen ovale

A

allows the transfer of the blood from the right to the left atrium

bypasses need for blood to go through pulmonary arteries and veins to go between the atria

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39
Q

How many cord vessels are there and what do they do?

A

There are 2 small arteries that carry deoxygenated blood to the placenta.

They leave CO2 in the placenta and pick up oxygen.

One large vein carries oxygenated blood from the placenta back to the fetal heart.

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40
Q

What is wharton’s jelly?

A

goo that protects the umbilical cord

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41
Q

Presumptive symptoms of pregnancy

A

amenorrhea
nausea
tender breasts

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42
Q

Probable signs of pregnancy

A

Braxton Hicks contractions
­Positive pregnancy test
­Softening of the cervix (Goodell’s sign)
­Bluish discoloration of the female genitalia (Chadwick’s sign)

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43
Q

Positive signs of pregnancy

A

Fetal heartbeat obtained
­Fetus visualized on ultrasound

44
Q

calculating due date

A

date of last menses minus 3 months plus 7 days

45
Q

what can high hCG indicate?

A

multifetal pregnancy
ectopic pregnancy
molar pregnancy
genetic abnormalities

46
Q

what does low hCG indicate?

A

miscarriage
ectopic pregnancy
pregnancy past 100 days

47
Q

What are the physiological changes a pregnant client may experience?

A

Cardiac output increases 30-50%
blood volume increases 30-45%
Heart rate increases 10-15 BPM by 32 weeks

48
Q

when is the fundal height at the level of the umbilicus?

A

20 weeks

49
Q

what are signs that mom should call the provider?

A

any bleeding
fetal movements stop
cramping
gush or trickle of fluid

50
Q

How often does a pregnant woman get an ultrasound?

A

twice: 11-14 weeks and 18 weeks

51
Q

What is a quad marker screen?

A

maternal blood test at 15-18 weeks

Down syndrome indicated by Low AFP, low estradiol, high hCG and high inhibin A

neural tube defects indicated by high AFP

52
Q

What is a MSAFP screen?

A

maternal alpha‐fetoprotein

done to detect neural tube defects

if findings suggest neural tube defects, refer for quad marker screening

53
Q

amniocentesis

A

happens at 15-20 weeks
transabdominal needle to collect amniotic fluid for neural tube or chromosomal disorders
concurrent ultrasound

54
Q

chorionic villus sampling

A

10-12 weeks
Needle goes in through cervix
Simultaneous ultrasound to visualize needle
first trimester alternative to amniocentesis

55
Q

percutaneous umbilical blood sampling

A

Sample of umbilical cord blood taken with needle after 16 weeks
transabdominal needle insertion like with amniocentesis
fetal blood type, CBC count, keryotyping, blood gases

56
Q

Non stress test

A

Fetal heart tones should accelerate twice in 20 minutes.
Accelerations should be 15 beats above baseline and last for 15 seconds.
Mom presses button when she feels movement so nurse can compare movement with FHR

57
Q

what does nonreactive stress test indicate?

A

baby is not getting enough oxygen

58
Q

biophysical profile

A

Reactive NST = 2 points
Pocket of amniotic fluid at least 2 cm = 2 points
Baby has breathing movements for at least 30 seconds= 2 points
Baby has 3 limb extensions, return to flexion in 30 minutes = 2 points
Baby has 1 episode of extension and quick return to flexion = 2 points

59
Q

what can happen if mom unknowingly has high blood sugar?

A

Stillbirth
congenital anomalies of CNS, heart, skeleton
Macrosomia - high body weight at birth 9lb 15oz

60
Q

what should mom’s blood sugar be before conception

A

6.1% or lower

61
Q

when does gestational diabetes develop?

A

24-28 weeks

62
Q

What is the difference between Type 1 diabetes and GDM?

A

In type 1 diabetes, the body does not produce enough insulin, while in GDM the body has insulin resistance

63
Q

what is the risk to the mother with high glucose in pregnancy?

A

hemorrhage

64
Q

what is blood pressure goal for mother with chronic hypertension?

A

140-150 systolic
90-100 diastolic

65
Q

blood pressure meds used in pregnancy

A

methyldopa, labetalol, and nifedipine

66
Q

diagnostic criteria for preeclampsia

A

BP 140/90 on two occasions at least 4 hours apart
Has proteinuria

67
Q

features of preeclampsia

A

Has hypertension - Systolic 160 or diastolic 110
Platelet count <100,000
Serum creatinine >1.1 mg/dL
Elevated liver enzymes
Pulmonary edema
New-onset visual or cerebral symptoms

68
Q

preeclampsia dangers to mother

A

stroke
renal damage
heart disease due to high blood pressure

69
Q

Eclamptic seizure warning signs

A

Headache
blurred vission or temporary blindness
Epigastric pain

70
Q

What does the HELLP acronym stand for?

A

Hemolysis
Elevated Liver enzymes
Low Platelets

71
Q

What is Cervical insufficiency?

A

Premature cervical dilation

72
Q

signs and symptoms of cervical insufficiency?

A

Pink discharge or bleeding
Urge to push or pelvic pressure
Rupture of membranes

73
Q

treatment for cervical insufficiency

A

Prophylactic cervical cerclage to prevent premature dilation, removed at 36 weeks or when spontaneous labor occurs
Bed rest
Avoid intercourse

74
Q

Premature rupture of membranes

A

bag of waters breaking before labor begins in women beyond 37 weeks’ gestation

75
Q

preterm premature rupture of membranes

A

bag of waters breaking before labor begins in women less than 37 weeks’ gestation

76
Q

what complications can come from hyperemesis gravidarum?

A

weight loss
malnutrition
dehydration
ketonuria
electrolyte imbalances

77
Q

risk factors for hyperemesis gravidarum

A

gestational trophoblastic disease
multiple pregnancy
hyperthyroidism
prior GI disease
depression and anxiety

78
Q

gestational hypertension

A

140 or 90 after 20 weeks of pregnancy

no proteinuria or organ dysfunction (this would be preeclampsia)

79
Q

what can cause preeclampsia?

A

disruptions in placental perfusion

poor perfusion due to vasospasm

80
Q

how common is preeclamspia?

A

3-5% of pregnancies

81
Q

oligohydramnosis

A

decreased amniotic fluid

82
Q

what medications can decrease risk of preeclampsia

A

aspirin and calcium supplementation

83
Q

what is the antidote for magnesium sulfate toxicity?

A

calcium gluconate

84
Q

signs of magnesium toxicity

A

Respiratory depression
Absent reflexes
Lethargy
Slurred speech
Loss of consciousness

85
Q

how common is gestational diabetes?

A

6%

86
Q

risks associated with gestational diabetes

A

macrosomia
organomegaly - large organs
polyhydramnios = too much amniotic fluid
perineal trauma or trauma to fetus
neonatal respiratory problems
neonatal metabolic problems

87
Q

risks of IUGR

A

hypoglycemia
problems with thermoregulation
respiratory distress
stillbirth

88
Q

polyhydramnios vs oligohydramnios numbers

A

20-25 cm is polyhydramnios
<5cm is oligohydramnios

89
Q

Intrahepatic cholestasis

A

impaired bile flow from liver

itching, clay stools, fatigue

delivery induced at 36 - 37

90
Q

when is RhoGAM administered?

A

28 weeks and 72 hours after birth

91
Q

how common is iron deficiency anemia in pregnancy?

A

16-29% of pregnancies

92
Q

diagnostic hemoglobin level for anemia in pregnancy

A

10.5 g/dL

93
Q

when do majority of miscarriages occur?

A

5-8 weeks

94
Q

risk of GBS in neonate

A

pneumonia
respiratory distress
sepsis
meningitis

95
Q

when is mom tested for GBS

A

34 weeks

96
Q

Risk of HSV in pregnancy

A

miscarriage
preterm labor
intrauterine growth restriction

97
Q

how does HSV present in neonate?

A

irritability
difficulty breathing
blisters
jaundice
bleeding

98
Q

risks of rubella in pregnancy

A

miscarriage, congenital anomalies, death

99
Q

how does congenital rubella present in neonate?

A

cataracts
congenital heart disease
hearing impairment
developmental delay

100
Q

how does congenital toxoplasmosis present in neonate?

A

jaundice
hepatosplenomegaly
myocarditis
hydrocephalus or microcephaly
seizures

101
Q

how does cytomegalovirus present in neonate?

A

Hearing loss
Small size, including small head size
hepatosplenomegaly
jaundice
Small broken blood vessels under the skin
Eye problems

102
Q

chlamydia risk to neonate

A

eye and lung infections
preterm labor
premature rupture of membranes
low birth weight

103
Q

risk of gonorrhea in pregnancy

A

miscarriage
premature birth and low birth weight
premature rupture of membranes
eye infections in neonate

104
Q

congenital syphilis

A

premature births, stillbirths, death shortly after birth
problems with brain, eyes, ears, heart, skin, teeth, and bones

105
Q

trichomoniasis in pregnancy

A

premature rupture of membranes
preterm birth
low birth weight infants

PRNU 129 (4 decks)

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