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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
When does ovulation occur in relation to menses?
12 to 14 days before menses
26
how long does the ovum last?
12-24 hours
27
what is cervical mucus like during ovulation?
watery and slippery
28
what is cervical mucus like when not fertile?
thick
29
meiosis vs mitosis
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
30
What are the 3 stages of prenatal development?
germinal - week 1-2 embryonic - week 3-8 fetal - week 9-birth
31
What is the morula and Blastocyst?
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
32
When does implantation occur?
day 7, blastocyst sheds zona pellucida
33
What are the germ cell layers and what do they form?
Ectoderm - skin and nervous system Mesoderm - bones, muscles, cardiovascular system, connective tissue Endoderm - gut and lungs
34
What is the purpose/function of the placenta?
acts as liver and lungs for the fetus nutrients, oxygen exchange, remove waste from blood
35
What hormones does the placenta produce?
hCG, lactogen, progesterone, estrogen
36
ductus venosus
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
37
ductus arteriosus
shunts blood away from lungs permits the transfer of the blood from the pulmonary artery to the aorta
38
foramen ovale
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
39
How many cord vessels are there and what do they do?
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.
40
What is wharton’s jelly?
goo that protects the umbilical cord
41
Presumptive symptoms of pregnancy
amenorrhea nausea tender breasts
42
Probable signs of pregnancy
Braxton Hicks contractions ­Positive pregnancy test ­Softening of the cervix (Goodell’s sign) ­Bluish discoloration of the female genitalia (Chadwick’s sign)
43
Positive signs of pregnancy
Fetal heartbeat obtained ­Fetus visualized on ultrasound
44
calculating due date
date of last menses minus 3 months plus 7 days
45
what can high hCG indicate?
multifetal pregnancy ectopic pregnancy molar pregnancy genetic abnormalities
46
what does low hCG indicate?
miscarriage ectopic pregnancy pregnancy past 100 days
47
What are the physiological changes a pregnant client may experience?
Cardiac output increases 30-50% blood volume increases 30-45% Heart rate increases 10-15 BPM by 32 weeks
48
when is the fundal height at the level of the umbilicus?
20 weeks
49
what are signs that mom should call the provider?
any bleeding fetal movements stop cramping gush or trickle of fluid
50
How often does a pregnant woman get an ultrasound?
twice: 11-14 weeks and 18 weeks
51
What is a quad marker screen?
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
What is a MSAFP screen?
maternal alpha‐fetoprotein done to detect neural tube defects if findings suggest neural tube defects, refer for quad marker screening
53
amniocentesis
happens at 15-20 weeks transabdominal needle to collect amniotic fluid for neural tube or chromosomal disorders concurrent ultrasound
54
chorionic villus sampling
10-12 weeks Needle goes in through cervix Simultaneous ultrasound to visualize needle first trimester alternative to amniocentesis
55
percutaneous umbilical blood sampling
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
Non stress test
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
what does nonreactive stress test indicate?
baby is not getting enough oxygen
58
biophysical profile
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
what can happen if mom unknowingly has high blood sugar?
Stillbirth congenital anomalies of CNS, heart, skeleton Macrosomia - high body weight at birth 9lb 15oz
60
what should mom's blood sugar be before conception
6.1% or lower
61
when does gestational diabetes develop?
24-28 weeks
62
What is the difference between Type 1 diabetes and GDM?
In type 1 diabetes, the body does not produce enough insulin, while in GDM the body has insulin resistance
63
what is the risk to the mother with high glucose in pregnancy?
hemorrhage
64
what is blood pressure goal for mother with chronic hypertension?
140-150 systolic 90-100 diastolic
65
blood pressure meds used in pregnancy
methyldopa, labetalol, and nifedipine
66
diagnostic criteria for preeclampsia
BP 140/90 on two occasions at least 4 hours apart Has proteinuria
67
features of preeclampsia
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
preeclampsia dangers to mother
stroke renal damage heart disease due to high blood pressure
69
Eclamptic seizure warning signs
Headache blurred vission or temporary blindness Epigastric pain
70
What does the HELLP acronym stand for?
Hemolysis Elevated Liver enzymes Low Platelets
71
What is Cervical insufficiency?
Premature cervical dilation
72
signs and symptoms of cervical insufficiency?
Pink discharge or bleeding Urge to push or pelvic pressure Rupture of membranes
73
treatment for cervical insufficiency
Prophylactic cervical cerclage to prevent premature dilation, removed at 36 weeks or when spontaneous labor occurs Bed rest Avoid intercourse
74
Premature rupture of membranes
bag of waters breaking before labor begins in women beyond 37 weeks’ gestation
75
preterm premature rupture of membranes
bag of waters breaking before labor begins in women less than 37 weeks’ gestation
76
what complications can come from hyperemesis gravidarum?
weight loss malnutrition dehydration ketonuria electrolyte imbalances
77
risk factors for hyperemesis gravidarum
gestational trophoblastic disease multiple pregnancy hyperthyroidism prior GI disease depression and anxiety
78
gestational hypertension
140 or 90 after 20 weeks of pregnancy no proteinuria or organ dysfunction (this would be preeclampsia)
79
what can cause preeclampsia?
disruptions in placental perfusion poor perfusion due to vasospasm
80
how common is preeclamspia?
3-5% of pregnancies
81
oligohydramnosis
decreased amniotic fluid
82
what medications can decrease risk of preeclampsia
aspirin and calcium supplementation
83
what is the antidote for magnesium sulfate toxicity?
calcium gluconate
84
signs of magnesium toxicity
Respiratory depression Absent reflexes Lethargy Slurred speech Loss of consciousness
85
how common is gestational diabetes?
6%
86
risks associated with gestational diabetes
macrosomia organomegaly - large organs polyhydramnios = too much amniotic fluid perineal trauma or trauma to fetus neonatal respiratory problems neonatal metabolic problems
87
risks of IUGR
hypoglycemia problems with thermoregulation respiratory distress stillbirth
88
polyhydramnios vs oligohydramnios numbers
20-25 cm is polyhydramnios <5cm is oligohydramnios
89
Intrahepatic cholestasis
impaired bile flow from liver itching, clay stools, fatigue delivery induced at 36 - 37
90
when is RhoGAM administered?
28 weeks and 72 hours after birth
91
how common is iron deficiency anemia in pregnancy?
16-29% of pregnancies
92
diagnostic hemoglobin level for anemia in pregnancy
10.5 g/dL
93
when do majority of miscarriages occur?
5-8 weeks
94
risk of GBS in neonate
pneumonia respiratory distress sepsis meningitis
95
when is mom tested for GBS
34 weeks
96
Risk of HSV in pregnancy
miscarriage preterm labor intrauterine growth restriction
97
how does HSV present in neonate?
irritability difficulty breathing blisters jaundice bleeding
98
risks of rubella in pregnancy
miscarriage, congenital anomalies, death
99
how does congenital rubella present in neonate?
cataracts congenital heart disease hearing impairment developmental delay
100
how does congenital toxoplasmosis present in neonate?
jaundice hepatosplenomegaly myocarditis hydrocephalus or microcephaly seizures
101
how does cytomegalovirus present in neonate?
Hearing loss Small size, including small head size hepatosplenomegaly jaundice Small broken blood vessels under the skin Eye problems
102
chlamydia risk to neonate
eye and lung infections preterm labor premature rupture of membranes low birth weight
103
risk of gonorrhea in pregnancy
miscarriage premature birth and low birth weight premature rupture of membranes eye infections in neonate
104
congenital syphilis
premature births, stillbirths, death shortly after birth problems with brain, eyes, ears, heart, skin, teeth, and bones
105
trichomoniasis in pregnancy
premature rupture of membranes preterm birth low birth weight infants

PRNU 129 (4 decks)

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