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N380 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Fertilization and Implantation

A

Fertilization occurs in the outer third of the fallopian tube
Implantation occurs 6-10 days after conception
Trophoblast sends chorionic villi into the endometrium for nutrients.
Becomes a fetus at day 15

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2
Q

Umbilical Cord

A

Two arteries take blood away from fetus and one vein returns it
Wharton’s jelly surrounds the blood vessels preventing compression

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3
Q

Nuchal cord

A

when the cord is wrapped around the fetus’ neck

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4
Q

Placenta

A

In place by day 17 when the heart starts beating
Placenta allows metabolic exchange
Placenta produces HCG (human chorionic gonadotropin), HPL (human placental lactogen, estrogen, and progesterone
Also provides respiration, nutrition, excretion, and storage of nutrients

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5
Q

Amniotic fluid

A

Surrounds the baby and allows weightlessness
First trimester most fluid comes from the mother
Second trimester the fetus starts contributing
helps maintain fetal body temperature, is a source of oral fluid and repository for waste, helps maintain electrolyte balance, cushions fetus from impact

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6
Q

First part of fetal development

A

Spine and heart develop first
New organs are developed during the first eight weeks
fetus is most at risk from teratogens during this time period

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7
Q

Fetal Circulation

A

Foramen Ovale is open between the atria
Ductus Arteriosus is open between the pulmonary artery and the aorta
Ductus Venous bypasses the liver

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8
Q

Ultrasounds

A

Early ultrasounds help to confirm pregnancy and determine molar vs regular
Later ultrasounds check for the correct development of anatomy

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9
Q

L/S ratio

A

Lecithin is a very important surfactant, its levels in comparison to sphingomyelin (which remains at constant levels) should be 2:1 before birth

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10
Q

Respiratory development

A

Development begins in week 4 and continues through week 32
Betamethazone used to hasten lung development in premature birth

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11
Q

Mono vs dizygotic twins

A

Mono is one egg that splits into two fetus
Dizygotic are two eggs that become two fetus

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12
Q

Lightening

A

When the fetus moves further down towards the birth canal
Can actually feel heavier

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13
Q

Quickening

A

The first movement detected by the mother

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14
Q

Presumptive signs of pregnancy

A

amenorrhea, fatigue, enlarged/sore breasts, increased urination, perceived movement, emesis/nausea

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15
Q

Probable signs of pregnancy

A

Positive Pregnancy test, ballottement (feeling for the fetus), braxton Hicks contractions, Goodell’s sign, Chadwick’s Sign, Hegar’s Sign

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16
Q

Positive signs of pregnancy

A

movement felt by doctor or nurse, heart beat detected, ultrasound, delivery of the baby

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17
Q

Braxton Hicks contractions

A

false contractions before labor

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18
Q

Goodell’s sign

A

softening of the cervix

19
Q

Chadwick’s sign

A

bluish color of the vulva and cervix

20
Q

Hegar’s sign

A

lower uterus/cervical isthmus is soft

21
Q

Naegel’s rule

A

Technically you subtract three months, add seven days, then add one year
But fr you should just add nine months and seven days

22
Q

Initial visit

A

Thorough review of systems, health history, family history, and psychosocial history
Urine, blood, and cervical samples collected
STI testing completed
TB skin test
Urine tested for UTI, protein, glucose, and leukocytes

23
Q

Glucose Tolerance Test

A

Make them drink a very sugary drink and see where their blood sugar lands
Over 200 indicates diabetes
Completed between 24-28 weeks of pregnancy

24
Q

Quad screen

A

Measures AFP (alpha-fetoprotein) - made by the baby, HCG (human chorionic gonadotropin) made by the placenta, estriol made by the placenta and the baby’s liver, and inhibin A made by the placenta
Completed between weeks 15–18 of pregnancy

25
Q

Adolescent pregnancy

A

Stigma
Don’t often follow most prenatal care recommendations
not physically developed enough for pregnancy

26
Q

Pregnancy > 35

A

Greater risks for hypertension and diabetes
Increased chance for miscarriage, stillbirth, placenta previa, and mortality

27
Q

Centering

A

Group care setting for pregnant folks
Group based education and social support provided
Resulted in better outcomes for maternal knowledge and prenatal care

28
Q

Pica

A

Consuming non food substances
Often soil or hair

29
Q

Vitamins

A

B9, folate - reduces risk of neural tube defects, also important in RBC production
B6 - essential for metabolism, production of RBCs, antibodies, and neurotransmitters
B12 - production of nucleic acids, protein, and RBCs, also important to neural function
C - tissue formation and absorption of iron

30
Q

First stage of labor

A

Early phase, dilation from 0 to 5cm, irregular contractions every 5-30 minutes that last 30 seconds a piece, then there are regular contractions 3-5 minutes that last one minute
Active phase: 60-90 second contractions every30 seconds to 2 minutes that last until the cervix is fully dilated

31
Q

Second stage of labor

A

lasts from full dilation of the cervix until the baby is born

32
Q

third stage of labor

A

delivery of the placenta

33
Q

Five P’s of labor

A

Power - primary powers are the involuntary contractions, secondary powers are the woman pushing
Passenger - remember fetal lie, position, and attitude
Passageway - shape of pelvis
Position of the mother - supine, hands and knees, squatting
Psychological response

34
Q

Fetal positions

A

Cephalic - head first, with vertex means the baby’s head is in flexion
mentum/brow - chin or face first
occiput - occipital bone first (posterior facing is best)
Sacral - sacrum or legs first
Shoulder - likely in transverse lie, shoulder is first

35
Q

Leopold’s maneuvers

A

Feel the top
Then the sides
then the bottom
then all over again
Used to determine where the back is so you can know where to put the fetal monitor

36
Q

Pain management contraindications

A

Contraindications: mom doesn’t want it, maternal hemorrhage, maternal hypotension, allergy to anesthetic, some types of cardiac conditions

37
Q

Signs of impending labor

A

bloody show (mucus plug)
rupture of membranes
lower back pain
weight loss
uterine contractions
Increased energy (nesting)
lightening

38
Q

Non-pharmacological pain options

A

Acupressure or acupuncture
TENS unit
Water therapy
Aromatherapy
Music
breathing techniques

39
Q

pharmacological pain options

A

Sedatives - relieve anxiety and allow sleep
Opioids - cross the placenta and can affect the fetus, that’s why fentanyl with its short half life is so good
Spinal anesthesia - puncture and blood patch
combo anesthetic and opioids intrathecally to use less of both
Laughing gas offers less pain control, but is not nearly as sedating

40
Q

accels

A

normal in response to movement

41
Q

decels

A

normal when early (aka matched with contractions)
concerning when late
concerning when variable
intervene with late or variable decels by discontinuing oxytocin, assist with position change, and administer o2

42
Q

variability

A

how much the heart rate changes on average over 10 minutes without counting gigantic variables
absent is undetectable to the naked eye
minimal is 1-5
moderate is 6-25
marked is greater than 25
moderate variability predicts normal acid base balance

43
Q

baseline heartrate

A

fetal heart rate on average over at least two minutes without a contraction

N380 (2 decks)

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