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N201 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Ectopic Rupture

A

Medical Emergency

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2
Q

Intense Pelvic and Lower Abd Pain
50% report shoulder pain
Leads to shock (Drop in BP, Spike in HR)

A

Ectopic Rupture

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3
Q

Dx Studies: Ectopic Pregnancy

A

Bimanual Exam
Serial B-hCG Levels (Slower rise than norm preg)
Transvaginal Ultrasound= Best Dx Tool
H&H
Culdocentesis
Laparoscopy (may also treat)

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4
Q

Most common site of Ectopic Pregnancy

A

Fallopian Tube

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5
Q

Implantation at any site other than endometrium

A

Ectopic Pregnancy

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6
Q

Risk Factors for Ectopic Pregnancy

A 
Endometriosis 
PID (Pelvic Inflammatory Disease = key)
Previous Ectopic (10% More likely)
Increased Progesterone 
Assisted Reproduction 
Tube  Abnormality (Sx, Birth, Sterilization)
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7
Q

Molar Pregnancy
46 Paternal Chromosomes
No Embryo
No Fetal Tissue

A

Complete Molar Pregnancy

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8
Q

2 Tx of Ectopic Pregnancy

A

Laparoscopy

Methrotrexate (Chemo–>destroys preg)

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9
Q

S/S Choriocarcinoma

A

Bloody, Brown Discharge

Elevated hCG

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10
Q

CA arose in placenta during pregnancy
Rare
Can Metastasize

A

Choriocarcinoma

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11
Q

Percentage of Females with molar pregnancy that develop Choriocarcinoma

A

20%

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12
Q

Important Teaching For Molar Pregnancy

A

STRESS: F/U hCG (Weekly then Monthly)
NO Pregnancy for at least 6 mo (Can Hide S/S)
Provide Support

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13
Q

Cure Rate for Choriocarcinoma

A

100% IF still in uterus w/ normal Subsequent Pregnancy

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14
Q

Termination of Pregnancy before viability

before 20 weeks

A

Abortion

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15
Q

Medical Termination of Pregnancy

A

Induced Abortion (Elective/ Therapeutic)

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16
Q

Miscarriage

A

Spontaneous Abortion

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17
Q

Roe v Wade 1973

A

Any woman may have an abortion within the first 12 wks of pregnancy

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18
Q

Abortion @>20 weeks of gestation

A

Illegal unless to save the life of mom

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19
Q

Abortion Method (12-20 weeks) 2nd Trimester

A

D&E (suction and evacuation)

Mifepristone w/ misopristol

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20
Q

80% of Spontaneous Abortions Occur w/in

A

The First Trimester

Before mom knows she is pregnancy–think heavy menses

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21
Q

Responsible for 50% of early spontaneous abortions

A

Fetal Chromosomal Abnormalities

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22
Q

Responsible for Late Spontaneous Abortion

A

weak cervix or maternal illness

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23
Q

Greatest Risk Factor for Spontaneous Abortion

A

AMA

> 35 years old

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24
Q

10% of birth defects are caused by

A

medications (OTC, Herbal, Street)

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25
Q

60% of woman use at least…

A

One Rx in pregnancy

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26
Q

FDA Maternal Medication Use

Category A

A

failed to show fetal risk - best choice

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27
Q

FDA Maternal Medication Use

Category B

A

animal studies failed to show fetal risk

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28
Q

FDA Maternal Medication Use

Category C

A

animal studies

show fetal risk

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29
Q

FDA Maternal Medication Use

Category D

A

evidence of human fetal risk

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30
Q

FDA Maternal Medication Use

Category X

A

studies have shown fetal abnormalities

DO NOT USE

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31
Q

Preferred Anticoagulant

A

Heparin

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32
Q

Leading cause of mental retardation

A

Alcohol During Pregnancy

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33
Q

Most Common teratogen

A

Alcohol During Pregnancy

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34
Q

Accutane

A

increase risk of spontaneous abortion & congenital deformity

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35
Q

Anticonvulsants-Valproic Acid, Carbamezapine

A

Increase risk of cognitive abnormality, neural tube defects, cleft pallet, and IUGR

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36
Q

Inhibits prostanglandin synthesis –> premature ductus arteriosis constriction

A

Salycilates (NSAIDS, ibuprofen, aspirin, motrin, advil)

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37
Q

List Salycilates

A 
NSAIDS
ibuprofen
aspirin
Motrin
Advil
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38
Q

Salycilates Asc Pregnancy

A

Do NOT use in late pregnancy >20 wks
Increases Birth Defects
Prolonged/ Inhib Labor

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39
Q

Premature Ductus Arteriosis Constriction

A

Allows fetal circulation to bypass lungs

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40
Q

Tetracycline

A

–>yellow teeth & depresses skeleton growth

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41
Q

ACE Inhibitors

A

Risk birth defects
IUGR
Fetal Death

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42
Q

Warafin

A

Risk of spontaneous abortion
Fetal demise
Fetal & NB Hemorrhage
CNS defects

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43
Q

Contraindicated Vaccines

A 
Measles
Mumps
Rubella
Varicella
Activated (Nasal) Flu
44
Q

Pregnant Nurses

A

Discuss w/ MD & inform work
Use universal precautions
Leave during X-rays

45
Q

Pregnant Nurses use caution with patient assignments including:

A

Radioactive implants
Nuclear procedures
(Dx using radionucleides, antineoplastics, chemicals, anesthetic gases, sterilizing agents)

46
Q

Caffeine

A

Increases risk of spontaneous abortion

47
Q

Safe Amt of Caffeine

A

300mg daily

3 average sized cups of coffee

48
Q

5A’s

A 
Ask - About
Advise- to quit smoking
Assess- willingness to quit
Assist- to quit
Arrange- for follow up care
* majority resume smoking w/in 1+ yo after birth
49
Q

Smoking

A

significant modifiable cause of poor pregnant outcomes
d/t hypoxemia & chemicals
Nicotine–> decreased uterine blood flow

50
Q

Smoking increases the risk of

A 
Low-birth wt & IUGR
Preterm delivery
Fetal death
SIDS
Asthma
Childhood CA
Learning disabilities 
Infant ear & respiratory infections
51
Q

Alcohol stopped mid pregnancy–>

A

inhibits protein synthesis

alters embryonic organization of cells - can not be fixed

52
Q

Alcohol increases the risk of

A

miscarriage, stillbirth,and death

53
Q

Congenital anomalies of eyes d/t alcohol

A 
Palpebral fissures (sm eye opening)
Strabismus (crosses)
Ptosis (saggy)
Myopia
Widest
54
Q

Congenital anomalies of nose d/t alcohol

A

Shortened, upturned, broad bridge

55
Q

Congenital anomalies of mouth d/t alcohol

A

Mircognathia
Smooth philtrum
sm chin/ smooth upper lip

56
Q

Midface of Fetal Alcohol Baby

A

Flattened

57
Q

Cardiac defects (alcohol)

A

murmurs
atrial-septal defects
ventricular septal defects

58
Q

FELOP

A 
FSH
Estrogen
LH (Surge)
Ovulation 
Progesterone
*menstrual cycle order*
59
Q

3 phases of Ovarian Cycle

A

Follicular Phase
Ovulatory Phase
Luteal Phase

60
Q

Variable Phase of Ovarian Cycle

A

Follicular Phase

Days 1-14

61
Q

Primary follicles=Immature, FSH –> growth into oocyte

Graafian follicle= small ovum, secrets EST

A

Follicular Phase of Ovarian Cycle

62
Q

Days 15-28 of Ovarian Cycle

Fixed Time Frame

A

Luteal Phase

63
Q

Upsurge of LH–>Ovulation
-Follicle ruptures, ovum free –>travels to Fallopian tube
Corpus luteum develops – remain follicle fills w/ fluid high in PRO

A

Luteal Phase

64
Q

Fertilized Ovum –>

A

egg secrets HCG–> maintains Corpus Luteum (secretes PRO–>maintains pregnancy)

65
Q

Ovum not fertilized–>

A

corpus luteum regresses–> Follicle atresia

66
Q

Hormone that controls secondary female sex characteristics

A

Estrogen

67
Q

Tattle tales w/ sense of justice

A

7 yo

68
Q

Keep promises

A

7 yo

69
Q

Will cheat to win

A

6 yo

70
Q

Most important socializing agent is the peer group

A

6-12 yo

71
Q

Marijuana –>

A

LBW
IUGR
Preterm Birth
Behavior Problems

72
Q

Methamphetamine

A

SIDS
IUGR
Reduced brain growth
Development effects

73
Q

Amniocentesis

A 
14-16wk gestation 
High risk pregnancy
US->local pocket of amniotic fluid
15-20 mL amniotic fluid aspirated, result in 2 wks
<1% risk
74
Q

Post Amniocentesis

A

Monitor FHR
RhoGam in Rh-
Minimal activity 24h –>decrease uterine irritability

75
Q

Begins when estrogen levels peak & ends with the release of the oocyte

A

Ovulatory phase

76
Q

3 phases of endometrial cycle

A

Proliferative
Secretory
Menstrual

77
Q

Implantation

A

7-10d after fertilization

Depends on vascular changes of endometrium

78
Q

genotype

A

persons genetic makeup

79
Q

genome

A

organisms complete set of DNA

80
Q

Key S/S of SBS (Shaken Baby Syndrome)

A 
Subdural Hemorrhages (80%)
Retinal Hemorrhage (50-100%)
81
Q

Most likely perpetrator in SBS

A

Father (44%)

Mother’s BF (23%)

82
Q

Least likely perpetrator in SBS

A

Mother is least likely

83
Q

Highest form of Child Maltreatment

A

Neglect (63%) of Child Abuse Cases

84
Q

Key in Child Maltreatment/ Abuse Cases

A

GOOD DOCUMENTATION

85
Q

A report of child abuse is made…

A

q 10 secs

86
Q

of children that die q day in the US from child abuse

A

5+

US= WORST industrialized nation

87
Q

% of abused & neglected children that abuse their own children

A

30% of abused and neglected children later abuse their own children

88
Q

Characteristics of Abusive Parents

A 
Majority were abused 
Difficulty coping 
Younger 
Drug, Alcohol, and decreased support network
Lack of education
89
Q

Emotional/ Verbal Abuse Froms

A 
belittling 
favoritism 
Corrupting 
Over-pressuring 
Isolation
Ignoring
90
Q

Deliberate attempt to destroy/ impair a child’s self-esteem or competence

A

Emotional/ verbal abuse

91
Q

S/S of SBS (ICP)

A 
Sleepy 
Irritable
Vomiting = RED FLAG
Respiratory Compromise 
Coma/ Death (Not Imminent)
92
Q

Health Risk of Childhood Obesity

A 
Cardiovascular 
Hyerinsulineamia 
Type II DM
CA
Sleep Apnea
Orthopedic Problems 
Adult Obesity
Social Discrimination
93
Q

BMI

A

WT/HT

(LBS/IN)*703

94
Q

Normal %tile range for wt

A

5-85

95
Q

5-2-1-almost none

A

5 fruits/ veggies
2 hours screen time
1 hour of activity
Almost no soda etc

96
Q

Tx Threatened Abortion

A 
Limit Activity (1st 12-24h)
No stress, sex, or fatigue
Be honest (may/ may not loose baby)
97
Q

S/S of Threatened Abortion

A

Cervix = Closed
Days of unexplained bleeding/ cramping
Risk of Expulsion

98
Q

Complications of Elective Abortions

A 
Hemorrhage
Infection 
Uterine Perforation 
Cervical Laceration 
Retained products of conception
99
Q

Immunological reactions against the sperm that causes a decreases in sperm motility

A

Sperm Antibodies

mainly w/ vasectomy reversal/ testicular trauma

100
Q

Seaman Analysis

A

Abstains 2-3d before sample(s)

101
Q

Ovarian Reserve Testing

A

day 3 of menses –>serum FSH and estradiol test

FSH>10 IU/l–>specialist

102
Q

BBT

A

Basal Body Testing

+0.4* F x3days = ovulation

103
Q

Detecting LH Surge

A

Surge in LH 36h before ovulation
Tested w/ Urine or Serum
-Ideal time for Sex if want Prego

104
Q

Endometrial Biopsy

A

Outpatient
Assess Response of Uterus to hormonal signals
Performed at end of menses

105
Q

Hysterosalpingogram

A

Radiological exam w/ dye

Info about endocervical canal, uterine cavity, and tubes

106
Q

Myomectomy

A

Sx removal of uterine fibroids

N201 (21 decks)

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