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Exam 3 seinor year Flashcards

1
Q

intentional physical abuse or neglect, emotional abuse or neglect or sexual abuse of children, usually done by adults

A

abuse/child maltreatment

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2
Q

who is at higher risk of death of children

A

younger parents (inadequate knowledge)

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3
Q

failure to provide for kids basic needs

A

neglect

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4
Q

deliberate attempt to destroy or significantly impair a child’s self esteem or competence

A

emotional abuse

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5
Q

deliberate infliction of physical injury on a child, usually by the child’s caregiver

A

physical abuse

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6
Q

inappropriate touching of child’s breast or genitalia

A

sexual abuse

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7
Q

signs and symptoms of child abuse

A

fearful behavior, bed wetting, UTI’s abdominal pain, extreme sexual behavior

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8
Q

characteristics of the typical child abuser

A

male, knows victim, any social level

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9
Q

illness that one person fabricates or induces in another person

A

Munchausen syndrome by proxy

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10
Q

infant can suffer trauma resulting from an intentional or non accidental head injury by caregiver

A

shaken baby syndrome

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11
Q

Signs and symptoms of shaken baby syndrome

A 
increase ICP
decrease LOC
resp compromise
vomiting
seizures
coma
death
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12
Q

when is the babies brain synapses being produced

A

first 3 years

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13
Q

cranio-cerebral patho of infant

A

heads disproportionably larger, weak cervico-spinal muscles, larger subarachnoid spaces

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14
Q

violent shaking of a baby causes

A

soft tissue of the brain to bounce around inside the skull

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15
Q

who is the least likely to be the perpetrator of the child during abuse

A

mother

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16
Q

injuries due to shaken baby syndrome (SBS)

A

increase ICP
retinal hemorrhage and or detachment
skeletal fractures

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17
Q

who is responsible for mandatory reporting of suspected child abuse

A

healthcare professionals, including nurses

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18
Q

when is a child diagnosed with failure to thrive

A

child’s weight for age is below 3rd or 5th percentile or falls more than 2 major percentile lines (ex. 75-25)

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19
Q

organic failure to thrive

A

cardiac, neurological, renal, GI, endocrine

Ex. cleft lip or palate, GERD, celiac, DM, hyperthyroidism

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20
Q

non organic failure to thrive

A

poverty, health beliefs, knowledge deficit, family stress

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21
Q

what are characteristics of failure to thrive

A

growth failure, failure to maintain growth patterns, developmental delays, flattened occiput, apathy, avoid eye contact, poor hygiene, feeding disorders

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22
Q

how do you Tx a child with failure to thrive

A

reverse malnutrition & provide sufficient calories to support “catch up” growth (150%), don’t overstimulate (cause baby to use more calories than needed)

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23
Q

what do you need to obtain during initial assessment

A

growth, diet hx, elimination pattern, medical hx, family hx, social hx (socioeconomic status of family)

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24
Q

overweight

A

85-95 percentile

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25
Q

obese

A

over 95 percentile

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26
Q

health risks due to obesity

A

DM, HTN, sleep apnea, cancer, obesity as adult

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27
Q

what is the #1 cause of obesity

A

inactivity

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28
Q

BMI

A

Ht (inches) 2 (squared)

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29
Q

treatment for obesity

A

exercise
5, 2, 1, almost none
(5 fruits/veggies, 2 hours of TV, 1 hour of activity, almost no sweets/sodas)

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30
Q

goal for obesity

A

maintain and allow for growth (plate method)

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31
Q

puberty

A

transition btwn childhood and sexual maturity

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32
Q

menarche

A

first menstruation

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33
Q

menstruation

A

periodic uterine bleeding
avg blood loss is 20-80 ml
14 days after ovulation

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34
Q

female hormones during menstrual cycle

A 
F-follicle stimulating hormone
E-estrogen
L-leutinizing hormone
O-ovulation
P-progesterone
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35
Q

corpus luteum

A

provides progesterone, helps with gestation of fetus

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36
Q

if the corpus luteum is not fertilized what will happen to it

A

shrink and degenerate (go away)

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37
Q

bleeding occurs when?

A

decrease of estrogen and progesterone

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38
Q

what does the fertilized egg secrets and what does it do

A

HCG, keeps corpus luteum “alive” which produces progesterone that keeps the fetus alive

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39
Q

effects of estrogen

A

endometrial growth, uterine change, liquidity and elasticity of cervical mucus, dilation of cervical os

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40
Q

effects of progesterone

A

relaxation of uterus, ripens uterine lining, prepares uterus for implantation, changes in cervical mucus, breast tissue preparation

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41
Q

what phase is estrogen seen the greatest

A

proliferative phase

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42
Q

what phase is progesterone seen the greatest

A

secretory phase (luteal)

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43
Q

phase 1 is

A

menstrual phase (shedding of endometrium)

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44
Q

phase 2 is

A

proliferative phase (rapid endometrial growth)

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45
Q

phase 3 is

A

luteal phase, increase of progesterone from corpus luteum matures endometrial lining

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46
Q

phase 4 is

A

ischemic phase (if egg is not fertilized, corpus luteum reaches end of life cycle,

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47
Q

unable to achieve conception after one year of unprotected intercourse

A

infertility

less than 6 months is over age of 35

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48
Q

absolute factor preventing reproduction

A

sterility

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49
Q

both partners have reduced fertility

A

subfertility

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50
Q

couple has never had a child

A

primary infertility

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51
Q

couple previously conceived, now unable to conceive

A

secondary infertility

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52
Q

factors that contribute to infertility

A

weight, smoking, stress, chemical exposure, age, reproduction organ issues

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53
Q

uterine fibroids

A

benign growths on uterine wall that interfere with embryonic and fetal development

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54
Q

what is the most common cause of tubal issues

A

PID

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55
Q

what is the most important determinant of infertility

A

age

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56
Q

male factors that are associated with infertility

A

substances, infections, heat exposure, pelvic radiation

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57
Q

varicocele

A

vein in testicle has inadequate valves causing blood to back up, results in poor sperm quality

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58
Q

retrograde ejaculation

A

ejaculate enters bladder instead of exiting penis

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59
Q

when can a sperm analysis be done

A

2-3 days after abstinence, deliver within one hour of collection, maintain body temperature

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60
Q

BBT

A

determines approx. time of ovulation

take temperature before rising our of bed, record for 3-4 months, ovulation temp will increase 0.4- degrees for 3 days

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61
Q

cervical mucus does what during ovulation

A

thins for sperm to be able to move easier

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62
Q

ferning capacity

A

shows lined channels that favor sperm migration (lok like road ways, look like a maze when ovulation is not occurring)

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63
Q

what must the cervical mucus be like for the sperm

A

thin, clear, watery, profuse, alkaline, acelluar

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64
Q

hysterosalpingography

A

checks tubal patency and uterine abnormalities, cause cramps

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65
Q

diagnostic laparascopy

A

general anesthesia, pump CO2 into pelvis for visualization, have post op neck and back pain

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66
Q

what is the first line therapy for females in infertility

A

clomid, simulates follicle growth, take po for 5 days, can have hot flashes, blurred vision, HA

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67
Q

when with polycystic ovarian disease may be given what

A

hypoglycemic, help to induce ovulation

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68
Q

homologous

A

husbands sperm used

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69
Q

heterologous

A

donors sperm used

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70
Q

gamete intra fallopian tube transfer (GIFT)

A

eggs retrieved and placed directly in fallopian tube with sperm before fertilization

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71
Q

IVF

A

women’s egg collected and fertilized in lab then placed in uterus

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72
Q

gene

A

basic unit of heredity

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73
Q

chromosomes

A

total of 46 (1 pair of sex chromosomes, 22 other pairs)

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74
Q

is the sex chromosomes is X and Y then the baby is

A

male

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75
Q

phenotype

A

outward appearance of gene

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76
Q

genotype

A

actual genetic composition

77
Q

genome

A

complete set of genes present

78
Q

homozygous

A

two like genes for a trait

79
Q

heterozygous

A

unlike genes for a trait

80
Q

dominate

A

dominant in their action over others

81
Q

autosomal dominance

A

person with dominant gene for a disease which is Heterozygous

82
Q

autosomal recessive

A

most genetic disorders are inherited as recessive traits

83
Q

X linked dominant

A

some genes for disorders are located on and transmitted only by female sex chromosome

84
Q

X linked recessive

A

female-normal gene also present blocks expression of the disease, only male children will have the disease (mother is carrier, father is normal)

85
Q

chromosomal abnormalities

A

mutation of chromosomes, usually lethal or cause profound disabilities

86
Q

meiosis

A

2 stage reduction, daughter cells, cell division

87
Q

what happens if you have 45 chromosomes or less

A

death

88
Q

a part of the chromosome breaks during cell division causing a normal number of chromosomes plus or minus an extra portion of a chromosome

A

deletion abnormalities

89
Q

child gains an additional chromosome through another route, one or more chromosomes are released or jumped to another one, still have the correct # of chromosomes

A

translocation abnormalities

90
Q

late division error, nondisjunction disorder occurs after fertilization of ovum as the structure begins mitotic division

A

mosaicism

91
Q

consanguineous couple

A

closely related

92
Q

visual presentation of a persons chromosome pattern

A

karyotyping, done by scraping of cells from buccal membrane

93
Q

Barr body

A

determine the sex of a child, scrape cells from buccal cavity, stain, magnify, dye will appear black.

94
Q

chorionic villi sampling

A

retrieve and analyze chorionic villi for chromosome analysis (10-12 weeks gestation)
cant detect neural tube defects

95
Q

amniocentesis

A

15-20 weeks gestation, 15-20 ml of amniotic fluid is aspirated , cant detect neural tube defects

96
Q

percutaneous umbilical blood sampling

A

cordocentesis, direct fetal blood sample from cord

97
Q

fertilization occurs where

A

outer 1/3 of the fallopian tube

98
Q

the highest estrogen production is during ovulation because

A

increases contractibility of FT, helps move ovum, thins cervical mucus, facilitates penetration of sperm

99
Q

what enzyme is used for the sperm penetration of ovum

A

hyaluronidase

100
Q

female pronucleus

A

once the ovum is penetrated the ovum completes maturation

101
Q

when do chromosomal abnormalities happen

A

moment of fertilization

102
Q

when does implantation occur

A

7-10 days after fertilization

103
Q

decidua

A

prevents menstrual sloughing, protects and nourishes embryo, after birth it becomes lochia

104
Q

purpose of amnion

A

protect and support the embryo as it grows and develops, contains amniotic fluid

105
Q

chorion

A

thick outer membrane, has villi on surface until month 4

106
Q

allantois

A

out pouching of yolk sac, forms basis of umbilical cord

107
Q

placenta

A

begins to shrink after 8 months, exchanges nutrients and waste products, functions as lungs

108
Q

umbilical cord has how many arteries and veins

A

2 arteries, one vein

109
Q

name the three primary germ layers

A

ectoderm (outer)
mesoderm (middle)
endoderm (inner)

110
Q

the primary germ layers eventually develop into what

A

all organ systems, organs and tissues

111
Q

pre embryonic stage

A

from zygote to implantation (about 2 weeks)

112
Q

embryonic period

A

15 days-8 weeks, all internal organs begin to form here, most vulnerable period

113
Q

fetal period

A

8-9 weeks to birth, 1st half growth and development, 2nd half weight increases

114
Q

first lunar month

A

1-4 weeks, germ layers develop, arm & leg buds, heart has 2 chambers, brain is visable

115
Q

second lunar month

A

5–8 weeks, all organs present, fetal circulation has begun, largest organ is brain

116
Q

3rd lunar month

A

9-12 weeks, end of 1st trimester, head is 1/3-1/2 of size of entire fetus, eye lids fuse together, FHT are heard with Doppler, kidney secretion by week 10 now responsible for amniotic fluid production, intestines now have bile

117
Q

4th lunar month

A

13-16 weeks, lanugo on head, Quickening, meconium present, sucking motions, swallow (this allows for swallowing of amniotic fluid which causes meconium to form)

118
Q

5th lunar month

A

17-20 weeks, prominent lanugo, sub Q fat, vernix, regular habits (sleep, suck, kick)

119
Q

6th lunar month

A

21-24 weeks, end of 2nd trimester, substantial weight gain, fetal respiratory movements (as breathe take in amniotic fluid into lungs),onsidered viable at the end of lunar month

120
Q

7th lunar month

A

25-28 weeks, surfactant production (allows aveoli opening, crucial part of getting the lungs to inflate, life depends on it), eyelids reopen, testes descend, respiratory and circulatory system sufficiently developed

121
Q

8th lunar month

A

29-32 weeks, mineral storage in bones, can be conditioned to respond to sounds outside of mothers body

122
Q

9th lunar month

A

33-36 weeks, increase of fat deposits, lanugo disappears

123
Q

10th lunar month

A

37-40 weeks, considered full term, fills uterus completely, acquires antibodies from mother

124
Q

Fetal nervous system

A

first to appear last to mature, full brain potential will occur after birth

125
Q

fetal respiratory system is fully developed at

A

age 8

126
Q

fetal urinary system

A

secretions begin at 9 weeks, urine present in bladder 16 weeks, prior not stored at all

127
Q

fetal GI system

A

umbilical hernia until week 10, bowels empty after birth, fetus begins swallowing amniotic fluid @ 4 months

128
Q

fetal musculoskeletal system

A

muscles contract week 7, calcium formation at 9 weeks

129
Q

what is the most common site for ectopic pregnancy

A

fallopian tube, increase of risk with surgeries, and use of intrauterine devices

130
Q

endometriosis

A

uterine tissue outside of uterus

131
Q

symptoms of ectopic pregnancy

A

N/V, breast tenderness, amenorrhea

132
Q

prior to rupture of ectopic pregnancy s/sx

A

abd pain, tenderness, delayed menses, spotting

133
Q

after rupture of ectopic pregnancy s/sx

A

severe pain, referred shoulder pain (phrenic nerve is irritated) shock, faint/dizzy

134
Q

gestational trophoblastic disease

A

trophoblastic cells on outer layer of blastocyte, grow abnormally fast, nonviable pregnancy
under 15, over 45, Asian/Latin American

135
Q

choriocarcinoma

A

cancer found in placenta during pregnancy, bloody brown discharge all the time

136
Q

10th lunar month

A

37-40 weeks, considered full term, fills uterus completely, acquires antibodies from mother

137
Q

Fetal nervous system

A

first to appear last to mature, full brain potential will occur after birth

138
Q

fetal respiratory system is fully developed at

A

age 8

139
Q

fetal urinary system

A

secretions begin at 9 weeks, urine present in bladder 16 weeks, prior not stored at all

140
Q

fetal GI system

A

umbilical hernia until week 10, bowels empty after birth, fetus begins swallowing amniotic fluid @ 4 months

141
Q

fetal musculoskeletal system

A

muscles contract week 7, calcium formation at 9 weeks

142
Q

what is the most common site for ectopic pregnancy

A

fallopian tube, increase of risk with surgeries, and use of intrauterine devices

143
Q

endometriosis

A

uterine tissue outside of uterus

144
Q

symptoms of ectopic pregnancy

A

N/V, breast tenderness, amenorrhea

145
Q

prior to rupture of ectopic pregnancy s/sx

A

abd pain, tenderness, delayed menses, spotting

146
Q

oral hypoglycemic

A

cause facial deformities, be alert for newborn hypoglycemia

147
Q

gestational trophoblastic disease

A

trophoblastic cells on outer layer of blastocyte, grow abnormally fast, nonviable pregnancy
under 15, over 45, Asian/latin american

148
Q

why is smoking bad for pregnancy

A

decreases fetal blood flow, decreases O2 to fetus

149
Q

abortion

A

termination of a pregnancy before 20 weeks

150
Q

spontaneous abortion

A

miscarriage, early in pregnancy

151
Q

threatened abortion

A

days of unexplained bleeding/cramping, cervix is closed, risk of expulsion

152
Q

blighted ovum

A

fertilized ovum stops developing in 1st 12 weeks, no gestational sac or fetal heart beat

153
Q

elective abortion

A

prior to 12 weeks gestation any women can get it, from 12-20 weeks state regulated, over 20 weeks is prohibited except to save moms life

154
Q

RU486, methotrexate

A

abortion pills

155
Q

substance that adversely affect the normal fetal growth and development

A

teratogens

156
Q

most birth defects happen bc of what

A

exposure happens before know they are pregnant

157
Q

accutane

A

increase risk of spontaneous abortion and congenital anomalies

158
Q

mycins

A

odotoxic, have damage to inner ear

159
Q

oral hypoglycemics

A

cause facial deformities, be alert for newborn hypoglycemia

160
Q

how much caffeine is considered safe

A

300 mg of caffeine is considered safe (3 cups)

161
Q

why is smoking bad for pregancy

A

decreases fetal blood flow, decreases O2 to fetus

162
Q

preterm delivery is at what week

A

26 6/7 weeks

163
Q

what is the most common teratogen and leading cause of intellectual disability

A

alcohol use

164
Q

umbrella term that includes all categories of prenatal alcohol exposure

A

fetal alcohol syndrome

165
Q

facial characteristics of FAS

A

strabismus, ptosis, eyes wide set, short, upturned nose, broad nasal bridge, thin upper lip, smooth phitrum, flattened cheeks

166
Q

neonatal abstinence syndrome

A

set of behaviors that results from fetal exposure to substance abuse in utero

167
Q

the closer to deliver a mom takes the drug the ____ the delay in onset of withdrawal

A

greater, usually within 72 hours

168
Q

do you use narcan on NAS babies

A

No, can cause automatic withdrawal, cause seizures

169
Q

signs of neonatal withdrawal

A

hypertonia, seizures, excess crying, yawning/sneezing than 3 consecutive yawns/sneezes, vomiting, por swallowing, fever, sweating, apnea/tachypnea, rash

170
Q

abstinence scoring system

A

used to objectively measure withdrawal symptoms, done within 2 hours of birth, Q4 hours after that

171
Q

assessment of NAS

A

urine and meconium toxicology screen (on 1st voids only), give higher cal meals

172
Q

mifepristone

A

stops pregnancy that is less than 49 days in duration, stops progesterone, 2 doses

173
Q

birth control

A

contains estrogen and progesterone, stops ovaries from releasing egg

174
Q

depo

A

prevents ovaries from releasing eggs, increases the mucus thickness

175
Q

diaphragm, cervical cap, leas shield

A

barrier method

176
Q

implonon

A

implant into arm, progesterone, increases cervix mucus

177
Q

sterilization (essure, tubal ligation)

A

tubes placed in FT (scar tissue forms)

tubes tied

178
Q

standard days method

A

calendar method, need to abstain btwn 8-19 days

179
Q

symptothermal

A

temperature, abstained 2 days prior and after ovulation

180
Q

lactational amenorrhea

A

moms who have child less than 6 months and are amenorrheic and are fully breast feeding

181
Q

plan b

A

taken as soon as after unprotected sex

182
Q

ovulation method

A

tracking changes in cervical mucous for BBT daily to determine fertility

183
Q

Ductus arteriosis

A

Opening in circulatory system that allows blood to bypass lungs, if closes prematurely can cause abnormal pressure in lungs & heart

184
Q

What anticoagulant is safer for pregnant women

A

Heparin

185
Q

What is a significant modifiable cause of poor pregnancy outcomes

A

Smoking

186
Q

HCG prevents what

A

Prevents menstrual Sloughing

Increase endometrium growth

187
Q

Amnion

A

Protects embryo thin membrane

188
Q

Chorion

A

Outer membrane has villi

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