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FN 123 > FN 124 LE 1 - Pregnancy > Flashcards

FN 124 LE 1 - Pregnancy Flashcards

1
Q

Conditions/Factors to consider during preconception care

A

o Care before pregnancy
o Fertility

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2
Q

o To motivate potential new parents to participate in
advanced planning of pregnancies
o Risks prior to conception include medical, social, psychological, or lifestyle conditions

A

preconception care

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3
Q

component of preconception care that includes:

o Individual and social conditions o Adverse health behaviors
o Medical conditions
o Psychological conditions
o Environmental conditions
o Barriers to Family Planning, Prenatal Care, and Primary
Health Care

A

Risk Assessment

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4
Q

component of preconception care that includes:

o Promotion of behaviors
o Counseling about the availability of social and financial
assistance programs
o Advice on family planning, birth spacing
o Counseling on the importance of prenatal care o Identification of barriers to care

A

Health Promotion

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5
Q

component of preconception care that includes:

o Treatment of medical conditions
o Referral for treatment of adverse health behavior(s) o Rubella and hepatitis immunization (free)
o Counseling to reduce psychosocial risks
o Nutrition counseling

A

Interventions to Reduce Risks

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6
Q

refers to nutrition during the time of
pregnancy

A

Perinatal Nutrition

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7
Q

what does Maternal Dietary Practices prior to pregnancy (always start with studying their dietary patterns) determine

A

(1) fertility, (2) pregnancy, and (3)
course of pregnancy

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8
Q

Stages of menstrual cycle

A
  • Follicular Phase
  • Ovulation – release of the egg cell
  • Luteal Phase
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9
Q

In this stage of the menstrual cycle, the egg is released from day 20-24

A

Ovulation

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10
Q

In this stage of the menstrual cycle, it is the optimal time for conception (when egg is most ready)

A

Ovulation

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11
Q

appetite-suppressing hormone produced by
adipocytes

A

Leptin

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12
Q

High leptin production result to?

A

creation of cysts in
the ovaries (PCOS)

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12
Q

what does high amounts of adipocytes result result to?

A

high leptin prod

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13
Q

Major preventive measure for PCOS

A

weight loss

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13
Q

Patients with PCOS are prescribed with?

A

Metformin treatment

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14
Q

an Oral Hypoglycemic Agent/Drug (OHA) that causes weight loss as one of its side effects

A

Metformin

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15
Q

What does undernutrition do to fertility?

A

can cause delayed puberty and amenorrhea

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15
Q

Individual experiences puberty, menarche, and ovulation as expected

A

Normal Nutrition

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16
Q

Besides undernourished mothers, ______ is usually experienced by female athletes

A

amenorrhea

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17
Q

being overweight/obese can result to
infertility

A

Overnutrition

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18
Q

Factors acting in fetal life that can affect future fertility of the baby

A

o Lifestyle, diet, environmental chemicals

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18
Q

Increased leptin production results in:

A

o Anovulation
o Hirsutism – hair in other parts of the body due to increase in androgen production

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19
Q

Factors acting in pregnant mother that can affect fetal
development

A

o Hormone changes due to over/undernutrition

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19
Q

Factors affecting future fertility that are already determined at
birth up to 1 year of age

A

o Health status of infant
* Female vs. male infants are affected by different factors

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19
Q

Factors acting in adulthood that can affect fertility for females

A

Female adult – diet, season, occupation, lifestyle

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20
Q

Factors acting in adulthood that can affect fertility for males

A

Male adult – season, occupation, scrotal heating (time
spent seated)

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21
Q

Role in Spermatogenesis: RNA and DNA synthesis

A

Cobalamin

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21
Q

Role in Spermatogenesis: Promotes healthy sperm

A

Folate

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22
Q

Role in Spermatogenesis: Spermatogonia differentiation

A

Vitamin A

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23
Q

Role in Spermatogenesis: Protects sperm from oxidative stress

A

Vit C

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23
Q

Role in Spermatogenesis: Defends sperm from ROS-related events

A

Vit E

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24
Q

Role in Spermatogenesis: Initiate sperm motility

A

Calcium

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24
Q

usually not consumed by pregnant women due to their side effects, primarily diarrhea

A

antibiotics

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25
Q

Role in Spermatogenesis: formation of the flagella

A

Selenium

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25
Q

Role in Spermatogenesis: Enhances sperm motility

A

Zinc

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25
Q

Role in Spermatogenesis: sperm production

A

Nickel

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25
Q

diarrhea during pregnancy lead to:

A

dehydration (due to water loss) where Less nutrients are available for the fetus since the GI tract is compromised and is unable to absorb

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26
Q

Expansion in red cell mass is proportionally smaller than that in plasma, resulting in the so-called ________

A

physiologic anemia of pregnancy

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26
Q

amount of volume of blood pumped
by the heart

A

Cardiac ouput

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26
Q

volume of blood pumped from
the left ventricle per contraction

A

Stroke volume

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26
Q

Due to the increase nutrients and the need of
something to transport them

A

Increased blood volume

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26
Q

usually decreased (1st and
2nd trimesters) under blood volume changes

A

arterial pressure

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26
Q

Induces changes in blood flow

A

Increased blood volume

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26
Q

occurs from
10-12wk through 33-35wk

A

Progressive plasma volume expansion

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26
Q

Weekly increments are maximal during _____

A

mid-gestation (5-6 months)

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26
Q

Blood pressure tone _____ and peripheral vascular resistance _____

A

decreases; falls

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26
Q

blood vessels far from the heart

A

Peripheral vascular system

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26
Q

blood vessels have decreased resistance to improve blood flow

A

Blood pressure tone

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27
Q

Resistance to blood _____ to induce better blood flow

A

decreases

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27
Q

Arterial pressure falls during the ______

A

1st trimester

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27
Q

used as the baseline to evaluate
pregnancy-induced hypertension (PIH) to the 3rd
trimester

A

Arterial pressure during the 1st trimester

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27
Q

Changes in regional blood flow: uterine blood flow increases from ______ in non-pregnant to ______ near term

A

15- 20 ml/min; 500-600 ml/min

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28
Q

Adjustments in respiration: results in increased intraabdominal pressure and elevation of the diaphragm

A

enlarging uterus

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29
Q

Resting ventilation increases by about ____

A

48%

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30
Q

Changes in Renal Function (4)

A

(1) urethral dilation, (2) slowed velocity of urine, (3) increased susceptibility to UTIs, and (4) uterine compression of the ureters

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31
Q

Renal blood flow and Glomerulus flow rate (GFR) are ______

A

increased

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32
Q

increase in ___ presents the tubules with greater quantities of nutrients than they can absorb

A

GFR

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33
Q

Changes in Gastrointestinal Function

A

(1) taste changes, (2) heartburn, (3) nausea & vomiting, and (4) constipation

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34
Q

detected by pregnancy tests through urine

A

HCG

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35
Q

Released after embryogenesis is completed

A

HCG

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36
Q

Some proteins cause unappetizing
smells/tastes/sensations for pregnant women

A

Taste changes

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37
Q

o Caused by relaxation of the esophageal sphincter (acids can more easily move through GI tract)
o Becomes normal through the 3rd trimester

A

Heartburn

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37
Q

Caused by the relaxation of GI muscles, reducing its motility (movement), resulting in difficulty of defecation

A

Constipation

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38
Q

Changes the progesterone causes:

A
  • Relaxation of the smooth muscles in the uterus for expansion
  • Relaxation of the GI muscles, thus reducing motility
  • Induces fat deposition
  • Reduces alveolar and arterial pressure (CO2)
  • Increases renal sodium excretion
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39
Q

____ is lower than progesterone during the 1st few months but rises sharply near term

A

Estrogen

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40
Q

Functions of estrogen

A

o Promotes growth and controls the function of
the uterus
o Alters the structure of the mucopolysaccharides
in the connective tissues (for flexibility and
water retention)

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40
Q

Excess fluid is a hallmark of _____

A

preeclampsia
(hypertension during delivery)

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41
Q

usually rises by the 4th month

A

BMR

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42
Q

The BMR increased by ____ by term and returns to normal 5-6 days postpartum

A

15-20%

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43
Q

reflects increased oxygen demands of the uterine placental fetal unit, as well as O2 consumption from increased maternal cardiac work

A

Elevated BMR

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43
Q

50-70% of the kcal needed by the fetus in the 3rd
trimester is derived from _______

A

glucose

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44
Q

20% is from _______; and the rest is from _____

A

amino acids; fats

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45
Q

when maternal blood glucose ____, the rate of glucose transfer to the fetus declines and ____ will be the more dominant fuel source

A

falls; fatty acids

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45
Q

The net effect of maternal fuel adaptations is to increase the use of ___ as fuel by the mother and conserve ____ to the fetus

A

fat; glucose

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46
Q

contain fetal blood vessels and extend into the pool of mother’s blood

A

Fingerlike projections (placental villi)

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47
Q

requires channels and carriers that are potassium and protein-dependent

A

Active transport

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47
Q

Recite transport mechanism and substance transported

A

(table for diffusion and transport)

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48
Q

Hormone produced by placenta

A

Human Chorionic Gonadotropin (HCG)

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49
Q

Produced by Trophoblasts

A

HCG

49
Q

Postulated mechanisms responsible for placental and fetal growth retardation as seen with maternal malnutrition

A

Recite the table

50
Q

Decreased placental size due to

A

lack of hPL produced

51
Q

Reduced nutrient transfer – due to

A

impaired transfer system

52
Q

Alters maternal physiology to ensure fetal nutrition in utero (inside the uterus)

A

ENDOCRINE FUNCTION OF FETAL PLACENTAL TISSUE

52
Q

Alters maternal pituitary function and mammary development to ensure ongoing fetal nutrition after birth (lactation)

A

ENDOCRINE FUNCTION OF FETAL PLACENTAL TISSUE

53
Q

Determines the time of labor and delivery (parturition)

A

ENDOCRINE FUNCTION OF FETAL PLACENTAL TISSUE

54
Q

Fetal testosterone production

A

placenta

55
Q

Male differentiation of the reproductive system before the fetal
hypothalamus and pituitary develop into a functional axis

A

placenta

56
Q

take about 6 days to complete

A

Events between fertilization and implantation

57
Q

occurs at about day 22 of the menstrual cycles

A

Implantation

57
Q

At this time, ovary is in the midluteal phase and secreting large amounts of progesterone

A

Implantation

58
Q

to maintain fetus… (“pampakapit”)

A

progesterone

59
Q

Stimulates secretion from the uterine glands, which provide
nutrients to the embryo (Histiotropic nutrition)

A

progesterone

60
Q

Inhibits myometrial contraction and prevents release of
paracrine factors
* Example: Cytokines, prostaglandins, chemokines, and
vasoconstrictors for menstruation

A

progesterone

60
Q

Induces the “window of receptivity” in the uterine
endometrium (D20-24)

A

progesterone

61
Q

optimal time in which oocyte
can receive the sperm

A

window of receptivity

62
Q

oocyte is released and no longer waits
for a sperm cell

A

After Day 24

63
Q

_____
levels can be used as one measure of fetal health

A

estriol/ estrogen

64
Q

Human chorionic somatomammotropin (hCS)

A

HPL

65
Q

placenta grows during
gestation, ____ secretion increases

A

hPL

65
Q

protein anabolic and lipolytic

A

hPL

65
Q

antagonistic action to insulin is the major basis for the diabetogenicity of pregnancy

A

hPL

65
Q

Antagonistic to insulin – counteractive action to insulin
(which decreases blood glucose)

A

hPL

66
Q

But if blood glucose is excessively high and goes
past the limit, it can induce ____ to the mother

A

gestational diabetes

66
Q

Insulin production and insulin sensitivity of cells is affected by ______

A

hPL and other hormones

67
Q

____ inhibits maternal glucose uptake and use, thereby _____ serum glucose levels.

A

hPL; increasing

68
Q

hPL ____ fetal glucose availability

A

increases

69
Q

THE THREE MAIN PLAYERS OF PREGNANCY

A

The Mother, the Placenta, and the Fetus

70
Q

did
not reach the uterus, embedded in the lines of the fallopian
tubes or ovaries

A

Ectopic pregnancy

70
Q

a stage in the development of the embryo in o which cells are arranged in a single layer to form a hollow
sphere

A

blastocyst

70
Q

A newly fertilized ovum is about the size of a period at the end of this sentence

A

zygote

71
Q

solid mass of cells representing a mulberry,
formed by cleavage of a fertilized ovum

A

morula

72
Q

at less than one week after fertilization is not much bigger and is ready for implantation.

A

zygote

73
Q

five weeks after fertilization is about 1⁄4 inch long.

A

embryo

74
Q

expected due to release of HCG (normal)

A

morning sickness

75
Q

measures close to 20 inches in length. From eight weeks to term, this infant grew 20 times longer and 50 times heavier.

A

infant

75
Q

The fertilized egg divides into cells that fold in on one
another

A

Blastogenesis Stage

76
Q

after 11 weeks of development is just over an inch long. Notice the umbilical cord and blood vessels connecting the fetus with the placenta.

A

fetus

77
Q

An inner cell mass evolves giving rise to the embryo and an
outer coat which becomes the placenta

A

Blastogenesis Stage

78
Q

The stage is complete in 2 weeks after fertilization

A

Blastogenesis Stage

79
Q

outer layer giving rise to the brain, nervous system, hair, and skin

A

ectoderm

80
Q

middle layer that produces all of their voluntary muscles, bones, cardiovascular, and excretory systems

A

mesoderm

81
Q

inner layer forms the digestive & respiratory systems, and the glandular organs

A

endoderm

81
Q

Period of most rapid growth

Implications to diet – time to increase caloric intake

Begins from the 3rd month until term

Fetal weight increases (from 6g to 3,000-3,500 at birth)

A

Fetal stage

82
Q

After __ days of gestation, all major features of the human infant have been achieved

A

60

83
Q

(conception to 2 weeks)
o Implantation into uterine wall

A

zygote

84
Q

o Rapid cell division (1.25 inches)
o Complete CNS, beating heart, digestive system (immature)

A

Embryo (2 weeks to 8 weeks)

85
Q

Each organ has defined growth rate

Birth (38 weeks to 42 weeks)

A

Fetus (8 weeks to birth)

85
Q

o After birth, before a baby becomes an infant (months
old)

A

Neonate

86
Q

Normal head circumference and skeletal growth but poorly developed muscles and no subcutaneous fat

A

Type I: Growth retardation primarily affecting weight

86
Q

weight of < 2500 g, irrespective of gestational age

A

low birth weight

87
Q

the first weight of the fetus or newborn obtained after birth; ideally measured within the first hour of life

A

birth weight

88
Q

Worse condition because at least Type II retains proportionality (all organs are within proportion of each other)

A

Type I: Growth retardation primarily affecting weight

89
Q

o Size of all body parts are reduced proportionally

A

Type II: Growth reduction in both weight and height

90
Q

Babyisstillalivebutsurvivalisthequestion

A

Very low birth weight (< 1500 g)

91
Q

Extremely low birth weight

A

< 1000 g

92
Q

height and pre-pregnancy weight of
the mother

A

maternal body size

93
Q

amount of weight gained by the
mother during pregnancy

A

maternal weight gain

94
Q

Peak age of reproduction

A

25-28

95
Q

Normal weight gain is about ______

A

11 to 15 kg

96
Q

the remainder in of maternal weight gain?

A

maternal
reproductive tissues, fluid, blood, and “stores” (fat)

96
Q

Less than 1⁄2 of the total weight gain where?

A

fetus,
placenta, and amniotic fluid

96
Q

Low birth weight is primarily related to:

A

o Low pre-pregnancy BMI (kg/m2)
o Low gestational weight gain

97
Q

determinant for how much you should gain

A

height

98
Q

These anthropometric factors reflect inadequate food intake, which may be related to:

A

o Poverty
o Cultural ideas of thinness

99
Q

Lessens later in the pregnancy due to less release of HCG

A

Nausea and vomiting

99
Q

components of weight gain table

A

recite the table

100
Q

Due to enlargement of uterus and stomach linings

A

Heartburn

101
Q

Intestines are crowded (“naiipit”), decreasing motility of
the GI Tract

A

Constipation

102
Q

Cravings are usually a sign of nutrient deficiency like
_____ and _____

A

calcium and iron

103
Q

factors that determine energy requirements

A

(1) Changes in the mother’s usual physical activity; and
(2) Increase in her metabolism to support the work
required for fetal growth and accessory tissues

104
Q

Cumulative energy cost of pregnancy

A
  • 40,000 to 70,000 kcal
  • Extra 200-300 kcal for the 2nd and 3rd trimesters
104
Q

About ____ CHON are deposited in a normal weight fetus and in the maternal accessory tissues divided by the ___ days of gestation = ___ of added CHON daily

A

925 g; 280; 3.3g

105
Q

can cause other nutrient deficiencies in both, improper bone matrix formation, and infertility

A

Protein deficiency

106
Q

in protein, leads to unhealthy and excessive maternal weight gain; impairs normal fetal development, inhibits fetal growth due to possible development of other nutrient deficiencies

A

excess intake

107
Q

____ kcal distribution for CHO

A

50-70%

107
Q

Required for cell division to proceed

A

folate

108
Q

Deficiency affects cells that have a high rate of turnover
(e.g. RBC and the CNS)

A

folate

109
Q

recommendation for folate

A

Recommendation: 300-400 μg/day

110
Q

important contributor to the process of cell division

A

B12

111
Q

concerned with amino acid metabolism and CHON
synthesis; believed to provide relief for nausea and
vomiting during early months of pregnancy

A

B6

111
Q

serve as coenzymes for energy production

A

B1, B2, B3

111
Q

believed to help alleviate symptoms of preeclampsia
and premature rupture of the cell membranes

A

C

111
Q

positive effects on calcium balance and neonatal calcium homeostasis

A

D

112
Q

fetal storage of the vitamin

A

A

113
Q

believed to prevent spontaneous abortion

A

E

113
Q

blood coagulation after giving birth

A

K

114
Q

Needed to manufacture hemoglobin for both maternal and
fetal needs

A

Iron

115
Q

Fetus acquires most of its ____ in the 3rd trimester when skeletal growth is maximum, and teeth are being formed

A

Ca

116
Q

During 3rd trimester, fetus draws ___ mg per hour of Ca from the maternal blood _____ mg/day

A

13 mg; 250-300 mg/day

117
Q

Believed to prevent pregnancy-induced hypertension

A

Calcium

118
Q

Loss of teeth and hair during
pregnancy

A

Calcium Deficiency

119
Q

Loss of calcium stores in mothers lead to early
______

A

osteoporosis

119
Q

Excess _____ is detrimental for calcium
absorption (uses the same enzymes for digestion and
absorption)

A

phosphorus

120
Q

Primarily important for males (spermatogenesis)

A

zinc

121
Q
  • Component of insulin
  • Part of an enzyme that helps maintain acid-base
    balance in tissues
  • Acts in the synthesis of DNA and RNA
A

zinc

121
Q

____ deficiency in rats has led to the development of congenital malformation

A

zinc

122
Q

Maternal ____ deficiency has led to cretinism at birth

A

iodine

122
Q

inadequate length and/or height

A

cretinism

123
Q

________ during conception brings out
children with autism

A

Hypo or hyperthyroidism

124
Q

_______ → role in iodine regulation

A

Thyroid

125
Q

2nd trimester onwards ONLY

A

vit A

126
Q

given in the 1st trimester

A

Iron and folate

127
Q

Additional energy intake during last half of gestation

A

o Additional 200-300 kcal

127
Q

Critical nutrients during 1st trimester

A

o Protein
o Folic Acid
o Vitamin B12
o Zinc

128
Q

Critical nutrients during 2nd and 3rd trimester

A

o Protein
o Iron
o Calcium
o Magnesium
o B Vitamins
o Omega-3-fatty acid, docosahexaenoic acid (DHA)

129
Q

Coffee max. amount

A

2 cups/day

130
Q

need to provide supplements because diet will never be sufficient

A

iron

130
Q

Cups of fluid

A

9-10

131
Q

Amount of fiber per day

A

(20-25 g/day)

132
Q
  • Low nasal bridge, flat midface, indistinct philtrum, thin upper lip, short nose, minor ear abnormalities, microcephally, very low-low IQ
A

FAS

133
Q
  • Mice – decreased brain and liver weight
  • Rats – reduced growth
A

Caffeine effect

134
Q

sugarcannotentercells

A

hyperglycemia

135
Q

Hyperglycemia in mother results in hyperglycemic child because placenta is immersed in the maternal blood

A

Causesmacrosomicinfant(excessivefetalgrowth
and fat deposition)

135
Q

sign to stop exercise: labored or difficulty in breathing

A

dyspnea

135
Q

Fetal pancreas is overworked in releasing insulin to lower glucose stores (Hyperglycemia)

A

Leads to hyperinsulinemia -> Macrosomic Infant

136
Q

sign to stop exercise: lightheadedness, muscle weakness, blurred vision, feeling faint

A

presyncopal

FN 123 (10 decks)

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