maternal-newborn nursing Flashcards
physical sexual maturity and reproductive potential begin when the primary and secondary sexual characteristics develop during _____ in response to neuroendocrine hormonal changes
puberty
what are the reproductive changes for females>
the uterus, ovaries, and vagina increase in size and blood supply, and hormones stimulate maturation of an ovum each month at the time of menarche
what are the skeletal changes for females?
the pelvis widens, and there is a sudden skeletal growth
what are the reproductive changes for males?
testosterone stimulates sexual interest, the production of sperm, and the growth and maturation of the penis, scrotum, testes, prostate gland, and seminal vesicles.
what are the skeletal changes for males?
rapid growth takes place in skeletal bones, including length and density, that continues until almost 18 or 20 years of age, widening of the shoulders, increased cellular metabolism, and increased RBC production also takes place
composed of the ovarian and endometrial cycles or phases, which are influences by hormones released in the brain.
Menstrual cycle
What are the phases of the ovarian cycle?
Follicular
Luteal
Occurs in the first half of the cycle, approximately 14 days prior to ovulation. The anterior pituitary gland in the brain releases follicle stimulating hormone luteinizing hormone.
Follicular phase
Stimulates the ovarian follicle, and the immature locate grows
FSH
Stimulates the final maturation of the follicle just prior to ovulation
LH
Begins when the ovum leaves the follicle, which occurs between day 15 and day 28 of a 28 day cycle. oh influences the development of the corpus leteum from the ruptured follicle. As it reaches a peak, estrogen levels drop, and progesterone secretion begins
When fertilization occurs, the corpus luteum is maintained until weeks 10 to 12 of pregnancy.
If fertilization does not occur, the corpus luteum degenerates, causing a decreased in estrogen and progesterone hormone levels, and menstruation follows by day 28 of the cycle
Luteal phase
Occurs during days 1 to 5, when estrogen and progesterone levels are low
Menstrual discharge or uterine blood loss is dark red and may contain sm clots
Menstrual phase
On days 7 to 14 the _____ of the endometrium corresponds to the follicular phase of the ovary
Estrogen causes the endometrial lining of the uterus to thicken in anticipation of the implantation of a fertilized ovum, and the cervical mucus becomes more hospitable to sperm
Proliferative phase
Occurs on days 15 to 26, corresponding to the Luteal phase of the ovary
Estrogen decreases as progresterone levels remain high and the vascularity of the endometrium and uterus increases. If fertilization and implantation occur, the endometrium remains thickened and continues to develop
Secretory phase
On days 27 to 28, if fertilization does not occur, the corpus luteum degenerates, and estrogen and progesterone levels fall. The endometrium becomes ischemic and pale as the vasculature constricts
Ischemic phase
A combination of two or more persons who are bound together over time by ties of mutual consent, birth, adoption, or placement and who, together, deliver physical care and maintained of group members, addition of new members through procreation or adoption, socialization of children, social control of members, etc
Family
Formed when both parents bring children from previous relationships into a new, joint living situation or when children from the current union and children from previous unions are living together
Blended family
Includes the nuclear family and other relatives
Extended or multigenerational family
Consist of one parent and one or more children
Lone parent family
Consist of people of the same sex who live together with or without children
Same sex family
Consist of a mother and father and then children
Traditional nuclear family
Community or private classes and programs, specialized programs such as Lamaze, breathing techniques, hypnosis, etc
Prenatal education and birth preferences
Often working in teams of two, provide holistic care for the client throughout the pregnancy and birth process. Birth options may include hospital, birth centre, health clinic, or home birth settings
Midwifery
A specially trained labour attendant. They provide continuous, one on one caring presence throughout the labour and birth process of the client they are attending
Doula
Refers to the coordination of the many facilities and professional services needed to provide optimal maternal newborn care to families
Regionalization
Sexual intercourse if avoided on the seventh day of the cycle or later, when a client with regular menstrual cycles is fertile
Fertility awareness based methods
Can be purchased without a prescription; this is a barrier the blocks the sperm from reaching the ovum and protects against HIV and STIs
Male condom
Can be inserted for up to 24hrs in advance of sexual intercourse; offer protection against HIV and STIs
Female condoms
Are taken daily. Contains the hormones estrogen and progestin, which suppress the release of the ovum
Oral contraceptives
Contains the hormones estrogen and progestin in a small patch applied once a week for three weeks on the skin
Transdermal contraceptive patch
A flexible soft transparent ring made of copolymer ethylene vinyl that delivers continuous levels of progesterone and ethanol estradiol, which are absorbed through the vaginal epithelium
Contraceptive vaginal ring
Contains only progestin and acts by thickening the cervical mucus so that sperm cannot reach the egg
The mini oral contraceptive
Device is placed in the uterus, preventing sperm from reaching the egg, the implantation of the fertilized egg or both
IUDs
An injection of the hormone progestin given every three months
Depo provera
An injection of the hormone progestin given every three months
Depo provera
There are barrier methods, used with spermicidal gel or foam prior to sexual intercourse. Both must be properly fitted to cover the cervix
Diaphragm, cervical cap
Prevents eggs from reaching the fallopian tube and uterus and is permanent method of birth control
Tubal ligation
Involves ligation, the removal of a piece of the vas deferens, or both thereby eliminating sperm from the semen
Vasectomy
A method used to prevent pregnancy after having unprotected sexual intercourse. It can be used in situations when a condom slips off or breaks or a diaphragm or cervical cap slips out of place.
Emergency contraceptives
A special formation containing progestin only. Hormones interfere with ovulation, and possibly implantation, preventing pregnancy from occurring
Hormonal EC methods
Should be inserted within 5 days of unprotected sexual intercourse. It is the most effective method of EC
Copper IUD
Is the purposeful interruption of pregnancy before 20 weeks gestation
Induced abortion
Used for client requesting an abortion
Elective abortion
Refers to abortions performed for maternal health, fetal health, or disease reasons
Therapeutic abortion
Are available up to 9 weeks gestation using methotrexate and misoprostol
Medical abortion
Most common procedure done in the first semester
Aspiration
Refers to a couple who has never conceived
Primary infertility
Describes a couple who experiences infertility after having at least one previous conception
Secondary infertility
Refers to a couple who experiences infertility after having at least one previous conception
Secondary infertility
viable and optimally fertile for 24hrs postejaculation, although they may survive and remain mobile in the cervical mucus for 2 to 3 days but may survive as long as 7 days
spermatozoa
enzymes in the sperms head are released, changing the outer coating of the ovum to allow one sperm to penetrate the ovum
capacitation
once a sperm has penetrated the ovum, cellular changes occur on the ovums surface membrane, preventing other sperm from entering
zonal reaction
occur due to the spontaneous division of one fertilized ovum early in development
identical twins
occur when two or more seperate ova are fertilized by two or more different spermatozoa
fraternal twins
lasts from conception to day 14. it is characterized by cellular division, formation of the blastocyst and beginnings of the embryonic membranes and differentiation of the primary germ layers
ovum stage
lasts from gestational day 15 until the embryo reaches a crown to rump length of 3cm, or approximately to the end of the eight week. this is a critical time of development of all organ systems and external body features and a high risk time for teratogenic substances to interfere with and harm organ and tissue development
embryonic stage
begins at week 9 and lasts until birth or the end of pregnancy.
fetal stage
is derived initially from maternal blood filtrates and eventually consists mostly of fetal urine
amniotic fluid
is a volume of less than 300ml, which impairs fetal movement and symmetrical growth and may be associated with fetal abnormalities, and if prolonged does not allow for normal alveoli development
oligohydramnios
is a volume greater than 1.5 to 2L and is associated with fetal abnormalities
polyhydramnios
is structurally complete by week 12 gestation; it continues to grow and expand until 20 weeks.
placenta
person who is pregnant
gravida
a person who has never been pregnant
nulligravida
a person who is pregnant for the first time
primigravida
a person who has been pregnant more than once
multigravida
an infant sufficiently developed enough to live outside the womb
viability
a person who has given birth after 20 weeks gestation
para
a person who has not given birth to an infant of viable age
nullipara
a person who has given birth at more than 20 weeks gestation, regardless of the outcome
primipara
a person who has had two or more viable births
multipara
what is GTPAL
gravidity, term, preterm, abortions, living
increase in BP after 20 weeks of pregnancy with proteinuria in a pregnant client who had normal BP prior to pregnancy or a client with preexisting hypertension
pre eclampsia
development of seizures or coma not identifiable to other causes in a client with pre eclampsia
eclampsia
the natural termination of the pregnancy before viability is established which is usually at 20 weeks testation or a fetal weight of less than 500g
miscarriage
the placenta implants in the lower uterus, at or near the internal os at the cervix, instead of the top one third of the uterus fundus
placenta previa
occurs when a normally implanted placenta prematurely separates or partially separates in the second half of pregnancy or during labour
placental abruption
occurs when the fertilized ovum implants itself in a location outside the uterine endometrium
ectopic pregnancy
conditions of severe, unrelenting nausea and vomiting
hyperemesis gravidarum
any agent, drug, toxin, chemical or infection that can harm the developing embryo or fetus
teratogen
high frequency sound waves are painlessly transmitted via a vaginal or abdominal transducer
ultrasonography
test used to obtain a sample of amniotic fluid for biochemical and genetic analysis
amniocentesis
is made up up the maternal structures of the pelvis and soft tissues that the fetus must navigate through in the process of being born
passageway
travels through the passage with an ease or degree of difficulty that is influenced by several factors
passanger
describes the relationship between the long axis of the pregnant clients and the long axis of the fetus
fetal lie
the bony part of the fetus that presents or enters the pelvic inlet first
fetal presentation
the relationship of fetal body parts to each other
fetal attitude
the relationship of the bony presenting part of the fetus to the four quadrants of the maternal pelvis
fetal position
this occurs when the largest transverse diameter of the presenting part has passed through the pelvic inlet and into the true pelvis
engagement
is the relationship of the presenting part to the ischial spines of the maternal pelvic
station
there are the involuntary utertine contractions, measured by their frequency, duration, and intensity as they thin and dilate the cervix
primary powers
when the cervix is completely dilated, they are an important aid in assisting with the descent of the fetus through the birth canal
secondary powers
