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Maternity I Flashcards

1
Q

What are 4 risk factors for maternal mortality?

A

age <20 or >35
lack of education
unmarried
non-caucasian

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2
Q

What are the 4 leading causes of maternal mortality in the US?

A

pre-existing conditions
hemorrhage
HYPERtension
infection

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3
Q

The US is ____ in the world for maternal mortality.

A

50th

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4
Q

How many women die per day giving birth in the US?

A

2-3

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5
Q

What are 2 benefits of vaginal delivery versus c-section?

A

exposure to mother’s flora

better breathing

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6
Q

What cells react to HPV? Where are they located?

A

transformation cells in the ectocervix (the outer, visible part of the cervix)

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7
Q

What is the isthmus?

A

the lower part of the body of the uterus that stretches and thins during pregnancy

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8
Q

What’s up with the os?

A

there’s an internal AND external os before reaching the inner body of the uterus

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9
Q

Why does being an adolescent make for a higher risk pregnancy?

A

they are psychologically unprepared
their hips may not be wide enough
they may not understand the importance of prenatal care
the may try to hide the baby with tight clothes

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10
Q

What is the normal duration range of the menstrual cycle?

A

21-35 days

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11
Q

What is the average age that girls begin menstruating?

A

12.8 years old

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12
Q

How long can an egg live?

A

24-48 hours

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13
Q

How long can sperm live?

A

72 hours

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14
Q

What are the 3 phases of the ovarian cycle? What days do they fall?

A

follicular (1-14)
ovulation (14)
luteal (15-28)

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15
Q

What happens during the follicular phase?

A

ovary follicles grow to form a mature egg
FSH and LH are secreted
Estrogen climbs

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16
Q

What causes the rupture of the mature follicle and subsequent release of the egg? When does this occur?

A

surge of LH hormone during ovulation

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17
Q

What stays behind in the ovary when the mature egg is released?

A

the corpus luteum (shell of the follicle)

secretes progesterone to keep potential pregnancy going

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18
Q

When is estrogen at its peak?

A

ovulation

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19
Q

When is progesterone (the pregnancy hormone) at its peak?

A

luteal phase

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20
Q

What vital sign changes during the luteal phase?

A

increase in body temp by 0.5 to 1 degree Fahrenheit

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21
Q

When are LH and FSH at their lowest?

A

during the luteal phase

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22
Q

WTF if the role of the corpus luteum?

A

it secretes progesterone which interacts with the endometrium to prepare it for implantation.

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23
Q

What is the corpus?

A

the main body of the uterus

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24
Q

How do you calculate the fertile period of a woman?

A

take the first of her last period and subtract 14 days

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25
What term describes too MUCH amniotic fluid? Too little?
too much: Hydramnios (over 2000mL) associated with renal | too little: Oligohydramnios (under 500mL) associated with maternal diabetes and CNS malformation
26
Amniotic fluid is ____% water
98%
27
Are the amniotic fluid's contents fluid or stable?
they are constantly changing.
28
What are 4 functions of amniotic fluid?
maintains temperature allows symmetric G&D cushions fetus from trauma prevents cord compression
29
What are the 3 genetic variations that can cause Down's syndrome?
trisomy 21 *** mosaic translocation
30
How long is the fertile period?
120 hours (5 days)
31
What is fetal nuchal translucent suggestive of?
Trisomy 21
32
What increases the risk of Trisomy 21?
maternal age
33
What are 2 defining characteristics of Down's syndrome?
Simian crease | Open mouth with protruding, large tongue
34
What is Tay-Sachs? What population is most a risk?
an autosomal recessive disorder Ashkenazi Jews
35
What factors would influence a family to seek genetic counseling?
maternal age >35 | paternal age >50
36
Which antibodies are present during the fetal stage of development?
IgG - crosses the placenta IgM - produced by the fetus IgA - not produced by fetus
37
When is surfactant produced?
Week 24
38
Since fetal circulation bypasses the right side of the heart b/c they don't use their lungs, what structures do they use instead?
foramen ovale ductus arteriosus ductus venosus
39
What vitamin do babies lack?
vitamin K
40
When does development of the brain/spinal cord occur?
3-4 weeks
41
When can fetuses hear? taste? see?
hear- 4 months taste- 5 months see- 7 months
42
When does sex differentiation occur?
week 7, but we can't tell until week 20
43
how likely is it to pass down an autosomal dominant disorder? autosomal recessive?
dominant - 50% | recessive - 25%
44
What is the role of the placenta as an interface b/w mother an baby?
protects fetus from immune attack by the mother if they are respectively Rh- and Rh+
45
What is Wharton's Jelly?
tissue surrounding the vein and 2 arteries to prevent compression
46
Function of hCG?
preserves corpus luteum and progesterone production (basis for pregnancy test)
47
Function of progesterone?
maintains endometrium | decreases uterine contractility
48
Function of estrogen?
enlarges breast and genital tissue | relaxation of pelvic ligaments and joints
49
Function of relaxin?
relaxation of pelvic ligaments | softens cervix
50
Function of hPL or hCS?
regulates metabolism development of breasts for lactation increases glucose availability for fetus
51
Where is oxytocin released?
posterior pituitary
52
Function of oxytocin?
stimulates uterine contractions decreases bleeding after delivery ejects milk during BF
53
What is meconium?
baby's first stool contains bile forms during week 12
54
What is vernix caseosa?
slimy, cottage cheese covering fetus that protects it from amniotic fluid
55
What is lanugo?
fine hair
56
How many weeks is a term pregnancy?
37-42
57
Describe GPTAL
``` Gravida - total pregnancies Para - preterm births after 20 weeks Term - births over 37 weeks Abortion- # of pregnancies ended before 20 weeks Living children ```
58
How do you use Naegele's Rule?
used to calculate date of delivery 1. 1st day of last period 2. (+) 9 months 4. (+) 7 days
59
What are the ONLY positive signs of pregnancy?
US verification Fetal movement felt by clinician Doppler finding of heart
60
What is Hegar's Sign?
softening of the lower uterine segment/isthmus at 6-12 weeks
61
What is Chadwick's Sign?
blue coloration of the vagina/cervix at 6-8 weeks
62
What is Goodell's Sign?
softening of the cervix at 5 weeks
63
How do you measure fundal height?
top of pubic bone to top of fundus | 20 cm should be 20 weeks(at umbilicus)
64
When does fundal height stop correlating to weeks of pregnancy?
36 weeks
65
Describe the cardiovascular changes that happen during pregnancy.
50% increases in plasma by week 30 which results in "physiologic anemia" (hematocrit <11) pregnancy is a hyper coagulable state. HR increases by 10-15
66
What happens to BP during pregnancy?
standard during the 1st and 3rd trimester | DROPS by 5-10 in the 2nd trimester
67
What BP is considered HYPERtension in pregnancy?
140/90
68
Do normal HgB and HcT increase or decrease during pregnancy?
increase in plasma causes decrease in HgB and HcT.
69
What is the term for excessive saliva that is normal in pregnancy?
ptyalism
70
what 5 integumentary changes happen to the mother during pregnancy?
hyperpiguentaion of breasts and genitalia melasma or cholasma (butterfly face - 70% of women) linea nigra striae gravidarum (stretch marks) vericosites (poor circulation r/t poor venous return)
71
Who would receive Rhogam? When?
an Rh (-) mother with an Rh (+) baby at 28 weeks gestation and again 72 hours after birth
72
When do pregnant women experience urinary frequency? Why?
trimesters 1 and 3 NOT 2 glomerular filtration rate (GFR) speeds up
73
What should mom eat when she gets morning sickness?
``` Crackers Cheerios Cheese Ginger Lemonade ```
74
During which trimester will mom experience Leukorrhea?
1st trimester | cottage cheesey, acidic secretions
75
How do you distinguish between a yeast infection and leukorrhea?
a yeast infection looks like leukorrhea but presents with itching
76
Amount of water recommended during pregnancy?
2L/day
77
Fetal movement count
"count to 10" method | if longer than 2 hours, call HCP
78
What methods are allowed during L&D?
Lamaze method - breathing and relaxation Bradley - partner coached childbirth Dick-Reed (natural childbirth) - fear reduction via knowledge
79
What vaccinations MAY be given during pregnancy? Which may NOT be given?
Yes: ``` TRIM-H (keep it trim-hunny, jus a lil) Tetanus Rabies Influenza (deactivated) Meningococcal Hep B ``` No: ``` I M Telling Vou B, do not take these vaccines: Influenza (activated) MMR Typhoid Varicella BCG ```
80
When is the rubella vaccine recommended?
after birth prior to discharge nursing mothers OK getting pregnant again NOT OK for 28 days
81
How many pounds should be gained for each BMI during pregnancy?
Underweight: 28-40 lbs Normal: 25-35 lbs Overweight: 15-25lbs Obese: 11-20lbs
82
Foods high in mercury to AVOID:
``` SSKOTT Shark Swordfish King Mackerel Orange Roughy Tuna Tilefish ```
83
Foods low in mercury you can EAT:
``` Shrimp Salmon Tuna (canned light) Talapia Catfish Cod Pollock ```
84
Which supplement should NOT be taken with antibiotics or estrogen?
calcium
85
What needs to be kept balanced with calcium?
vitamin D
86
What supplements should be taken before and during the early weeks of pregnancy?
Folic acid and iron - hard to get the needed amounts just through diet
87
Sources of Folic Acid
Dark leafy greens
88
What foods that may contain the bacteria Listeria should be avoided during pregnancy?
processed meat soft cheese smoked seafood salads made in stores
89
What should not be taken with vitamin C?
antacids with aluminum
90
What should not be taken with vitamin A?
antibiotics and warfarin
91
How should iron supplements be taken?
withOUT food
92
What is the mucous plug called?
operculum

ABSN (18 decks)

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