Maternity/Infant Health (Exam Two) Flashcards

1
Q

What is the most common cause of alterations in pelvic support?

A

Childbirth

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2
Q

Involving the uterus and cervix, what occurs during uterine displacement and prolapse?

A
  • The uterus tips posteriorly (tip to the back)

- The cervix rotates anteriorly (rotate to the front)

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3
Q

What are the signs and symptoms of uterine displacement?

A
  • Pelvic pain
  • Back pain
  • PMS
  • Painful intercourse
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4
Q

What becomes visible during a uterine prolapse?

A

The uterine will be seen protruding out from the vagina

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5
Q

Which condition is more serious, uterine displacement or uterine prolapse?

A

Uterine prolapse

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6
Q

What is cystocele?

A

Protrusion of the bladder into the vagina

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7
Q

What are the causes of cystocele?

A
  • Childbirth
  • Obesity
  • Age
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8
Q

What are the signs and symptoms of cystocele?

A
  • Heaviness inside of the vagina

- Urinary incontinence

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9
Q

What is rectocele?

A

Herniation of the anterior rectal wall through vaginal tissue

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10
Q

What are the management options for both cystocele and rectocele?

A
  • Surgical repair

- Pelvic physical therapy

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11
Q

What are genital fistulas?

A

Perforations between genital track organs

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12
Q

What are the signs and symptoms of genital fistulas?

A
  • Depends on location
  • Leaking of urine
  • Gas
  • Feces in vagina
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13
Q

What are the treatment options for genital fistulas?

A

-Surgical repair (surgery may not always fix it)

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14
Q

What percentage of females experience urinary incontinence? It is common after what procedure in women?

A
  • 75% of females

- Vaginal childbirth

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15
Q

Urinary incontinence increases with what?

A
  • Parity (number of births)
  • Age
  • Obesity
  • Smoking
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16
Q

Ovarian cysts are often associated with what?

A

Menstrual cycle

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17
Q

What are the two types of ovarian cysts?

A
  • Follicular cysts

- Polycystic Ovarian Syndrome (PCOS)

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18
Q

Follicular cysts are most common in…

A

Normal ovaries of younger females

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19
Q

Follicular cysts generally present with ___________, unless it ________.

A
  • No signs or symptoms

- Ruptures

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20
Q

If a follicular cyst ruptures, what will the female experience?

A

Pelvic pain

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21
Q

What will happen to the follicular cyst if it does not rupture?

A

It will shrink in size after 2 or 3 menstrual cycles

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22
Q

What are the treatment options for follicular cysts?

A
  • NSAIDS
  • Oral contraceptives
  • Larger cysts can be surgically removed
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23
Q

What is polycystic ovarian syndrome (PCOS)?

A
  • Endocrine imbalance

- Multiple follicular cysts due to overproduction of estrogen

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24
Q

What hormones will be increased with polycystic ovarian syndrome (PCOS)? Which hormones will be decreased?

A
  • Increase in estrogen, testosterone, and luteinizing hormone (LH)
  • Decrease in follicle stimulating hormone (FSH)
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25
Q

What are the treatment and management options for polycystic ovarian syndrome (PCOS)?

A
  • Encourage diet
  • Encourage weight loss
  • Oral contraceptives
  • Metformin
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26
Q

What are the signs and symptoms associated with polycystic ovarian syndrome (PCOS)?

A
  • Obesity
  • Hirsutism
  • Irregular menstrual cycles
  • Infertility
  • Glucose intolerance
  • Hyperinsulinemia
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27
Q

Where do uterine polyps originate?

A

In the endometrium or the cervix

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28
Q

Uterine polyps can be surgically removed in an outpatient setting if they are located where?

A

In cervical tissue

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29
Q

After the removal of a uterine polyp, what education should the nurse provide to the patient?

A
  • No tampons for one week
  • No sex for one week
  • Signs and symptoms of infection
  • Notify HCP if they experience heavy bleeding
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30
Q

What age group is most likely to develop uterine polyps?

A

Multiparous women older than 40

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31
Q

What is the most common type of benign tumor?

A

Fibroid tumors

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32
Q

These women are at a higher risk for developing fibroid tumors?

A
  • African Americans
  • Nulliparity (no pregnancies)
  • Obese
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33
Q

What are the signs and symptoms of fibroid tumors? Which of these symptoms are specific to large tumors?

A
  • Typically asymptomatic
  • Abnormal uterine bleeding
  • Anemia

Specific to large tumors:

  • Back pain
  • Pressure in lower abdomen
  • Constipation
  • Dysmenorrhea
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34
Q

Fibroid tumors are heavily influenced by what? What will this impact?

A

-Influenced by estrogen

  • Implantation
  • Maintenance of pregnancy
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35
Q

Regarding pregnancy, fibroid tumors may cause what?

A
  • Miscarriage
  • Pre-term labor
  • Difficult labor
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36
Q

What are the management options for fibroid tumors?

A
  • NSAIDS
  • Oral contraceptives
  • Growth hormone agonist
  • Uterine artery embolization
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37
Q

Why would a women with fibroid tumors be prescribed growth hormone agonists?

A

They will decrease the size of the fibroid

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38
Q

What is uterine artery embolization?

A

Blocks the blood supply (perfusion) to the fibroid tumor causing it to shrink

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39
Q

Regarding fibroid tumors, what signs and symptoms would indicates the need for a hysterectomy?

A
  • Very large tumor
  • Severe bleeding
  • Tumor is obstructing other organs
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40
Q

What are the nursing interventions for fibroid tumors?

A
  • Discuss fertility
  • Obtain consent
  • Discuss childbearing
  • Monitor bleeding
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41
Q

How long will a patient stay in the hospital after having a hysterectomy?

A

1 to 2 days

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42
Q

What signs and symptoms might the patient experience postop from a hysterectomy? What education should the nurse provide to this patient?

A
  • Pain
  • Fatigue
  • Depression
  • Promote pelvic rest
  • Patient can engage in sexual intercourse after healing
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43
Q

What is the most common type of reproductive cancer?

A

Endometrial cancer

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44
Q

What are the risk factors for developing endometrial cancer?

A
  • Obesity
  • Nulliparity
  • Infertility
  • Late onset menopause
  • Diabetes
  • Hypertension
  • PCOS
  • Family history of ovarian/ breast cancer
  • Tamoxifen use
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45
Q

What is the MOST significant risk factor for developing endometrial cancer? List other signs and symptoms of endometrial cancer.

A

*Hormonal imbalance

  • Pinkish mucus vaginal discharge
  • Lower back pain
  • Pelvic pain
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46
Q

What is the cardinal sign of endometrial cancer?

A

Abnormal uterine bleeding

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47
Q

How is endometrial cancer diagnosed?

A
  • Pap smear
  • Biopsy
  • Pelvic exam
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48
Q

How many women are diagnosed with endometrial cancer annually? What characteristic do these women have in common?

A
  • Over 100,000

- Obesity

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49
Q

What is the second most common reproductive cancer?

A

Ovarian cancer

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50
Q

The signs and symptoms of ovarian cancer are usually _____.

A

Vague

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51
Q

List the signs and symptoms of ovarian cancer.

A
  • Urinary urgency
  • Urinary frequency
  • Increased abdominal girth
  • Abdominal bloating
  • Pelvic pain
  • Abdominal pain
  • Feeling of fullness quickly after eating
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52
Q

How is ovarian cancer diagnosed? Are women who have ovarian cancer usually diagnosed early or late in the disease process?

A
  • Definitive screenings or diagnostic testing does not exist
  • The cancer is generally very progressed or in the later stages when found
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53
Q

What ethnicity is most at risk for developing ovarian cancer?

A
  • North American

- European descent

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54
Q

What are treatment options for ovarian cancer?

A
  • Surgical removal of ovaries or uterus
  • Cyctoreductive surgery
  • Antineoplastic surgery
  • Chemotherapy
  • Radiation
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55
Q

What is cyctoreductive surgery?

A

Debulking (shrinking) of the tumor

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56
Q

What treatment options for ovarian cancer are commonly used simultaneously?

A
  • Antineoplastic surgery
  • Chemotherapy
  • Radiation
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57
Q

What is the third most common reproductive cancer?

A

Cervical cancer

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58
Q

What common places does cervical cancer spread?

A
  • Vaginal mucosa
  • Pelvic wall
  • Bowel
  • Bladder
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59
Q

The incidence of cervical cancer is highest in what ethnicity?

A

Hispanic women

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60
Q

90% of cervical cancers are caused by what?

A

Human papilloma virus (HPV)

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61
Q

What is the most reliable method for detecting cervical cancer? What percent of malignancies does it detect?

A
  • Pap smear

- 90%

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62
Q

Besides a pap smear, what are other methods used to diagnose cervical cancer?

A
  • Colposcopy

- Biopsy

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63
Q

What are the signs and symptoms of cervical cancer?

A
  • Most often asymptomatic
  • Abnormal bleeding after sexual intercourse
  • Rectal bleeding
  • Hematuria
  • Back pain
  • Leg pain
  • Anemia
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64
Q

Abnormal bleeding puts any patient at an increased risk for what?

A

Anemia

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65
Q

If cervical cancer is considered invasive, what method of treatment is commonly used?

A

Hysterectomy

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66
Q

What is the fourth most common gynecological cancer?

A

Cancer of the vulva

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67
Q

What is the most common site for cancer of the vulva?

A

Labia majora

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68
Q

What is contraception?

A
  • Keeping the egg and the sperm apart

- Intentional prevention of pregnancy during intercourse

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69
Q

What is birth control?

A

Device or practice that decreases the risk for conceiving

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70
Q

What is family planning?

A

Conscious decision on when to conceive throughout the reproductive years

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71
Q

The decision to practice conception should be a decision made by who?

A
  • A woman

- A woman and her significant other

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72
Q

What should the nurse consider when looking at fertility awareness based methods (natural family planning) for the patient?

A
  • Cultural beliefs

- Religious belies

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73
Q

How can a women determine when she is fertile or ovulating?

A
  • Fertile test strips
  • Basal temperature
  • Symptoms (individualized for each woman)
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74
Q

Besides decreasing the risk of pregnancy, condoms also aid in preventing what?

A

Sexually transmitted diseases (STDs)

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75
Q

If a patient is using diaphragms, cervical caps, or sponges to prevent pregnancy, the nurse should educate them on what?

A

Toxic shock syndrome (TSS)

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76
Q

What is the point of oral contraceptives?

A
  • To prevent the formation of a follicle, thus prohibiting ovulation
  • Suppressing of the surge of the luteinizing hormone (LH)
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77
Q

What are the forms of combined estrogen-progestin contraceptives?

A
  • Oral
  • Transdermal
  • Vaginal rings
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78
Q

Describe transdermal patches for contraception.

A
  • A new patch is placed on each week for three weeks
  • Patch is removed on the four week
  • Placement of the patch should be alternated
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79
Q

What method of contraception requires a back-up method for seven days after insertion?

A

Vaginal ring (i.e. Nuvaring)

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80
Q

What are the warning signs to teach patients who are starting or taking COCs?

HINT: ACHES

A
A: abdominal pain 
C: chest pain 
H: headaches
E: eye problems 
S: severe leg pain
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81
Q

COCs are not recommended for patients with what?

A

Cardiac issues

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82
Q

What side effect is very common with the Nuvaring?

A
  • Severe leg pain

- Blood clots

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83
Q

It is extremely to educate your patient on what regarding oral contraceptives and antibiotics?

A
  • Antibiotics reduce the effectiveness of oral contraception
  • Will need a back-up method
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84
Q

Side effects for COCs is directly correlated with receiving too much of which hormone?

A

Estrogen

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85
Q

What are the common side effects of progestin-only contraception?

A
  • Irregular bleeding/spotting
  • Depression
  • Mood changes
  • Decreased libido
  • Weight gain
  • Recurrent yeast infections
  • Acne
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86
Q

How does progestin-only contraception inhibit conception?

A
  • Increases the viscosity (thickens) of cervical mucus

- Suppressing of the surge of the luteinizing hormone (LH)

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87
Q

Progestin-only contraceptives are a good option for mothers who are what?

A

Breastfeeding

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88
Q

_____ may be delayed after stopping injectable progestins.

A

Fertility

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89
Q

What are implantable progestins? How long can they last?

A
  • Implanted rods located in the upper arm

- Last up to three years

90
Q

Patients using this method of contraceptive should also be educated on the ACHES side effects.

A

Intrauterine devices (IUDs)

91
Q

What is a vasectomy?

A

surgical interruption of the male vas deferens

92
Q

What education should be provided to the patient regarding the oral contraceptive start dose?

A

It is best started on the first day the female experiences menstrual flow

93
Q

What is a quick-start dose? What education must be included with a quick-start dose?

A
  • Patient can start contraceptive method at anytime
  • Pregnancy MUST be ruled out before taking
  • Patient must use back-up birth control for seven days
94
Q

If a patient misses one dose of COC, what should they do?

A

-Take both the missed dose tablet and the next scheduled tablet

95
Q

If a patient misses three or more doses of COC, what should they do?

A
  • Discontinue the pack
  • Allow for withdrawal bleeding
  • Start a new pack
96
Q

If a patient misses one dose of progestin-only contraceptive, what should they do?

A
  • Take the missed dose tablet as soon as possible

- Use back-up contraception for 48 hours

97
Q

Where do the sperm and the egg (ovum) join?

A

In the outer 1/3 of the fallopian tube

98
Q

How many hours are sperm fertile?

A

48 hours

99
Q

How many hours are ovum fertile?

A

24 hours

100
Q

How much amniotic fluid should be present at birth?

A

800 - 1200mL

101
Q

What is polyhydramnios?

A
  • Excessive amount of amniotic fluid

- Amniotic fluid >2000mL

102
Q

Polyhydramnios may indicate what?

A

> 2000mL of amniotic fluid may indicate GI malformations of the fetus

103
Q

What is oligohydramnios?

A
  • Insufficient amount of amniotic fluid

- Amniotic fluid <300mL

104
Q

Oligohydramnios may indicate what?

A

<300mL of amniotic fluid may indicate renal malformations of the fetus

105
Q

What protects the umbilical cord?

A

Wharton’s Jelly

106
Q

What is the umbilical cord comprised of?

A
  • 2 arteries

- 1 vein

107
Q

The two arteries of the umbilical cord are responsible for what?

A

Carries deoxygenated blood and waste away from the fetus

108
Q

The one vein of the umbilical cord is responsible for what?

A

Carries oxygenated and nutrient rich blood to the fetus

109
Q

Where do abdominal organs of the fetus initially develop? Why?

A
  • Inside of the umbilical cord

- Abdomen of the fetus is too small to house these organs during initial growth

110
Q

The placenta acts as what? Why?

A
  • Endocrine gland

- Because it secretes hormones

111
Q

What hormones are secreted by the placenta?

A
  • hCG
  • HPL
  • Estrogen
  • Progesterone
112
Q

What is the role of the placenta?

A

Regulates transport of gases, nutrients, and waste

113
Q

The placenta develops during which week of pregnancy?

A

Week 3

114
Q

The placenta is fully functional by which week of pregnancy?

A

Week 12

115
Q

What is the basis for all tissue and organ development?

A

Germ layers

116
Q

During what stage are defects most likely to occur?

A

Embryonic stage

117
Q

Describe the pre-embryonic stage.

A
  • Conception to day 14
  • Rapid cell division
  • Primary germ layers and embryonic membrane form
118
Q

Describe the embryonic stage.

A
  • Day 15 to week 8
  • Structures of major organs are complete
  • Organ systems are functioning
  • Teratogens
119
Q

What is the greatest threat to the fetus during the embryonic stage?

A

Teratogens

120
Q

List examples of teratogens.

A
  • Radiation
  • Lead
  • Chemotherapy agents
  • CMV
  • MMR = Rubella!
121
Q

How long should a woman avoid pregnancy after receiving the MMR vaccine?

A

28 days

122
Q

Can a woman receive the MMR vaccine if she is breastfeeding?

A

Yes

123
Q

What is the very first system to fully function within the fetus?

A

Cardiac system

124
Q

During development of the fetus, malfunctions of the cardiac system can occur as early as…

A

One month

125
Q

What is the second most component when assessing blood type?

A

rH Factor

126
Q

When is the rH factor developed during pregnancy?

A

During Month 2 or >6 weeks

127
Q

The doppler heartbeat can be heard as early as which month?

A

Month 3

128
Q

What protects the fetus’s skin integrity from the amniotic fluid?

A
  • Lanugo

- Vernix

129
Q

When does the fetus become viable?

A

24 weeks of gestation

130
Q

During what month is meconium forming in the fetus?

A

Month 4

131
Q

Ideally, when is meconium expelled from the fetus?

A

24 hours after birth

132
Q

Regarding meconium, what may occur if the birth is stressful on the fetus?

A
  • The meconium can be passes into the amniotic fluid

- The fetus may aspirate the amniotic fluid and, in turn, aspirate the meconium

133
Q

When can a fetus be actively felt by the mother?

A

Week 20

134
Q

The third trimester is a period of _____ and _____.

A

Refinement and growth

135
Q

What is the average weight and length of a full term fetus?

A
  • 6 to 9 lbs

- 19 to 21 inches long

136
Q

What are the three structures involved in fetal circulation?

A
  • Fetal heart
  • Placenta
  • Fetal tissues
137
Q

What are the three purposes of fetal circulation?

A
  • Increase blood flow to head and heart
  • Decrease blood flow to the fetal lungs
  • Direct blood to the placenta
138
Q

While in utero, will the baby perfuse blood to the lungs?

A
  • No!

- In utero the fetus shunts blood to the lungs

139
Q

How is effective fetal circulation determined in utero?

A

By the fetal heart rate

140
Q

How can the fetal heart rate be increased while in utero?

A

Perform interventions on mom (i.e. turning to one side)

141
Q

When is fetal circulation no longer needed?

A

When the fetus takes his/her first breath

142
Q

Describe surfactant? How does it work within the lungs?

A
  • Produced within the lungs
  • Stabilizes alveoli
  • Decreases surface tension within the lungs
  • Allows the lungs to inflate which will decrease the effort needed to breath
  • Keeps lungs from sticking together when deflated
143
Q

When does the fetus’s alveoli become mature?

A

Between 35 and 37 weeks

144
Q

What is the desired L/S ratio? What does this L/S ratio indicate?

A
  • 2:1 ratio

- Indicates lung maturity of the fetus

145
Q

What can stimulate the production of L/S?

A

Maternal use of steroids

146
Q

A multifetal pregnancy is always considered what?

A

High-risk

147
Q

How are multifetal pregnancies diagnosed?

A
  • Polyhydramnios
  • Asynchronous fetal heart rate
  • Ultrasound evidence
148
Q

Multifetal pregnancies often end in what?

A

Prematurity

149
Q

What is monozygotic?

A
  • Fertilization of a single ovum by one sperm

- Identical twins

150
Q

What is dizygotic?

A
  • Fertilization of two ova by two sperm

- Fraternal/Nonidentical twins

151
Q

Are congenital malformation most common among monozygotic or dizygotic twins?

A

Monozygotic

152
Q

What is gravidity?

A

Number of pregnancies the woman has had regardless of the outcome

153
Q

What is term birth?

A

A birth that is completed after 37 weeks

154
Q

What is preterm?

A

A birth prior to 37 weeks

155
Q

What is abortion?

A

Termination of the fetus, either spontaneous or therapeutic

156
Q

What is a spontaneous abortion?

A

A miscarriage or stillbirth

157
Q

What is a medical/therapeutic abortion?

A

An abortion involving a medical procedure or medication

158
Q

What is living?

A

The number of living children at that very moment

159
Q

What is nulligravida?

A

Never been pregnant

160
Q

What is primigravida?

A

First pregnancy

161
Q

What is multigravida?

A

More than one pregnancy

162
Q

Presumptive pregnancy data is _______ data.

A

Subjective data

163
Q

List presumptive signs of pregnancy.

A
  • Amenorrhea
  • Fatigue
  • Breast changes (heaviness, darkened areola)
  • Nausea
  • Increased urinary frequency
  • Quickening between 16 and 20 weeks (fetal movement)
164
Q

Probable pregnancy data is observed by who?

A

-The examiner:

  • OBGYN
  • Midwife
  • Nurse
165
Q

List probable signs of pregnancy.

A
  • Goodell sign
  • Chadwick sign
  • Hegar sign
  • Uterine fundus will press on bladder
  • hCG pregnancy test
  • Ballottement
166
Q

What is Goodell’s sign?

A
  • Noted as early as 5 weeks after conception

- Softening of the cervix

167
Q

What is Chadwick’s sign?

A
  • Occurs between week 6 to 8
  • Bluish-purple discoloration or hue to the cervix
  • Noted through the vaginal canal
168
Q

What is Hegar’s sign?

A
  • Occurs between week 6 to 12

- Softening of the lower segment of the uterus

169
Q

What is ballottement?

A
  • Noted between week 16 and 28 of pregnancy
  • Examiner gently taps on cervix and feels the bounce of fetus
  • Fetus will move up and come back down
170
Q

Explain positive pregnancy data.

A
  • Considered definitive evidence or sign of pregnancy

- Only attributed to the presence of a fetus

171
Q

List positive signs of pregnancy.

A
  • Ultrasound (as early as 5 to 6 weeks)
  • Fetal heart rate (as early as 6 weeks)
  • Palpation of fetal movement (as early as 19 to 22 weeks)
172
Q

What is Leopold’s maneuver?

A

Palpating the outline of the fetus

173
Q

Where can the uterus be palpated? During what weeks is the uterus palpable?

A
  • Above the symphysis pubis between 12 to 14 weeks

- At the umbilicus between 22 and 24 weeks

174
Q

What is the purpose of the mucus plug?

A

Acts as a barrier against infection for the fetus

175
Q

Loss of the mucus plug _____ for every woman.

A

Varies

176
Q

What is leukorrhea?

A
  • Response to an increase in estrogen and progesterone

- Increase in vaginal secretions

177
Q

What is the importance of the perineum?

A
  • Supports the pelvic structures
  • Often lacerated during childbirth
  • Surgical incision may be utilized to widen the birth canal
178
Q

What is the function of the breasts during pregnancy?

A
  • Manufactures breast milk

- Stores breast milk

179
Q

What is colostrum?

A
  • Precursor to breast milk

- Can be noted in the pregnant woman as early as 16 weeks

180
Q

When is complete lactation able to occur?

A
  • After pregnancy

- Once estrogen levels have declined

181
Q

Striae gravidarum can appear on the _____.

A

Breasts

182
Q

Why is cardiac output increased during pregnancy?

A

Ensures the body is able to perfuse and supply the placenta

183
Q

A drop in maternal blood pressure will occur during which week of pregnancy?

A

Week 20

184
Q

Is an elevated blood pressure normal or abnormal during pregnancy?

A

Completely abnormal!

185
Q

Regarding hypertension, the nurse should educate the pregnant patient on what signs and symptoms?

A
  • Dizziness
  • Headache
  • Blurred vision
186
Q

Pregnancy is considered a _____ state.

A

Hypercoagulable

187
Q

What is a hypercoagulable state?

A
  • Clotting factors are increased

- Protective mechanism against hemorrhage during childbirth

188
Q

The hypercoagulable state puts the pregnant woman at an increased risk for what?

A
  • Blood stasis

- Blood clots

189
Q

During pregnancy, the respiratory tract becomes what? What is this in response to?

A
  • Highly vascular

- In response to estrogen

190
Q

Describe what happens to the renal system during pregnancy.

A
  • Bladder becomes more sensitive
  • Uterus presses up against bladder
  • Increase is urine frequency
191
Q

What is melasma?

A
  • Blotchy brown mask
  • Also known as the mask of pregnancy
  • More common in darker complected females
  • Fades after childbirth
192
Q

What vascular changes remain after childbirth?

A
  • Striae gravidarum

- Angiomas

193
Q

What vascular changes fade after childbirth?

A
  • Melasma
  • Linea Nigra
  • Palmar erythema
194
Q

What is pica?

A

Non-food cravings

195
Q

Pica cravings often signify what?

A

Signifies what the woman is lacking in her diet

196
Q

If a woman is craving dirt or ice chips, she may be what?

A

Anemic

197
Q

Oxytocin is responsible for what?

A
  • Uterine contraction

- Breast milk production

198
Q

Progesterone is needed to _____ pregnancy.

A

Maintain

199
Q

Which hormone is responsible for morning sickness?

A

hCG

200
Q

Why might the pregnant woman have a lower blood sugar during the first trimester?

A
  • Fetus relies on maternal glucose

- Fetus pulls glucose from maternal supplies

201
Q

What are the two major affects of high blood glucose levels?

A
  • Makes more glucose available for fetal energy needs

- Stimulates the pancreas of a healthy woman to produce more insulin

202
Q

Discuss the fetal implications of a pregnant woman developing gestational diabetes.

A
  • Fetus becomes accustomed to high levels of glucose in utero
  • Once the umbilical cord is cut the high amount of glucose received by the fetus is stopped
  • Fetal blood glucose will plummet causing fetus to become hypoglycemic
  • Fetus glucose levels will still need to be monitored after birth
203
Q

Women with gestational diabetes often have _____ babies.

A

Large

204
Q

When does prenatal care begin and end?

A
  • Before conception

- Up to one year after birth

205
Q

Most women deliver within how many weeks of their estimated due date?

A

+/- 2 weeks

206
Q

How is an estimated due date determined?

A

Nagaele’s rule

207
Q

Explain Nagaele’s rule.

A
  • Assumes every female has a 28 day menstrual cycle

- Assumes fertilization occurred on day 14

208
Q

How is Nagaele’s rule calculated?

A
  • Add 7 to the first day of the last menstrual period (LMP)
  • Subtract 3 from the current month
  • Add 1 to the year (if applicable)
209
Q

List the maternal stages of transition to parenthood.

A
  • Acceptance of pregnancy
  • Identifying as a mother
  • Establishing personal relationship with fetus
  • Preparation for childbirth
210
Q

What is the biggest maternal milestone?

A

Verbalizing pregnancy

211
Q

What is couvade syndrome?

A

Father experiences pregnancy like symptoms (i.e. nausea, cravings, weight gain)

212
Q

List the five screenings done on every single pregnant woman?

A
  • HIV (consent needed)
  • Syphilis
  • Gonorrhea
  • Chlamydia
  • Group B Strep (GBS)
213
Q

Describe the Group B Strep (GBS) screening?

A
  • Completed between the 35 and 37 week of pregnancy
  • Swab of the vaginal canal to the rectum to detect presence (GBS thrives in this area)
  • Can be passed from mother to fetus during childbirth and cause sepsis of the fetus
  • Completed on all women regardless of childbirth route
  • GBS results can vary with each pregnancy
214
Q

What is included in the fetal assessment?

A
  • Fundal height
  • Fetal heart trends
  • Estimated gestational age
  • Labs (i.e. genetic testing)
  • Education
215
Q

After 20 weeks, the pregnant woman should notify her HCP if she notices a decrease in what?

A

Fetal movement

216
Q

List abnormal pregnancy discomforts.

A
  • Bright red bleeding
  • Uterine contractions
  • Changes in fetal movement

*Needs to seek medical help

217
Q

List normal pregnancy discomforts.

A
  • Nausea
  • Vomiting
  • Back pain
218
Q

Libido may increase during which trimester?

A

Second trimester

219
Q

Pregnant women cannot receive an immunizations that contain what? Give examples.

A
  • Live viruses
  • MMR
  • Varicella
220
Q

What common OTC medication should be avoided during pregnancy?

A

Ibuprofen

221
Q

Which vaccines are safe to administer during pregnancy?

A
  • Hep B
  • Flu
  • Tdap
222
Q

Advanced maternal age is considered what?

A

35+ years old