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Maternity > Midterm - Mod 1 - 2 > Flashcards

Midterm - Mod 1 - 2 Flashcards

1
Q

*women with what disorders should not take oral contraceptives or use with caution?

A
  • thromboembolic disorders (blood clots)
  • cerebrovascular accident or heart disease
  • estrogen-dependent cancer or breast cancer
  • smoking over 15 cigs a day older than 35
  • impaired liver function
  • pregnant
  • undiagnosed vaginal bleeding
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2
Q

What is a mammography and how often should a woman get one?

What is a pap smear and how often should a woman get one?

A
  • Uses very low does x-rays to visualize the breast tissue. Can detect tumor long before it’s able to be felt.
  • Annually for all women over 40. Women at risk for breast cancer may begin earlier.
  • Identifies conditions such as tumors, abnormal discharge, infections or unusual pain.
  • Sexually active woman: every 3 years – age 21 – 29, every 5 years – age 30-65. No screening over 65 with negative screening for past 10 years
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3
Q

Define menopause

A

no menstrual period for 12 months because of changes in estrogen production

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4
Q

What are the warning Signs to Report when Taking Oral Contraceptives

A

ACHES

  • Abdominal pain (severe)
  • Chest pain, dyspnea, bloody sputum
  • Headache (severe), weakness, or numbness of extremities
  • Eye problems
  • Severe leg pain or swelling, speech disturbance
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5
Q

What type of pelvis is best for child birth? worst?

A

best - Gynocoid

worst - Platypelloid

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6
Q

What is the most common site for fertilization?

A

Ampulla

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7
Q

the menstrual cycle begins with the anterior pituitary gland releasing of FSH and LH. Describe the first stage - follicular stage?

A
  • ovary senses release of FSH, stimulates growth of follicles, but only one will mature (called a Graafin follicle) that will release an egg, the others die.
  • maturing ovum and corpus luteum (follicle left empty after ovum released) produces increase of estrogen and progesterone which enlarges endometrium
  • surge in LH stimulates final maturation and release of ovum - about 24-36 hours after surge
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8
Q

Describe ovulation phase

A

occurs when a mature ovum is released about 14 days before onset of menstrual period.

  • Corpus luteum turns yellow and secretes increased quantities of progesterone to prepare uterine lining.
  • Approx. 12 days after ovulation, corpus luteum degenerates if no fetilization = decreased levels of progesterone and estrogen = endometrium break down = menstruation
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9
Q

When is a women most fertile? sperm can live in the reproductive tract up to how many days?

A

about cycle 9-16 days

- 5 days

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10
Q

Physical changes of menopause

A
  • Change in mentstrual cycle due to decreased estrogen (uterus shrinks and ovaries atrophy)
  • vasomotor instability (hot flashes)
  • Decrease elasticity and moisture of vagina which can cause painful intercourse (dyspareunia)
  • mood swings and irratibility
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11
Q

treatment options for menopause

A
  • Exercise
  • Increase in calcium, magnesium, and high-fiber, low-fat diet rich in antioxidants is essential
  • Hormone replacement therapy (HRT), which
    may increase risk of heart attack and stroke, is
    based on the individual patient and discussions
    with her health care provider
  • Complementary and alternative therapies (yam root, ginseng, soy products, Vitamin E, calcium and vitamin D if not getting more than 30 min of sun)
  • Prevention of osteoporosis
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12
Q

What is the most common viral STI? how is it transmitted? Treatment?

A 
Human papillomavirus (HPV) through skin-to-skin contact. 
- tx: cryotherapy, laser vaporization, electrodiathermy, and electrofulguration. Topical agents are used and lidocaine cream may be used 20 min before painful tx.
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13
Q

All newborns receive what type of prophylactic eye care?

A

Within hour of being born all new borns get a erythromycin eye appointment to protect different STI infections that can cause blindness

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14
Q

What are 3 examples of natural birth control

A

> Basal Body Temperature – best at predicting when ovulation has already occurred
­>Cervical mucous method (failure rate of 20%) - dry phase and sticky phase = not fertile (days 1-6); Creamy phase = semi fertile (days 7-9); clear phase = Very fertile (days 10-14)
- calendar method - tracking menstrual cycles for a few months

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15
Q

what are hormonal contraceptives?

A

Temporary
o A form of temporary birth control
o Prevents ovulation
o Makes cervical mucus thick and resistant to sperm penetration
o Makes uterine endometrium less hospitable if fertilized ovum arrives

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16
Q

what are examples of barrier contraceptives? Only method than can prevent?

A 
 Diaphragm
 Cervical cap
 Male condom
 Female condom
 Spermicides
- Can prevent STI's
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17
Q

What are the three stages of fetal development?

A

Stage 1: Zygote: cell formed by union of sperm and ovum – stage lasts about 2 weeks
Stage 2: Embryo: second to eighth week of development
Stage 3: Fetus: ninth week until birth

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18
Q

what is the age of viability and why?

A

20 weeks of gestation – lungs have matured functionally enough for the fetus to survive outside the uterus but with lots of support – requires NICU care to survive

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19
Q

the lifeline between mother and fetus, the umbilical cord, transfers blood how? how is it protected?

A

AVA – 2 arteries carry blood away from fetus, and 1 vein carries blood to the fetus
- Wharton jelly covers and cushions cord vessels.

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20
Q

*After the 4th week of gestation, circulation of blood through the placenta to the fetus is well established. What are the three fetal circulatory shunts and what do they do?

A
  • Foramen ovale - diverts most blood from the right atrium directly to the left atrium, rather than circulating it to the lungs.
  • Ductus arteriosus - diverts most blood from the pulmonary artery into the aorta
  • Ductus venosus - diverts some blood away from the liver as it returns from the placenta
    (After permanent closure, the ductus arteriosus and ductus venosus become ligaments)
21
Q

You should educate patients as soon as they think they are pregnant to take..

A

take folic acid - integral for maternal tube development

22
Q

Who can deliver prenatal care in Alberta?

A

Obstetricians, family practice physicians,

certified nurse-midwives and nurse practitioners

23
Q

what is the role of a midwife?

A

birth attendants
o Prenatal & Postnatal care & attends uncomplicated deliveries
o Ensures that each patient has a backup physician who will assume her care should a problem occur
- Home birth - using midwives is not currently a widespread practice because malpractice insurance is expensive & emergency equipment for unexpected complications is not available

24
Q

What are presumptive signs of pregnancy

A

indications of pregnancy are those from which a definite diagnoses of pregnancy can not be made.
Ex. Amenorrhea, Nausea, Breast tenderness, Deepening pigmentation, Urinary frequency,Fatigue and drowsiness, Quickening, Breast changes, pigmentation

25
Q

What are probable signs of pregnancy

A

Stronger evidence of pregnancy, but could be caused by other conditions.
Ex. Goodell sign, Chadwick sign, Hegar sign, Abdominal enlargement, Braxton Hicks contractions, Ballottement or fetal outline, Abdominal striae, Positive pregnancy test result

26
Q

What are positive signs of pregnancy

A

Only a developing fetus causes positive signs of pregnancy,

Includes: Audible fetal heartbeat, Fetal movement felt by examiner, Ultrasound visualization of fetus

27
Q

Difference between gravida and parity or “para”

A

Gravida - number of times a woman is or has been pregnant
Parity - number of pregnancies reaching gestational age (20 weeks - including live births and stillbirths). The number of fetuses does not determine the parity.

28
Q

The obstetric history includes?

GTPALM

A 
G – gravida
Term – baby born at 37 weeks or more
Preterm – born between 20 – 37 weeks
Abortion – termination of pregnancy before 20 weeks
Living – number of children living now
M – multiple (optional)
29
Q

How do you calculate estimated date of delivery (EDD)?

A

Nägele’s rule:

  • Identify first day of LNMP.
  • Count backward 3 months.
  • Add 7 days.
  • Update year, if applicable.
30
Q

What is the weight gain for women of normal weight?

A

25 to 35 lb (11.4 to 15.9 kg)

31
Q

Describe the nutritional requirements during pregnancy to maintain a healthy baby.

A
  • First trimester: Increase by 300 kcal/day
  • Second trimester: Increase by 40 to 340 kcal/day
  • Third trimester: Increase by 110 to 450 kcal/day
  • Take folic acid
  • Eat foods that are nutrient dense.
  • Protein versus sugary foods
  • Lower sodium - not restricted but not encouraged
32
Q

What changes do you see to the reproductive system during pregnancy?

A
  • Cervix: Changes in color and consistency, glands in cervical mucosa increase – (changing color is called Chadwick)
  • Ovaries: produce progesterone to maintain decidua until the placenta can take over
  • Vagina: secretions and pH increases, higher glycogen level = higher risk of getting bacterial infections
  • Breasts: Montgomery glands become prominent, Areola pigment deepens
33
Q

What changes occur in the respiratory system during pregnancy?

A
  • Increase depth of breath - oxygen consumption increases by 15%
  • Uterus exerts upward pressure on the diaphragm
  • Rib cage flares
  • Dyspnea (SOB) may occur until lightening - edema of mucous membranes in the nose, pharynx, mouth and trachea
34
Q

What changes occur in the Cardiovascular system during pregnancy?

A
  • Blood volume increases to 45% greater than pre-pregnant state
  • *HR and Cardiac output increase
  • *Coagulation increase
  • Vascular resistance decreases – *BP may decrease
  • Orthostatic hypotension & palpitations can occur
  • Aortocaval compression can occur – advise not to sleep on back, lay on side, preferably left side. Avoiding weight of uterus on aorta and inferior vena cava which will inhibit blood flow
35
Q

What changes occur in the GI during pregnancy?

A
  • Stomach and intestines displaced – can lead constipation, purosis, heartburn
  • Increased salivary secretions
  • Oral mucosa may become tender and bleed more easily
  • Appetite and thirst may increase
  • Gastric acid secretions decrease
  • Delayed gastric emptying, intestinal motility and relaxation of cardiac sphincter – teach patient to stay upright for comfort
36
Q

The fetal heart rate should be

A

110-160bpm

37
Q

What are the Major Goals of Prenatal Care

A

 Ensure a safe birth for mother and child by promoting good health habits and reducing risk factors.
 Teach health habits that may be continued after pregnancy.
 Educate in self-care for pregnancy.
 Provide physical care.
 Prepare parents for the responsibilities of parenthood.

38
Q

what are the Routine Assessments at Each Prenatal Visit

A
  • Risk factors
  • Vital signs + weight (determine if gain is normal)
  • Urinalysis: protein, glucose, and ketone levels
  • Blood glucose screening – between 24 and 38 weeks gestation
  • Fundal height: to determine fetal growth and amniotic fluid volume
  • Leopold maneuvers: assess presentation and position by abdominal palpation
  • Fetal heart rate: can be seen 8 weeks after LNMP
  • Fetal activity – “kick count” may be done at 28 weeks
  • Nutrition intake:
  • Any discomforts or problems since last visit
39
Q

what is the non-stress test?

A

• Recording of the fetal heart beat that is evaluated against certain criteria to establish fetal well-being.

40
Q

what are the most common complications of amniocentesis related to the baby ?

A

Hemorrhage and Preterm labor

41
Q

what is the Glucose Tolerance Test and when should it be done?

A
  • Detects diabetes in pregnancy

- done at 26-28 weeks

42
Q

AFP (Alpha-Fetoprotein) hormone comes from baby. what are some complications with this?

A
  • More AFP in blood = potential problem with spine

- Lower levels of AFP = possible Downs child

43
Q

Term is a baby born at 37 weeks or more

A

37 weeks or more

44
Q

preterm is a baby born

A

between 20 weeks – 37 weeks

45
Q

Abortion is

A

termination of pregnancy before 20 weeks

46
Q

the muscular layer of the uterus that is the functional unit in pregnancy and labor is the…

A

myometrium

47
Q

when does ovulation occur

A

14 days BEFORE the onset of the next menstrual period

48
Q

after development of breasts, the first menstrual period occurs how long after?

A

2-2 1/2 years later

49
Q

When is the best time for a breast self exam (BSE)?

A

1 week after the beginning of the menstrual period.

Maternity (10 decks)

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