NUR 360 - Exam 1 Flashcards
1
Q
serousal layer
A
outer layer of uterus
2
Q
myometrium
A
middle layer made of smooth muscle - responsible for contracting during labor
3
Q
endometrium
A
inner mucus layer
4
Q
fundus
A
top of uterus where contractions start
5
Q
isthmus
A
lower uterine part just above cervix
6
Q
where is the site for c-section?
A
isthmus
7
Q
what does it mean for the cervix to “efface”?
A
thins and shortens
8
Q
what hormones do the ovaries produce?
A
estrogen
progesterone
testosterone
9
Q
what hormones are the ovaries sensitive to?
A
FSH + LH
10
Q
what is the role of estrogen in the cycle?
A
thickening of endometrial mucosa
11
Q
when is estrogen the highest?
A
follicular phase
12
Q
what 4 supplies does estrogen supply to the uterus?
A
glycogen, amino acids, electrolytes, and h2o
13
Q
what hormone does estrogen inhibit?
A
FSH
14
Q
what hormones does estrogen stimulate?
A
LH
15
Q
what is the role of progesterone in the cycle?
A
vaginal epithelium grows and cervical mucous becomes thick
16
Q
what is the effect of progesterone on the breasts?
A
glandular tissues increases in size and complexity
prep for lactation
17
Q
what does progesterone do during ovulation and secretory phase?
A
increase body temp
18
Q
what hormone does a fertilized egg produce?
A
hCG
19
Q
how long is the corpus luteum producing progesterone?
A
until week 10 of pregnancy
20
Q
what is the role of progesterone during pregnancy?
A
maintain lining of uterus until placenta is mature
21
Q
what hormone supresses uterine contractions?
A
progesterone
22
Q
what hormone supresses the maternal immunologic response to reject pregnancy?
A
progesterone
23
Q
what makes cervical mucus?
A
bartholin gland
24
Q
normal cervical mucus pH
A
4-5
25
ovulation mucus pH
7.5
26
how long is the ova viable?
6-24 hours
27
when is the sperm most healthy?
first 24 hours
28
what do fallopian tube enzymes do?
remove protective coating from sperm
29
what is the acromosomal reaction?
when sperm comes in contact with ovum
30
how do sperm get to the ovum?
sperm enzymes penetrate layers of the ovum
31
what is the endometrium called during pregnancy?
decidua
32
how is the decidua maintained?
estrogen, progesterone, and hCG
33
what can increase the chance of having twins?
increased maternal age, infertility treatment, first 3mo of marriage, more babies one has,
34
what can decrease the chance of having twins?
winter/spring in norhtern hemisphere and malnutrition
35
mono chorionic-diamniotic
- most common
- one chorion, two amniotic sacs
36
dichorionic-diamniotic
- 25% chance
- two chorions, two amnionic sacs
37
monochorionic-monoamniotic
- FATAL
- one chorion, one amniotic sac
38
when does implantation spotting occur?
7-10 days after fetilization
39
amnion
innermost embryonic membrane
40
chorion
outermost embryonic membrane
41
chorionic villi
finger like projections that delivery o2 and nutrients to fetus - used for prenatal testing
42
what is hCG doing in early pregnancy?
doubles every 48h until 10 weeks
43
what is hCG effect on hormones?
- stimulates estrogen and progesterone
- prevents ovulation and menstruation during pregnancy
44
immunologic capabilites of hCG
stops body from rejecting pregnancy
45
role of hCG in male fetuses
stimulates testosterone and develops genitals
46
what are the 8 roles of amniotic fluid?
1. cushion
2. control embryo temp.
3. support symmetrical growth
4. prevent embryo from sticking to amnion
5. free movement
6. prevent crushing of umbilical cord
7. wedge during labor
8. tells us if fetus is healthy and maturing
47
oligohydraminos
too little amnionic fluid
48
polyhydraminos
too much amniotic fluid
49
what is the umbilical cord protected by?
whartons jelly
50
how are blood vessels organized in the umbilical cord?
2 arteries and 1 vein spiral in cord
51
are there nerves in the umbilical cord?
no
52
what is a nuchal cord?
umbilical cord around neck
53
when does the placenta develope?
14 weeks but could start working as early as 11 weeks
54
what are the cotyledons?
15-20 subdivisions of the placenta that have their own vascular system
55
when does the placenta start producing hormones?
produces estrogen + progesterone at 11-12weeks
56
what viruses cross the placenta easily?
HIV, cytomegalovirus, rubella, polio
57
its harder for bacteria to cross the placenta but which one can?
treponema pallidum (syphillus)
58
what is the endocrine function of the placenta?
provide glycogen, cholesterol, and fatty acids
59
what is hPL?
human placental lactogen hormone that stimulates breast growth
60
what does hPL regulate?
moms glucose, fat, and protein
61
goodells sign
softening of cervix
62
chadwicks sign
bluish color of cervix
63
hegars sign
softening of isthmus
64
ballottement
fetal movement
65
what is a qualitiative pregnancy test?
urine test to detect if hCG present
66
what is a quantitative pregnancy test?
maternal serum test detects how much hCG and 48h doubling
67
gravida
of pregnancies
68
nulligravida
never been pregnant
69
primigravida
first pregnancy
70
multigravida
2+ pregnancies
71
para
of pregnancies carried to 20 weeks
72
what is the edge of viability?
22-25 weeks
73
term
delivered 37+ weeks
74
preterm
delivered 20-36 weeks
75
1 trimester
0-13 weeks
76
2 trimester
14-26 weeks
77
3rd trimester
27-40 weeks
78
intrapartum
active labor
79
naegeles rule
LMP - 3 months + 7 days + year if needed = due date
80
non invasive tests
- nuchal translucency
- maternal serum
- quad screen
81
invasive tests
- CVS
- amniocentesis
82
purpose of nuchal translucency and maternal serum tests
assess risk of chromosomal abnormalities and neural tube defects
83
what is the first trimester alternative to amniocentesis?
CVS test
84
what can the CVS test not determine?
spina bifida or analcephaly
85
what does the quad screen screen for?
- hCG production
- alpha-fetoprotein
- estriol
- inhibin A
86
what does decreased AFP mean on a quad screening?
downsyndrome
87
what does increased AFP mean on a quad screening?
neural tube defects
88
what does increased hCG+inhibin A mean on a quad screening?
downsyndrome
89
what does decreased estriol mean on a quad screening?
downsyndrome
90
when can a transvaginal ultrasound be performed?
1st trimester
91
when can an abdominal ultrasound be performed?
2nd + 3rd trimester
92
how often do you visit the provider during the first and second trimester?
every 4 weeks
93
when is the anatomy scan?
20 weeks
94
how often do you visit the provider in the 3rd trimester?
every 2 weeks until 36 weeks then every 1 week
95
can an HIV mom breastfeed?
yes
96
what causes fatigue?
increased metabolic needs of mom + fetus
97
what can cause acute pain?
stretching of round ligaments
98
what can cause constipation?
increase of progesterone can cause sluggish bowels
99
risks of sex during pregnancy
- rupturing of membranes
- bleeding
- preterm labor
100
how much should calories increase during the 2nd trimester?
340 cals
101
how much should calories increase during the 3rd trimester?
462 cals
102
how come pregnancy women are more prone to dehydration?
increased basal metabolic rate
103
effects of dehydration
preterm labor
104
how much liquid to consume a day?
8-10 glasses
105
what vitamin is NOT stored in the liver?
vit C
106
what are the B vitamins?
thiamine, riboflavin, niacin
107
what are the effects of folic acid deficiency
neural tube defects
108
how much weight should a mom gain during pregnancy if she is at a normal weight?
25-35lbs
109
how much weight should an underweight mom gain?
28-40lbs
110
how much weight should an overweight mom gain?
15-25lbs
111
how much weight should an obese mom gain?
11-20lbs
112
how much weight should you gain in the first trimester?
2.2-4.4lbs
113
how much weight should you gain in the 2nd and 3rd trimester?
1lb per week
114
if you have maternal PKU, what foods should you avoid?
high protein and aspartame
115
pica
eating non-nutritional things due to anemia
116
dysuria
pain when urinating
117
couvade
dad/partner mimics pregancy symptoms
118
how much does the uterus weigh during pregnancy
50-1000g
119
when does quickening start?
20 weeks
120
when does urinary frequency start?
1st and 3rd trimester
121
when does fundus reach umbilicus?
20 weeks
122
how much should the fundus grow?
1cm per week until 36 weeks
123
what creates the mucous plug?
endocervical glands
124
how does the cervical os change after birth?
changes from dimple to slit
125
when do you start producing colostrum?
20 weeks
126
how does estrogen change the respiratory tract?
estrogen induced edema causes stuffiness
127
how does tidal volume change during pregnancy?
increases up to 40%
128
how does blood volume change during pregnancy?
increases up to 45%
129
how does pulse change during pregnancy?
increases by 10-15 bpm
130
how does blood pressure change?
BP decreases slightly- lowest during 2nd trimester
131
how does cardiac output change?
up 30-50%
132
what position compresses vena cava?
laying on back
133
why does RBC increase?
for increased oxygen carrying capacity
134
what causes pseudoanemia?
increase in plasma volume
135
what increases the risk for thrombosis?
clotting
136
why are pregnant ppl at increased risk for gallstones?
slow emptying of gallbladder causes increased levels of cholesterol in bile
137
how does glomerular filtration rate change?
increases 50%
138
what is the proteinuria level for preeclampsia patients?
>300mg/24hrs
139
where is spider nevi?
face, neck, chest, arms
139
how long does hair shedding last?
1-4mo PP
140
what causes waddling gait?
relaxation of pelvic joints
141
diastasis recti
ab muscles seperate in 3rd trimester
142
can diastasis recti be prevented?
yes, with exercise
143
what causes carpal tunnel syndrome?
median nerve compression
144
what system causes the BMR to increase?
endocrine system causes it to increase by 20-25%
145
what hormone stimulates colostrum?
prolactin
146
labor dystocia is more common in what age group?
teens
147
what are the 3 types of anemia?
- folic acid
- sickle cell
- iron deficiency
148
what IM injection is given to anemic patients?
imferon
149
crack can cause what placental disease?
abruptio placentae- placental detaches from uterine wall
150
symptoms of neonatal abstinence syndrome
- high pitched cry
- increased moro (falling) reflex
- nasal flaring
151
what disease can cause an increased risk of PP hemorrage?
HIV/AIDS
152
what do you treat HIV with?
antiretrovirals
153
if an HIV patient has a high viral load, when should a c/s be done?
38 weeks
154
what does TORCH stand for?
Toxoplasmosis
Other
Rubella
Cytomegalovirus
Herpes
155
how can you get toxoplasmosis?
cat litter + raw meat + raw goats milk
156
how do you diagnos toxoplasmosis?
test igG/igM, test amniotic fluid at delivery, ultrasound
157
how do you treat the mom for toxoplasmosis?
- spiramycin
- sulfa drug + pyrime drug
- folinic acid
158
fetal risk of toxoplasmosis
- blindness
- retinochoroditis (teens)
- microcephaly
- coma
- convulsions
- cognitive defects
159
what does 1:18 immunity against rubella mean?
immune
160
what does 1:8 immunity against rubella mean?
at risk
161
fetal risks of rubella
- congenital heart disease
- cerebral palsy
- deafness
162
where is cytomegalovirus found?
ALL body fluids
163
how does cytomegalovirus affect adults, kids, and fetuses?
not harmful in adults/kids but fatal in fetus
164
when is cytomegalovirus the greatest risk to fetus?
1st trimester
165
fetal risks pf cytomegalovirus
- microcephaly
- hydrocephaly
- small for gest. age
- intellectual disability
166
how is herpes transmitted to baby?
birth canal
167
if the primary infection of herpes was close to the birth site then what is the rate of infection?
30-50%
168
what is the maternal treatment for herpes?
acyclovir started at 36 weeks
169
what is the herpes treatment for a neonate?
acyclovir started at birth
170
fetal risk of herpes
- fever/ hypothermia
- jaundice
- seizures
- poor feeding
171
early onset fetal risks of GBS
pneumonia, spesis, apnea
172
late onset fetal risks of GBS
meningitis, pneumonia
173
long term fetal risks of GBS
neuro complications
174
two common reasons for 1st trimester spontaneous abortion
- chromosomal abnormalities
- uterine/cervical issues
175
threatened cervix
cramping, bleeding, backache, but cervix is closed
176
imminent/inevitable cervix
dilated cervix
176
incomplete cervix
some products of conception retained - usually placenta
177
complete cervix
all products of conception passed
178
missed cervix
fetus dies but is not passed
179
if you do not get a dead fetus out within 6 weeks, what disease can occur?
Disseminated Intravascular Coagulation
180
recurrent
consecutive losses in 3 or more pregnancies
181
ectopic pregnancy
implantation in fallopian tube
182
treatments for ectopic pregnancy
- surgical removal
- methotrexate (IM or PO)
- rhogam if Rh negative
183
symptoms of ectopic pregnancy
severe one sided pain
184
