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OB, fetal dev & care of newborn (test 2) > PP 1 of test 2 > Flashcards

PP 1 of test 2 Flashcards

1
Q

What is mitosis

A

Process of somatic cell division in which a single cell divides, both cells have same # of chromosomes as 1st.

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2
Q

What is meiosis

A

Process by which germ cells divide and decrease their chromosomal numbers by 1 half.

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3
Q

What is gametogenesis

A

oogenesis, the process of ovum formation, begins during fetal life of the female.

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4
Q

what is Conception and what does it include?

A

union of a single egg and sperm. Occurs as a sequential process including a gamete (egg & sperm) which results in an embryo and implantation.

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5
Q

How long is the ovum fertile?

A

24 hrs

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6
Q

how long is sperm viable?

A

2-3 days

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7
Q

Where does fertilization take place?

A

the ampula (outer third of the uterine tube)

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8
Q

What is zona reaction?

A

When the ovum is fertilized with sperm and becomes impermeable to other sperm

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9
Q

What is a fertilized (ovum) egg called?

A

A zygote

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10
Q

Implantation occurs how many days after conception?

A

6-10 days

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11
Q

What is chorionic villi?

A

finger-like projections, that project into the uterin wall and help form the placenta and secrete human chorionic gonadotropin

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12
Q

Why does spotting occur during implantation?

A

because the process causes endometrial blood vessels to erode

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13
Q

What are the germ layers?

A

Ectoderm, Mesoderm & Endoderm

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14
Q

What is the Ectoderm?

A

The upper layer of embryonic disc that helps form the epidermis, glands, nails & hair, central & peripheral nervous system, lens of eye, tooth enamel & the floor of amniotic cavity.

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15
Q

What is the Mesoderm?

A

The middle layer of the embryonic disk that helps form bone, teeth, muscles (smooth muscle & cardiac), dermis, connective tissue, spleen & urogenital system.

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16
Q

What is the Endoderm?

A

Lower layer that helps form the epilthelium of the respiratory & digestive tract, oropharynx liver, pancreas, urethra bladder & vagina and the roof of the yolk sac)

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17
Q

what week are all organ systems and external structures present?

A

after week 8

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18
Q

What is the age of viability?

A

24 weeks, 22 is iffy (due date may also be squed so some leeway)

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19
Q

What is a major factor in the viability of an infant at such an early gestation age?

A

Lung maturity, still forming after 24 wks till birth. Lack pulmonary surfactants (phospholipids that decrease surface tension of alveoli - levels are pretty low early in gestation.

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20
Q

What are the 2 alveolar surfactants that are required for postnatal lung expansion?

A

Lecithin & Sphingomyelin

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21
Q

What does the L/S ratio mean?

A

how much is present in relation to the other (lecithin is detectable @21 wks & starts to increase @24 wks and is a 1:2 ratio to sphingomyelin around 35 wks

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22
Q

What can speed up development of surfactants?

A

Hypertension, infection, steroid use

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23
Q

What can slow down lung maturity (development of surfactants)?

A

Renal problems & gestational diabetes (GD can also cause early delivery and baby may be underdeveloped).

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24
Q

what 3 shunts permit most of the blood to bypass the liver & lungs?

A

Ductus venosus, foreman ovale, ductus arteriosis

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25
What is hematopoiesis?
formation of blood, system seeds the fetal liver around the 5th week.
26
What is the hepatic system?
the start of liver growth and iron storage
27
Neuro
1st 16 wks - neuro is essential in growth
28
Dizygotic twins
fraternal
29
monozygotic twins
identical
30
What phase is birth and how long is this phase?
transition; 6-8 hrs
31
what are the interventions given to newborns?
1. AIRWAY (need o2 w/in a minute of birth. AIRWAY AIRWAY AIRWAY!!! through suction, O2 or intubate) 2. Dry 3. Stimulate - slapping feet
32
What does the apgar score show?
how the baby is transitioning from interuterine to extrauterine life; and if you need resusitation or not.
33
What do scores mean and when are they done?
1 minute and 5 minutes. 0-3 - severe distress 4-6 - moderate difficulty 7-10 - no difficulty
34
what are the priorities after birth?
respiratory, cardiac then neuro
35
What factors affect 1st breath?
Pressure changes; chemoreceptors (in aorta initiate reflex when O2 decreases) & chilling
36
After respirations are established, breaths are…
shallow and irregular, with a rate of 30-60 breaths/min, with periods of periodic breathing that include pauses in respirations lasting less than 20 sec. Anything over 20 sec is of concern
37
What are some signs of respiratory distress?
nasal flaring, intercostal or subcostal retractions, grunting with respirations.
38
Apneic episodes can be related to what?
rapid increase in temp, hypothermia, hypoglycemia and sepsis.
39
What is the HR of an infant?
100-160 beats/min
40
what is the BP of an infant?
60-80/40-50
41
pressure changes stimulate the cardiovascular system to make what changes?
foramen ovale to close (min) ductus Arteriosis constricts (24 hrs) ductus venosus closes with cutting of cord (2-3mths)
42
hgb values
14-24
43
hct values
44%-64%
44
RBC values
4.8-7.1 mil
45
WBC (leukocytes) value
avg around 18k but increases to 23k-24k 1st day after birth
46
platelet count
200,000-300,000, same as adults
47
What is the thermogenic system?
heat regulation
48
What is thermogenesis?
infants ability to produce heat. Infants can lose heat quicker in cold environments and newborns have the inability to shiver.
49
What is Brown fat?
unique to newborns, produced by lipid metabolic activity and is a layer of fat that is rich in vascular & nerve supply. Lasts for several weeks.
50
Heat loss in nb occur in 4 modes, what are they?
Convection Radiation Evaporation Conduction
51
What is Convection?
Heat loss due to colder air
52
What is Radiation?
Heat loss due to cold surface NOT in direct contact but relative proximity. ex. cribs near a window can be colder
53
What is Evaporation?
Heat loss due to wetness. Insensible water loss and most significant cause of heat loss in the first few days of life.
54
What is Conduction?
Heat loss due to cold surface in DIRECT contact. Setting baby on cold surface
55
What is cold stress and how does it affect the baby?
when the infant is excessively cold, causes metabolic and physiologic demands on the infant. Respiratory rate increases, O2 consumption and energy are diverted from maintaining normal brain & cardiac function to thermogenesis for survival.
56
Why shouldn't you overheat an infant?
because their sweat glands don't work as well
57
What is the NIPS assessment?
A scale used to indicate pain or stress in the nb facial expression, cry, breathing patterns, arms, legs,state of arousal. Scored 0-7 0-2 none, 3-4 reassess in 30 min, >4severe pain, reassess in 30 - possible pharmacological intervention
58
What is vernix caseosa?
A cheeselike, whitish substance, serves as a protective covering.
59
What is acrocyanosis?
bluish coloring of hands and feet, caused by vasomotor instability and capillary stasis. Normal and appears intermittently 7-10 days of birth.
60
what reflexes to check on newborn?
Root, suck & swallow Extrusion - touch tongue, will push it outward Grasp - palmer & plantar Tonic neck - "fencing" position. persistant response after wk 6 could be cerebral palsy Moro - startle hands in air when feeling of falling Trunk incurvation Stepping - infant on feet, will simulate stepping Babinski - + sign = good! stroke bottom of feet, toes hyperextend
61
what meds are given to newborns?
eye ointment - Erythromycin - gonorrheal or chlamydial infection Vitamin K Hep B vaccine
62
Why do they get Vitamin K?
Intramuscular injection!! 0.5-1.0mg (0.25-0.5ml) in vastus lateralis muscle w/ 25 gauge 5/8" needle for prevention of hemorrhagic disease. NB doen't have intestinal flora to produce K in first week of birth & promotes formation of clotting factors 2, 7, 9 & 10. NEVER administered IV route unless no muscle mass in preterm, even then it should be diluted and given over 10-15 min. w/ cardiorespiratory monitoring. - could cause cardiac arrest if given too fast!
63
Where/why is the hep B vaccine given?
Intramuscular injection!!! 5-10mcg before discharge - vastus lateralis muscle
64
Bilirubin values
0.2-1.4
65
What newborn screening tests are performed?
Bilirubin Newborn screen (heel stick) Hearing screen Blood Glucose
66
What tests are done with the heel stick?
PKU, hypothyroidism
67
What is the PKU test for?
to check for lacking enzyme for metabolisms; can cause neuro/seizures.
68
What causes physiologic jaundice and when is it noticed?
Increased bilirubin production, short RBC lifespan & immature liver. Begins AFTER 24 hrs of life.
69
What is kernicterus jaundice?
depostition of bilirubin in the brain
70
what does the colostrum contain?
rich in immunoglobulins. Higher concentration of protein and minerals.

OB, fetal dev & care of newborn (test 2) (3 decks)

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