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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
Q

What is hematopoiesis?

A

formation of blood, system seeds the fetal liver around the 5th week.

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26
Q

What is the hepatic system?

A

the start of liver growth and iron storage

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27
Q

Neuro

A

1st 16 wks - neuro is essential in growth

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28
Q

Dizygotic twins

A

fraternal

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29
Q

monozygotic twins

A

identical

30
Q

What phase is birth and how long is this phase?

A

transition; 6-8 hrs

31
Q

what are the interventions given to newborns?

A
  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
Q

What does the apgar score show?

A

how the baby is transitioning from interuterine to extrauterine life; and if you need resusitation or not.

33
Q

What do scores mean and when are they done?

A

1 minute and 5 minutes.
0-3 - severe distress
4-6 - moderate difficulty
7-10 - no difficulty

34
Q

what are the priorities after birth?

A

respiratory, cardiac then neuro

35
Q

What factors affect 1st breath?

A

Pressure changes; chemoreceptors (in aorta initiate reflex when O2 decreases) & chilling

36
Q

After respirations are established, breaths are…

A

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
Q

What are some signs of respiratory distress?

A

nasal flaring, intercostal or subcostal retractions, grunting with respirations.

38
Q

Apneic episodes can be related to what?

A

rapid increase in temp, hypothermia, hypoglycemia and sepsis.

39
Q

What is the HR of an infant?

A

100-160 beats/min

40
Q

what is the BP of an infant?

A

60-80/40-50

41
Q

pressure changes stimulate the cardiovascular system to make what changes?

A

foramen ovale to close (min)
ductus Arteriosis constricts (24 hrs)
ductus venosus closes with cutting of cord (2-3mths)

42
Q

hgb values

A

14-24

43
Q

hct values

A

44%-64%

44
Q

RBC values

A

4.8-7.1 mil

45
Q

WBC (leukocytes) value

A

avg around 18k but increases to 23k-24k 1st day after birth

46
Q

platelet count

A

200,000-300,000, same as adults

47
Q

What is the thermogenic system?

A

heat regulation

48
Q

What is thermogenesis?

A

infants ability to produce heat. Infants can lose heat quicker in cold environments and newborns have the inability to shiver.

49
Q

What is Brown fat?

A

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
Q

Heat loss in nb occur in 4 modes, what are they?

A

Convection
Radiation
Evaporation
Conduction

51
Q

What is Convection?

A

Heat loss due to colder air

52
Q

What is Radiation?

A

Heat loss due to cold surface NOT in direct contact but relative proximity. ex. cribs near a window can be colder

53
Q

What is Evaporation?

A

Heat loss due to wetness. Insensible water loss and most significant cause of heat loss in the first few days of life.

54
Q

What is Conduction?

A

Heat loss due to cold surface in DIRECT contact. Setting baby on cold surface

55
Q

What is cold stress and how does it affect the baby?

A

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
Q

Why shouldn’t you overheat an infant?

A

because their sweat glands don’t work as well

57
Q

What is the NIPS assessment?

A

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
Q

What is vernix caseosa?

A

A cheeselike, whitish substance, serves as a protective covering.

59
Q

What is acrocyanosis?

A

bluish coloring of hands and feet, caused by vasomotor instability and capillary stasis. Normal and appears intermittently 7-10 days of birth.

60
Q

what reflexes to check on newborn?

A

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
Q

what meds are given to newborns?

A

eye ointment - Erythromycin - gonorrheal or chlamydial infection
Vitamin K
Hep B vaccine

62
Q

Why do they get Vitamin K?

A

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
Q

Where/why is the hep B vaccine given?

A

Intramuscular injection!!! 5-10mcg before discharge - vastus lateralis muscle

64
Q

Bilirubin values

A

0.2-1.4

65
Q

What newborn screening tests are performed?

A

Bilirubin
Newborn screen (heel stick)
Hearing screen
Blood Glucose

66
Q

What tests are done with the heel stick?

A

PKU, hypothyroidism

67
Q

What is the PKU test for?

A

to check for lacking enzyme for metabolisms; can cause neuro/seizures.

68
Q

What causes physiologic jaundice and when is it noticed?

A

Increased bilirubin production, short RBC lifespan & immature liver. Begins AFTER 24 hrs of life.

69
Q

What is kernicterus jaundice?

A

depostition of bilirubin in the brain

70
Q

what does the colostrum contain?

A

rich in immunoglobulins. Higher concentration of protein and minerals.

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

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