Pregnancy I Flashcards
1
Q
What is the function of the Skene duct?
A
Lubrication and antimicrobial properties
2
Q
What happens to the Bartholin duct opening during arousal?
A
It swells
3
Q
Where is the perineum located?
A
Between vagina and anus
4
Q
When might the perineum need to be cut or tear?
A
During labor
5
Q
What is the fundus?
A
Hollow organ farthest from cervix
6
Q
What is the function of the cervix?
A
Helps keep the baby in the uterus
7
Q
What is the size of the cervix?
A
About 2-3 cm
8
Q
How does the cervix feel under normal conditions?
A
Elasticity of nose
9
Q
Describe the external os.
A
Round
10
Q
How does the external os change after pregnancy?
A
Smiley face shape
11
Q
Where is the uterus located?
A
Behind the bladder
12
Q
What can happen if the bladder is too full during childbirth?
A
Baby can come down
13
Q
What can happen postpartum if the bladder is too full?
A
Fundus cannot come back down
14
Q
What are the two types of influences on childbearing?
A
Hereditary and Environmental
15
Q
What is a genetic counselor?
A
A professional who provides guidance and support on genetic disorders and inherited conditions.
16
Q
What are autosomal dominant traits?
A
Expressed by dominant gene on a non-sex chromosome
17
Q
What is the chance of passing on an autosomal dominant trait to a child?
A
50%
18
Q
Give examples of autosomal dominant traits.
A
Huntington’s disease, neurofibromatosis
19
Q
What are autosomal recessive traits?
A
Expressed if a person receives two copies of a recessive gene
20
Q
Name some examples of autosomal recessive diseases.
A
Tay-Sachs, sickle cell, cystic fibrosis, PKU
21
Q
Need two carriers for the trait to be expressed in an autosomal recessive trait t/f
A
TRUE
22
Q
What are some examples of autosomal recessive disorders?
A
PKU, Tay Sachs, Sickle cell, cystic fibrosis
23
Q
What is the chance of gene expression when both parents are carriers of an autosomal recessive trait?
A
1/4 or 25%
24
Q
What is the chance of not having the disease when both parents are carriers?
A
25%
25
What is the chance of being a carrier for the gene when both parents are carriers?
50%
26
What are X-Linked traits?
Males usually affected, females carriers
27
Give examples of X-Linked traits.
Color blindness, Duchenne's muscular dystrophy, hemophilia A, Turner syndrome
28
What are some common symptoms of Turner syndrome?
Less fertility, barrel chest, altered appearance
29
How is X-linked inheritance different from other types with inheritance?
Dads don't pass it on to sons
30
What is a trisomy?
Extra copy of a chromosome
31
What is monosomy?
Missing a chromosome
32
What is polyploidy?
One or more extra sets of chromosomes
33
What are structural chromosomal abnormalities?
Missing, added, or rearranged part of a chromosome
34
What is a possible cause of spontaneous abortion in the first trimester?
Polyploidy
35
Which gender is fragile X syndrome more commonly seen in?
Males
36
What is an example of Monosomy?
Turner syndrome
37
What is an example of a structural abnormality?
Fragile X syndrome
38
Substances that can cause abnormalities in fetal development
teratogens
39
What are the effects of teratogens in embryonic development?
Abnormalities in organ development, growth, and function
40
What can teratogens lead to?
Birth defects or developmental disabilities
41
When do teratogens have the most impact?
During the first trimester of pregnancy
42
Name three examples of teratogens mentioned in the text.
Psych meds, alcohol, tobacco
43
What are some teratogens that can influence the environment?
Alcohol, Aminoglycosides, Anticonvulsant agents, Antihyperlipidemic agents (statins), Antineoplastic agents, Antithyroid drugs, Cocaine, Diethylstilbestrol (DES), Folic acid antagonists, Lithium, Mercury, Retinoic acid, Tetracycline, Tobacco, Warfarin
44
What are some infections that can influence the environment as teratogens?
Cytomegalovirus, Herpes simplex virus, HIV, Parvo, Rubella, Syphilis, Toxoplasmosis, Varicella, Zika
45
What should you do if someone has chicken pox?
Keep them away from babies less than 1 year and pregnant moms.
46
What is one role of the nurse in genetic counseling?
Recognize need for genetic counseling and gather medical history. provide education & emotional support.
47
What should you consider when talking to moms?
Family history, medical history, risk factors (teratogens)
48
Why are hot tubs bad for babies and what is the limit?
Too much heat can be bad, no more than 10 minutes for sure, preferably not at all though.
49
What should all pregnant women take?
Folic acid
50
What is the process of fertilization?
Sperm and ovum unite to form a zygote.
51
What is the lining of the uterus called during pregnancy?
Decidua.
52
What hormone is secreted by the zygote?
hCG.
53
What can occur around week 2 of pregnancy after implantation?
Spotting.
54
What is the process of implantation?
Zygote enters uterus and implants in the fundus in the uterus
55
What happens during the preembryonic period? and how long does it last?
Inner part of zygote develops into fetus and outer part develops into the placenta. two weeks.
56
What hormone stimulates estrogen and progesterone and protects pregnancy?
HcG. will protect the pregnancy until the placenta takes over in a few weeks.
57
What can implantation cause?
Spotting or small bleeding, which can be confused for a light period ---they think theyre not pregnant
58
What happens during the embryonic period?
Development of the central nervous system (CNS)
59
What happens during week 3 of the embryonic period?
CNS develops
60
What happens during week 4 of the embryonic period?
Neural tube closes
61
What happens during week 5 of the embryonic period?
Heart begins to beat
62
What is the importance of folic acid?
Prevents spina bifida
63
When does the heartbeat begin?
5th week
64
What happens during Week 6 of the embryonic period?
Upper and lower extremities are defined
65
What happens during Week 7 of the embryonic period?
Face more human looking
66
What happens during Week 8 of the embryonic period?
Well-defined fingers & toes, external genitalia begins to differentiate
67
At what week does external genitalia begin to differentiate?
Week 8
68
What happens during the fetal period?
Fetal movements, urine production, gender determination
69
What happens during weeks 9-12 of the fetal period?
Fetal movements, urine production, gender determination
70
What happens during weeks 13-16 of the fetal period?
Rapid body growth
71
What happens during weeks 17-20 of the fetal period?
Increased fluttering movements, development of eyebrows, head hair, lanugo, and vernix
72
When does the first trimester end?
12th week
73
At what week does the baby close its eyes?
9 weeks
74
When will the baby open its eyes again?
26 weeks
75
What happens during weeks 21-24 of the fetal period?
Little subcut fat, red and translucent skin, surfactant barely produced, can survive - ICU babies
76
What happens during weeks 25-28 of the fetal period?
Plumper, eyes open, rotates to head down position
77
What happens during weeks 29-32 of the fetal period?
Toenails & fingernails & skin pigmentation
78
What happens during weeks 33-38 of the fetal period?
Mainly gaining weight
79
How does the fetus look during weeks 33-38 of the fetal period?
More plumper with abundant subcutaneous fat
80
What is fertilization age?
Not really used in practice
81
How is gestational age determined?
By last menstrual period
82
What is the typical range for gestational age?
38-42 weeks
83
What is the key function of the placenta?
Respiration
84
Describe the fetal side of the placenta.
Smooth
85
Describe the maternal side of the placenta.
Rough where it attaches to uterus
86
What is the composition of the umbilical cord?
2 arteries & 1 vein (AVA)
87
What do the arteries in the umbilical cord carry?
Deoxygenated blood & waste products
88
What does the vein in the umbilical cord return?
Oxygenated blood and nutrients
89
What does the placenta do?
Remove waste and provide nutrients and oxygen to the baby.
90
Is the placenta intact when it comes out?
Yes.
91
How should the placenta come out?
it should come out intact
92
What are the two fetal membranes?
amnion and chorion
93
What is the function of amniotic fluid?
cushioning
temp control
prevents membranes from attaching
provides room to move
94
What structure surrounds the amnion?
chorion
95
What is oligohydramnios?
Low levels of amniotic fluid
96
What is hydramnios?
High levels of amniotic fluid (or polyhydramnios)
97
What is the ideal volume of amniotic fluid?
700-800 mL
98
What is the ideal volume of oligohydramnios?
400 mL
99
What are some possible causes of oligohydramnios?
Poor placental perfusion, fetal kidney failure
100
What are some potential complications of oligohydramnios?
Poor lung development, premature rupture of membranes
101
What is the volume of amniotic fluid in hydramnios or polyhydramnios?
Over 2000 mL
102
What condition is associated with uncontrolled diabetes in the mother?
Polyhydramnios
103
What are some possible complications of polyhydramnios?
Malformation of CNS, Cardiovascular system issues, GI tract issues
104
What are presumptive indicators?
amenorrhea
n/v
fatigue
urinary frequency
105
What is amenorrhea?
Absence of menstruation
106
What is the prevalence of nausea and vomiting in pregnancy?
60-80% in 1st trimester but 45% in 3rd trimester
107
What are the least reliable indicators?
presumptive indicators
108
What are subjective changes that can indicate pregnancy?
breast changes, hyperpigmentation, fetal movement
109
What are breast changes that can indicate pregnancy?
Enlargement and tenderness.
110
What is hyperpigmentation and how can it indicate pregnancy?
Darkening of the skin, particularly around the nipples and genital area.
111
What is Chadwick's sign?
Change of color in cervix, vagina, and vulva
112
What is Goodell's sign?
Softening of the cervix
113
What is Hegar's sign?
Ability to fold the body of the uterus
114
What does a pregnancy test check for?
hCG
115
What can cause a false negative in a pregnancy test? and how can you help prevent it?
Dilute urine, take sample first thing in the morning
116
What can cause a false positive in a pregnancy test?
Tumor, blood or protein in urine, certain medications (Parkinson's or anticonvulsants)
117
What is ballottement? what can cause a false one?
provider taps cervix, Baby floats up in the cervix and then comes down. a tumor could also do this.
118
What is Braxton Hicks? What can cause a false one?
contractions, False contractions caused by intestinal gas
119
What is palpation of fetal outline?
Feeling the shape of the baby through the abdomen
120
What is uterine soufflé?
Hearing the flow in the uterus matching the mom's heartbeat
121
What are some positive indicators during pregnancy?
Auscultation of fetal heart sounds, fetal movements detected by examiner, visualization of fetus
122
What are the landmarks for uterine growth?
12 weeks: above symphysis pubis, 16 weeks: midway symphysis pubis & umbilicus, 20 weeks: umbilicus, 36 weeks: xiphoid process
123
What happens during 'lightening'?
Baby flips and head comes down
124
What are Braxton Hicks contractions?
Practice contractions that are not effective in delivering the baby, felt in the third trimester mostly
125
When should a pregnant woman go to the doctor regarding Braxton Hicks contractions?
If she has 5-6 in an hour
126
What is Chadwick’s sign?
bluish color
127
What is Goodell’s sign?
softening bc of hormones
128
What is the purpose of the mucous plug?
forms a plug so no bacteria goes to the membranes
129
What happens when the mucous plug breaks?
can have some blood happen when it breaks bc it does have some capillaries
130
What causes the pH in the vagina to become acidic?
Glycogen turns to lactic acid
131
Why are pregnant women prone to fungal infections?
Changes in pH
132
What stops during pregnancy?
ovulation stops
133
What is the role of progesterone during pregnancy? aka hormone of pregnancy""
Prevents tissue rejection and suppresses contractions. prevents miscarriage.
134
What stimulates the growth of mammary ductal tissue?
Estrogen
135
What stimulates the growth of lobes, lobules, and alveoli?
Progesterone
136
What do the Tubercles of Montgomery do?
help to lubricate nipple
137
Is breastfeeding allowed during pregnancy?
Yes, if there are no risk factors.
138
What happens to the heart during pregnancy?
Heart is pushed upward and to the left
139
What might be heard when listening to the heart during pregnancy?
Systolic murmur, this is alright
140
What happens to plasma volume during pregnancy?
Plasma volume increases
141
How does the increase in plasma volume affect blood thickness?
Blood is less thick, which helps prevent clots
142
What happens to RBC, HGB, and HCT levels during pregnancy?
Dilution of RBC, ↓ HGB/HCT
143
What term is used to describe the decrease in RBC, HGB, and HCT levels during pregnancy?
Pseudoanemia of pregnancy
144
What type of anemia may occur during pregnancy?
Iron deficiency anemia
145
What type of anemia is present if the hemoglobin is less than 10.5 during the second trimester?
Iron deficiency anemia
146
How do you treat both types of anemia?
Iron supplements
147
What are the cardiovascular changes during pregnancy?
Increased cardiac output, decreased systemic vascular resistance, slight decrease in diastolic pressure
148
What is supine hypotensive syndrome?
Slight decrease of diastolic pressure when lying on back
149
What is the best position for side laying?
Left side
150
How can you remove pressure on the aorta while side laying?
Raise one of the hips with a pillow
151
What happens to clotting factors in the blood?
They increase
152
What happens to fibrinolytic activity in the blood?
It decreases
153
What is the function of fibrinolytic activity?
To protect from hemorrhage and increase the chance of blood clots
154
What happens to leukocytes in the blood?
They increase
155
What happens to erythrocytes in the blood?
They increase
156
Why is more iron needed?
To support increased erythrocyte production
157
What are the respiratory changes?
Oxygen consumption ↑
158
What happens to tidal volume?
Tidal volume ↑
159
Which hormones are involved in increased tidal volume and respiratory changes?
Progesterone, Estrogen
160
What does estrogen do to muscles?
Relaxes muscles
161
How does estrogen affect breathing?
Allows deeper breathing
162
What does estrogen do to vascularity?
Increases vascularity
163
What can increased vascularity in the face cause?
Nose bleeds, congestion, fullness in the ears
164
What happens to the voice due to estrogen?
Lowered voice
165
What are epulis? why does this happen during pregnancy
Growths that happen in gum from extra estrogen
166
What is ptyalism? why does this happen during preganacy
Excessive salivation
167
What is pyrosis? happens during preganacy.
Reflux due to relaxation of the sphincter. estrogen causes the relaxation.
168
How does pregnancy affect the tone and motility of the GI tract?
Slows down
169
What happens to the gallbladder during pregnancy?
Bile becomes thicker and more prone to gall stones
170
What is pruritis?
Itching caused by retained bile salts
171
What is stress incontinence?
Involuntary urine leakage during activities that increase abdominal pressure
172
What is nocturia and how does it affect pregnancy?
Increased need to urinate at night.
173
Why do some people experience nocturia?
Due to water and sodium retention during the day
174
What happens to the ureters?
They can become somewhat compressed
175
What can happen due to compressed ureters?
Increased risk of urinary tract infection or pyelonephritis
176
What causes hyperpigmentation?
Estrogen
177
Name two integumentary changes during pregnancy.
Angiomas and palmar erythema
178
What are striae gravidarum?
Stretch marks
179
What is melasma also known as?
Mask of pregnancy
180
What is a musculoskeletal change that can occur during pregnancy?
Waddling gait
181
What is the term for an excessive inward curve of the lower back?
Lordosis
182
What is diastasis recti?
Separation of abdominal muscles. sometimes they go back and sometimes they dont, might need surgery if it doesn’t resolve post partum
183
what can happen to blood glucose?
hypoglycemia possible between meals and at night.
184
What is the role of hCS in pregnancy?
allowing for more glucose to be available to baby
185
What does relaxin do?
helps inhibit urine activity, soften cervix, and relax joints in pelvis
186
What is a potential endocrine change during pregnancy related to glucose?
hypoglycemia between meals and at night
187
What is the goal of weight gain during pregnancy if the person has a normal BMI?
25-35 pounds
188
What makes up less than half of the recommended weight gain during pregnancy?
Fetus, placenta, and amniotic fluid
189
What is dependent edema?
Swelling due to fluid retention
190
What are some common feelings during the first trimester?
Uncertainty, ambivalence, unstable moods
191
What is one of the concerns during the first trimester?
How to cope with life and other family
192
What is the focus on during the first trimester?
Self
193
What is the primary focus during the second trimester?
Fetus
194
What are two psychological characteristics during the second trimester?
Narcissism, introversion
195
What is a common concern during the second trimester?
Body image
196
What may experience changes during the second trimester?
Sexuality
197
What are some common experiences during the third trimester?
Vulnerability, increasing dependence, trouble concentrating, preparation for birth
198
What are some common nightmares during the third trimester?
Deformity or harm
199
What does a pregnant person typically want during the third trimester?
Their partner close
200
What is a common behavior in the third trimester?
Nesting
201
What are some behaviors associated with maternal role taking?
Mimicry, role play, fantasy
202
What is mimicry in maternal role taking?
Mimicking behaviors, waddle gait, or posture
203
What is role play in maternal role taking?
Seeking holding or caring for infants
204
What is fantasy in maternal role taking?
Imagining what the baby might look like, having fearful fantasies
205
What is the search for role fit in maternal role taking?
Comparing oneself to other mothers to find a suitable role
206
What is grief work in maternal role taking?
Coming to terms with the loss of one's former self
207
What is couvade?
the dad will take on the moms symptoms of pregnancy.
208
What are some symptoms experienced by dads during couvade?
Fatigue, cravings, weight gain
209
What are some potential effects of couvade?
Insomnia, restlessness, irritability
210
Do fathers have different responses?
Yes
211
What is a major factor in emotional response for grandparents?
Age
212
What is the importance of the number and spacing of other grandchildren for grandparents?
It affects their response
213
What is the awareness of toddlers regarding pregnancy?
Unaware
214
How aware are older children (ages 3-12) of pregnancy?
More aware
215
Are adolescents aware of pregnancy?
Depends on developmental level
216
What is a typical day like for an IVF coordinator?
clinic setting, lots of blood draws, education, empathy
217
What is the biggest focus for an IVF coordinator?
having empathy and making patients feel supported
218
What is the purpose of the IVF class?
to inform patients of expectations and provide standardized information
219
What do testosterone and anabolic steroids do to sperm count?
decrease it
220
What is the purpose of starting antibiotics for spouses in IVF?
to prevent bacterial contamination when the egg is present
221
Does insurance typically cover IVF?
no
