Reproduction Flashcards
Exemplars:
Pregnancy
Gestational Conditions:
Hyperemesis Gravidarum
Pre-term labor
Dystocia
Prolapsed Cord
Postpartum Hemorrhage
Pregnancy: Also known as gestation, lasts about 40 weeks or 280 days measured from the last menstrual period or 266 days from conception. Also described in terms of trimesters.
Hyperemesis Gravidarum: Excessive vomiting while pregnant
Pre-Term labor: Labor before the baby is born
Dystocia: Difficult labor from abnormal uterine contractions preventing normal progress of cervical dilation, effacement (primary powers), & descent (secondary powers)
Prolapsed Cord: Uncommon obstetric emergency that occurs when the cord lies below the presenting fetus.
Postpartum hemorrhage: Obstetric emergency & a leading cause of maternal morbidity & mortality in the U. S. & throughout the world.
What is reproduction?
The creation of all life occurs as a result of reproduction, a foundational concept in biological sciences.
What is the scope of reproduction?
Reproduction falls into two categories: sexual & asexual reproduction. This representation focuses on human reproduction, from the formation of reproductive cells to childbirth.
-Asexual reproduction is when you don’t another organism to create a copy of what you are. Like fungi, bacteria, viruses.
-Sexual reproduction is when you need another source to create a copy of you.
Human reproduction:
What is the overview process?
Male/Female Reproductive Systems:
The process by which human beings produce a new individual, starting with the fertilization of an egg by a sperm.
*Fraternal twins will have two separate eggs & two sperm will go into the two eggs. (Two separate babies-two separate processes). Identical twins will have everything in one sac.
*Women need the sperm to get pregnant. Male parts have to be working properly and enough healthy sperm to go along with women eggs to produce a baby.
-Women reproductive system: We need the vagina, uterus, fallopian tubes, ovaries, & cervix to be working properly. You can still produce a baby with only one ovary producing eggs. It’s slim chance since the ovaries may produce eggs one month and not any the next month.
Normal Physiological Processes:
-Formation of reproductive cells: Oogenesis in females & Spermatogenesis in males.
-Menstrual cycle & Ovulation: Four Stages of menstrual cycle & their role in preparing for conception-Women of age & that can get pregnant can. *Even if they don’t bleed on their cycle, women can still get pregnant because the ovaries are still producing eggs and if sperm gets to egg, you can still get pregnant.
-Fertilization & Pregnancy: Steps from fertilization to implantation & stages of pregnancy (Ovaries release & goes into fallopian tubes. This is where the sperm has to get to. The sperm can survive up to 5 days.)
-Embryonic & Fetal Development: Key stages of development from the embryonic period to the fetal period
Complications
-Infertility: Causes & risks factors for infertility in both males and females (hormonal imbalance, male or female parts not working properly.
-Pregnancy complications: Issues that can arise during pregnancy, including spontaneous abortion (before the 20th week of pregnancy because something may be wrong with the embryo/If it’s not viable your body will get rid of that embryo own its own), gestational diabetes-Glucose regulation issue (Affects mother & baby & testing has to be done), preeclampsia, and more(RH - blood type mother that is producing a RH+ baby but has built up an immunity in the previous pregnancy will not be able to give birth to the baby due to the immunity being up.)
Populations at risk
Populations at greatest risk for problems with reproduction:
Adolescents because of the body and depending on the age the pelvic isn’t adequate enough to have a baby.
*Alot of adolescents hide the pregnancy. They have problems with anemia because of the change in the body there is an increase in the blood supply but not a increase in RBC supply. *Reason they have to take iron supplements.
*They don’t eat right when you need lots of protein, folic acid, Vitamin C, Calcium, & Vitamin D.
*They can deliver a baby early or one that is not healthy.
Individual Risk Factors:
-Biophysical (Genetic concerns-altered or mutated genes, inherited disorders, multiple gestation large fetal size)
-Psychosocial (Smoking, excessive caffeine intake, alcohol consumption, drug/spousal abuse, & addictive lifestyles)
-Sociodemographic (Low income, prenatal care, age (younger than 15 yrs. old or greater than 35 yrs. old, marital status, location)
-Environmental (Industrial pollution, radiation, chemical exposure, bacterial/viral infections, drugs-over the counter, therapeutic, and illegal, and stress.)
*Educate on health insurance, safe sexual practices, finding resources so that they will get the prenatal care needed, having a clinic for low socioeconomic issues with low income)
Reproductive Health & Nursing Care
-Assessment & Diagnostic Tests: Key assessments & tests for evaluating reproductive health
-Clinical management: Strategies for managing reproductive health, including primary & secondary prevention, & collaborative interventions
-Pregnant women get assessment, history (How many pregnancies, healthy baby, abortions, how many sexual partners do you have, any STDs)
-Any surgeries, gynecologists visits related to reproductive system
-Menstrual history to know when they got pregnant
-Immunization status we could give while in hospital or during pregnancy to keep them healthy & baby.
-Why do they come to hospital when they think they are pregnant? Ask about symptoms, do more tests to confirm pregnancy
Diagnostic Laboratory Tests
*Pregnancy testing (urine, serum-blood test to confirm elevated HCG levels-mean you have a fertilized egg & could be ectopic pregnancy or egg could be in fallopian tubes & travels to uterus can stay in tubes & grow there & if it’s not a viable pregnancy it has to be removed)
*CBC, blood type, RH factor, rubella titer
*Maternal assay (If mother is O negative, A negative, B negative, or AB negative This test is done to see if they have antibodies. If they do then the RH factor should be negative, something positive was introduced into the mother to make her positive.
*Screening for Sexual Transmitted Diseases
-Imaging: Ultrasound (To confirm the pregnancy-Fetus must be in the uterus)
*Amniocentesis- (For problems-A needle goes through the abdomen & through the uterus to test the fluid (amniotic fluid) there.
-Any time you introduce anything invasive into the mother makes her at risk for an infection, pre-term labor.
Clinical Management: Primary Prevention
Health Education:
-Safe sex (Don’t have sex if you don’t want kids, one partner, birth control, condoms
-Contraception
-Avoidance of smoking, alcohol, drug use (First 6-9 weeks fetal parts are growing so you don’t want to do anything that will jeopardize the pregnancy)
-Nutrition
-Exercise (Don’t do anything that wasn’t done prior to finding out you were pregnant.)
Clinical Prevention: Secondary Prevention (Screening)
-Prenatal care monitors the progress of pregnancy & allows early detection of problems
*Weight gain (Add calories for fetus instead of eating for two)
*Blood pressure
*Fundal height
*Edema
*Fetal heart sounds
Laboratory screening (ex. urine for protein, Blood type & Rh factor, rubella titer, blood glucose)
Special Considerations
-Assisted Reproductive Technologies: Overview of technologies like in vitro fertilization & gamete intrafallopian transfer (In vitro-Having an egg & sperm fertilized outside of the woman & implanting that embryo after fertilization into the uterus & this is expensive)/Alot of insurance companies want pay for it.
*Not 100% positive that a woman will get pregnant because of other issues going on-They go through injection shots to be sure that their body is receptive to carrying a baby
-High Risk Pregnancies: Factors & management strategies for high-risk pregnancies.
*Women at risk for pre-term labor or risk of having a spontaneous abortion/If found out ahead of time they can maneuver around these problems
-Look and see if they are overweight, older woman with any disease processes-autoimmune disorder)
-Abortion: Procedures & considerations for elective termination of pregnancy before 20 weeks on its own/Also called miscarriage
What happens in reproduction?
When ejaculation occurs, over 3 million sperm move from the testes through the tubes (vas deferens) into the area called the prostate. Prostate contracts closing off the opening between the bladder and the urethra releasing fluid and pushing semen on through. The seminal forms a thick fluid that is alkaline in order to protect the sperm from the acidic environment of the female vagina. The gel is liquified by enzymes from the prostate gland. It also contains sugars to nourish the sperm. The seminal plasma is left in the vagina. Sperm uses tails to swim through the cervical mucous left in the urethra. During ovulation this barrier becomes thinner and changes its acidity in a friendlier environment for the sperm. After releasing the egg at about day 14, the egg arrives at the Ampullar Isthmic Junction of the tubes. It rests for another 30 hrs. Fertilization occurs at this point in the tube. Once the sperm has entered the uterus, contractions occur in the pelvis up into the fallopian tubes to meet the waiting egg. Sperm must travel from the vagina to the fallopian tubes. A tough journey that few sperm survive. A way allowing only the healthy sperm to fertilize the egg. To provide the best chances of producing a healthy baby. The first sperm enter the tubes a few minutes after ejaculation, but the first sperm are not likely to fertilize the egg. Motile sperm can survive in the female reproductive tract for up to five days. The magic happens in the fallopian tubes. The fallopian tube pushes the egg toward the uterus. Sperm is pushed toward the egg. The surrounding cells of the eggs produce a chemical that attracts sperm. The sperm goes through the corona radaita upon contact with the zona pedllucida. Sperm binds to the pedullucida. Then the enzyme filled cap called the Arcuzone. releases it stored digestive enzymes. Finally, the sperm must fuse with the egg plasma membrane. This causes the egg membrane to change and prevent other sperm from attaching to it. Now attached, the sperm’s nucleus where chromosomes are stored towards the egg’s cells. Egg combines genetic material with the sperm to create a full set of chromosome DNA. With 23 pairs of chromosomes take a copy of the parent’s genetic DNA. This is the blueprint for a whole unique new person. Instantly determining hair, eye color, and many other characteristics. The combined sperm & egg is called a zygote. It divides rapidly following fertilization. The zygote travels down the fallopian tubes to the uterus. After fertilization the zygote continues to divide more into a blastocyst ball. Five -six days after fertilization. Only 20% to 30% of fertilized eggs will reach the Blastocyst stage. Embryos that survive this stage of development have a high implantation potential once transferred into the uterine cavity. The blastocyst hatches out of its shell and burrow into the uterine wall endometrium serves as the source of oxygen and nutrients. About 4 weeks from the beginning of the last period to the next period the blastocyst has begun to produce the pregnancy hormone to tell the ovaries to stop producing eggs. From then on, the menstrual cycle pauses. The blastocyst is called an embryo now. Home pregnancy test may be able to give a positive pregnancy test. At week 5, the circulatory, brain, and spinal cord have been to form. The tiny heart has begun to beat. The baby’s heart beats about 54 million times before birth. The placenta provides oxygen and nutrients to the growing baby and removes waste products from the baby’s blood via the umbilical cord. By week 6 the baby’s nose, mouth, & ears are starting to shape. At weeks 7 & 8 the embryo has doubled in size (kidney bean size). Little hands & feet start to grow. At week 9 to 12, the embryo is called a fetus. The baby is almost fully formed. Facial characteristics are more recognizable. Fetus head is rotated and towards the chest & can occasionally touch their face. Diaphragm muscles start to grow. The reproductive, circulatory, & urinary systems at an advanced stage of development. The fetus will urinate in the amniotic sac. It is a sign of the proper function of the fetus’s body. If the baby is a girl, her ovaries contain millions of eggs. If it is a boy, his testicles will already start producing testosterone-male sex hormone which is necessary for the male reproductive system. She or he is about 5cm in size. & 14g in weight. She or he is growing & maturing already to birth.
Trimesters of Pregnancy: 1st Trimester
*1st day of last menstrual period up until 13 wks. & 6 days
*Length-0.25-inch, Weight 0.5grams
*Fetal heart, brain& spinal cord is developing
*Mother has a lot of hormonal changes, nausea, fatigue, increased volume of blood
*Important tests: Initial prenatal visit, ultrasound, & genetic screening
13 weeks Ending of first/Beginning of Second Trimester
*Length is 3-inch, Weigtht-22g
*Weeks 1-4 Implantation, neural tube formation
*Weeks 5-8: Heartbeat detectable, limbs bud
*Weeks 9-13: Major organs forming, genitalia
