Special Populations Flashcards
An oocyte matures when the anterior pituitary gland releases:
Follicle-stimulatig hormone
___ is the hormone that stimulates the maturation of an oocyte
Follicle-stimulating hormone
___ stimulates the release of the ovum
Luteinizing hormone
What is left of the follice after the egg/ovum has been released becomes the ___
Corpus luteum
The corpus luteum secretes:
Estrogen, progesterone, and inhibin
3 layers of the uterus
Perimetrium, myometrium, endometrium
On implantation, the egg adheres to the ___
Endometrium
Implantation of the blastocyst occurs approximately ___ after fertilization
1 week
The formation of placental tissues stimulates the release of ___
Human chorionic gonadotropin hormone
The ___ carries oxygenated blood from the placenta to the unborn baby
Umbillical vein
Kidney volume can increase as much as ___% during pregnancy
30
Number of live births
Parity
Cardiac output may increase by as much as ___% during pregnancy
30-50
ECG changes that can occur during pregnancy include:
Ectopic beats and SVT
Standard birthing position in the US
Lithotomy position
Elevated BP, facial edema, or hyperactive reflexes strongly suggest the presence of ___ in a pregnant woman
Preeclampsia
Management for supine hypertensive syndrome involves:
Placing the PT in the left lateral recumbent position & treating underlying causes
Uncommon form of heart failure that happens during the last month of pregnancy
Peripartum cardiomyopathy
DBP greater than ___ places the pregnant PT in an increased risk category
110 mmHg
Severe preeclampsia may require administration of ___ to prevent seizures along with emergency antihypertensive meds
Magnesium sulfate
Severe preeclapmsia is defined as a SBP greather than ___ mmHg or DBP greater than ___ mmHg
160; 110
Seizures that result from severe hypertension in a pregnant woman
Ecalmpsia
___ is the recommended treatment for a pregnant PT with seizures, especially when eclampsia is present
Magnesium sulfate
___ and ___ are contraindicated for seizures in a pregnant PT due to their ability to cross the placental barrier
Diazepam (valium) and phenobarbital
Inability to process carbohydrates during pregnancy
Gestational diabetes
The ___ produces hormones designed to support pregnancy until the placenta is fully developed
Corpus luteum
In the ___ week after conception, the egg is officially recognized as an embryo
3rd
Beginnings of the CNS, CV system, spine, and skeletal anatomy begin to appear during the ___ week after conception
3rd
The placenta begins to develop around the ___ week of pregnancy
4th
The placenta acts as an early liver for the unborn baby, synthesizing ___ & ___
glycogen & cholesterol
THe umbillical ___ carries oxygenated blood from the placenta to the baby, while the umbillical ___ carry arteriovenous blood to the placenta
vein; arteries
The ___ connects the umbillical vein and the inferior vena cava in the unborn baby
ductus venosus
The ___ connects the pulmonary artery and the aorta in an unborn baby
ductus arteriosus
The ___ separates the right & left atria of the unborn baby’s heart
foramen ovale
By the end of a full-term pregnancy, the uterus has an internal volume of approximately ___
5,000 mL
Kidney volume can increase as much as ___ during pregnancy
30%
A dark line down the midline of the abdomen that develops during pregnancy in many women
linea nigra
Total number of time a woman has been pregnant
gravidity
Number of live births a woman has had
parity
At term, the uterus normally contains ___ % of the woman’s total circulating blood volume
15 -16%
Shunting of blood back into maternal circulation during uterine contraction
autotransfusion
RBC count may increase by as much as ___% during pregnancy
33%
Cardiac output in a pregnant woman may increase by ___% above pre-pregnancy level
30%-50%
Cardiac output reaches it’s maximum at about ___ weeks gestation
22
At term, a pregnant woman’s HR will increase by an average of about ___ bpm
15-20
SBP & DBP may decrease until approximately ___ weeks gestation
24
By 8 weeks gestation, increasing levels of ___ cause the tidal volume to increase by as much as 30%-50% of the non-pregnant level
progesterone
Increased joint laxity is due to the release of the hormone ___ during pregnancy
relaxin
Hormone which decreases the utilization of insulin by cells during pregnancy
progesterone
A woman who has had 2 or more pregnancies:
Multigravida
A woman who has had 2 or more deliveries
multipara
Irregularly spaced contractions are most likely signs of ___
false labor
If the fundus is palpable just above the symphisis pubis, the gestational age is ___
12-16 weeks
If the fundus is palpable at the level of the umbillicus, the gestational age is ___
20 weeks
Fetal HR less than ___ bpm suggests fetal distress in most pregnancies
120
Maternal hypotension translate into:
placental hypoperfusion
Early signs of supine hypotensive syndrome
Nausea, dizziness, tachycardia, anxiety
PPCM
peripartum/postpartum cardiomyopathy
Triad of symptoms associated with preeclampsia
Edema (face, ankles, hands),
gradual onset HTN,
Proteinuria
Visual disturbances in a pregnant PT may indicate ___
Severe preeclampsia
HELLP stands for:
Hemolysis, Elevated Liver enzymes, Low Platelets
Inability to process carbohydrates during pregnancy
Gestational diabetes
If protocols allow, administer ___ for persistent N/V in pregnant patients
diphenhydramine or ondansetron
___ is the leading cause of life-threatening infections in newborns during their first week after birth
Group B streptococcus
___ is a bloodborne pathogen that can be passed from mother to infant during the birthing process
HIV
TORCH stands for:
Toxoplasmosis, Other agents Rubella Cytomegalovirus Herpes
___ refers to infections that occur in neonates because of organisms passing through the placenta from woman to baby
TORCH syndrome
Member of the herpes family of viruses that pregnant women are at increased risk of contracting
cytomegalovirus
___ occurs naturally in 10-25% of all pregnancies
spontaneous aboriton
3 or more consecutive pregnancies that end in miscarriage
habitual abortion
An abortion that is attempting to take place, may not always lead to abortion of the baby
threatened abortion
Spontaneous abortion that cannot be prevented
imminent abortion
When treating a PT experiencing spontaneous abortion, treatment goals should include:
maintaining BP and preventing hypovolemia
___ occurs when the uterus becomes infected, often by normal vaginal flora
septic abortion
A pregnant woman can lose up to ___% of circulating volume before significant S&S of hypovolemia become apparent
40%
Life-threatening condition in which a fertilized ovum becomes implanted somewhere other than the uterus
ectopic pregnancy
All female PTs of child-bearing age reporting severe, lower abdominal pain should be considered to be experiencing:
ectopic pregnancy
Premature, or incomplete separation of the placenta from the uterine wall
abruptio placenta
Abruptio placenta most commonly occurs during the ___ trimester
3rd
Tender abdomen, rigid uterus, and sudden, severe abdominal pain that radiates to the back, is indicative of:
abruptio placenta
In ___ the placenta is implanted low in the uterus, and partially or fully obscures the cervical canal
placenta previa
Leading cause of painless vaginal bleeding in the 2nd and 3rd trimester of pregnancy
placenta previa
Signs of shock with sudden & severe abdominal pain along with decreased fetal heart tones indicates:
abruptio placenta
Painless vaginal bleeding with bright red blood, and normal fetal heart tones & fetal movement indicates:
placenta previa
Fluid resucitation in a pregnant PT should continue as indicated, up to ___mL/kg, or until SBP reaches ___ mmHg
20; 90mmHg
In pregnancy, a feeling of relief of pressure in the upper abdomen
lightening
___ begins with the onset of labor pains
The first stage of labor
The first stage of labor lasts until ___
the cervix is fully dilated
The second stage of labor begins when:
the head of the baby descends and flexes to enter the birth canal
The 3rd stage of labor is the period that involves:
separation of the placenta from the uterine wall
Vaginal discharge of blood & mucus that occurs following delivery of a newborn
Lochia
Placnetal delivery may be delayed as long as:
30 minutes
Magensium sulfate is classified as a(n):
electrolyte
Magneseium sulfate acts as a ___ when given during pregnancy
CNS depressant
Magnesium sulfate is principally used in pregnancy in the management of ___
eclampsia
Mag sulfate is given to treat/prevent ___ in pregnancy/delivery
seizures
If mag sulfate administration causes respiratory depression, administer ___ as an antidote to counter the effects
calcium gluconate/chloride
Side effects of clacium cholride include:
N/V, syncope, bradycardia, & dysrhythmias
Tocolytic and sympathetic agonist
Terbutaline
Side effects of terbutaline:
HTN, N/V, dizziness, chest pain, dysrhythmias
___ is indicated to treat exclampsia when seizures do not respond to mag sulfate
diazepam/Valium
Principle side effects of diazepam (Valium) administration
N/V,
respiratory depression,
hypotension
___ is also useful in treating hyperemesis gravidarum
Benadryl/Diphenhydramine
Diphenhydramine is classified as an:
antihistamine
Side effects of diphenhydramine
Drowsiness
Headache
Tachycardia
Hypotension