T1 - Blueprint Flashcards
Sperm development is stimulated by which hormone?
testosterone
The pH of Seminal Fluid is —, which makes is nutritive for sperm.
alkaline
Sperm survive —
Ova survive —
48-72 hrs
24 hrs
By — weeks gestation, female has lifetime supply of oocytes.
12
Which hormone causes ovulation to occur?
LH
When does the placenta take over secreting P and E from the corpus luteum?
~ 3 months
How long does it take the zygote to reach the uterus?
3-4 days
Implantation occurs — days after conception.
Book: 6-10 days
PPT notes: 6-8 days
***Just when estrogen and progesterone by the corpus luteum is at its highest
Premenopausal women have lower levels of E and P, which means they have what two things happen?
decreased bleeding
decreased blood levels of P and E
The chorionic villi develop out of which structure?
trophoblast
What allows the sperm to penetrate the egg?
Hyaluronidase (enzyme) allows the sperm to penetrate the corona radiata (outside membrane) of the ovum
Where does Hyaluronidase come from?
released by the acrosomal cap of the sperm to penetrate the egg
When does the blastocyte implant?
6 days after conception
Why give Rhogam?
If mother is Rh- and baby is Rh+ and their blood mixes at birth, the mother’s blood can form antibodies against the Rh+ blood.
This can be fatal for a subsequent baby that may be Rh+.
When do we give Rhogam?
- 28 weeks prophylactically
- again within 72 hrs after birth
- after any invasive procedure like amnioscentesis
Fetal heart starts to beat at what week gestation?
3rd week
When can fetal heart by seen by doppler?
10-12 wks
***heard by 8 wks
Characteristic will be expressed in the individual even if it’s partner is different.
Dominant Gene (AA)
Characteristic will be expressed only if both parents are carriers.
Recessive Gene (aa)
With an Autosomal Recessive Gene, which people are unaffected clinically but are still carriers?
Heterozygous
Cystic Fibrosis is an example of which type of disease:
- Dominant (AA)
- Recessive (aa)
Recessive
**two genes are required for a person to inherit the disease
Why do we test for glycosuria?
sugar in urine
sign of gestational diabetes
During the perimenopause stage, there is a decrease in which hormones?
Progesterone
Estrogen
Ductus Venosus shunts blood around the fetal — into the fetal —
liver
IVC
How much folic acid should a pregnant woman recieve?
600 mcg
- grains
- green leafy veggies
- oranges
- broccoli
- asparagus
- artichokes
- liver
How much iron should pregnant mom recieve?
30 mg starting at 12 weeks
- liver
- meat
- whole grain / enriched breads
- dark leafy greens
- legumes
- dried fruits
How much calcium should pregnant mom receive?
600 mg (if it appears low)
- milk
- cheese
- yogurt
- sardines (or fish with bones left in)
- dark green leafy veggies
- baked beans
- tortillas
How much protein does a pregnant mom need?
First Trimester = 46 g
Second - Third Trimester = 71 g
Avoid extra — because it will lead to edema.
sodium
Pregnant women who smoke need more — in their diet.
Vit C
Maternal complications from cigarette smoke.
Placenta previa
Placental abruption
Preterm Premature ROM
Ectopic Pregnancy
— is known to be a risk factor in LBW and IUGR
***LBW = low birth weight
***IUGR = Intrauterine Growth Restriction
Smoking
***May also impair lactation
The first — weeks of pregnancy are most susceptible to alcohol.
6
What is the most preventable cause of cognitive disability in neonates?
ETOH consumption
What is the safe level of ETOH in pregnancy?
no known safe level
DON’T DRINK ETOH!!!
How can smoking make the baby hypoxic?
vasoconstriction decreases perfusion to the baby
What can pregnant mom do to reduce heartburn?
Antacids
Gum, mint, hard candy
Remain in sitting position after eating
Avoid fatty, fried foods and overeating
What is the most common manifestation of neonatal Gonorrhea infections?
Ophtalmia Neonatrum
***leads to blindness if not treated
Gonorrhea S/E during pregnancy?
purulent endocervical discharge
menstrual irregularities
abdominal pain
painful menses
Can an HIV mom breastfeed?
NO
Stages of Syphilis
Primary syphilis: primary lesion (painless papule to an ulcer in 5 to 90 days)
Secondary syphilis: widespread symmetric maculopapular rash on palms and soles + lymphadenopathy + fever, headache, malaise–6 wweks to 6 months)
Latent: asymptomatic, can only be detecting in serologic testing
**If untreated, tertiary syphilis will develop
**Neurologic, CV, musculoskeletal, or multiorgan system failure can occur
Which STD requires a Rapid Plasma Reagent?
Syphilis
What is the most common STI?
Chlamydia
***can cause Ectopic Pregnancy and Tubal Factor Infertility
Nursing intervention for Hypotension
Fall risk
- have patient sit up slowly and dangle legs
- help patient get up and walk to prevent falls
Instruction for Early Pregnancy Test (EPT)
First voided urine in AM
HCG detected 4 days after implantation
Meds can interfere with accuracy
— cause false negative pregnancy tests.
— cause false positive pregnancy tests.
Diuretics and Promethazine
Anticonvulsants and Tranquilizers
Softening and thinning of the lower segment of the uterus.
Hegar Sign
*** happens ~ 6th wk
Who is IUD not recommended for?
Women who haven’t had children (can tear cervix b/c it’s so tight)
Pelvic Inflammatory Disease
If pregnancy occurs (cause miscarriage or premature labor)
Avoid oral contraceptives if history of —
Thrombophlebitis
Pulmonary Embolism
CVA
CAD
Breast Cancer (estrogen feeds cancer)
Impaired liver function
Severe HTN
What is required in order to continue prescriptions for Oral Contraceptives?
Yearly exams
What may alter effectiveness of Oral Contraceptives?
St John’s Wart
Anticonvulsants
Antifungals
Antituberculosis Drugs
anti-HIV Protease Inhibitors
What causes morning sickness?
unknown
maybe Hcg or emotional
What causes fatigue/malaise?
unknown
maybe Hcg or increase in estrogen and progesterone
maybe increased BBT
What causes urinary frequency?
vascular enlargement and altered bladder function due to hormonal changes
bladder capacity reduced by enlarging uterus
What causes Heartburn (Pyrosis)?
Progesterone is a smooth muscle relaxer
slows GI tract motility and digestion and relaxes cardiac sphincter, delaying emptying of stomach contents
What causes Hemorrhoids and Variocisties?
relaxation of smooth muscle walsl of veins b/c of hormones causing dilated veins in legs and perineal area
veins become engorged w/ blood
bearing down for BMs
What causes backache?
Relaxation of symphyseal and sacroiliac joints because of hormones, resulting in unstable pelvis; exaggerated lumbar and cervicothoracic curves caused by change in center of gravity resulting from enlarging abdomen
What causes leg cramps?
Compression of nerves supplying lower extremities because of enlarging uterus; reduced level of diffusible serum calcium or elevation of serum phosphorus;
aggravating factors:
- fatigue
- poor peripheral circulation
- pointing toes when stretching legs or when walking
- drinking more than 1 L of milk per day
What causes supine hypotension syndrome?
pressure of gravid uterus on ascending vena cava when woman is supine
***lay on left side
S/S of Pregnancy Induced Hypertension (PIH)
Visual disturbances
Periorital edema
FVD
***associated w/ Preeclampsia
What happens to liver enzymes with Preeclampsia?
elevated
***Put on magnesium sulfate for remainder of pregnancy (BURNS)
HELLP Syndrome (signs of Preeclampsia)
Hemolysis (H)
Elevated Liver Enzymes (EL)
Low Platelets (LP)
Cardinal signs of Preeclampsia
Proteinuria
Edema
Elevated BP
Headaches / Dizziness
Blurred Vision
Serious signs of Preeclampsia
Persistent Headache
Blurred Vision
Severe Epigastric Pain (RUQ)
Altered Mental Status
Rapid Onset Convulstions
When does quickening happen?
16-20 wks (primgravida)
14-16 wks (multip)
At 28 wks, fundal height would be —
26-30 cm
A decrease of Hgb to less than —- equals anemia.
10 g/dL
A decrease in HCT to less than — equals anemia.
30%
If the pregnant mom has a negative rubella titer, when should she receive the immunization?
postpartum
NEVER during pregnancy
At approx 24-28 weeks, what do all pregnant women receive?
one hour glucose tolerance test
if fail, they take a 3 hour test
Glycosuria is a result of decreased — — and may indicate —-
renal threshold
diabetes
Proteinuria may be a sign of — or —
preeclampsia
infaction
***2+ to 4+ on dipstick
What could cause Ketonuria in pregnancy?
insufficient food intake
or
hyperemesis
Client education regarding Braxton Hicks
drink water to help w/ BP and amount of AF
UTI correlates with — —
preterm labor
For UNDERWEIGHT clients, what is a healthy amount of weight gain during 1st Trimester?
What about 2nd and 3rd Trimesters?
1st = 2.2-4.4 lb total
2nd and 3rd = 1-1.3 lb/wk
For NORMAL WEIGHT clients, what is a healthy amount of weight gain during 1st Trimester?
What about 2nd and 3rd Trimesters?
1st = 2.2-4.4 lb total
2nd and 3rd = 0.8-1 lb/wk
For OVERWEIGHT clients, what is a healthy amount of weight gain during 1st Trimester?
What about 2nd and 3rd Trimesters?
1st = 1-1.4 lb total
2nd and 3rd = 0.5-0.7 lb/wk
For OBESE clients, what is a healthy amount of weight gain during 1st Trimester?
What about 2nd and 3rd Trimesters?
1st = 1-1.4 lb total
2nd and 3rd = 0.4-0.6 lb/wk
Total weight gain during pregnancy should be?
Underweight = 28-40 lb
Normal weight = 25-35 lb
Overweight = 15-25 lb
Obese = 11-20 lb
Naegle’s Rule
start w/ FIRST DAY of last menstrual period
- subtract 3 months
- add 7 days
ex: 4/1/16 would by 1/8/17
Which period is susceptible to major congenital anomalies from teratogens?
Which period is susceptible to functional defects and minor anomalies?
Embryonic (day 15 - 8 wks)
Fetal (9 wks - birth)
ETOH is associated with what birth defects?
LBW
FAS
Intellectual disabilities
Behavior probs
Learning / Physcial probs
Caffeine is associated w/ which birth defects?
Heart dysrythmias
When should a woman get Rubella immunization?
3 months or more prior to pregnancy
***use BC to prevent pregnancy during this period
What causes Pseudoanemai?
Increase in vascular vol –>
Increase in RBCs –>
Hemodilution –>
Hgb and HCT levels decrease –>
pseudoanemia
Client education regarding diaphragms?
Inserted into vagina up to 6 hours before
Use with spermicidal jelly or scream
Must remain in place 6-8 hours after intecourse
Increases risk of UTI
Return to health care provider for size refitting if weight fluctuates up or down
Does not prevent STD
Must be washed with mild soap and water, dried and kept away from heat
Nutritional concerns vegetarian pregnant client?
Vit B12 deceicienty (could result in neuro defects)
***eat milk, eggs, meat (liver) as sources of B12
***B12 fortified soy milk
***take 2.6 mcg daily of B12
Viability
20 weeks
500 grams
