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Women's Health > Test 1 > Flashcards

Test 1 Flashcards

1
Q

4 Phases of Menstrual Cycle

A

Menstrual/Shedding
Proliferative/Follicular
Secretory Phase
Ischemic Phase

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2
Q

Menstrual Phase

A
  • Functional 2/3 of endometrium is shed if NO pregnancy occurs
  • Body retains basal layer of endometrium
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3
Q

Proliferative Phase/Follicular

A
  • Rapid growth causing rebuilding of endometrial layer
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4
Q

Secretory phase

A
  • Endometrium is thick velvet with rich blood supply and glandular secretions
  • Supportive environment for fertilized ovum
  • Layer regresses if NO fertilization
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5
Q

Ischemic Phase

A
  • If no pregnancy, blood supply to endometrium is cut off and necrosis occurs
  • Forces functional layer to separate from basal layer and menstrual bleeding occurs.
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6
Q

Ovulatory Phase

A
  • 2 days before ovulation
  • Final follicular maturation,
  • Rise in LH and FSH, Progesterone, Decrease in Estrogen
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7
Q

Luteal Phase

A
  • Progesterone is dominant hormone
  • Begins after ovulation with release/rupture of ovum
  • Corpus luteum secretes progesterone to support fertilized egg until placenta takes over, but regresses if implantation does not occur, as well as decline in progesterone/estrogen
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8
Q

Placenta Function

A

-Exchange nutrients/waste products between fetus and mom
-Forms at implantation and complete by week 12
-Produces hormones to maintain pregnancy
- Provides fetus with passive immunity in 3rd trimester

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9
Q

Placenta Structure

A
  • formed from trophoblast
  • Inner Membrane: Amnion
  • Outer Membrane: Chorion
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10
Q

Amniotic Fluid

A
  • 800-1200mL by end of pregnancy
  • Surrounds, cushions, protects and allows for movement
  • Maintains fetal body temp
  • Allows for maturation of urinary, respiratory and GI tract (and auditory stimulation)
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11
Q

Umbilical Cord

A
  • 2 arteries, 1 vein (AVA)
  • Arteries carry deoxygenated blood/waste from fetus
    -Vein carry deoxygenated blood/oxygen TO fetus
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12
Q

Subjective Signs of Ovulation

A

Abdominal Pain/Mittelschermz

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13
Q

Objective Signs of Ovulation

A

Body Temp - Increaes .5-1 degree day of
Pre/Post Mucus - Thick
Cervical Mucus - clear, egg white
Microscopic Ferning

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14
Q

Presumptive Signs of Pregnancy

A

MAY mean pregnancy

Amenorrhea
Breast Tenderness
Fatigue
Potential spotting

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15
Q

Probable Signs of Pregnancy

A

Indicative of pregnancy

  • positive HCG
  • Chadwick’s Sign - bluish cervix/vagina
  • Hegar’s Sign - softening of uterine walls
  • Goodell’s Sign - softening of cervix
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16
Q

Positive Signs of Pregnancy

A

Only result of fetus

Palpate mother pulse and find different sound using doppler
See fetus on US
Palpate fetal movement

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17
Q

Zygote

A

12-14 days post-ovulation
Ovum is fertilized until implanted in uterus

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18
Q

Embryo

A

3-8 weeks after fertilization
Embryo most vulnerable during first 8 weeks

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19
Q

Fetus

A

9 weeks after fertilization to 38+ weeks
Fewer anomalies caused by teratogens

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20
Q

Human Chorionic Gonadotropin

A
  • HCG
  • Peaks at 10 weeks, 50-70 days
  • Glycoprotein
  • Stimulates production of progesterone and estrogen in corpus luteum until placenta takes over
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21
Q

Estrogen

A
  • Stimulates uterine development to create suitable environment
  • Peaks at 32 weeks
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22
Q

Relaxin

A
  • True pregnancy hormone
  • Diminishes contraction strength and softens cervix
  • Leads to long term collagen remodeling to allow ligaments to stretch
  • Aids breast development
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23
Q

Prostaglandin

A
  • Lipid
  • Function unknown
  • Thought to induce labor since it’s in high amounts at time of labor
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24
Q

Progesterone

A
  • Maintains endometrium/decidua
  • Relaxes smooth muscle to prevent spontaneous contractions
  • Aids in breast development
  • Peaks at 32 weeks
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25
Q

Nausea Prevention

A

Dry Crackers before getting out of bed
Small, frequent meals
Do not skip meals
Avoid fatty goods

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26
Q

Pregnancy Safety

A

NO hot tubs, saunas, steam rooms

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27
Q

How to prepare client for pregnancy

A

Attitudes, pregnancy classes, childbirth prep, doula

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28
Q

Triple/Quad screen results have come back with an elevated MSAFP level even after verifying gestational dates with repeating ultrasound. What would you anticipate would be net step in the assessment sequence to determine the wellbeing of the fetus?

A

Amniocentesis

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29
Q

After which of the following prenatal tests would you anticipate that you wil be asked to administer RhoGam to RH negative woman?

A

Direct Coombs or amniocentesis

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30
Q

What tests are administered during the second trimesteer?

A

Indirect Coombs in RH neg mom
Free cell DNA and/or MSAFP (triscreen/quad)

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31
Q

What is the most common hematological disorder in pregnancy?

A

iron deficiency anemia

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32
Q

What sexually transmitted disease if left untreated can b transmitted to fetus?

A

syphilis

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33
Q

What is a normal fasting glucose for a pregnant woman/

A

65-95

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34
Q

What normal flora can produce meningitis in a newborn?

A

group beta strep

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35
Q

T/F: Only woman who are Rh negative (A-,B-,AB- or O-) are at risk for Rh?

A

True

36
Q

T/F: It is important to evaluate the CBC before delivery (at 36 weeks) to ascertain if mom has normal platelets which will prevent her from hemorrhage at delivery?

A

True

37
Q

Benefits of breast feeding for mom and baby

A

Low cost
immunologic advantages for baby

38
Q

What type of system is breast feeding?

A

Supply-and-demand

If there is no demand, there will be no supply

39
Q

Physical assessment of breasts/nipples for breast feeding

A

Actual breast size does not matter
Inverted/retracted nipples require shields

40
Q

Lacerated Nipples

A

Allows bacteria to enter breast and cause mastitis

Teach mom to assess nipple prior to latch, if latch hurts than break suction and reattach

41
Q

Mastitis

A

Bacterial infection
Broad-spectrum antibiotic

Mom can then continue breast feeding from both breasts

42
Q

How do you care for a woman who has decided not to breast feed?

A

Avoid breast stimulation
Cabbage
Ice packs
Do not let running shower water hit breast

43
Q

Maternal exam: Normal vs Abnormal Skin Findings

A

Normal - pink or tan; linea nigra, cholasma, striae, pruritc urticarial, papules, plaques of pregnancy (PUPS)
Abnormal - red, pale, grey, jaundice; bruising, MRSA,

44
Q

Maternal Exam: Normal vs Abnormal Face

A

Abnormal - swelling

45
Q

Maternal exam: Normal vs Abnormal Eyes

A

Normal - white sclera, normal dilation, PERRLA, EOM w/o nystagmus

Abnormal - yellow sclera, overdilation, pupil constriction, EOM w/ nystagmus

46
Q

Maternal Exam: Normal vs Abnormal Mouth

A

Normal - tonsils 0 1 2, tonsils symmetric, no inflammation

Abnormal - lesions, HSV, HPV, tonsils 3 or 4, asymmetric tonsils, inflammed tonsils, dry mucus membranes

47
Q

Maternal Exam: Normal vs Abnormal heart

A

Normal: systolic murmur, S3

Abnormal: diastolic murmur, S4

48
Q

Maternal Exam: Normal vs Abnormal Lungs

A

Normal: 12-20 respirations

Abnormal: wheezes, crackles, stridor, frictionrub, tachypnea, bradypnea, decreased oxygenation

49
Q

Should clonus be positive or negative on pregnant woman?

A

negative

50
Q

Newborn Brown Fat

A
  • Protects against cold stress and hypoglycemia
  • Develops in 3rd trimester (not present in preterm <24 weeks)
  • Glucose storage
51
Q

Cold Stress

A

Fetus uses amniotic fluid to stay warm and does not have hypothalmic function during first few days of life

AKA non-shivering thermogenesis

52
Q

What is the triad of doom? Give specific numbers

A

Respiratory distress (grunting, nasal flaring)
Hypoglycemia <45
Cold stress <97.8

53
Q

How do neonates lose body heat?

A

Conduction
Evaporation
Convection
Radiation

54
Q

What is conduction?

A

Placed on cold surface

Always put blanket on scale before placing baby

55
Q

What is evaporation?

A

Baby is wet after delivery and water cools baby quickly, dry baby off immediately

56
Q

What is convection?

A

Baby is under ac vent or fan, do not place warmer near fan or ac vent

57
Q

What is radiation?

A

Baby placed near cold surface, baby is warmer than bed so bed will warm and baby will cool

58
Q

Stage 1 Labor

A

Early/latent 0-5cm
Active 6-10cm with cervical dilation

59
Q

Stage 2 labor

A

Pushing and birth of neonate
Ends with delivery of baby’s feet

60
Q

Stage 3 of labor

A

Delivery of placenta
Must not exceed 20 minutes due to dilated uterine veins and increased hemorrhage risk

61
Q

True labor

A

Cervix dilates and effaces
Contractions become more frequent and in pattern
Contractions are stronger and duration lengthens

62
Q

False Labor

A

NO CERVICAL CHANGE
Irregular contractions and varied length
Not as painful
Likely caused by fatigue, stress or dehydration

63
Q

Neonate Exam: Normal vs Abnormal Posture

A

Normal - flexion
Abnormal - exension

64
Q

Neonate Exam: Normal vs Abnormal Cry

A

Normal - lusty, vigorous
Abnormal - weak or absent

65
Q

Neonate Exam: Normal vs Abnormal Skin

A

Normal - thick, peeling
Abnormal - clear, translucent, cracked, leathered

66
Q

Neonate Exam: Normal vs Abnormal Lanugo

A

Normal - mostly or entirely bald
Abnormal - abundant, thinning

67
Q

Neonate Exam: Skin

A

Normal - vernix, milia, mongolian spots, erythemia toxicum, telangietic nevi

68
Q

Neonate Exam: Head

A

Normal - caput
Abnormal - cephalhematoma

69
Q

Neonate Exam: fontanels

A

Normal - open, overriding, molding

Abnormal - fused, bulging (unless crying), depressed, sunken, fused

70
Q

Why do we use the ballard exam?

A

Estimates gestational age/maturity
Can be used up to 4 days post birth
Assess physical and neuromuscular activity

71
Q

Neonate Axillary Temp

A

97.8-99.5F

72
Q

Neonate HR

A

110-160

73
Q

Neonate RR

A

30-60

74
Q

Nenoate O2 Sats

A

> = 95

75
Q

VEAL
CHOP

A

Variable Cord Compression
Early Head Compression
Accelerations OK
Late Placenta issue

76
Q

Late Decelerations: What are they? Interventions?

A
  • Starts AFTER peak of contraction
  • Associated with placenta issue

Interventions:
- Patient on left side
- stop pitocin
- Administer O2
- Fluid bolus
- elevate legs
- notify provider

77
Q

Early Decelerations: What are they? Interventions?

A
  • Before peak of contraction
  • Associated with head compression resulting in vagus stimulation and slowing of HR
  • NO interventions, baby is coming
78
Q

Variable Decelerations: What are they? Interventions?

A
  • Resemble U, V, W
  • Associated with cord compression cutting O2 at random times

Nursing Interventions:
- change maternal position
- drink juice
- stop pitocin
- administer O2
- vaginal exam for cord prolapse
- Severe - amniocentesis

79
Q

What are normal contraction rates?

A

Every 3-5 minutes
Last 45-90 seconds
Uterus is soft and relaxed between contractions

80
Q

What are abnormal contraction rates?

A

Less than 3 minutes
Longer than 90 seconds or absent

81
Q

Variable Fetal Heart Tones

A

Normal is 6 to 25 beats
IF <5, fetus may be sleeping

82
Q

Abnormal Fetal heart Tones

A

Absent - hypoxia, brain damage
Minimal - 1-5 beats longer than 20 minutes - hypoxia/asphyxia, acidosis, drugs

83
Q

What are positive signs of variability?

A

Accelerations of 15 beats for 15 seconds in 10-15 minute time frame

84
Q

Bradycardia

A

HR <110 for 10 minutes

Causes:
- late sign of fetal hypoxia
- medication
- maternal hypotension
- fetal heart block
- prolonged umbilical cord compression

85
Q

Tachycardia

A

HR >160 for 10 minutes

Causes:
- early sign fetal hypoxia
- fetal anemia
- dehydration
- maternal fever/infection
- maternal hypothyroid
medication - atropine, etc.

86
Q

Reactive NST

A

Positive
Baby can pick up HR to gain O2 when needed

87
Q

NONreactive NST

A

Negative
Did not meet acceleration requirements
May be due to fetal sleep or hypoxia

Women's Health (6 decks)

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