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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
Nausea Prevention
Dry Crackers before getting out of bed Small, frequent meals Do not skip meals Avoid fatty goods
26
Pregnancy Safety
NO hot tubs, saunas, steam rooms
27
How to prepare client for pregnancy
Attitudes, pregnancy classes, childbirth prep, doula
28
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?
Amniocentesis
29
After which of the following prenatal tests would you anticipate that you wil be asked to administer RhoGam to RH negative woman?
Direct Coombs or amniocentesis
30
What tests are administered during the second trimesteer?
Indirect Coombs in RH neg mom Free cell DNA and/or MSAFP (triscreen/quad)
31
What is the most common hematological disorder in pregnancy?
iron deficiency anemia
32
What sexually transmitted disease if left untreated can b transmitted to fetus?
syphilis
33
What is a normal fasting glucose for a pregnant woman/
65-95
34
What normal flora can produce meningitis in a newborn?
group beta strep
35
T/F: Only woman who are Rh negative (A-,B-,AB- or O-) are at risk for Rh?
True
36
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?
True
37
Benefits of breast feeding for mom and baby
Low cost immunologic advantages for baby
38
What type of system is breast feeding?
Supply-and-demand If there is no demand, there will be no supply
39
Physical assessment of breasts/nipples for breast feeding
Actual breast size does not matter Inverted/retracted nipples require shields
40
Lacerated Nipples
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
Mastitis
Bacterial infection Broad-spectrum antibiotic Mom can then continue breast feeding from both breasts
42
How do you care for a woman who has decided not to breast feed?
Avoid breast stimulation Cabbage Ice packs Do not let running shower water hit breast
43
Maternal exam: Normal vs Abnormal Skin Findings
Normal - pink or tan; linea nigra, cholasma, striae, pruritc urticarial, papules, plaques of pregnancy (PUPS) Abnormal - red, pale, grey, jaundice; bruising, MRSA,
44
Maternal Exam: Normal vs Abnormal Face
Abnormal - swelling
45
Maternal exam: Normal vs Abnormal Eyes
Normal - white sclera, normal dilation, PERRLA, EOM w/o nystagmus Abnormal - yellow sclera, overdilation, pupil constriction, EOM w/ nystagmus
46
Maternal Exam: Normal vs Abnormal Mouth
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
Maternal Exam: Normal vs Abnormal heart
Normal: systolic murmur, S3 Abnormal: diastolic murmur, S4
48
Maternal Exam: Normal vs Abnormal Lungs
Normal: 12-20 respirations Abnormal: wheezes, crackles, stridor, frictionrub, tachypnea, bradypnea, decreased oxygenation
49
Should clonus be positive or negative on pregnant woman?
negative
50
Newborn Brown Fat
- Protects against cold stress and hypoglycemia - Develops in 3rd trimester (not present in preterm <24 weeks) - Glucose storage
51
Cold Stress
Fetus uses amniotic fluid to stay warm and does not have hypothalmic function during first few days of life AKA non-shivering thermogenesis
52
What is the triad of doom? Give specific numbers
Respiratory distress (grunting, nasal flaring) Hypoglycemia <45 Cold stress <97.8
53
How do neonates lose body heat?
Conduction Evaporation Convection Radiation
54
What is conduction?
Placed on cold surface Always put blanket on scale before placing baby
55
What is evaporation?
Baby is wet after delivery and water cools baby quickly, dry baby off immediately
56
What is convection?
Baby is under ac vent or fan, do not place warmer near fan or ac vent
57
What is radiation?
Baby placed near cold surface, baby is warmer than bed so bed will warm and baby will cool
58
Stage 1 Labor
Early/latent 0-5cm Active 6-10cm with cervical dilation
59
Stage 2 labor
Pushing and birth of neonate Ends with delivery of baby's feet
60
Stage 3 of labor
Delivery of placenta Must not exceed 20 minutes due to dilated uterine veins and increased hemorrhage risk
61
True labor
Cervix dilates and effaces Contractions become more frequent and in pattern Contractions are stronger and duration lengthens
62
False Labor
NO CERVICAL CHANGE Irregular contractions and varied length Not as painful Likely caused by fatigue, stress or dehydration
63
Neonate Exam: Normal vs Abnormal Posture
Normal - flexion Abnormal - exension
64
Neonate Exam: Normal vs Abnormal Cry
Normal - lusty, vigorous Abnormal - weak or absent
65
Neonate Exam: Normal vs Abnormal Skin
Normal - thick, peeling Abnormal - clear, translucent, cracked, leathered
66
Neonate Exam: Normal vs Abnormal Lanugo
Normal - mostly or entirely bald Abnormal - abundant, thinning
67
Neonate Exam: Skin
Normal - vernix, milia, mongolian spots, erythemia toxicum, telangietic nevi
68
Neonate Exam: Head
Normal - caput Abnormal - cephalhematoma
69
Neonate Exam: fontanels
Normal - open, overriding, molding Abnormal - fused, bulging (unless crying), depressed, sunken, fused
70
Why do we use the ballard exam?
Estimates gestational age/maturity Can be used up to 4 days post birth Assess physical and neuromuscular activity
71
Neonate Axillary Temp
97.8-99.5F
72
Neonate HR
110-160
73
Neonate RR
30-60
74
Nenoate O2 Sats
> = 95
75
VEAL CHOP
Variable Cord Compression Early Head Compression Accelerations OK Late Placenta issue
76
Late Decelerations: What are they? Interventions?
- 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
Early Decelerations: What are they? Interventions?
- Before peak of contraction - Associated with head compression resulting in vagus stimulation and slowing of HR - NO interventions, baby is coming
78
Variable Decelerations: What are they? Interventions?
- 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
What are normal contraction rates?
Every 3-5 minutes Last 45-90 seconds Uterus is soft and relaxed between contractions
80
What are abnormal contraction rates?
Less than 3 minutes Longer than 90 seconds or absent
81
Variable Fetal Heart Tones
Normal is 6 to 25 beats IF <5, fetus may be sleeping
82
Abnormal Fetal heart Tones
Absent - hypoxia, brain damage Minimal - 1-5 beats longer than 20 minutes - hypoxia/asphyxia, acidosis, drugs
83
What are positive signs of variability?
Accelerations of 15 beats for 15 seconds in 10-15 minute time frame
84
Bradycardia
HR <110 for 10 minutes Causes: - late sign of fetal hypoxia - medication - maternal hypotension - fetal heart block - prolonged umbilical cord compression
85
Tachycardia
HR >160 for 10 minutes Causes: - early sign fetal hypoxia - fetal anemia - dehydration - maternal fever/infection - maternal hypothyroid medication - atropine, etc.
86
Reactive NST
Positive Baby can pick up HR to gain O2 when needed
87
NONreactive NST
Negative Did not meet acceleration requirements May be due to fetal sleep or hypoxia

Women's Health (6 decks)

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