Test 2 Flashcards
The visual appearance of chromosomes in the nuclei
Kayotype(1)
the study of genes and their functions and related techniques. All genes and their inter relationships to identify the growth development of the organism
Genomics (1)
The study of heredity function and composition of the single genes
gentics (1)
between Turner and Klinefleters syndrome which is monosamy x and which is triosomy xxy
Turner= monosamy x
Klinefleters sydnrome =triosomy xxy(2)
This syndrome is characterized when an “x” is absent (webbed thick neck, candiac prob, widespread nipples
Turner syndrome (2)
Ovulation
The release of egg (4)
Gamete
(egg & sperm formation)
fetilization
union of gametes
How much iron should be consumed
30 mg/day
liver, meats, whole grain, deep green leafy vegetables, legumes, dried fruit are all considered apart of this essential nutrient in food
Iron
fortified cereals & grain, green leafy vegetable, oranges, broccoli, asparagus, artichokes, & liver)
Folic acid foods
400-600 mg/day of this should be taken to prevent nuro tube defects in pregnancy
Folic Acid dosage
Mitotic replication begins as zygote travels the uterine tube this is called
cleavage (6)
How many days, luna months, calender months and wks is pregancacy
appox 280 days 10 Lunal months 9 calendar 40 wekks [6]
what is this stage of interuterine development 1st 14 days)
Ovum or Preembryonic [6]
what is this stage of interuterine development 15 days to8 wks
embryo [6]
hat is this stage of interuterine development 8 weeks until birth
fetus [6]
____cm from crown to rump or or 15 days to 8 weeks is which phase of intrauterine development
Embroyo and 3 cm from crown to rump [6]
What is the most critical and vuneralbe stage to fetal development & when are people recognized as people
critical: embryo
Peps: 8 wks all organs and external structure are present [6]
How many arteries and veins does the umblical cord have and how long is it? Remember The cord is usually located centrally with the blood vessels fanned out to all parts of the placenta
Arteries 2 (carry blood from the embryo) right veins 1 (carry blood to embryo) left 55 cm at therm (7)
This prevents compression of vessels
Whartons Jelly (which is loose mesenchyme with intercellular ground substance )
This is a Functional unit of utero placenta circulation. Exchange of gases & nutrients across these vascular systems. There are__-___ of them and by day __________ this is in circulation and what else is happening.
The 15-20 cotyledons of teh placenta by 17 heart beats as well
During this period of refinement of structure the womb child matures and is less vuneralbe to tetrogens except those affecting ______
the CNS
what are the days and weeks of the following periods in a womb childs development: Ovum or pre-embroyotic, embryo, fetus
Ovum day 1-14
Embryo day 15- 8 or 9 weeks
Fetus 8 or 9 weeks until birth
what is EDC
Estimated Date of Confinement
What is EDD
Estimated date of delivery
What is EDB
Estimated date of birth
Based on a 28 day cyclewith conception on 14thday this EDC is discovered by taking the first day of the LMP and subtracting 3 months then adding 7 days and a year
Nagele’s Rule
you can also add 9 months and 7 days
Nagele’s Rule is Based on a ____day cycle the EDC is discovered by taking the__ day of the LMP and subtracting ___ months then adding ___ days and _______
28 day with conception on 14 day 1st day of LMP 3 months 7 days One year
what is Goodell sign?
Cervical softening (Cervice like service is good-hey)
What is chadwicks sign
When vaginal mucousa is a bluish color b/c of increased vascularity
Pigment change or “line negra” is a ____indicator of pregnancy bellybutton to labia
probable
what is the hormone that may pregnancy
HCG Human chorionic gonadtropin ( 8 days after concpetion max level at 50to 70 days
What is ballotment
Rebound of the fetus against examiner hand
The rushing of blood through the uterus to the placenta is called
Uterine soufflee.
what is Gravididty “GRAVA”
This term refers to pregnancy in general think Grava big like grande
Paritity “para’
of pregnancy that reached viablity (AKA 20 wks)
If rubella titers is less than __:____ (negative) immunize within ________wks after devlieray
1:10
six weeks
Which of the following is not considered apart of the TORCH screening for infections
a. toxoplmosis f. TB
b. Rubella g. cytomeglo virus
C. Measals h. Mumps
d.Varicella I. Group beta streptococcus
e. Hepatitis J. Herpes simplex 1
D. Varicella F. TB H. Mumps Maybe I J. Herpes simplex 1 because it is type 2of HSV
what does torch stand for
T: toxoplamos R: rubella O: other infections C: cytomegloviurs H: herpes simplex-2
What is the most common cause of neonatal sepsis and meningitis
Group beta streptococuss
early onset: first seven days ussualy w/in 24 hr
Late onset: 1 wk-3months ussualy 24 days
what is the main cause of fetal and neonatla health problems
Congential anomalis. b/t nicu helps survival rates babes <1500g.
what is the only test that can evaluate fetal compromise before intrauterine asphyxia and
No test it’s a joint number of tests
IF there is a suspciious/ __________ response to EFM
suspecious/equivocal, do AFI , coninue for 20 -60 min, repeat if necssary
If there a pathological/_____ response EFM what action should be taken?
COnsider delivery for abnormal/pathological response, contine for 20-60 min, biophyscial profile
If there is a reassuring/________ resposne to EFM
Normal/reasurring Do AFIand or repeat and afi weekly or more often
Give the equation for the mean arteirial pressure. IF it is over _______ then this in considered Preeclampsia. This is based on ___measuremetns
Systolic +2 (diastolic) all divided by 3
based on 2 measurements
Proteneruia is when it is _______mg/dl in 2 random urnie speciments or more than ______ mg/dl in a 24 hr period
30 mg/dl in two randoms
300 in 24 hr period
In trainsiet hypertension bp returns to normal ____ wks after delivery
12 weeks
What is severe and normal preeclampsia
severe preeclampsia 160/110 preeclampsia 140/90 OR mAP mean arterial pressure of 105 or up OR 30 mmg over baseline systolic and 15 mmg over basline diastolic
What is protenuria for sever preeclampsia
seever is greater than 5g with 160/110
oliguria, altered loc, ha viusal probs ru liver epigastric pain
When hypertension is present in pregnancy before 20 weeks gestatation it is considered
Chronic hypertension
when does an L/S ratio indicate mature fetal lungs
> 2 mg/dl
When does creatinine levels indicate gestational age of 37 weeks
> 2 mg/dl
When high this indicates neuro tube defects
what is it and what does it indicate when low
AFP (Alpha-fetoprotien)
Low =down syndrome
When is an AFP conducted on maternal blood
4-8 weeks in
_______ most common medical complication of pregnancy Incidence 5-8% of all pregnancy not terminated in 1st trimester
Hypertension
Pregers should lay on ____, bedrest for ____hrs and not ave a wt gain of _____kg/wk
left side lay, 12hrs bed rest, 2kg/wk
Magnesiium sulfate & ______ are given to encourage utrerus contractions also given during PIH. IT helps reduce muscle irrability so decreases chance of seizure doesn’t lower bp
oxytocin
what is mag suflfate loading dose, then normal dosage , therapuetic level and how ofetn should it be checked, lso be checked when on thwhat should ais med
“feel miserable on this med”
Loading dose 4-6g over 15-30 min Therapeutic 4-8, normal 1-2g/hr check Every 2 hrs acutally every 4-6 hrs Check also deep tendeon relfexes b/c if high then chance for deep tendon reflex
Maternal age __ are risk factors for PIH
19, 40
H/A severe epigastric pain (liver involvement) and hypereflexia are occuring what might this be indicateive of in a patient with severe preeclampsia.
Eclampisa
when Ovum implants outside ___ cavity this is an ectopic pregnancy. accounting for 2% of all pregenancy. Where are the locatiosn at
percents of 953-, 4, 1
Uterine cavitiy
Uterine tube 95%
Abdominal 3-4%
Other (ovary & cervix) 1%
what accounts for 10% of all maternal deaths and is the
Leading cause of infertility
ectopic pregnancy
At 16 weeks gestation. 41 yr Laine presents to her doctors office. She has a blood pressure of 143/92. She complains of N/v and abdominal cramps. She is measuring large fro her pregneancy and has experienced some vaginal bleeding. An HCG titer is drawn and remains as high as it did for the first test. IT should hav dropped within 70-100 days. What is likely wrong with her.
Laine symptoms suggest a molar pregnancy aka Hydatidiform MoleGestational Trophoblastic Disease. She is also at risk now for to choriocarcinoma or PE which both occur within 20 percent of pregnancies
HCG levels that platueo _______times after a molar pregnancy might indicate______including rising titer and inlargeing uterus
3Xs to choriocarcinoma (rapidly metastasizing malignancy)
This is the most common cause of painless bleeding in the ______ trimester of pregnancy. often around teh _____ week.
Placenta Previa
3rd trimester about teh 30th week
SVD (sponeous vagnal delvery or C/S cesarian section must be perormed if over or under this this percentage on placenta precvia
C/S if > than 30% previa
SVD if < 30% previa & mature fetus
No vag exams for these two serious conditions of pregancy and vs q 15 for one and 5-15 for the other
placenta previa q15
Abruptio Placentae q5-15
When the placenta is implatned in the lower uterine segment near or over cercical os this is called?
Placenta Previa
Urine output should be evaluted not just by 30 mL/hr b/c it’s too general but by
1-2ml/kg/hr
Detachment of all or part of the placenta from implantation after 20 weeks adn before birth is called
Abruptio Placetna
Maternal HTN, Cocaine, MVA, maternal battering are all risk factors of
Abruptio Placetna
Advanced age,multiple fetal prgencacy, previous happening and vag delivary after c section are associated with
Placenta Previa
a board like abdomen with sharp stabbing pain and shock is associated with.
A. abruptio placenta
B. Placenta Previa
C. ectopic pregnacny
A. Yes.
B no bleeding, no pain
C. yes but unilateral cramps, plevic bapin and sharpness, ussually occilt bleed
smoking IUD, invitro, congetnail anomiles of tubes, are all high risk factors to what pregie condition
Ecptoic pregnancy
IUD b/c slows zygote throug tube
stopping contraceptive prior to pregnacny have decreased risks (unkown why)
Is blood pressure and pulse up or down with hyperemesis gravidarum, how much wt loss to meet crieeria
bp=down pulse=up wt. Loss 5% with: Dehydration Electrolyte imbalance Ketosis Acetonuria
How long NPO in hyperemisis and what three meds (which for refractory)
NPO 48x vomiting free
MEdS. Droperiodol (Inaspine) and Metoclopramide (reglan)
corticosteriods for refractory
high levels of estrogen or HCG,
transient hyperthyroidism.
Vitamin B deficiency & increased sensitivity to circulating sex steroid hormones.
Psychological factors may also play a part
are all part of the obscrue etiology of this pregnancy condition
Hyperemeiss gravadarium
when the Cord lies below the presenting part of fetus mothers pelviso cutting off blood flow
Occult or visable
Cord length > ___cm this can casue ______
Prolapsed cord
>100 cm
variable decelerations
Fetal bradycardia with variable deceleration during contraction is occuring Cord is seen or felt in or protruding from vagina. What position should be taken? what other actions
Trendelenburg, modified sims or knee chest position keeps presenting part off cord
. O2/mask at 8-10 L/min until birth.
Increase IV fluids.
Continuous FHR monitoring.
Immediate vag delivery if fully dilated or C/S if not
WHAT 3 position are acceptable for prolapsed cord
Trendburg, ; leggs up
modified sims: curled up like
knee chest; butt up in the air
Is the prolapsed cord felt above or below presenting part: oftten seen in
Cephalo-pelvic disproportion (CPD)
Placenta previa
Multiparity
Below seen in
Cephalo-pelvic disproportion (CPD)
Placenta previa
Multiparity
This medicine is given IV to mom immediatlay after birth to prevent AFE (what dose) and what other measure prevetns this
Amniotic Fluid emobolism-2o units pitosin or baby goes straight to breast
AFE happens when this serrpeates immdieatly or shorty affter delviery and amnioitic c fluide enters circualtion
Placenta
What are the S& S of AFE. on blood pressure and heart.
hypotesnion, tachycardia
what is the third and 4th stage of labor.
3rd placental
4th postpartum neeed good assemsent for AFE women and babies after
when fetus & placenta have severe edema because of RH incompatility causing Pleural & cardiac effusions Cardiac enlargement Hepatomegaly Splenomegaly this is called
Hydrops fetalis
RH incompatiablity can occur
early as 8 wks gestation or during an can abortion, amniocentesis, ectopic pregnancy, hydatidiform mole, abdominal trauma, or when the placenta separates during delivery.
This is the relationship of the fetal spine to the maternal spine
The Lie
In this primary lie a baby can be delivered breech or cephalic
Logitudial or vertical
In this primary lie a vagnial birth is not possible
Transverse (horiontal/oblique)
what is another name for cephalic presntaion
Vertex presentation (shows the head as the presnting part.
when is the epidural given
1st stage of labor in Active part at about 4 cm. also anglessics at 3-4 cm for multipara and 4-5 cm for nuliparia
Distinguish which part of the first stage of labor Marieye is inShe holds tighlty to her husbands hand and asks him not to leave the room. She seems to be thinking inwardsly, and is flushed and has trouble following directions
Active Moderate – strong contractions 3-6 hours average length 4-7 cm cervical dilation contractions last about 30-40 seconds
Marieve is irritalbe and vaguely communicates when asked a question. She has some N/V headache and shaking thights which part of the first stage of labor is she in
Transition Strong – very strong contractions 20-40 minutes average length 8-10 cm cervical dilation with duration of 90 sec and frequency q2-3 min
what is average and moderate variablity in FHR
moderate6-25
so if below five minimal
, if above 25 marked variablity.
avg 6-10 which is good
Marieve is apprehenxive, and alert, she has some brown to pale pink bloody show. What part of the first stage of labor is she in
Latent
Mild - moderate regular contractions
6-20 hours (average 8 ½ hours)
0-3 cm cervical dilation
This decleration occurs with head compression. It happens during the contraction and is back by the end of the contraction. No compromoise, not interventions
Early Decleartion “mirror image”
remember mirror mirrio as a child “early’ in life you watched snow white
This decleaarion has impaired placental or unteropalcental sufficeincy. It begins after contractions and retursn after contraction.
Late decelerations “late lagas behind a bit”
In what stage of labor is thereComplete cervical dilation – delivery of infant
and what are contractions like during this period
Contractions: q 2 min, 60-90 sec duration
Crowning: fetal head is visible, urge to push
transition
In what stage of labor is thereComplete cervical dilation – delivery of infant
and what are contractions like during this period
Contractions: q 2 min, 60-90 sec duration
Crowning: fetal head is visible, urge to push
2nd me thinks
What are the fetal descent cardinal moves
- Descent,
- Flexion,
- Internal rotation
- Extension,
- external rotation s 48 look it up
20 units of this drug is given after the baby is out
pitocin b/c of possible PE also helps stop hemorrahge
What involvoes the third & fourth stage of labor
seperatin/delivery of placenta-third stage(increased time increased risk of hemorrahge)
postpartum-fourth stage
How long does the fourth stage of labor lasts, how about the neonate period
fourth stage 28 days post delivery
30 days
What is the primary source of pain during the first stage of labor
Dilatation of cervix (primary source)
Stretching of lower uterine segment
Pressure on adjacent structure
Hypoxia of uterine muscle cells during contractions
what are some causes of pain during the second stage of labor and what methods can be useful
Hypoxia of contracting uterine muscles
Distention of vagina & perineum
Pressure on adjacent structures
efflurage and sacral pressue can help
Narcotic aren’t given ____hrs b4 delivery or ___-_ cm dialatied
4hrs before or 7-8 cm dialted
if membrances rupture what should be done first
Check Fetal Heart sounds
Vital signs for during transition phase and labor in genral form mom and fetus h=should be taken
Monmm q30min baby q 15 min Maternal V/S q 30 minutes Position for comfort Ice chips Lip balm Assist with breathing technique Fetus FHT q 15 minutes
What three known factors can decrease uterine
Maternal arterial pressure
conttraction of the uture
maternal supine position
direct coombs is for
BABY
Persistant lochia rubra in early pregenancy might mean
retained placental fragments
reoccurance of rubra in 7-14 days may mean
healing of the placental site
If wk 3-4 and still serosa or alba esp with fever, pan or tenderness this may mean
endometriosis
