Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

LPN to RN > x N209 - Reproductive Health > Flashcards

x N209 - Reproductive Health Flashcards

You may prefer our related Brainscape-certified flashcards:
NCLEX-RN® flashcards
1
Q

Puberty Onset

A

Onset 7 - 11 girls / 9.5-13 Boys

Pocess 3-4 yrs long

Af-Am / Latinos start puberty earlier.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Sex Hormone

A

Estrogen / Testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Sex Hormone

A

Estrogen / Testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Precocious Puberty

A

happens in 2 yr instead of 4

Risk Factors: AfAm, Obesity, contact w estrogen/testosterone cream, having other medical conditions involving adrenal gland. hypothyroidism, radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Precocious Puberty

A

happens in 2 yr instead of 4

Risk Factors: AfAm, Obesity, contact w estrogen/testosterone cream, having other medical conditions involving adrenal gland. hypothyroidism, radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Female Repro Development

A

begins 12 - 18

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Menstrual Cycle Phase

A

4-7 days.

no pregnancy occurs, corpeus luteum dies and progerterone drops.

  1. Proliferative (follicular)
  2. Secretory (luteal): after ovulation.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Male Puberty

A

9-15

pituitary secretes hormones to stim testes to secrete testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sexual Orientation

A

who you are atracted to sexually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Gender Identity

A

person’s innate, deeply felt phychological id as a man, woman or other gender.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pansexual

A

attracted to any gender or non gendered person, identifying with any sexual orientation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Bisexual population larger

A

than lesbian, gay

more likely to commit suicide. earn less, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Transsexual

A

strong desire to assume gender role of oppos sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Transvestite

A

person adopts dress and behaviour of opp sex for emotional sexual gratification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Gender Socialization

A

process thru which individuals learn gender norms of their society and come to develop an internal gender id

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Gender Identity

A

developed btwn 18mos - 3 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Sexual Response Cycle

A

sequence of physical and emotional changes tha occur as person becauomes sexially arounsed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Sexual Response Cycle

A

Phase 1: Excitement
Phase 2: Plateau
Phase 3: Orgasm
Phase 4: Resolution (men go through refractory period before they can orgasm again, women do not)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Gonorhea

A 
15 - 24
10 days after exposure
.thick cloudy bloody discharge
. painful bowel mvmt
.discharge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Trichomoniasis

A

trichomonas vaginallis

no ss, usually vagina infected

5-28days from exposure

green/yello/frothy/ vag itching, burning after urination or efac for men

gluey, sticky rather than creamy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Bacterival Vaginosis

A

15 - 44
most common infection in women

overgrowth of several types bac normally in vagina upset natural balance.

ss: discharge, grey, thinnish white. fishy smell. after intercourse, yellow white discharge.

burning urination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Genital Herpes

A

Simplex 1 (cold sore) or 2 (genital)

1/6 14 - 49 have Genital herpes.

first time outbreak flu like ss.

no cure, meds to prevent. can transfer to other parts of body by transferring fluids.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Syphillis

A

irreperable damage to organ

bacterial infection

Tx: pencillin

.Primary: small chancre sore (painless)
.Secondary: spready through blood, skin, joints etc. highly infectious
.Latent: w no Tx, disase moves latent w no SS. dormant for years
.Tertialr (late: 15 - 30% infeted don’t get Tx. damage to brain, heart, never, eye and more.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

HPV

A

untreated HPV is main cause of cervical cancer.

vaccination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Genital Herpes

A

.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Viagra, Levitra, Cialis

A

do NOT increase sex drive, only cause erections when sexually stimulated
.Nitric Oxide? see slide 65, Unit 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Age related changes to sexuality

A

as men age, 15-25% of men experience impotence 1/4 times they have sex.

HTN, HD, DM, meds for chronic illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

** Nursing Dx pertinent to Preconception

A

Slide 66

Mosby’s Guide to Nursing Dx

.Defincient Knowlendge
.Anxiety r/t infertility
.Risk for Situational low self esteem r/t infertility
.Risk for infection r/t infertility tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

.

A

.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

.

A

.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

.

A

.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

.

A

.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Reproductive Health
UNIT 2
Preconception Period

A

Reproductive Health
UNIT 2
Preconception Period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Preconception Care:

A

Defined by the CDC as a set of interventions
aimed at identifying and modifying biomedical, behavioral, and social
risks to a woman’s health or pregnancy outcome through prevention
and management.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Age Related Risk Factors

A

o Age > 35 – increased risk for infertility, miscarriage, chromosomal
abnormalities
o Adolescents – increased risk for stillbirth, pre-term delivery, low
birth weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Overweight Ris Factora

A 
.gestational DM
.preeclampsia
.Infection (i.e. UTI)
.post date pregnancy
.labor probs
.c-section
.macrosomia
.miscarriage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Macrosomia

A

large baby born to mother with DM. baby not always also Diabetic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Macrosomia

A

large baby born to mother with DM. baby not always also Diabetic.

The babies will be hypoglycemic at first until things level out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Brittle Diabetic

A

someone who has difficulty managing their blood sugar.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Infertility

A

inability to conceive after 12 mos

over age 35, trying 6 mos.

affects 1 in 8 couples

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

2 Types of Infertility

A

Unexplained infertility: No known cause.

secondary infertility: inability to conceive or carry preg to term after having a child

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Impact of Infertility

A

.loss self worth
.loss stable relationship
.loss work productive
…….

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Semen Analysis

A

Most important Dx testing for Male infertility

. Volume – 25 ml is a normal volume
. Count – 40-300 million is normal range
. Motility and velocity
. 50% should be active
. Quality of movement (0-4; 2 or more is satisfactory)
. Liquefaction – Failure to coagulate and then liquify
. Cultures – Bacteria or STDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Kruger Morphology test

A

a Dx testing for Male infertility

Examines shape and size of sperm head

Normal 14% or more have normal head. <4% equals significant probs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Types of Infertility Tx

A 
.Treat infections
.Hormone tx for men
.ovulation stimulating for women
.IUI (intrauterine insemination)
.ART (Assisted reproductive tech)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Types of ART (Assisted Reproductive Tech)

A

.IVF, in vitro (fertilize egg and sperm in lab)
.ICSI (Intracytoplasmic sperm injection), inject 1 sperm into egg
.donor egg or sperm
.gestational carrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Risks to Infertility Tx

A 
.multiple preg
.ovarian hyperstimulation syndrome
.infection
.pre term delivery
.lo birth weight
.UP risk for heart, digestive, cleft lip/palate probs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Nursing Dx’s related to Human Sexuality

A

.Deficient knowledge: r/t safe sex practices, birth control, medication side effects,
age-related sexual disorders
.Anxiety: r/t sexual dysfunction, STD diagnosis
.Altered oral mucous membranes: r/t HSV
.Risk for latex allergy response: r/t STD prevention barrier methods
.Impaired tissue integrity: r/t menopausal changes
.Dysfunctional family processes: ineffective sexuality patterns r/t religious/cultural
beliefs, sexual dysfunction, sexual identity issues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Unit 3

A

Start

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Unit 4

A

Intrapartal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Gravida

A

of pregananceis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Para

A

of pregnancies beyond 20 wks (multiples count as one)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Nulligravida

A

never been pregnant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Primigravida

A

first pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Primapara

A

first birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Multipara

A

two or more pregnancies with viable offspring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Multigravida

A

two or more pregnancies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Labor

A

series of rhythmic contractions causing effacement and dilation of cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

EDC

A

Estimated date of confinement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

EDD

A

Estimated due date

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Naegele’s Rule

A

calculate EDC

First day of LMP + one year, subtract 3 months, and add 7 days
280 days from LMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Cervical Dilation

A

1-10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Engagement

A

when largest part of head enters birth canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Presentation

A

the way a baby is positioned to come down birth canal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Station

A

presenting part is in pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Stages of Labor

A

Stage 1: 2 Phases, Latent and Active

onset of labor.

Stage 2: full dilation to deliver

Stage 3: delivery of baby to deliver of placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Lightening

A

Baby “drops” into pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Leopold’s Maneuver

A

palpate to determine fetal position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Fetal Heart Rate Monitoring

A

Auscultation w fetoscope or doppler

Electronic Fetal Monitoring in response to contractions. Internal, external or combo.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

External Fetal Monitor

A
  • Tocodynamometer (measures tension across abdomen during contractions)
  • Ultrasound Transducer (records FHR)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Internal Fetal Monitor

A

Scalp Electrode: on fetal scalp, closest to cervix.

IUPC (Intrauterine Pressure Catheter), inserted into amniotic space to measure contraction strength

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Fetal Heart Rate

A

Baseline: 110-160bpm

Tachy: >160bpm

Brady: <110 bpm

73
Q

Variability

A

.Minimal Variability = <5 bpm

.Moderate Variability = 6 to 25 bpm

.Marked Variability = >25 bpm

74
Q

Early decelerations

A

Associated with fetal head compression

75
Q

Variable decelerations

A

Associated with cord compression;

most common pattern in labor

76
Q

Late decelerations

A

Associated with uteroplacental insufficiency

77
Q

(PROM) Premature Rupture of Membranes

A

rupture of membrane before onset of labor

78
Q

Umbilical cord prolapse

A

umbilical cord in front of presenting part

79
Q

Amniotic fluid embolism

A

entrance or amniotic fluid and fetal cells in maternal circulation

80
Q

Fetal dystocia

A

abnormal fetal size or position = diff delivery

81
Q

Inverted Uterus

A

uterus inside out and protrudes into vagina

82
Q

Placenta Accreta

A

abnormally adherent placenta, grow into myometrium

83
Q

Protracted Labor

A

abnormally slow dilation or descent

84
Q

Uterine rupture

A

full thickness rupture of uterine wall and overlying visceral peritoneum

85
Q

Placental abruption

A

detachment of placenta from uterine wall (complete or partial)

86
Q

Occiput posterior

A

The fetal neck is flexed; most common

abnormal presentation

87
Q

Face or brow presentation

A

fetal head hyperextended

88
Q

Normal presentation

A

Vertex with occiput anterior

89
Q

Frank

A

buttocks before head

90
Q

Complete

A

Fetus sitting w hips and knees flexed

91
Q

footling

A

one or both left extended and present before butt

92
Q

Fetal Lie

A

relationship btwn long axis of fetus to long axis of mother

93
Q

Transverse

A

long axis of fetus horizontal to long axis of mother

94
Q

Oblique

A

no presenting part

95
Q

Shoulder dystocia

A

The presenting part is vertex, but the fetal
shoulder becomes lodged behind symphasis pubis after delivery of
the head

96
Q

Turtle sign

A

The fetal head is delivered but pulls back tightly

against perineum

97
Q

maneuvers for Shoulder Dystocia Delivery

A

.McRoberts Maneuver: The mother’s thighs are hyperflexed and
suprapubic pressure is applied

.Wood Screw Maneuver: The physician or midwife inserts a
hand into vagina posteriorly and presses on the posterior shoulder
to rotate the fetus

.Zavanelli Maneuver: If all attempts are unsuccessful, the
infant’s head is flexed, replaced back, and rotated into the vagina
followed by C-section delivery

98
Q

Cesarian Section

A

30-32% of deliveries.

99
Q

Types of Incisions

A

.Classical
.low transverse (most common)
.low vertical

100
Q

TOLAC

A

trial of labor after cesarean

risk of uterine rupture

101
Q

Induction

A

scheduled if necessary AFTER 39 weeks

best practice, Bishop Score of 8 or up

use cervical ripening agents (Cervidil, Prostaglandin Gel prior to induction)

102
Q

Bishop Score

A

.evaluates readiness of cervix
.use 5 measurements: dilation, effacement, station, consistency, position
.score of less than 6: cervix is unfavorable “unripe” for induction
.score of 8 and up: favorable cervix “ripe”w good chance of vaginal delivery

103
Q

Nursing Dx’s

A

.Risk for disturbed maternal-fetal dyad r/t prolonged second stage of
labor, cephalopelvic disproportion, premature rupture of membranes
.Impaired urinary elimination r/t regional anesthesia
.Deficient knowledge r/t labor, fetal monitoring, pain control options
.Anxiety r/t labor complications, anticipated labor pain, childbirth,
parenting
.Risk for infection r/t C-section, prolonged rupture of membranes

104
Q

Postpartal Family

A

Unit 5

105
Q

Postpartum Period

A

4th stages of labor

.Also known as puerperium or puerperal period
.up to six weeks after delivery
.anatomic and physiologic changes of pregnancy reversed.
.body returns to prepregnant state

106
Q

Stages of Postpartum

A
  1. Initial/Acute
    6-12hrs pp, rapid changes, potential for complications, shivering 25-50% up to 60 min.
  2. Subacute
    2-6wks, less rapid change back to prepreg. change in hemodynamic, genitourinary, emotional, matabolism
  3. Delayed PP
    up to 6mos, gradual changes, complications rare, muscle tone, connect tissue back to prepreg state,
107
Q

Uterine Involution

A

begins during 3rd stage labor. back to prepreg size by 4-6wks.

108
Q

Lochia

A

Rubra: dk red, bloody discharge, first 3-4days, may have clots

Serosa: pink/light brown, watery discharge, 3-10d pp

Alba: white/yellow discarge, 7-10d - 5-6wks

109
Q

Lochia amounts

A

o Scant: 1” stain on peri pad (approximately 10 ml)
o Light or small: 1-4” stain (approximately 10-25 ml)
o Moderate: 4-6” stain (approximately 25-50 ml)
o Heavy/large: Saturate pad within one hour

110
Q

Cervix closes to about 1 in how long pp?

A

1 week

111
Q

Pelvic Floor Support

A

may not rever to pregreg state

112
Q

Breast

A

o Lactogenesis: Initially triggered by delivery of placenta
o If not breastfeeding, prolactin levels decrease and return to normal
within 2-3 weeks
o Colostrum is produced during the first 2-4 days
o Suckling stimulates milk ejection and oxytocin release, which then
stimulates milk production

113
Q

Cardiovascular Changes

A

o Increase in blood volume of 50% at time of delivery
o Average blood loss is 400-500 ml for vaginal delivery; 750-100 ml for
C-section

114
Q

PP Depression

A

lasting longer than 2wks pp and interferes with ADL.

10-15% women

115
Q

Parental Stages

A
  1. Bonding: 1-2d pp
  2. Taking Hold: mother assumes responsibility, father may feel neglected
  3. Letting Go: couple acknowledge loss of lifestyle prior to baby. adjust and learn to care for baby
116
Q

PP Lacerations: classified according to depth

A

 First degree: Skin and subcutaneous tissue of vagina and perineum;
muscles intact; may not require repair
 Second degree: Vaginal mucosa and perineal muscle involvement;
usually extends midline towards anus
 Third degree: Second degree extending into anal sphincter
 Fourth degree: Most severe; extends into rectum

 Third and fourth degree lacerations: Associated with increased pain,
infection, bleeding, and anal incontinence

Periurethral laceration: Tear into the area around the urethra
o Must be carefully repaired to avoid urethral damage; often catheter is
inserted for repair
 Cervical tear: May cause significant bleeding
o Risk factors: Precipitous labor, operative vaginal delivery, manual
dilation of cervix or previous cerclage placement

o Often diagnosed with postpartum hemorrhage despite well-
contracted uterus

 Vaginal wall tear: Usually seen with forcep delivery
o Can have significant blood loss if undiagnosed or untreated

117
Q

Hematomas

A

vulvovaginal (most common), paravaginal, retroperitoneal (most dangerous)

118
Q

PP Hemorrhage

A

loss of more than 500ml blood after delivery

severe > 1,000ml

most common life-threatening condition in pregnancy

25% morbidity worldwide

if already severly anemic, poss hypovolemic shock and/or death prior to 500ml loss.

Tx: uterine massage, manual extrac of placental, clots. Meds (pitocin, methergine, cytotec

119
Q

PP Hermorrhage Risks

A 
-long 3rd state labor
.multiple delivery
.macrosomia
.hx of pp hemorrhage
.episiotomy
120
Q

Puerperal Infections

A

6th leading cause of maternal death

bacterial infection, 24-72hr pp. usually after c-section.

SS: uterine tenderness, pelvic pain, fever, malais, foul smelling lochia

Tx: abx

121
Q

PP Meds

A

Methergine: UP uterine contractions, UP tone. control bleeding: NEVER B4 delivery

Pitocin (Oxytocin): : favorite

Analgesic, Comfort

122
Q

Cold Stress

A

excessive heat loss causing newborn to compensate to maintain temp.

123
Q

Brown Fat

A

only in newborns
oBegins to form towards the end of second trimester (between 26-
30 weeks), and increases until 2-5 weeks after birth or stores are
depleted
oLocated in midscapular area, neck, axilla
oDeeper stores are located around trachea, esophagus, aorta,
kidneys, and adrenal glands

124
Q

Foramen Ovale

A

changes from fetal circulation to neonatal circ. From placental to pulmonary gas exchange

125
Q

Moro

A

when infant is startled of feels like they are falling. arms flail, palms up, thumb flexed.

126
Q

Suckling

A

suck when touched around mouth

127
Q

Rooting

A

w turn towards side which cheek stroked

128
Q

Step

A

stepping motion when foot touches hard surface

129
Q

NeoNate Senses

A

 Hearing: Developed at birth; can respond to sound by turning towards
it
 Taste: Develops by 72 hours of age
 Smell: Can tell mother’s breast milk
 Vision: The least mature sense; can focus only within 7-12”
 Behavioral Adaptation: Two reactive periods with one sleep period
 First reactive period: Birth to 30 minutes of life
o Alert, suckling, rooting
o Allows bonding and breastfeeding

130
Q

Gastrointestinal Adaptation

A

.mature at 36-38 wks gestation
.6ml stomach capacity at birth. UP to 90ml by eoweek.
.no amylase for fat digestion for first few months
.LO production lipase, bile
.

131
Q

Gastro Adaptation (contd)

A

 Immediately after delivery, air enters the stomach; reaches small
intestine by 12 hours of age
 Bowel sounds are present within 15-30 minutes due to air entry into
stomach
 Salivary glands are immature at birth; decreased saliva for first three
months
 Cardiac sphincter (between stomach and esophagus) is immature,
making regurgitation common

132
Q

Infant Nutritional Needs

A

Fluid Requirements:
o 60-80 ml/kg during first 24-48 hours
o Increases to 100-150 ml/kg within a few days
 Caloric Requirements:
o Up to two months: 110-120 kcal/kg (50-55 kcal/lb)
o After two months: Declines gradually to 100 kcal/kg (45 kcal/lb) by 1
year
o Depends upon infant’s activity level (i.e., frequent crying, squirming)

133
Q

VIT K after birth

A

o Given after birth to prevent hemorrhagic disease of the newborn
o Newborns are inherently vitamin K deficient at birth and have a
decreased ability to effectively metabolize vitamin k
o Withholding of vitamin K at birth increases the risk of late onset
(between 2-6 months of age) vitamin K deficiency bleeding by 81
times per HealthyChildren.org
o Dosage: 0.5 – 1 mg IM single dose

134
Q

Prematurity

A

cause of 35% infant deaths

135
Q

Postmaturity

A

born after 42wks

Complications:
o Loss of vernix (loss of protective covering to skin; leads to dry, scaly
skin)
o Fetal weight loss
o Passing of meconium in utero
o Fetal distress
o Fetal death
 Warning signs: Decrease in fundal height, decreased AFI
136
Q

Fetal Spectrum Disorder (Fetal Alcohol Spectrum Disorder)

A

abnomal features
small head, short, hyperactive, poor memory, learning disab, low iq, eye/ea probs, heart/kidney/bone probs

no cure, early intervention improves development

137
Q

FASD Features

A

microcephaly, low nasal bridge, epicanthal folds, smooth philtrum, thin upper lip

138
Q

NDs for PosPartal Family

A

 Risk for bleeding: r/t retained placenta, uterine atony, cervical tear
 Impaired urinary elimination: r/t regional anesthesia, extensive
perineal repair
 Deficient knowledge: r/t postpartum care, newborn care
 Interrupted breastfeeding: r/t prematurity, congenital anomaly,
maternal complication
 Risk for infection: r/t retained placenta, mastitis, C-section

139
Q

Needs of Childbearing Family

A

Unit 6

140
Q

Ventral Septal Defect

A

.most common
.hole in heart
.blood leaks from left to right ventricle

141
Q

Atrial Septal Defect

A

Atrias connected

UP blood to lungs

usually in down syndrome

142
Q

Patent Ductus Arteriosus

http://www.registerednursern.com/patent-ductus-arteriosus-pda-nclex-questions/

A

duct connecting pulmonary artery to aorta, skipping lungs since fetal lungs not operational. After birth, duct should close. Aorta to Pulmunary Artery

SS: vary depending on size of opening
.mostly no ss
.most common in PREMI’s

CALL
C-Cardiac, continuous machine like murmor (left upper sternal border)
.Wide pulse pressure
.easy fatigue
.Endocarditis, UP HR
.Heart Failure, crackles, dyspnea
A- activity intolerance
L- lung issues (HTN, infection)
L- loss weight

MED: Indomethacin

143
Q

Tetralogy of Fallot

‘Blue Baby Syndrome’

http://www.registerednursern.com/tetralogy-fallot-nclex-questions/

A

FOUR structural defects of heart

.most common complex defect. form in utero
.cyanotic heart defect

RAPS
.Right ventricular hypertrophy 
.Aorta displacement
.Pulmonary Stenosis
.Septal defect (ventricle)
SS: AFFLICT
.Activity, cyanosis, SOB, 'Tet Spell'
.Fingernail: CLUBBING
.Fatigue/Faint easily
***.Lift knee to chest/(squat)
.Inability to grow
.Cardiac sounds
.Trouble feeding/thriving
.murmur near pulmonic valve (left )

TX:
Sx to dix structure
MED: ALPROSTADIL (prostaglandin) to keep ductus arteriosis open.

144
Q

Squatting with Tet de Fallot`

A

increases vascular resistance.

reduces RIGHT to left shunt flow

145
Q

Flow of Heart

A

http://www.registerednursern.com/quiz-on-the-blood-flow-of-the-heart-anatomy-physiology-pathophysiology/

146
Q

Pulmonary Stenosis

A

narrowing of pulmonary vale from R ventricle to pulmonary artery

SS:
serious, HFailure, R sided heart enlargement

147
Q

Aortic Stenosis

A

interferes w blood flow to Aorta

Cause: heart enlargement, L side heart failure, arrhythmias, endocarditis

SS: heart murmur, asymptomatic

severe: heart failure in first days of life

TX: Valvuloplasty/Valve Replacement

148
Q

Coarctation of Aorta

A

narrowing in section of aorta

LARGEST artery. blood from lungs to body.

AORTA
.Ascending: coronary arteries
.Aortic Arch: head, neck, upper extremities
.Descending: chest structures
.Abdominal Aorta: organs, lower extremities

TYPES:
-Preductal (infantile) narrowing betwn l subclavian and ductus arteriosis

-Postductal (adult type): narrowing after the ductus arteriosis

SS: pale skin, irritability, diff bore, nose bleed, h/a, stroke,

LO BP in lower extremities, HI SP in upper

Heart Murmur, on BACK

Rib notching, creates new blood vessels to by pass the stenosis

MED: Prostoglandin infusion.
Digoxin
Diuretics

149
Q

Transposition of Great Vessels

TGA

A

SWAP

Severe Cyanosis (LO O2, UP HR, UP RR, poor feeding, poor growth, cool extremeties

Watch HR, rythym, O2,prepare for intervention

ALPROSTADIL (Prostoglandin E) infusion to KEEP connection to Aorta and PA and keep Ductus Arteriosis open.

Procedures to correct. temporary balook atrial septesomy. Arterial Switch Procerdure (premanent)

150
Q

Hypoplastic Left Heart Syndrome

A

o Life-threatening condition where the left side of the heart is
underdeveloped (aorta, aortic valve, left ventricle, and mitral valve)
o Results in decreased oxygenation
o Normal blood flow while ductus arteriosus remains open, but when DA
closes oxygen level decreases
o S/S: Cyanosis, respiratory and feeding problems
o Treatment: Heart transplant or extensive surgery

151
Q

Truncus Arteriosus

A

aka ‘common truncus’

usually accompanied by VSD.

o Rare defect where there is a single vessel (truncal valve) coming from
the heart instead of both the main pulmonary artery and aorta
o Truncal valve is often abnormal (too thick, narrow or leaky)
o Different types depending upon how arteries remain connected
o Treatment: Surgery soon after birth

152
Q

Tricuspid Atresia

A

Ticuspid valve not formed. no right atrium to ventricle flow.

o Leads to severely underdeveloped right ventricle
o Survival depends upon presence of VSD or PDA to allow circulation to
the lungs
o Treatment: Requires surgery in the first few days of life

153
Q

Cystic Fibrosis

A

second most common inheritied disorder. Sickle cell 1st. common in whites.

autosomal recessive. one gene per parent

id w prenatal screening

TX: postural drainage, percussion, inhaled meds, abx, anti inflam meds, lung transplant, dietary change

leading cause of death, chronic respiratory infection

154
Q

Esophageal Atresia

A

incomplete esophagus

SS: cyanosis, choking/gagging while feeding, drooling

Tx: Sx

PostOp: Prone position with HOB elevated 30-40 degrees; right side is down
to enhance gastric emptying

155
Q

Tracheosophageal Fistula (TUF)

A

100% survival rate if no other severe congenital anomalies

SS; feeding probs, distended abdomen, vomiting

156
Q

Biliary Atresia

A

Incomplete bile ducts with blockage of bile from the liver to gallbladder
o Bile is then trapped within the liver, causing scarring (cirrhosis)
o Can eventually lead to liver failure

TX: Sx, Kasai Procerdure

SS: jaundice, dark urine, clay colored stools d/t lack of bilirubin reaching intestines, weight loss, irritability

DX: liver biopsy

157
Q

Diaphragmatic Hernia

A

hole in diaphragm allows movement of gastric organs into chest cavity.

158
Q

Hirschprung Disease

A

aka
Congenial aganglionic megacolon

Obstruction of distal colon resulting in megacolon.

no ganglion cells/nerves to assist with peristalsis down the rectum. No signal to relax intestinal wall remains contracted.

SS: failure to pass meconium in first 24hrs, abdominal distension. , diarrhea, vomit

“Blast sign”: Occurs in older infants; no stool palpated in rectum on
exam but there is an explosive passing of stool after the finger is
removed (stool is usually high up in the colon)

Tx: Laparoscopic sx repair

159
Q

Pyloric Stenosis

A

Thickening of the pylorus muscles between the stomach and small
intestine

S/S:
• Projectile vomiting, usually within 30 minutes after a feed
• Persistent hunger and weight loss
• Dehydration (not tears and decreased wet diapers)
• Constipation (because food cannot reach the intestines)

Dx: o Diagnosis: Confirmed on US; may feel a lump on the abdomen over
pyloric muscle with palpation due to enlargement
o Treatment: Surgery
• Pyloromyotomy: Done laparoscopically; usually successful with
few complications

160
Q

Phenylketonuria (PKU)

A

People not able to convert Phenylalanine to Tyroside.

needs low protein diet. eliminate milk, cheese, milk

SS: S/S: Normal at birth with development of symptoms over months as
the phenylalanine accumulates, Severe intellectual disability, gait disturbance, hyperactivity, psychosis, body odor, eczema

Tx: life time diet restriction

NO croissants, red meat, chicken, eggs

Take amino acide 3x/day

161
Q

Hypospadius

A

abnormal formation of urethra where opening is below end of penis

  1. Subcoronal: Opening of urethra is near head of penis
  2. Midshaft: Opening is located along the penile shaft
  3. Penoscrotal: Opening is where the penis and scrotum meet
162
Q

Hydrocele

A

fluid filled sac surrounding testicle, swelling in scrotum

  1. Non-communicating: Sac closes and normally fluid is reabsorbed;
    fluid remains after sac closes but is usually absorbed in the first year
    of life
  2. Communicating: Sac remains open and fluid can flow back into the
    abdomen; often associated with inguinal hernia
163
Q

Muscular Dystrophy

A

group of genetic disorders that result in progressive muscle weakness
and loss

Duchenne, most common

164
Q

Spina Bifida Types

A

-Occulta (moss common) one or more vertebrae are malformed. mildest form. covered by skin.

-Closed NTDs ( there are spinal cord malformations in fat, bones or
meninges; usually no or few symptoms, but some closed NTDs can result in
incomplete paralysis with urinary and bowel problems)

-Meningocele ( Protrusion of spinal fluid and meninges through abnormal
vertebrae; may or may not be covered with skin and s/s are same as with
closed NTDs)

-Myelomenigocele (fluid filled protrusion, sac and spinal cord exposed.
most common?)

165
Q

Anencephaly

A

most sever NTD

neural tube, doesn’t copletely close, missing parts of brain, skull and scalp.

Live on few hrs after birth.

girls

166
Q

Down Syndrome

A

defect involving extra chromosome 21.

Screening:
.Nuchal Translucency via US
.NIPT: eval circulting fetal DNA in maternal blood

Dx:
o Chorionic Villus Sampling (CVS)
o Amniocentesis
o Percutaneous Umbilical Cord Sampling (PUBS)

167
Q

Down Syndrome: Types

A

o Trisomy 21: 95% of cases; there are three copies of chromosome 21
instead of two
o Translocation Down Syndrome: 3% of cases; extra chromosome 21
attached to a different chromosome
o Mosaic Down Syndrome: 2% of Down’s; some cells have three copies
of chromosome 21, but other cells are normal (often have fewer
features of Down Syndrome due to the presence of normal cells)

168
Q

Down Syndrome Physical Characteristics

A

o Hypotonia
o Flattening of the bridge of the nose
o Eyes that are slanted upward with epicanthal folds at inner corners
o Large, protruding tongue
o Simian crease in palms
o Mean IQ of 50
o ADD in childhood, depression is common in both children and adults

169
Q

Turner Syndrome

A

only affects GIRLS

partially or completely missing X chromosome

Physical Char:
Have female sex characteristics which are underdeveloped
o Short, webbed neck
o Shorter stature
o Ovaries are missing or do not function properly
o Pregnancy in 95% of patients can only occur with ART (most are
infertile)
o Most do not start puberty naturally
o Underdeveloped breasts due to lack of estrogen

TX:
growth hormone, estrogen

170
Q

Edwards Syndrome (Trisomy 18)

A

o Caused by an extra copy of chromosome 18
o Occurs in 1:5000 births
o Serious heart, brain and organ defects along with severe intellectual
disability
o Characteristics: Small, abnormally shaped head, small jaw and mouth,
clenched fists with overlapping fingers
o Survival is less than one year; many die before birth or within the first
month of life

171
Q

Patau Syndrome (Trisomy 13)

A

o Caused by an extra copy of chromosome 13
o Occurs in 1:16,000 newborns
o Heart, brain and spinal cord defects
o Characteristics: Extra fingers or toes, cleft lip with/without cleft palate,
hyptonia
o Only 5-10% live past first year of life

172
Q

Klinefelter Syndrome

A

o Caused by an extra X chromosome in males (XXY)
o Occurs in 1:500-1000 newborn males
o Affects male physical and cognitive development
o Have small testes that do not produce adequate testosterone
o Characteristics: Incomplete puberty, breast development,
decreased body hair, infertility
o May also have learning disabilities, delayed language and speech

173
Q

Fragile X syndrome

A

o Caused by mutations in the FMRI gene (inherited in an X-linked
dominant manner
o Causes learning disabilities and cognitive impairment
o Affects males more severely than females
o One-third of those with fragile X have features of autism disorder
(communication and social difficulties)
o Characteristics: Long, narrow face, large ears, prominent
jaw/forehead, unusually flexible fingers; in males, especially large
testes
o May also have anxiety and ADD
o Women with pre-mutation have in increased risk to have a child with
Fragile X
o Men with pre-mutation will pass it on to all of their daughters and
none of their sons (because boys receive only a Y chromosome from
their fathers)

174
Q

Cerebral Palsy Types

A

85-90% of cases of cerebral palsy are congenital, occurring before or
during birth

Aquired: more than 28 days after birth due to
infection or injury

Types:
1. Spastic: The most common type; 80% of those with CP
•Increased muscle tone with stiff muscles
• May see “scissoring” with walking
• Can affect one side of the body, the legs or all 4 extremities with trunk and
faced included
85
Cerebral Palsy (Continued)
 Types (Continued):
2. Dyskinetic: Problems controlling movement of all four extremities
3. Ataxic: Problems with balance and coordination
• Difficulty walking, sucking, swallowing, and talking
• Difficulty walking, writing, and reaching for objects
4. Mixed: The most common is spastic-dyskinetic

SS:
S/S in newborns:
o Head lag when picked up
o May feel stiff or floppy
o Over-extension of back and neck when held
o Stiff legs or scissoring when picked up

175
Q

Sickle Cell Disease

A

.A group of inherited red blood cell disorders, resulting in hard, sticky,
“sickle-shaped” red blood cells
o The sickle cells die early, causing a shortage of RBCs
o They also can get stuck traveling through small blood vessels causing
occlusion

176
Q

Sickle Cell Types

A

o HbSS: The most severe form; also referred to as Sickle Cell Anemia;
child inherits one sickle cell gene from each parent
o HbSC: A milder form of SCD; child inherits one sickle cell gene from
one parent, and an abnormal hemoglobin gene called “C”
from the other parent
o HbS beta thalassemia: The child inherits one sickle cell gene from one
parent and one gene for beta thalassemia from the other parent

177
Q

ND re Congenital, Genetic, Developmental Issues

A

o Deficient knowledge: r/t caring for child with congenital anomaly
o Ineffective infant feeding pattern: r/t cleft lip/palate
o Risk for decreased cardiac tissue perfusion: r/t aortic stenosis,
patent ductus arteriosus, ventral septal defect, etc.
o Deficient knowledge: r/t care of the newborn with congenital
anomaly
o Grieving: r/t fetal condition incompatible with life

178
Q

Reproductive Disorders

A

Unit 7

179
Q

Menses

A

begins 11-16

Phases:
o Follicular: FSH, LH, and estrogen stimulate egg production; one
dominant egg within follicle remains to move on to ovulation
o Ovulatory: Midpoint of cycle; egg is released from ovary
o Luteal: Follicle, now empty, forms corpus luteum; corpus luteum
secretes estrogen and progesterone to prepare for implantation; if
no fertilization occurs, then the lining is shed and the menstrual
period begins

LPN to RN (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions