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Maternal Newborn
Pregnancy
| Question | Answer |
|---|---|
| a technique of palpation to detect or examine a floating object in the body, in obstetrics, the fetus, when pushed, floats away and then returns to touch the examiner's fingers | ballottement |
| intermittent painless contractions of the uterus that may occur every 10-20 minutes they occure more frequently toward the end of pregnancy and are sometimes mistaken for true labor signs | Braxton Hicks contractions |
| Violet bluish color of the vaginal mucous membrane caused by increased vascularity visible from about the fourth week of pregnancy | Chadwick's sign |
| brownish pigmentation over the bridge of the nose and cheeks during pregnancy and in some women who are taking oral contraceptives. Also called the mask of pregnancy | Melasma also known as Chloasma |
| Secretion from the breast before the onset of true lactation; contains mainly serum and white blood corpuscles. It has a high protein content, provides some immune properties, and cleanses the neonate's intestinal tract of mucus and meconium | Colostrum |
| In some cultures, the male's observance of certain rituals and taboos to signify the transition to fatherhood | couvade |
| softening of the cervix that occures during the second month of pregnancy | Goodell's sign |
| A softening of the lower uterine segment found upon palpation in the second or third month of pregnancy | Hegar's sign |
| The line of darker pigmentation extending from the umbilicus to the pubis noted in some women during the later months of pregnancy | linea nigra |
| a harmless condition in which the hemoglobin levels drops in the first 6 to 12 weeks after birth then revents to normal levels | physiologic anemia of infancy |
| stretch marks; shiny reddish lines that appear on the abdomen, breasts, thighs, and buttocks of pregnant women as a result of stretching the skin | striae gravidarum |
| symptoms of dizziness, pallor, and clamminess that result from lowered blood pressure when a pregnant woman lies supine and the enlarged uterus presses on the vena cava | vena cava syndrome |
| numer of live births per 1000 people | birth rate |
| number of deaths of infants under 1 year of age per 1000 live births in a givn population | infant mortality |
| the number of death of infants less than 28 days of age per 1000 live births | neonatal mortality |
| number of deaths during the pregnancy cycle (including the 42 days postpartal period) per 100,000 live births | maternal mortality |
| Self concept or self -esteem, masculinity or femininity and generativity (creating the next generation) are all ____ for pregnancy | motivation |
| Risk factors | under 16 over 35, socioeconomic status healthcare availability,pre-existing medical disorders, and previous pregnancy |
| Crisis situations in pregnancy | physiologic changes, emotional lability, role transition with higher responsibility, cultural expectations and social climate (need interventions and crisis resolution) |
| primary psychological tasks throughout pregnancy | acceptance and safe passage |
| psychological tasks of first trimester | disbelief (ambivalence) and self-concern (baby is a non-event at this point) |
| psychological tasts of the second trimester | aceptance (baby becomes real with quickening) and focus more toward infant (fantasies about infant and seeking information) |
| psychological tasks of the third trimester | Prepares for separation from baby and concern for labor and delivery (safe passage) |
| denial of pregnancy, absence of response to quickening, lack of preparation for delivery and baby, excessive physical complaints and excessive emotional withdraw are all behaviors indicating potential | Risk |
| The uterus grows ____ - ____ times in capacity due to: | 500-1000 times. hypertrtrophy of myometrial cells, estrogen, distention by growing fetus |
| The fibrous tissue increases in the uterus to add strength and ____ | elasticity |
| The uterus walls thin with ____ | distention |
| Preception of Braxton Hix contraction in multigravida | higher |
| During pregnancy, the ovaries cease ovum production and the corpus luteum secretes progesterone until produced by the placenta by ___ week | 10th to 12th week |
| The cervix mucosa changes by increasing gradular tissue and secretions to form____ | mucous plug |
| Which hormone induces the epithelium of the vagina to hypertrophy and hyperplasia | estrogen |
| The increase in mucosa secretions of the vagina is called | leukorrhea |
| leukorrhea secretions are thick, white and ____ with a pH of ____. Why | acidic pH 3.5-6.0 to protect against pathogens. |
| The high acidic content of eukorrhea favors the groth of ____ | yeast - candadiasis (Moniliasis), yeast infections are common |
| Breasts increase in size and ____ | nodularity - grandular hypertropy and hyperplasia influenced by estrogen and progesterone |
| Changes in breasts during pregnancy, most noticible in which gravida | veins are prominent, nipples erectile, increased pigmentation of areola, hypertropy of montgomery's follicles, striae, most noticeable in primigravida |
| ____ may be expressed or leak during the last trimester | colostrum |
| where does the heart move during pregnancy | upward and to the left, lengthened in logitudinal and transverse diameter (see changes in EKG) |
| What happens to the pulse rate during pregnancy | increased slightly (normal is 60-100) |
| T/F blood pressure normally rises during pregnancy | False, remains unaltered but lowers during the second trimester |
| blood volume increases ___ - ___% why | 30-50% - peaks around 36 weeks. hypervolemia protects from blood loss at delivery |
| What happens to cardiac output during pregnancy | increases due to hypervolemia |
| The total RBC's increase ____% due to increased oxygen needs and hematocrit decreases ____% | 33% 7% = hemodilution. physiologic anemia of pregnancy |
| fibrin levels and plasma fibrinogen increase how much | fibrin levels 40%, plasma fibrinogen 50% |
| What causes a decrease venous return from the lower extremities? | postural hypotension, varicosities, dependent edema, vena caval syndrome (uterus compresses vena cava in supine position) |
| respiratory rate and tital volume ____ | increase causing a small degree of hypervention |
| a decrease in airway resistance is due to ____ relaxation | smooth muscle relaxation |
| How much does oxygen consumption increase by term | 14% increase |
| ___ is elevated in substernal angle | diaphragm |
| How much does the chest circumference increase due to increased lung capacity | may increase 6cm |
| breathing changes from abdominal to | thoracic |
| Vascular congestion of nasal mucosa cause ____ & ____ | nasal stuffiness and epistaxis (nosebleed) |
| 2 changes that cause morning sickness | increased HCG levels and changes in carbohydrate metabolism |
| physiologic changes in GI system | decrease in gastric emptying time, relaxation of cardiac spincter (reflux heartburn) and decrease in intestinal motility (constipation) |
| What causes hypercholesterolemia | decreased emptying time of gallbladder, pressure on gallbladder, and predisposed to gallstone formation |
| When is urinary fereuqncy most common | 1st and 3rd trimester due to pressure on the bladder |
| physiologic changes in urinary system | capacity increases, dilitation of ureters and increased potential for UTI |
| glycosuria is episodic due to ____ renal threshold | lower. The threshold is low but the function is increased. |
| The increased renal function clears ____ & ____ from the blood | urea and creatinine, therefore the blood urea nitrogen (BUN) is lowered |
| changes in pigmentation | cholasma (mask of pregnancy), nipple and aerola darken, linea nigra, vascular spider nevi |
| T/F sweat and sebaceous glands hyperactive | True |
| during pregnancy leukocytes may increase to ____ and during labor may go as high as ____. Normal is 5000 - 12000 | pregnancy up to 15,000 and labor up to 25,000 |
| although the immune system increases, some ____ occures due to the fetal allograft (genetically dissimilar) | immunosuppression |
| ____ & ____ joints relax | joints of the pelvis (waddling gait) and symphysis pubis may separate |
| what happens to the lumbodorsal spine curve | accentuate (backache) |
| Pressure on nerves are due to ____ of tissues | congestion. facial nerve paralysis and carpel tunnel syndrome |
| T/F bones and teeth demineralize to provide for the increae in calcium and phosphorus reuirements | False |
| increased risk of dental carries is due to ____ | changes in pH of the saliva |
| basal metabolic rate increases by ____% | 25% |
| thyroid function ____ | increases and thyroid often enlarges slightly |
| Changes in carbohydrate metabolism in clude ____ in fatty acids and ____ in maternal metabolism of glucose | increase in free fatty acids for maternal use and decrease in maternal metabolism of glucose |
| weight gain is specific to ____ weight and pregnancy | maternal |
| ____kcal are increased over the RDA for pregnancy | 300 kcal |
| T/F protein, carbohydrate and fat needs increase during pregnancy | False - just protein and carbohydrate needs increase |
| maternal tissue demands are greater in which trimester | first and second. Third trimester is increased fetal demands |
| recommend foods high in ____ & ____ | Iron and Calcium |
| What are the three main dangers that can be consumed | Listeria (can grow in cold refrigerators), Mercury (some fish), and toxoplasma (uncooked meat and unwashed fruits and veggies, cat feses/gardening) |
| Don't eat any kind of refrierated ____, must be reheated until steamy hot | Meat/Fish |
| Don't eat any product with _____ milk | unpasteurized including soft cheese |
| Don't eat any ____ size fish even if it is cooked | medium to large due to mercury |
| water retention is due to increased levels of | steroid sex hormones(androgens, estrogens, and progestagens) |
| What causes the increase fluid demands of pregnancy | blood volume, amniotic fluid, fetus and placenta |
| Adequate fluid intake daily | 8-10 eight oz glasses of water or other fluid daily |
| Hormones of pregnancy | estrogen, progesterone (pregnancy maintenance), hCG (pregnancy test), relaxin |
| What increases the demands for insulin | hPL antagonizes insulin |
| presumptive signs (subjective) of pregnancy include | amenorrhea, breast tenderness, N/V |
| probable signs (objective) of pregnancy include | abdominal enlargement, ballottement, pregnancy test (HCG). These are not conclusive for pregnancy, may be caused by other conditions |
| Positive signs (diagnostic) of pregnancy include | audible fetal heartbeat, fetal movement (felt by an examiner), visualization (ultrasound) |
| 10 common discomforts of pregnancy | fatigue, N/V, frequent urination, heartburn, constipation, hemorrhoids, varicosities, edema, bachache, and leg cramps |
| fatigue is most common in which trimester | first and third - promote adequate rest |
| T/F N/V is expected during the first trimester | True - eat dry charboyhdrate food like crackers in am |
| When is frequent urination common | first and third trimester, maintain fluid intake. may need to assess for sx of UTI |
| when is heartburn common in pregnancy | last half. Take antacids in moderation, eat small freuent meals and avoid lying down after meals |
| constipation is more common when | 2nd and 3rd trimesters, control with diet, fluids, exercise, and stool softeners |
| hemorrhoids are most common when | last half of pregnancy, avoid constipation and straining, exacerbated (irritated) by delivery |
| varicosities are common when | last half of pregnancy due to decreased venous return by increased abdominal pressure, avoid constricting clothes and crossing legs, elevate legs when possible |
| Edema is most common when | last trimester, lower extremity due to decreased venous return, elevate legs when possible |
| back ache is most common when | last half of pregnancy, pelvic tilt exercises |
| leg cramps are most common when | first few weeks then last half. assess intake of CA (excessive milk?), extend the leg and dorsiflex the foot |
| T/F pregnancy is a time to increase exercise like a new sport | False - continue with previous exercise routine (mild to moderate is beneficial) |
| After first trimester, avoid which position during exercise | supine |
| Do not exceed ____ bpm during exercise | 140 |
| which vaccines should be considered if otherwise indicated for pregnant women | Inactive influenza, Hep B, Tetanus-Diptheria, meningococcal and rabies |
| which vaccinations are contraindicated during pregnancy | Active form of influenza, measles, mumps, rubella, varicella, and zoster |
| special/conditional recommendation vaccinations during pregnancy | hepA, HPV, meningoccal, pneumococcal, polio, Tdap (tetanus, diptheria, pertussis), typhoid and yellow fever |
| Which vaccine is recommended during pregnancy | inactive influenza |
| ____ is any substance that adversely affects the growth and development of the fetus | teratogens |
| name some teratogens | x-rays, pesticides, smoking, alcohol, caffeine in lg amounts and certain persecription and OTC drugs |
| cocaine and other stimulants cause what alterations in pregnancy | abruptio placentae, preterm birth, fetal distress, LBW, neonatal withdrawal, and congenital anomalies such as GU, heart, limb defects, and CNS anomalies |
| TORCH infections are generally mild in adult but significant consequences for embryo and fetus what does TORCH stand for | Toxoplasmosis, Other, Rubella, CMV and Herpes |
| What is toxoplasmosis | protozoan infection contracted from undercooked or raw meat (pork) or cat feces |
| "Other" in TORCH includes | varicella and Beta Strep |
| What can Rubella cause in the first trimester and what is a susceptible maternal AB titer | congenital heart disease, IUGR, cataracts and mental retardation. Titer less than 1:8 susceptibility |
| What is the most common of the TORCH infections | cytomegalovirus (CMV), can be transmitted across placenta or cervical route, causes fetal death, microcephaly, and mental retardation, symptomatic NB is 30% mortality rate |
| Herpes 1&2 infection can cause | SAB, LBW and preterm birth |
| Herpes infection cause ____% of infected infants | 50% of these, 60% mortality rate, if survive, 50% have microcephaly, mental retardation, seizures and retinal dysplasia. |
| If a pregnant woman has an active herpes lesion how should delivery be handled | deliver by C-section ASAP after ROM |
| Why should UTI be treated ASAP | ascending infection causes pyelonephritis and may cause preterm labor/birth and may be difficult to treat - IV antibiotics |
| bacterial vaginosis may be a cause of | preterm labor |
| Transmission of the HIV virus from mother to baby occures where and when | transplacentally at birth and via breastmilk |
| ZDV therapy decreases transmission rate of HIV from 25% to ____ during birth | 5-8% |
| Iron deficiency anemia less than12 (10-11) g/dL increases susceptibility to ____ and sx include | infection, fatigue, less reserve for blood loss at delivery |
| T/F potential for sickle cell crises increases during pregnancy | True - also increased risk of UTI |
| although there has been a ____ in adolescent birth rate in US, the US has one of the highest adolescent birth rates amount industrialized countries | decline in adolescent birth rate |
| Incidence of sexual activity in adolescents is higher than other industalized countries due to | family influence, openness about sexual activity, access to contraceptives and comprenhensive sex education |
| socioeconomic/cultral contributing factors to adolescent pregnancy | poverty low educational achievement |
| high risk behaviors of adolescent pregnancy | peer pressure, multiple partners, lack of contraceptive use, lack of accurate and adequate knowledge |
| increased risks for adolescent pregnancy include | preterm birth, LBW, cephalopelvic disporportion, iron deficiency anemia, preeclapsia-eclampsia, high incidence of STI, and psycho-social risks |
| A pregnant adolescent becomes an emancipated minor, what rights does this include | right to make healthcare decisions for herself and the baby and right to confidentiality including parents. |
| T/F if unwed, a name on a birth certificate establish paternity rights or responsibility | False |
| What can the adolescent father of the baby do to accept parenity legally | sign a witnessed/notarized affidavid accepting parenity |
Created by:
cgwayland
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