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SelfLearningEx
21A
Question | Answer |
---|---|
what is estrogen's fx | development of female secondary cx |
female 2ndary cx are | breast dev, widened hips, deposits of fat tissue, body hair |
During what mestrual phase is estrogen fx | proliferative phase |
estrogen assists in | maturations of the ovarian follicles |
maturation of ovarian follicles causes | endometrial mucosa to proliferate |
How does estrogen affect FSH and LH | inhibits FSH and stimulate LH |
Progesterone is secreted by ….. | corpus lutem |
progesterone is found in greater amount during ……Phase | secretory |
progesterone is also called………… | the hormone of pregnancy b/c |
hormone of pregnancy b/c | effects on the uterus(endometrium)maintans pregnancy |
prostaglandins are…… | oxygenated fatty acids produced by cells of endometrium |
CNS signals the hypothalamus to release.... | GnRH |
GnRH stimulates anterior pituitary to release | FSH and LH |
What is FSH responsible for | maturation of the ovarian follicle |
When ovarian follicle matures it secretes….. | estrogen |
estrogen enhances the …… | development of the follicle |
The maturation of the follicle comes about w/ the action of | LH |
LH increase precedes…… | ovulation |
when ovulatinon occurs this hormone decreases | estrogen |
after the follicle rupture this occurs | complete lutienization |
the mass of cells becomes… | corpus luteum w/c |
corpus luteum secretes | large amounts of progesterone |
corpus luteum loses secretory function | 7 or 8 days after the ovulation |
After fertilization and implantation the ovum.... | secrete hCG |
hCG is needed to ... | maintain the corpus luteum |
the menstrual cycle has this many phases | four phases |
these are | menstrual, proliferative, secretory, and ischemic |
menstrual phase lasts…. | 1 to 6 days |
what hormone is low during menstrual phase? | estrogen |
during menstrual phase cervical mucus is …… | scanty, viscous, and opaque |
The endometrium ..... during menstrual phase | sheds |
the phase after menstrual phase is …… | proliferative |
proliferative phase lasts | 7 to 14 days |
during proliferative phase the endometrium.... | thickens |
During proliferative phase the estrogen | peaks |
cx of mucosa during proliferative phase | favors sperm, elast. ,ferning pattern |
vascularity of the entire uterus increases during this phase | secretory phase secretory phase lasts |
secretory phase is d/t this hormone | progesterone |
what is the next phase and how long does it last? | ischemic phase/days 27 to 28 |
during ischemic phase estrogen and progesterone….. | decreases |
during ischemic phase endometrium | becomes pale |
what are the signs of ovulation? | amt of mucus increases, thin, watery, clear, s s of ovul continued |
s of ovul continued | T increases, midcycle spotting |
How many chromosomes are in each cell | 46 divided in 23 pairs |
how many are similar | 22 similar in males & females |
how many are different | one pair of sex chromosomes (XX females, XY in males) |
what are genes | regions in DNA containing info for traits of the individual |
what are fraternal twins? | dizygotic meaning…. |
dizygotic means | arise from 2 separate eggs fertil by 2 separate spermatozoa |
what are other cx of dizygotic twins | they 2 placentas, 2 chorions, 2amnions |
what are monozygotic twins? | develop from 1 fertilized ovum/common placenta |
after the zygote forms it enters a division period called… | cleavage during wc during cleavage continues to divide into cells called…. |
upon entrying in the uterus morula develops a | central cavity w/in the cell mass |
the inner solid mass of cells is called | blastocyst |
the outer layer of cells surrounding the cavity is called…. | trophoblast |
trophoblast eventually develops into …. | chorion |
the cells of the trophoblast grow | grow into the lining of the uterus |
they form processes called | villi |
The name of the endometrium after implantation is … | decidua |
the portion of the decidua that covers the blastocyt is… | dedicua capsularis |
the portion of the decidua under the blastocyst is the … | decidua basalis |
the maternal part of the placenta develops from | the decidua basalis |
the fetal portion of the placenta will form by way of … | thechorionic villi |
what is the first embryonic membrane to form | chorion |
chorion is.. | the outermost embryonic membrane |
it encircles | the amnion, embryo, and yolk sac |
chorion develops from | trophoblast |
chorion has many fingerlike projections called | chorionic villi |
chorionic villi are used for | early genetic testing at around 8 to 10 weeks |
the second membrane to develop | amnion |
amnion is ….. | thin protective membrane that contains amniotic fluid |
amniotic fluid is | cushion to protect agaisnt injury |
amniotic fluid also | controls embryo's temperature, allows freedom of movement |
How does the fetus breath | through the amniotic fluid |
what is the placenta | measn of metabolic and nutrient exchange |
Placenta develops around week | third week of embryonic development |
the placenta has …. | decidua basalis (maternal portion) and chorionic villi |
placenta begin to fx in metabolic exchange | by week four |
what is the funic souffle | a soft blowing sound heard over the umbilical cord |
what is an uterine souffle | timed w/ mother's pulse/heard above symphysis |
what is it caused by | blood flow entering dilated uterine arteries |
what hormones does placenta produce? | hCG, hPL, estrogen and progesterone |
what is hCG similar to? | LH |
hCG prevents…. | normal involutionof the corpus luteum |
when ? | at the end of menstrual cycle |
if the corpus luteum stops fx before the 11th wk of pregnancy this happens | spontaneous abortion |
how soon is hCG present in maternal blood serum | 8 to 10 days after fertilization |
when is detectable in the urine | at the time of missed menses |
when does it reach its highest level | 50 to 70 days gestation after w/c |
placental hormone production increases | |
how does progesterone prevent spontaneous abortion | decreases contractility of the uterus |
when does placenta take over w// production of progesterone | after week 10 |
the fx of estrogen is | proliferative |
proliferative meaning | enlarges uterus, breasts, glandular tissue, increse vascularity, vasodilation |
hPL is similar to..... b/c .... | growth hormone/stimulates certain changes in the mother's metabolic processes |
most of the fetal blood supply bypasses | fetal lungs |
because | don't carry out respiratory gas exchange |
the gas exchange is assumed by the | placenta |
the blood flow from placenta through the ..... | umbilical umbilical vein |
after w/c enters the | abdominal wall at the umbilicus |
after entering the abdominal wall.... | divides into small vessesl to liver and ductus venosus |
ductus venosus empties into | fetal vena cava |
fetal vena cava enters.... and passes through the....in the .... and it is pumped into.... | right atrium/foramen ovale/left atrium/aorta |
the larger portion of the blood passes from the pulmonary artery through teh .... into the .... bypassing.... | ductus arteriosus/descending aorta/the lungs |
how does the fetus receives O2 | via diffusion from maternal circulation |
fetal circulation delivers the highest O2 concentration to..., ..., ...., w/c instead allow | head, neck, brain/cephalocaudal development |
how early is the fetal heart rate detected? | 7 weeks |
when is the heart essentially completely developed | 8 weeks |
when is the sex determination possible | week 16 |
when are heart tones audible with the stethoscope | at 16 to 20 weeks |
when does the brain look like mature brain | 24 weeks |
how long does the embryonic stage last | starts on day 15 until week 8 |
what happens during embryonic development | tissue differentiation into essential organs and the main external features develop |
during this stage the embryo is most vulnerable to... | teratogens |
by the end of week 8 the embryo | develops into ftus w/ every organ and external structure present |
what is the reminder of gestation devoted to from this point on | to refining structures and perfecting function |
at 4 weeks of age... | the heart begins to beat |
at 8 weeks of age... | all organs are formed |
by week 8 to 12 | fetal heart tones can be heard by Doppler |
by week 16 | baby's sex can be seen |
when can mother feel movement? | by week 20 |
when can hands grasp | by week 20 |
when is fetal respiration possible | by week 28 |
irregular contractions of the uterus that occur intermittently throughout pregnancy are... | Braxton Hicks contractions |
when do they begin | by week 16 (about 4 mo) |
what is their fx | help stimulate movement of blood through the intervillous spaces of the placenta |
endocervical glands secrete | mucus |
w/c fx to | form a mucus plug that prevents the ascent of bacteria & other foreign substances |
softening of the cervix is called | goodell's sign |
increased vascularization causes | softening and purplish coloration of the cervic |
thi is called | Chadwick's sign |
by week 12 a yellow secretion named ... may be expresed manually and may leak from breast | colostrum/leaks during third trimester |
colostrum converts to ... during.... | mature milk/first few days following childbirth |
what is the amt in rise of volume of air breathed each time | 30 to 40 % |
although pulmonary fx is not impaired by pregnancy this is experienced b/c | dyspnea b/c of increase in tidal volume w/c causes slight decrease in PCO2 |
what are nose bleeds or nasal congestion d/t | estrogen induced edema and vascular congestion of the nasal mucosa |
blood volume increases by.... | 40 to 50 % |
it is d/t | increase in plasma and erythrocytes |
CO increases by about.... | 30 to 50% |
pulse rate increases by about | 10 to 15 bpm |
the enlarged uterus may put pressure on.... | vena cava |
when a woman is supine this results | vena cava syndrome |
it can be corrected by... | lie on the left side |
the erythrocyte volume increases by about ... | 30@ to transport additional O2 |
plasma increase is greater than erythrocyte increase resulting in | dilutional anemia |
total recommended weight gain is... | 25 to 25 lbs |
for overweight women? | 15 to 25 lbs |
underweight? | ideal weight plus 25 to 35 |
the BMR increases by | 20 to 25% |
this instead results in | increase thyroid activity |
to parallel calcium req. by fetus this increases | concentration of PTH |
this hormone inhibits uterine activity | relaxin |
it also | diminishes the strenght of uterine contractions and aids in the softening of the cervix |
another fx of relaxin is to | long term effect of remodeling collagen |
decrease in prostaglandins are thought to contribute to.... | HTN and preeclamsia b/c are responsible for reduced placetnal vascular resistance |
what are the presumptive signs of pregnancy | amenorrhea, N, V, excessive fatigue, urinary frequency, changes in the breast, quickening |
Objective signs are.... | changes in the pelvic organs, chadwicks, goodells, uterine souffle, funic souffle, changes in pigmentation, striae, ballotment, pregnancy tests |
diagnostic (positive) changes> | fetal heartbeat, fetal movement, visualization of the fetus |
term abortion means | birth that occurs before 20 weeks |
term? | normal duration of pregnancy |
preterm? | labor occuring between 20 and 37 weeks |
postterm | after 42 weeks |
gravida | any pregnancy regardless of duration |
nulligravida | never pregnant |
primigravida | pregnant the first time |
multigravida | 2nd or more |
para | birth after 20 regardless of dead or alive |
nullipara | never gave birth |
primipara | one birth more than 20 weeks |
the terms gravida and para refers to... | pregnancies not to the fetus |
GTPAL | gravida (# of pregnancies), term (37 and over), para (preterm 20 to 37), abortion (spontaneous or therapeutic), L (living) |
Nagele's rule | LMP - 3 Months + 7 days |
what is Mc Donalds method? | measure the distance from the top of the symphysis over the abdomen to the fundus |
what can be used as an indicator for uterine size? | fundal height |
McDonald method may be inaccurate d/t | obesity, uterine fibroids, hydramnios |
Quickening can be felt when? | between 16 and 20 weeks |
fetal heartbeat can be felt by ultrasonic doppleer at about | 10to 12 weeks |
by fetoscope | by week 16 |
gestational sack by ultrasound can be detected by | 5 to 6 |
fetal heart rate by ultrasound | 6 to 7 |
vegetable high in calcium are | broccoli, collards, kale, mustard greens, turnips, greens |
fish high in ca | salmon canned w/ bones, sardines |
fruits high in calcium are | figs, raisins |
best sources of folic acid are | green leafy vegetables, orange juice, liver, peanuts, yeast prep, whole grains, cereals |
if pica develops what can be substituted by? | nonfat powder milk instead of laudry starch and frozen fruit pops instead of ice |
what does AFP test for? | trisomy 21, spina bifida, neural tube defects |
what does increase in AFP indicate | neural tube defects or intestines outside of abdomen |
what is AFP produced by and when is it tested? | fetal liver/by week 8 to 18 |
what will be done if HEP B + | IVIG the first 12 hours after birth |
what if negative? | baby still gets Hep B vaccine w/in first month of life |
why is HGB electrophoresis done? | r/o sickle cell,thalassemias (for pt at risk) |
what is it given to mother to decrease transmission of HIV | Zidovudine |
what level of blood sugar is not ok | 1+ |
what is CVS | small tissue sample of fetal side of placenta |
what does it reflect and when is it doen | genetic makeup/10 tp 12 weeks |
what are the risks | higher risk of loss of pregnancy |
what does amniotic fluid contain | fetal cells |
when is it possible to test | 14 weeks |
what is it indicated for | genetic dz, congenital abnormalities such as neural tube defect, pulmonary maturity (surfactant), dx of hemolytic dz |
what does it need | consent |
if rH incompatible... | Rhogam needs to be given to mom after amniocentesis |
what is a NST | fetal HR patterns in response to fetal mvmt/should be accelerations w/ movement |
what does a blunted response indicate? | hypoxia, CNS or congenital anomalies |
what is a biophysical profile | a NST test w/ real time US |
what does it measure | body mvmt, fetal tone, HR, amniotic fluid volume, fetal breaths |
how long to observe for? | for 30 min max (has to do things in 30 min) |
what is the scoring | O for absence 2 for presence |
w/c part is most indicative of neuro deficits? | fetal tone |
if score is 4 to 6 what is it done | repeat on the same day |
for a normal pregnancy up to 28 weeks gestation how often should visit | once per month |
29 to 36> | q2wks |
37 to 40 | qwk |
when is fetal mvmt not felt | during sleep cycle |
how long shoudl mvt be counted for | until reach 10/count 4 movts in 1hrX3 times per day |
when is US and AFP done | at 20 wks |
when is gestational diabetes detected? | 24 to 48 weeks |
what are variable decelerations d/t | umbilical cord compression |
what are late decelerations d/t | uteroplacental insufficiency |
what are early decelerations d/t | head compression |
interventions to improve uterine blood flow | lateral positioning, elevation of feet, increase hydration, anxiety reduction, ephedrine |
interventions to improve umbilical circulation | position change, amnioinfusion, modified pushing |
interventions to improve O2 | maternal O2, modified breathing techniques |
interventions to reduce uterine activity | position changes, increase hydration, modify pushing, decreases or dc oxytocin, terbutaline |
how to get more info | extend monitor observatin, verify data, change methoid of assessm, fetal stimulation, vaginal exam, maternal VS, US |
for a breastfeeding mom, how many extra calories per day are needed | 500 cal |
what is the finger position for breastfeeding | four fingers under and thumb on top |
how should tongue be for breastfeeding? | forward cradling the nipple and areola |
how does breastfeeding help w/ uterus involution? | helps uterus contract (oxytocin) |
can a woman w/ flat nipple breastfeed? | yes, it will pop out |
how about inverted? | nipple shield, pumping, stimulation |
what are the hormones of lactation | estrogen, progesterone, oxytocin, prolactin |
which one is responsible for growth of the ducts? | estrogen |
which one is responsible for the let down reflex? | oxytocin |
which is is responsible for producing milk? | prolactin |
what is colostrum | type of milk produced begining w/ 4 mo, available immdiately after birth until day 10 |
what is transitional milk? | combination of colostrum and mature milk available 1 to 2 wks post delivery |
what is foremilk | milk at beginning of feeding, thin, watery, and blue, low in fat and calories but high in antibodies and proteins |
what is hindmilk | milk at the end of feeding, high in fat and calories |
where does milk pools? | in the sinuses |
how does it gets out? | by baby's pressure of the mouth w/c squeezes it out |
when is a baby hungry? | when REM, when rooting, when brings hands to mouth or over head, when makes sucking or smacking noise |
what is a late sign? | crying |
which breastfeeding position is good for c-sec mom | side lying |
what position is good for first time moms | cross-cradle, football hold |
what is the frequency of feeding | 8 to 12 feeds per day or every 2 to 3 hrs |
how long should feed for? | as long as the baby continues to suck when stimulated |
what is the expected output? | the rule is 1 wet and soiled diaper for each day of life |
what is the output by end of first week | 6 to 8 diapers per 24 hours |
how many stools should the baby have by end of first week | 3 to 5 per 24 hours |
how does the meconium look like by day five | yellow and seedy |
what are the benefits of kangaroo care? | bonding, temp stability, calms, improves breastfeeding and hormonal response |
how soon after c-sec should a woman feed? | in delivery room or recovery room if possible |
when do usually complication of pp occur? | 24 to 48 hrs |
how often shoudl pp asssesm be done? | q15min for the first hr/q30min for another hr/than evey 4hr |
what is normal lochia amount? | one saturated pad per hr |
what if the T is over 101 | ABX |
when is gestational diabetes detected? | 24 to 48 weeks |
what are variable decelerations d/t | umbilical cord compression |
what are late decelerations d/t | uteroplacental insufficiency |
what are early decelerations d/t | head compression |
interventions to improve uterine blood flow | lateral positioning, elevation of feet, increase hydration, anxiety reduction, ephedrine |
interventions to improve umbilical circulation | position change, amnioinfusion, modified pushing |
interventions to improve O2 | maternal O2, modified breathing techniques |
interventions to reduce uterine activity | position changes, increase hydration, modify pushing, decreases or dc oxytocin, terbutaline |
how to get more info | extend monitor observatin, verify data, change methoid of assessm, fetal stimulation, vaginal exam, maternal VS, US |
for a breastfeeding mom, how many extra calories per day are needed | 500 cal |
what is the finger position for breastfeeding | four fingers under and thumb on top |
how should tongue be for breastfeeding? | forward cradling the nipple and areola |
how does breastfeeding help w/ uterus involution? | helps uterus contract (oxytocin) |
can a woman w/ flat nipple breastfeed? | yes, it will pop out |
how about inverted? | nipple shield, pumping, stimulation |
what are the hormones of lactation | estrogen, progesterone, oxytocin, prolactin |
which one is responsible for growth of the ducts? | estrogen |
which one is responsible for the let down reflex? | oxytocin |
which is is responsible for producing milk? | prolactin |
what is colostrum | type of milk produced begining w/ 4 mo, available immdiately after birth until day 10 |
what is transitional milk? | combination of colostrum and mature milk available 1 to 2 wks post delivery |
what is foremilk | milk at beginning of feeding, thin, watery, and blue, low in fat and calories but high in antibodies and proteins |
what is hindmilk | milk at the end of feeding, high in fat and calories |
where does milk pools? | in the sinuses |
how does it gets out? | by baby's pressure of the mouth w/c squeezes it out |
when is a baby hungry? | when REM, when rooting, when brings hands to mouth or over head, when makes sucking or smacking noise |
what is a late sign? | crying |
which breastfeeding position is good for c-sec mom | side lying |
what position is good for first time moms | cross-cradle, football hold |
what is the frequency of feeding | 8 to 12 feeds per day or every 2 to 3 hrs |
how long should feed for? | as long as the baby continues to suck when stimulated |
what is the expected output? | the rule is 1 wet and soiled diaper for each day of life |
what is the output by end of first week | 6 to 8 diapers per 24 hours |
how many stools should the baby have by end of first week | 3 to 5 per 24 hours |
how does the meconium look like by day five | yellow and seedy |
what are the benefits of kangaroo care? | bonding, temp stability, calms, improves breastfeeding and hormonal response |
how soon after c-sec should a woman feed? | in delivery room or recovery room if possible |
when do usually complication of pp occur? | 24 to 48 hrs |
how often shoudl pp asssesm be done? | q15min for the first hr/q30min for another hr/than evey 4hr |
what is normal lochia amount? | one saturated pad per hr |
what if the T is over 101 | ABX |
what is an important assessmt for c-sec | BS |
what kind of products besides ice packs are used for hemorrhoids? | corticosteroid cream |
what is americaid | helps w/ pain and comfort |
how do tucks help | provide cooling and clean environment |
what do you need dr order for | nipple cream |
how is it applied | express a little milk, than rub the cream, apply a support bra |
what is important for teaching w/ pads | don't touch in the middle (bacteria, infection) |
how long is ice pack used for? | for the first day usually |
what kind of clots are normal? | small size the size of a dime |
what would a full bladder cause? | false info on the pp assessm when palpating fundus |
what is a normal head circumference? | 32 to 37 |
what is a normal chest circumference? | 30 to 35 |
how is the head measured? | prominent part of occiput and above eyebrown |
how is chest measurement done? | lower edge of scapula and around directly over the nipple line |
what is Ballard scoring system done for? | gestational age w/ weight (ntrauterine growth) |
what is acrocyanosis? | hands and feet are always blue |
what would morphine and magnesium induce in a newborn? | depress resp |
how often is APGAR done? | at 1 min, than 5min |
what would a baby w/ a score of 5 to 7 need? | stimulation, adm of O2 via a bag or face mask |
what would a baby w/ a score below 4 need? | resuscitation |
what is the normal BP for a newborn | 60to 80/30 to 40 |
what is the normal respirations for a newborn | 30 to 60 |
what is the normal HR for a newborn | 110 to 160 |