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Maternal Newborn


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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