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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 |
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