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Maternity chpt 1-5
| Question | Answer |
|---|---|
| Birth rate | # of live births per 1000 people. In 2005, US was 14.1 |
| Maternal mortality rate | # of deaths r/t pregnancy including 42 days postpartum |
| Infant mortality rate | # of infant deaths under 1 year of age per 1000 LB |
| neonatal mortality | less than 28 days per 1000 LB |
| fetal death | in utero age 20 weeks or older |
| perinatal mortality | includes both neonatal and fetal death per 1000 LB |
| scope of practice | limits of nursing practice set forth in state statutes |
| nurse's role in informed consent | to witness the pt signature |
| Abortion | legal if b/f the age of viability (fetus may survive outside the womb)- (roe vs wade)- disputed beyond that |
| main focus of a NP | physical and Psychosocial clinical assessment |
| nurses advocate for children by encouraging families to investigate ____________ eligibility | SCHIP (state children's health insurance program) |
| for maternity nurses, the best defense in lawsuits is to meets standards of practice as set forth by ____________ | AWHONN (Association of Women's Health, Obstetric and Neonatal Nurses) |
| what is the most common cause of death in children ages 1-4? | accidentall injuries |
| In the Korean family, who plays a major role with the parents? | the grandfather |
| regarding herbs, what should be avoided? | using high concentration extracts |
| the uterus includes which parts | fundus, corpus and cervix |
| perimetrium | seosal outer layer |
| myometrium | muscular layer |
| endometrium | innermost layer which changes monthly |
| during pregnancy, the endometrium becomes the _____________ | decidua [basalis (bottom), capsularis, vera or parietalis] |
| round ligaments may cause what during pregnancy | discomfort |
| the uterus elarges from an organ the shape of a ________, to a thin-walled organ capable of containing _______ liters | pear, 20 |
| which 2 hormones are secreted by anterior pituitary | FSH and LH |
| __________ is essential to maintain pregnancy & is secreted by the _________ after the corpus luteum retires | progesterone, placenta |
| what is mittleschmerz | pain experienced by some women during ovulation |
| _____________ measures the INLET of the pelvis from the _________ to the ____________. These are measurements from inside the pelvis, hence the _________ diameter the baby has to pass | Obstetric conjugate, sacral promontary to the symphis pubis, smallest diameter |
| Depo provera is for __________-term BC | long |
| safest way of sterilization | vasectomy |
| fibrocystic breast changes | most common BENIGN breast d/o, ages 30-50 |
| fibroadenoma | common benign tumor- teens and early 20s- POTENTIALLY MALIGNANT |
| intraductal papilloma | in the terminal portion of the duct, associated w/menopause, most are benign, potentially MALIGNANT, nipple d/c |
| what is endometriosis? | ages 20-45, 1/3 infertile women have it (usually when dx made), found outside of uterus & interferes w/other organs. Misplaced tissue proliferates & bleeds w/menstruation & this tissue is not eliminated but reabsorbed leaving scars & ADHESIONS |
| endometriosis can be d/t what? | can be d/t immunologic malfx (familial), environmental (dioxin/plastic) weakening immune system |
| endometriosis symptom | PAIN is most common (dysmenorrhea) |
| severe cases of endometriosis need what? | surgery, even COLOSTOMY to SEPERATE ADHESIONS |
| drugs for suppressing endometriosis | danazol- a weak androgen causing menopausal effects on endometrium & suppresses ectopic implants, medroxy progesterone acetate (Provera)-causes sustained progestational effect causes atrophic changes in implants |
| Toxic Shock Syndrome (TSS)is what? | a multisystem bacterial infx of group A & B streptococci, and staph areus-- acute, severe & potentially fatal. Occurs near menses or postpartum. |
| who does TSS effect? | children & adolescents, those who use tampons |
| TSS s/s | fever >102, myalgia, rash over chest and abdomen, palms and soles w/later desquamation/peeling (SCARLATINA), about 3 weeks post onset. severe cases: acute renal tubular necrosis w/susequent death |
| Rx for TSS | antbx to tx septicemia |
| vaginitis s/s | increase in vag d/c, vulvar irritation, pruritis, pain, odor-- most common reason women seek care |
| vaginitis is /dt what? | infection or change in the normal flora (candida albicans) |
| bacterial vaginosis | change in normal vaginal bacterial flora- |
| bacterial vaginosis s/s | thin, watery, white/gray d/, smells FISHY, LUE- cells are seen are wet mount |
| rx for bacterial vaginosis | flagyl/metronidazole- tx partner as well |
| trichomaniasis | cuased by motile protozoan |
| chlamydia & g onorrhea | most common bacterial sti in the US |
| most common cause of PID | chlamydia and gonorrhea, but also sexual promiscuity & IUD |
| PID effects __________ b/c | fertility, it leaves scar tissue in the FT (ECTOPIC PREGNANCY) |
| PID s/s | may be assymptomatic or fever, chills, pain, vag d/c, GI symptoms |
| UTI during prego | SERIOUS & must be tx immendiately even if assymptomatic (>100,000 bacteria/mm3). |
| Pregnancy promotes bacterial growth in UTI how | pressure of uterus, dilation of ureters, stasis of loop of henle |
| Acute symptoms of UTI have what cultures | chlamydia trachomatis- tx always required |
| what is cystis | lower UTI |
| risk presented by cystis | acute pylonephritis; inceases fetal/maternal morbidity, preterm labor and birth, potential teratogenic effects from increased temp & anbx, septicemia/septic shock, chronic renal |
| to prevent tss, one should avoid | super absorbent tampons |
| in the tx of vaginal candidiasis | BOTH PARTNERS SHOULD BE TX |
| SYMPTOM OF PYLONEPHRITIS IS... | RIGHT FLANK PAIN D/T THE POSITION OF THE UTERUS |
| EXPOSURE TO STI INCREASES THE RISK OF _________ | CERVICAL CA |
| primary care | promotion and prevention |
| assisted reproductive technology | term used to describe highly technoligic approaches to produce pregnancy |
| Baby doe regulations | protect the rts of infants w/severe defects |
| nuclear family | mother, father & children |
| stages of family life cycle (8) | 1)beginning families 2)childbearing 3)w/preschool children 4)school-age kids 5)teenagers 6) young adults 7)middle-aged parents 8) young adults |
| complementary therapy | adjunct therapy which has been researched |
| alternative therapy | adjunt therapy which HAS NOT been researched |
| dysmenorrhea tx | oral contraceptives, NSAIDS, prostaglandins inhibitors |
| PMS associated with | luteal phase (2 weeks prior to) |
| PMS tx with | progesterone agonists, prostaglandins inhibitors (anti inflammatory) |
| PMS self care | vitamin B, E, CA, avoid NA+, caffeine, aerobic exercise |
| menopause | ovulation ceases 12 years prior, FSH levels rise, < estrogen prod, atrophy vagina/vulva/urethra, , inc risk CAD |
| mammograms & paps | Q2 years after 40, Q year after 50, paps yearly |
| fertility awareness pros/cons | pros: natural, non-invasive; cons; need counseling, practicing abstinence, less reliable |
| barrier contraceptives: pros/cons | pros: easy to use w/no s/e, condoms great w/STIs, excellent when used rt; Cons: some must be fitted, placed prior to sex, used w/spermicides |
| spermicides: pros/cons | pros: inexpensive, easy to get; cons: must be applied prior to sex, messy minimally effective when used alone |
| intrauterine devices: pros/cons | pros: very effective, good for 5-10 yrs; cons: cramping/bleeding first 3-6 months, checking for proper placement b/f menses, may predispose to PID |
| hormonal contraceptives; pros/cons | pros: effective, mestrual s/s lessened, and predictable; cons: chance of blood clots, no smokers, those w/heart conditions, thromboembolytic dz, doesn't protect from STI |
| sterilization: pros/cons | pros; permanent, effective, no additional costs; cons; vasectomy is not immediate, some not reversible, requires some types anesthesia |
| fibrocystic breast changes | benign; d/t imbalance estrogen/progesterone, inc tenderness/swelling b/f menses, Na+/caffeine restrition helps |
| fibroadenoma | freely moveable, solid, benign; asymptomatic, nontender, surgically removed if malignancy suspected |
| intraductal papilloma | in ductal system of breast, potentially malignant, nipple d/c, MUST be surgically removed |
| duct ectasis (comedomastitis) | inflammation of duct behind nipple, during/near menopause, tx w/symptom relief or surgery |
| what is disparunia | painful intercourse |
| chlamydia | may cause dz in newborn, often asymptomatic (Sosi)ycyclin, both partners tx w/azithromycin or dox |
| syphilis | testing required during pregnancy, tx w/PNCN |
| HPV | linked to cervical CA- defferent types (6,11,16,18), still need pap smears even w/Gardasil, tx w/chemical/surgical removal |
| what is colposcopy? | special magnifying device to look at cervic |
| what is the internal/external os? | beats me!!!! |
| maternal mortality rate | per 100,000 LB 13.1 in US |
| preterm | before 37 weeks |
| low birth wt | under 2500 grams |
| clinical nurse specialists (CNS)require a .... | master's degree |
| false pelvis | above pelvic brim, supports wt of prego uterus, directs fetus ito true pelvis |
| inlet | upper border of pelvis |
| pelvic cavity | curved canal w/longer posterior than anterior wall |
| pelvic outlet | lower border of true pelvis |
| other divisions of pelvis | gynecoid, android, anthropoid, platypelloid |
| estrogen | secondary sex characteristics, maturation of ovarian follicles, causes endometrial mucousa to proliferate after menstruation, uterus inc in sz & wt, inc myometrial contractility in uterus & FT, inc sensitivity to oxytocin |
| estrogen inhibits ________ and stimulates ___________ | FSH, LH |
| progesterone | dec uterine motility & contractility, fascilitates vag epthelium proliferation, secretes thick viscous cervical mucous, inc breast glandular tissue in preparation for breast feeding |
| prostaglandins | increases during follicuar maturation (needed to release egg) |
| follicular phase | hypothalamus releases GnRH-> FSH, LH; FSH responsible for maturation of ovarian follicle, then secrete estrogen. Final maturation by LH which results in ovulation |
| luteal phase | release of ovum; LH: corpus luteum develops from ruptured follicle, secretion of progesterone increases, fertilized ovum able to implant into endometrium, secretion of human chorionic gonadotropin (hCG)- that's how u know you're prego |
| absence of fertilization in luteal phase | the c. luteum degenerates, dec amts estrogen & progesterone (which causes neg feedback)--> inc in LH and FSH |
| Menstrual phase | shedding of endometrial lining, low estrogen |
| proliferative phase | enlargement of endometrial glands, changes in cervical mucous, increases in estrogen levels |
| secretory phase | follows ovulation, inc in vascularity in uterus (for fetus), inc in myometrial glandular secretions |
| ischemic phase | if fertilization does not occur, this phase begins. The c.luteum degenerates, both estrogen & progesterone levels fall, escape of blood into the stromal cells of the endometrium |
| meiosis | produce gametes (haploid) |
| mitosis | 2 identical diploid (46) daughter cells |
| oogenesis | process that produces female egg, begins as a fetus, are all present @ birth, during puberty, mature primary oocyte goes through 1st mitotic division |
| oogenesis, the 1st meitotic division | 2 cells of unequal size, same # 22 double-structured autosomal chromosomes and 1 double-structured (x)-sex chromosome, one is the polar body, the other is the secondary oocyte |
| meiosis | go over |
| SPERMATOGENESIS | begins w/a set/diploid chromosomes which replicate- this cell is now primary spermatocyte.1st meiotic division-form 2 secondary spermatocytes w/haploid 22 autosomal chrommosomes & 1 x or y. During second meiotic divison, they become 4 spermatids |
| ovum released into FT is viable for __________ | 24 hours |
| sperm in vagina viable for _________ | 24- 48 hrs (highly viable for 24 hours) |
| sperm must undergo ______ & ________ reaction, which is what | capacitation & acrosomal reaction. Capacitation; sperm must lose it's plasma coating w/in 7 hours, acrosomal rx is when the acrosomes of the the sperms surrounding ovum release enzymed to to break down the hylaluronic acid surrounding corona radiata |
| blastomeres grow into a _________ of how many cells? | morula of 12-16 cells |
| morula becomes a _____________ surrounded by an outer layer called a __________ | blastocyst, trophoblast |
| implantation occurs in how many days | 7 |
| cell differentiation; the ___________ differentiates into the________, _________, &_______ in how many days | blastocyst into the endoderm, ectoderm, & mesoderm in 10-14 days |
| what embryonic membranes form at implantation? | the chorion & amnion |
| amniotic fluid | created when amniotic and chorionic grow & connect to produce fluid |
| yolk sac | develop as part of the blastocyst, produces primitive RBC, soon incorporated into umbilical cord |
| endoderm | results in formation of epithelial lining of respiratory & digestive tract |
| umbilical cord | provides circulatory pathway- developed from amnion, body stalk attaches embryo to yolk sac, fuses w/embryonic portion of placenta. Provides pathway from chorionic villi to embryo, surrounded by wharton's jelly. |
| placenta | begins 3rd week for metabolic & nutrient exchange- has 2 parts, maternal & fetal |
| maternal portion of placenta | consists of decidua basalis 7 it's circulation- red & fleshlike |
| fetal portion of placenta | consists of chorionic villi & circulation, fetal surface covered by amnion, shiny and gray |
| identical twins | sing fetilized ovum, same sex/genotype, common placenta, # amnions & chorions depends on # of divisions. |
| monozygosity is not affected by | environment, race, fertility, physical characteristics |
| identical twins, division within 3 days= | 2 embryos, 2 amnions, 2 chorions |
| identical twins, division within 5 days= | 2 embryos, 2 amniotic sacs, common chorion-- so it's a monochorionic-diamniotic placenta |
| fraternal twins/dizygotic | from 2 seperate ova fertilized by 2 seperate spermatazoa, 2 placentas (sometimes fuse), 2 chorions, 2 amnions, same sex or different |
Created by:
arsho
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