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68WM6 MaternalChild

Maternal Child

QuestionAnswer
what is the purpose of meiosis? to reduce the diploid number (46) to the haploid (23) for reproduction
how many mature ova can be produced by each oogonium? 1
when does meiosis occur in the female? partially in utero, before 30 weeks gestation, completes at fertilization
when does meiosis occur in the male? constantly after puberty
how many mature spermatozoa are produced from each spermatogonium? 4
where does fertilization usually occur? distal 1/3rd of the fallopian tube
what are the purposes of seminal fluid? nourishment, protection, and transport of sperm to the cervix
what three things happen when the spermatazoon enters the ovum? 1)zona pelucida changes to prevent entrance of other sperm 2)2nd polar body is expelled from ovum 3) cell membranes break down to allow mixing of chromosomes from parents
when is fertilization complete? when the chromosomes complete recombination from haploid to diploid (46)
when does implantation occur? by the 10th day
what are advantages of implantation in the upper uterus? larger supply of blood, thicker uterine lining, limits blood loss during childbirth
how is the embryo nourished before the development of the placenta? diffusion, pinocytosis
why is the embryo (as opposed to the fetus) particularly susceptible to damage from teratogens because development is occuring at a rapid rate
how does the lower respiratory tract develop? starts as a branch of the GI tract, separates from esophagus, and then branches to form bronchus, bronchioles, and eventually alveoli
why are the intestines contained withing the umbilical cord until the 10th week? they develop faster than the abdominal cavity and there is not room for them
the term for age calculated in weeks from the time of conception fertilization age
the term for age calculated in weeks from the last menstrual period gestational age
which is used more commonly, fertilization age or gestational age, and why? gestational age because more women know when their last period was than know the exact time of conception
what postition does the fetus assume in late pregnancy? head down
thick whitish substance secreted by fetus to protect skin from prolonged contact with amniotic fluid vernix
soft, downy hair that helps adhere vernix to the skin lanugo
heat producing fat stored in back of neck, behind sternum, and around kidneys to help regulate temperature in neonates brown fat
lubricant produced in the lung that prevents the collapse of alveoli; important in determining viability of the fetus in case of early delivery surfactant
which function takes over the endocrine functions of the corpus luteum during pregnancy placenta
what happens in the intervillous spaces of the placenta? exchange of oxygen, nutrients and waste
why should fetal and maternal blood not mix? non compatible blood types can result in sensitization of mother and spontaneous abortion of subsequent pregnancies
what factors allow the fetus to thrive in a low oxygen environment? more effecient hemoglobin, higher hct and hgb, lower CO2 in fetal blood
causes corpus luteum to persist for 6-8 weeks and causes fetal testes to secrete testosterone hCG
promotes fetal growth and nutrition, decreases maternal sensitivity to insulin, and promotes maternal breast development for lactation human placental lactogen
promotes enlargement of the uterus and breasts as well as the ductal system of the breasts and the external genitalia estrogen
promotes changes in endometrium to allow pregnancy, reduces muscle contractions in the uterus to prevent spontaneous abortion, and may promote immune tolerance in the mother to allow pregnancy progesterone
what is the purpose of the fetal membranes? to contain amniotic fluid
what are the functions of amniotic fluid? protection, cushioning, temperature stability, promote symmetric development, prevent membranes from adhering to fetus
shunts oxygenated blood from umbilical vein to inferior vena cava ductus venosus
shunts blood from right to left atrium foramen ovale
shunts blood from right ventricle directly into the aorta ductus arteriosus
carry oxygenated blood from placenta to fetal circulation umbilical veins
carry deoxygenated blood from fetus to placenta umbilical arteries
key sign of threatened abortion bleeding
key signs of inevitable abortion cervical dilation and membrane rupture (evidenced by loss of amniotic fluid)
causes of spontaneous abortion genetic/chromosomal abnormalities; incompetent cervix; bicornuate uterus; hormonal deficiencies; immunologic factors; systemic disease (diabetes mellitus, lupus); Rh incompatibility
appropriate nursing interventions for grief following spontaneous abortion listening, acceptance, provide information
inappropriate initiation of clotting factors caused by a variety of factors during pregnancy DIC (disseminated intravascular coagulation)
causes of disseminated intravascular coagulation abruptio placentae, missed abortion, crossover of thromboplastin from placenta, endothelial damage (preeclampsia, HELLP syndrome), sepsis, amniotic fluid embolism
how is disseminated intravascular coagulation treated supportive treatment until underlying cause can be corrected
known as a "disaster of reproduction" because if undetected it can lead to death or subsequent infertility ectopic pregnancy
causes of increased rates of ectopic pregnancy in the united states increased rates of pelvic infection, inflammation, and surgery
how is ectopic precnancy treated? methotrexate to prevent cell division at early stages, linear salpingostomy to remove pregnancy, or salpingectomy if too far progressed
abnormal trophoblast development with or without partial fetus hydatiform mole
what are the two phases of treatment for molar pregnancy? evacuation of abnormal tissue, continuous followup to detect malignant changes
what is the most common sign of placenta previa painless uterine bleeding
how is placenta previa diagnosed ultrasound
treatment of placenta previa bedrest, pt teaching (of warning signs), delivery by c section in placenta is completely blocking the cervix
bleeding, uterine tenderness, contractions, abdominal or low back pain, and high uterine resting tone are signs of abruptio placentae
major concerns with placental abruption include maternal hemorrhage, fetal death
uncontrollable vomiting resulting in weight loss, dehydration, acid/base/electrolyte imbalances, low vitamin k (coagulation disorders) and low thiamine (encephalopathy) hyperemisis gravidarum
hyperemisis gravidarum begins before what week of pregnancy 20th
what are the goals of hyperemesis gravidarum management? maintain hydration and nutrition
BP greater than 140/90 with proteinuria beginning after the 20th week of pregnancy preeclampsia
BP greater than 140/90 with proteinuria beginning after the the 20th week of pregnancy and resulting in seizures eclampsia
BP greater than 140/90 without proteinuria beginning after 20th week of pregnancy gestational hypertension
BP greater than 140/90 existing before pregnancy or manifesting before 20th week chronic hypertension
preexisting hypertension with proteinuria that develops or increases significantly after the 20th week preeclampsia superimposed on chronic hypertension
results in decreased placental circulation, decreased O2 availability to fetus, decreased nutrient and waste exchange in placenta vasospasm
is reduced activity beneficial after diagnosis of preeclampsia yes, lying down for periods during the day reduces pressure on the vena cava and increases cardiac return leading to better perfusion
causes decreased cranial perfusion, altered mental status, and seizures in mother vasospasm
what is the primary adverse effect of magnesium sulfate? CNS depression, resulting in respiratory depression
the antidote to magnesium sulfate calcium gluconate
possible complications of eclampsia HELLP, DIC, abruptio placentae
what assesments should be frequently completed on mother with preeclampsia? DTR, vitals, chest auscultation, edema evaluation, protein in urine, daily weights
what is the preferred medical management of seizures during pregnancy magnesium sulfate
what are some nursing interventions appropriate for a woman with preeclampsia? calm, quiet, relaxing environment with minimal light and sound, limit visitation, avoid disturbing when possible
causes of disseminated intravascular coagulation abruptio placentae, missed abortion, crossover of thromboplastin from placenta, endothelial damage (preeclampsia, HELLP syndrome), sepsis, amniotic fluid embolism
causes of disseminated intravascular coagulation abruptio placentae, missed abortion, crossover of thromboplastin from placenta, endothelial damage (preeclampsia, HELLP syndrome), sepsis, amniotic fluid embolism
how is disseminated intravascular coagulation treated supportive treatment until underlying cause can be corrected
causes of increased rates of ectopic pregnancy in the united states increased rates of pelvic infection, inflammation, and surgery
known as a "disaster of reproduction" because if undetected it can lead to death or subsequent infertility ectopic pregnancy
causes of increased rates of ectopic pregnancy in the united states increased rates of pelvic infection, inflammation, and surgery
abnormal trophoblast development with or without partial fetus hydatiform mole
how is ectopic precnancy treated? methotrexate to prevent cell division at early stages, linear salpingostomy to remove pregnancy, or salpingectomy if too far progressed
what is the most common sign of placenta previa painless uterine bleeding
abnormal trophoblast development with or without partial fetus hydatiform mole
how is placenta previa diagnosed ultrasound
what are the two phases of treatment for molar pregnancy? evacuation of abnormal tissue, continuous followup to detect malignant changes
treatment of placenta previa bedrest, pt teaching (of warning signs), delivery by c section in placenta is completely blocking the cervix
what is the most common sign of placenta previa painless uterine bleeding
bleeding, uterine tenderness, contractions, abdominal or low back pain, and high uterine resting tone are signs of abruptio placentae
how is placenta previa diagnosed ultrasound
major concerns with placental abruption include maternal hemorrhage, fetal death
treatment of placenta previa bedrest, pt teaching (of warning signs), delivery by c section in placenta is completely blocking the cervix
uncontrollable vomiting resulting in weight loss, dehydration, acid/base/electrolyte imbalances, low vitamin k (coagulation disorders) and low thiamine (encephalopathy) hyperemisis gravidarum
bleeding, uterine tenderness, contractions, abdominal or low back pain, and high uterine resting tone are signs of abruptio placentae
major concerns with placental abruption include maternal hemorrhage, fetal death
BP greater than 140/90 with proteinuria beginning after the 20th week of pregnancy preeclampsia
uncontrollable vomiting resulting in weight loss, dehydration, acid/base/electrolyte imbalances, low vitamin k (coagulation disorders) and low thiamine (encephalopathy) hyperemisis gravidarum
BP greater than 140/90 with proteinuria beginning after the the 20th week of pregnancy and resulting in seizures eclampsia
hyperemisis gravidarum begins before what week of pregnancy 20th
BP greater than 140/90 without proteinuria beginning after 20th week of pregnancy gestational hypertension
what are the goals of hyperemesis gravidarum management? maintain hydration and nutrition
BP greater than 140/90 with proteinuria beginning after the 20th week of pregnancy preeclampsia
BP greater than 140/90 with proteinuria beginning after the the 20th week of pregnancy and resulting in seizures eclampsia
BP greater than 140/90 without proteinuria beginning after 20th week of pregnancy gestational hypertension
BP greater than 140/90 existing before pregnancy or manifesting before 20th week chronic hypertension
causes decreased cranial perfusion, altered mental status, and seizures in mother vasospasm
preexisting hypertension with proteinuria that develops or increases significantly after the 20th week preeclampsia superimposed on chronic hypertension
what is the primary adverse effect of magnesium sulfate? CNS depression, resulting in respiratory depression
results in decreased placental circulation, decreased O2 availability to fetus, decreased nutrient and waste exchange in placenta vasospasm
the antidote to magnesium sulfate calcium gluconate
is reduced activity beneficial after diagnosis of preeclampsia yes, lying down for periods during the day reduces pressure on the vena cava and increases cardiac return leading to better perfusion
possible complications of eclampsia HELLP, DIC, abruptio placentae
causes decreased cranial perfusion, altered mental status, and seizures in mother vasospasm
what assesments should be frequently completed on mother with preeclampsia? DTR, vitals, chest auscultation, edema evaluation, protein in urine, daily weights
what is the primary adverse effect of magnesium sulfate? CNS depression, resulting in respiratory depression
the antidote to magnesium sulfate calcium gluconate
possible complications of eclampsia HELLP, DIC, abruptio placentae
what assesments should be frequently completed on mother with preeclampsia? DTR, vitals, chest auscultation, edema evaluation, protein in urine, daily weights
what are some precautions that can help prevent injury during a seizure? pad side rails, have O2 and suction on hand
what is the preferred medical management of seizures during pregnancy magnesium sulfate
what are some nursing interventions appropriate for a woman with preeclampsia? calm, quiet, relaxing environment with minimal light and sound, limit visitation, avoid disturbing when possible
what are some precautions that can help prevent injury during a seizure? pad side rails, have O2 and suction on hand
what are some signs and symptoms of magnesium toxicity? decreased respirations, decreased SPO2, absent deep tendon reflexes, sweating and flushing
what is the antidote for magnesium? calcium gluconate
what does HELLP stand for? Hemolysis, Elevated liver enzymes, Low platelets
what is the perferred medication for HTN during pregnancy? methyldopa (Aldomet)
if methyldopa is ineffective, what classes of medication can be used to prevent HTN during pregnancy? beta blockers and calcium channel blockers
what is a vassodialator used for HTN crisis during pregnancy? hydralazine
which diuretics are considered safe to use during pregnancy? thyazide diuretics
who receives Rhogan followed by or during pregnancy? all RH negative mothers
how can an ABO incapability effect the fetus? results in hemolysis resulting in jaundice in newborn
why is ABO incapability not as serious as RH incapability during pregnancy? ABO antibodies do not cross the placenta very easily
which is more likely to cause birth defects, gestational diabetes or prepregnancy diabetes? prepregnancy diabetes
what is the gold standard for diabetes diagnosis? oral glucose tolerance test
why do many heart defects do not manifest until pregnancy? increased cardiovascular workload
two major categories of heart disease during pregnancy congenital and rhuematic
during labor the nurse should be cautious about administration of fluid to a patient with heart disease for what reason? fluid overload during contractions can lead to congestive heart failure
how much blood is added to intravascular volume following placenta delivery? 500ml
the supplement helps prevent anemia during pregnancy iron
a deficency in this can lead to maternal magaloblastic anemia and nuero tube defects in the fetus? folic acid
Created by: ewoff85
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