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Maternal Child

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