Term
| where is the ovum secreted from? |
|
Definition
|
|
Term
| after its secretion from the ovary, how long is the ovum viable for? |
|
Definition
|
|
Term
| after ejaculation how long are sperm viable for? |
|
Definition
|
|
Term
| fertilization usually occurs where? |
|
Definition
| the ampule of the fallopian tube |
|
|
Term
| where must the fertilized egg travel for implantation? |
|
Definition
| through the fallopian tube into the uterus for implantation |
|
|
Term
| when does implantation occur? |
|
Definition
| 9-11 days after fertilization |
|
|
Term
| when implantation occurs what is the structure of the egg and sperm called? |
|
Definition
| the fertilized egg is a 2 cell structure called a zygote |
|
|
Term
| what does the zygote secrete? |
|
Definition
| its own human chorionic gonadotropin (hCG, the hormone of pregnancy |
|
|
Term
| what is the hormone of pregnancy? |
|
Definition
| human chorionic gonadotropin (hCG) |
|
|
Term
| besides secreting hCG, what does the zygote also do? |
|
Definition
| sends messages to the corpus luteum to secrete estrogen and progesterone needed to maintain pregnancy until placenta takes over this function |
|
|
Term
| explain the three stages of fetal development |
|
Definition
1. pre-embryonic (weeks 1-3)
2. embryonic (weeks 4-8) where there is rapid cell differentiation
3. fetal (many milestones occur) |
|
|
Term
| what is IMPERATIVE to explain to patients about weeks 4-8 of pregnancy? |
|
Definition
| that exposure to diseases, drugs, viruses, radiation may cause serious anomalies |
|
|
Term
|
Definition
-weeks 1-3
-begins with fertilization
-time of rapid cell division |
|
|
Term
| by the 3rd week, the end of the pre-embryonic period, what has formed? |
|
Definition
| the endoderm, mesoderm, and ectoderm and formation of the neural tube |
|
|
Term
| by the third week, what is the condition of the neural tube? |
|
Definition
| formation has begun, the ends are still open must fuses in the middle |
|
|
Term
| in what type of direction orientation does the baby develop? |
|
Definition
cephalo-caudal or head to toe
and central to peripheral |
|
|
Term
| in the formation of a 3 week embryo what is prominent feature? |
|
Definition
| the brain because it forms more rapidly than the lower portions of the body |
|
|
Term
|
Definition
-rapid cell differentiation
-dorsal part of the yolk sac is incorporated into embryo
-primitive gut begins to form
-neural tube closes at week 4
-embryo will exhibit primitive eyes, ears, jaws, and limb buds, kidneys
-day 28 a 2 chamber heart forms that beings to pump blood
-42 somites will develop into vertebral column and muscles |
|
|
Term
| when do women suspect that they are pregnant? |
|
Definition
| by the end of week 3, the pre-embryonic stage |
|
|
Term
| when does the neural tube close? |
|
Definition
| at week 4 during the embryonic period |
|
|
Term
| what occurs when the neural tube closes? |
|
Definition
| it forms the brain and spinal cord |
|
|
Term
| during what period does the embryo exhibit primitive eyes, ears, jaw, and limb buds, kidneys? |
|
Definition
| embryonic period (4-8 weeks after fertilization) |
|
|
Term
| in what period does a 2 chamber heart form and begins to pump blood? |
|
Definition
| in the 28th day or 4th week, the embryonic period |
|
|
Term
| the 42 somites that are present in the embryonic period will develop into what? |
|
Definition
|
|
Term
| when does spina bifida occur and why? |
|
Definition
| during the 4th week, in the embryonic period because this is when the neural tube closes |
|
|
Term
|
Definition
-brain is larger than rest of body
-brain has 5 distinct areas and 10 pairs of cranial nerves
-cephalo-caudal growth continues |
|
|
Term
|
Definition
-limb buds are extending
-MS developing
-heart has 4 chambers and are visible on real time ultrasound scan
-liver beging to form blood
-ears begin to appear
-trachea, bronchi, and lung buds developing
-upper lip and oral and nasal passages are developing
-it is at this time that cleft lip will occur it is will |
|
|
Term
| at what period does cleft lip occur if it will? |
|
Definition
|
|
Term
|
Definition
-ultrasound heart is visible
-face formed with tongue and palate folds
-optic nerve formed
-fused eyelids are visible
-diaphragm is complete
-internal productive organs are beginning to diffrentiate
-gender cannot be told
-begin to take on human appearance
-very small only seen under a microscope
-brain and head are still larger and more developed than the rest of body |
|
|
Term
|
Definition
-fingers and toes are forming
-ear structure is formed but embryo cannot hear until week 22
-heart function and fetal circulation are fully functioning
-organ cells are differentiated |
|
|
Term
| when will the embryo be able to hear? |
|
Definition
|
|
Term
| what is the major milestone for embryonic period, week 8? |
|
Definition
last week of embryonic period
ALL structures are full differentiated even though they are not all functional and are very primitive |
|
|
Term
| during the process of diffrentiation which is complete by week 8 of the embryonic period, what is the embryo susceptible to? |
|
Definition
|
|
Term
|
Definition
| environmental factors that can cause birth defects |
|
|
Term
| 65% birth defects occur during this period |
|
Definition
|
|
Term
| by week 8, the end of the embryonic period, many women may not be aware that they are pregnant. why is this dangerous? |
|
Definition
| they should be in prenatal care to stop smoking, ETOH, and drugs |
|
|
Term
| when does fetal circulation begin? |
|
Definition
|
|
Term
| describe the circulatory path from the mother to the fetus? |
|
Definition
| from the placenta in the mother to the umbilical cord to the fetus |
|
|
Term
| lifeline between the fetus and placenta |
|
Definition
|
|
Term
| three structures within the umbilical cord |
|
Definition
1. umbilical vein
2. 2 umbilical arteries |
|
|
Term
|
Definition
| carries oxygenated blood from the placenta of the mother to the fetus |
|
|
Term
|
Definition
| there are 2 of them; carry deoxygenated blood and wastes to the placenta in the mother |
|
|
Term
| what is so significant about the arteries and vein of the umbilical cord? |
|
Definition
| they carry the opposite kinds of blood that adult vessels carry, the vein carries the O2 blood while the two arteries carry the deO2 blood and wastes |
|
|
Term
| what are the 3 structures within the fetus that perform circulation within the fetus? |
|
Definition
ductus venosus
ductus arteriosis
foramen ovale |
|
|
Term
|
Definition
| helps bypass the fetal liver |
|
|
Term
| in the fetus does detoxification take place in the liver? |
|
Definition
| no, in the maternal placenta |
|
|
Term
|
Definition
| bypasses around the pulmonary vessels |
|
|
Term
| does the fetus ever use respiration in utero? |
|
Definition
|
|
Term
|
Definition
a hole b/t the left and right atrium
after birth it will shut |
|
|
Term
| in the fetus, which side of the heart has more atrial pressure? |
|
Definition
|
|
Term
| how do we increase the left atrial pressure of the babies heart after birth? |
|
Definition
|
|
Term
the ductus venosus, ductus arteriosis
and foramen ovale are what type of structures? |
|
Definition
| temporary and designed only to work during the fetal period, after birth when they are no longer needed, they will close |
|
|
Term
| at what time would you expect male and female genitalia to become apparent? |
|
Definition
|
|
Term
|
Definition
-male and female genitalia become apparent but no well defined
-heart sounds can be heard around week 10
-bone and tooth formation
-fingers and toes are distinguishable
-kidneys produce urine as practice urine that becomes part of the amniotic fluid, the kidneys are NOT filtering, the other portion of the amniotic fluid comes from mother |
|
|
Term
|
Definition
-RAPID fetal growth
-digestive system produces meconium
-sucking and swallowing reflexes
-quickening movement
-arms and legs becoming larger
-more symmetry
-very large head |
|
|
Term
| can hear fetal heart tones with Doppler ultrasound |
|
Definition
|
|
Term
|
Definition
| black, tarry substance that grows in between the intestines to make sure that they do not collapse on each other and grow together |
|
|
Term
| when does quickening occur for the fetus? |
|
Definition
|
|
Term
|
Definition
| first fluttering of fetal movement, often missed because it is so light |
|
|
Term
|
Definition
-begins to lay down lanugo
-develops vernix
-hearing around week 22
-fetal movement detectment
-alveoli of the lungs are complete
-swallows amniotic fluid
-brown fat starts to deposit |
|
|
Term
|
Definition
|
|
Term
|
Definition
| cheese like substance that protects baby from the fluid that he floats around in |
|
|
Term
| without vernix and lanugo what would happen? |
|
Definition
| the pruny effect of staying in fluid to long |
|
|
Term
| when are the fetal alveoli complete? |
|
Definition
|
|
Term
| surfactant; when does the baby create it own? |
|
Definition
a substance that can keep the lungs open
week 27 |
|
|
Term
|
Definition
| very vascular and helps baby to maintain body temperature at birth since fetus does not have ability to shiver |
|
|
Term
|
Definition
-major organs are functional but not FULLY functional
-nostrils are open
-actively practicing resp movements
-survival is based on the level of surfactant in the lungs
-lengthening of arms and legs
-large head
-weighs about 600 grams |
|
|
Term
| does the fetus have an intra-utero respiratory exchange? |
|
Definition
| no, it is done by the placenta although by about 24-27 weeks the fetus is actively practicing |
|
|
Term
| what is so significant about the fetal surfactant? |
|
Definition
| survival is based on the level of surfactant in the lungs; it decreases surface tension since taking the first breath for the infant is VERY hard and takes alot of energy! if he has enough surfactant he can maintain air in his lungs between each breath or residual capacity but without surfactant, each breath is like his first breath, requiring alot of energy |
|
|
Term
|
Definition
-weighs a pound and few ounces
-can evaluate lung maturity with amount of lethicin/sphingomyelin, L/S of 2:1 ratio is ideal
-responding to noises
-eyelids are open
-fingernails have developed
-subQ fat
-heavy vernix |
|
|
Term
| with each week as the fetus ages what happens to its viability? |
|
Definition
|
|
Term
| what lethicin/sphingomyelin ratio is ideal? |
|
Definition
|
|
Term
|
Definition
-chances of viability are high
-surfactant levels increasing
-increase in subQ fat
-less translucent and wrinkly
-organs function more efficiently
-fetus get messages to decrease the vernix, lanugo and amniotic fluid |
|
|
Term
| at around what time does the fetus get messages to decrease the vernix, lanugo and amniotic fluid? |
|
Definition
|
|
Term
|
Definition
| born beyond 42 weeks of gestation |
|
|
Term
| is a 37 week old fetus a full term baby? |
|
Definition
| no, it is a near-term infant |
|
|
Term
|
Definition
born at 37 weeks
continue to have problems: feeding, resp, temp reg
may develop learning disabilities |
|
|
Term
|
Definition
38-40 weeks of gestation
eyes and limbs are fully functional
skin smooth and supple
laying down fat tracks for temp reg
testes of normal male have fully descended into the scrotum
generally adapt quite well |
|
|
Term
| when does the placenta begin to break down? |
|
Definition
|
|
Term
| what measures are taken for a fetus that is in post maturity? |
|
Definition
induction of labor
c-section |
|
|
Term
|
Definition
-aging placenta deprives infant of nutrients and oxygen
-may lose weight
-risk for hypoxia
-may excrete meconium into amniotic fluid which may be aspirated and cause chemical pneumonia
-a decrease in amniotic fluid: oligohydramnios which is less than 500 cc which can cause the cord tangled or knotted or impede the circulatory path |
|
|
Term
| average baby has how much amniotic fluid? |
|
Definition
|
|
Term
| what are the types of twins? |
|
Definition
-dizygotic (fraternal, non identical)
-monozygotic (identical) |
|
|
Term
|
Definition
| 2 ova that are released at the same time but are fertilized by 2 different sperm cells. they may be the same or different sex and have 2 placentas, amnions, and chorions in the bags that surround them |
|
|
Term
|
Definition
| are identical twins. it is ONE fertilized egg that splits into 2 before the 15th day after conception. will be the same sex, one placenta for them both, one chorion, but each will have their own amnion |
|
|
Term
| when does the placenta begin to form? |
|
Definition
|
|
Term
| what are the functional parts of the placenta? |
|
Definition
|
|
Term
|
Definition
| functional parts of the placenta that are formed by endometrial spiral arteries |
|
|
Term
| during the formation of the placenta, what occurs to uteran capillaries? spiral arteries? |
|
Definition
they become capped off.
the spiral arteries of the endometrium fill with maternal blood and form cotyledons |
|
|
Term
|
Definition
| found numerously on each cotyledon and allow blood to cross from mother to fetus and where waste product is crossed from fetus to mother |
|
|
Term
| maternal and embryonic circulation has begun to form |
|
Definition
|
|
Term
| functions of the placenta |
|
Definition
gas exchange
nutrient exchange
waste removal
passive protection from disease by passing antibodies
endocrine hormone that picks up hCG and estrogen and progesterone from corpus luteum |
|
|
Term
| is there a direct mixing of maternal and fetal blood? |
|
Definition
|
|
Term
| in fetal circulation, where does the gas exchange take place? |
|
Definition
|
|
Term
|
Definition
amnion (inner) is continuous with umbilical cord
and chorion which is outer |
|
|
Term
| components of amniotic fluid |
|
Definition
fetal urine
rest from mother |
|
|
Term
| purposes of amniotic fluid |
|
Definition
-cushions fetus from impact
-temperature stability
-buoyancy for fetal movement
-keeps body parts from adhering to mother's body and symmetrical growth |
|
|
Term
| is spina bifida hereditary? |
|
Definition
|
|
Term
| minor form of spina bifida |
|
Definition
|
|
Term
|
Definition
ability of fetus to survive outside of womb
gestation of 20 weeks with weight of 500 grams or greater |
|
|
Term
| as pregnancy advances, breathing changes from abdominal to |
|
Definition
|
|
Term
| during the third trimester, may women find they are out of breath when in a reclined position, what can be done to help? |
|
Definition
| place a pillow to elevate their head when reclining |
|
|
Term
| what is the optimal position for a pregnant women? |
|
Definition
| on her side because it allows for optimal blood flow |
|
|
Term
| factors that effect teratogenic potential |
|
Definition
-timing of exposure
-amount/length of exposure
-varied susceptibility levels of organ system
-placental transfer
-individual variations |
|
|
Term
| class C drugs are unacceptable during pregnancy because |
|
Definition
| they cannot be tested on humans and therefore maybe harmful to a fetus |
|
|
Term
|
Definition
infections
radiation
env factors
ETOH, tobacco & drug use |
|
|
Term
| infectious agents that can be teratogenic |
|
Definition
rubella
herpes
CMV
AIDS
hepatitis |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| fetal alcohol syndrome produces a baby that is small for gestational age, cranio-facial and cardiac anomalies, developmental delays,attention deficits,and is untreatable after birth |
|
|
Term
|
Definition
enters mother's bloodstream and the baby gets the same amount of nictoine, cyanide, CO, and lead
can cause coughs in uteri
small infant for gestational age
low birth weight
increased misccariages and preterm babies
also increased incidence of learning defects |
|
|
Term
|
Definition
| mother should NOT have x-rays during the embryonic period |
|
|
Term
| anytime a mother takes a drug, most drugs |
|
Definition
| crosses the placenta and exposes the baby |
|
|
Term
| babies who are exposed to illegal drugs |
|
Definition
jittery
shrill cry
hyperactive
vomiting
diarrhea
low birth weight
learning deficits
same physiological but more due to small size |
|
|
Term
|
Definition
ultrasound
nuchal translucency
doppler flow
alpha fetal protein screening
chorionic villus sampling
amniocentesis |
|
|
Term
|
Definition
uses high frequency sound waves
gives real time scanning
determines: # of fetuses, presence/absence of uterine/placental abnormalities, date pregnancies |
|
|
Term
| what can be observed with an ultrasound |
|
Definition
| fetal movements, breathing, heart viability |
|
|
Term
|
Definition
| an ultrasound to determine and examine the edema or fluid buildup in fetal neck, time is 10-14 weeks, used for early examination. increased edema is associated with cardiac problems, diaphragmatic hernia, and genetic abnormalities |
|
|
Term
| what are the criteria for a nuchal translucency exam? |
|
Definition
done by a skilled sonographer
and fetus must be in good position (neck must be in good visible position) |
|
|
Term
|
Definition
| allows the visualization of fetal blood as it flows through the umbilical cord vessels. done around 15 weeks, and to check for intrauterine growth restriction. if fetus has minimal blood flow, it can result in growth restriction |
|
|
Term
| what are the risks and side effects of ultrasound, nuchal translucency, and Doppler flow testing? |
|
Definition
|
|
Term
| alpha fetal protein screening |
|
Definition
invasive where mother's blood is drawn to examine amount of maternal blood levels of alpha serum protein to identify abnormal levels: low=chromosomal abnormalities, high=neural tube defects.
only a SCREENING tool! if abnormal results are detected they will be verified with more testing: ultrasound (high) or amniocentesis (low). has many false positives for this exam |
|
|
Term
| alpha fetal protein screening is often done at what time and why? |
|
Definition
| 15-20 weeks to give her options and time to decide whether the pregnancy will be maintained based on the results |
|
|
Term
| chorionic villus sampling |
|
Definition
an early test
the chorionic villi are the finger like projections for the blood to diffuse across and are part of the basic functional unit of the placenta, the cotyledons
can be done at 10 weeks
findings are available early for parent decision
it detects chromosomal problems and genetic problem
recommended for high risk pts like those with children with previous Down's syndrome or genetic abnormalities |
|
|
Term
| 1st trimester alternative to amniocentesis |
|
Definition
| chorionic villus sampling |
|
|
Term
| if during chorionic villus sampling there is a high risk for specific abnormalities or chromosomal problems what will happen |
|
Definition
| a high risk perenatologist will be brought in |
|
|
Term
| techniques of chorionic villus sampling |
|
Definition
1. transcervical aspiration under direct vision with real time sonography. where they do it through the cervix with the ultrasound guiding the movement
2. transabdominal with ultrasound |
|
|
Term
| advantages of chorionic villus sampling over amniocentesis |
|
Definition
performed earlier (10-12 weeks)
rapid result return (within 48 hours) |
|
|
Term
| risks of chorionic villus sampling |
|
Definition
| risk for infection and small rate of pregnancy loss, mixing of fetal and maternal blood (for Rh situation) |
|
|
Term
| after an invasive procedure all Rh- mothers are given |
|
Definition
|
|
Term
|
Definition
| aspiration of amniotic fluid from the amniotic sac for examination |
|
|
Term
| amniocentesis tests and looks at |
|
Definition
examines fetal cells
chromosomal ration
LS ratio
test for hemolytic disease
genetic makeup of fetus |
|
|
Term
| to prepare for amniocentesis |
|
Definition
1. ultrasound is used to locate the fetus
2. identify largest pocket of fluid
3. skin is prepped with antiseptic and a 3-4 inch needle is inserted
4. 20 cc fluid is drawn
5. is painless due to anesthetic |
|
|
Term
| amniocentesis is done when? |
|
Definition
| after 15 weeks of gestation |
|
|
Term
| disadvantages of amniocentesis |
|
Definition
cells take 10 days to grown
test after 15 weeks of gestation |
|
|
Term
| when is genetic sex determined? |
|
Definition
|
|
Term
| what are the two components required for conception? |
|
Definition
| spermatozoon (X or Y) and an ovum (X) |
|
|
Term
|
Definition
| refers to the time during which the reproductive organs become fully functional |
|
|
Term
| when does puberty take place? |
|
Definition
| late childhood and early adolescence |
|
|
Term
| primary sex characteristics |
|
Definition
| maturation of ova in the ovaries and sperm in the testes |
|
|
Term
| secondary sex characteristics |
|
Definition
| changes in other systems that differentiate females from males but do not directly relate to reproduction |
|
|
Term
|
Definition
| gonadotropin releasing hormone; is released by the hypothalamus and gradually increases at ages 9-12 until it slowly reaches a level that stimulates the anterior pituitary to increase its production of follicle stimulating hormone (FSH) and luteinizine hormone (LH). in response to increases of FSH and LH the ovaries increase production of sex hormones and begn maturing gametes |
|
|
Term
| the secretion of FSH and LH in response to GnRH, what is released by the ovary? |
|
Definition
| estrogens and progesterones |
|
|
Term
| the release of estrogens and progesterones by the ovaries in response to the release of FSH and LH what occurs in females? |
|
Definition
|
|
Term
| first noticeable change of puberty and girls followed by what |
|
Definition
| breast development (8-13) then menstruation (9-16 years or 2-2.5 years after breast development) |
|
|
Term
| girls grow taller for several years during early puberty is response to estrogen stimulation. when does this growth spurt begin? |
|
Definition
| about 1 year after breast development |
|
|
Term
| estrogen's effect in puberty |
|
Definition
1. causes growth spurt 1 year after breast development
2. cause epiphyses or growth areas on bone to eventually stop growth in height |
|
|
Term
|
Definition
|
|
Term
|
Definition
| delayed onset of menstruation if they have not begun within 2 years after the onset of breast development or by age 16 or if the girl is more than 1 year older than when her mom or sisters began their period |
|
|
Term
|
Definition
| absence of period for at least 2 cycles after regular cycles have been established for 6 months |
|
|
Term
| both 1o and 2o amenorrhea are common is what type of women? |
|
Definition
|
|
Term
| atheltic woman, thin woman, those that suffer from eating disorders, or ballet dancers may have too little what to produce enough sex hormones to stimulate ovulation and menstruation? |
|
Definition
|
|
Term
| LH and FSH in males stimulate the secretion of testosterone and eventually causes |
|
Definition
| spermatogenesis in the maturing adolescent |
|
|
Term
| first outward sign of male puberty is |
|
Definition
| growth of the testes (9.5 yoa) |
|
|
Term
| what causes epiphysis union with the shaft in males? |
|
Definition
|
|
Term
|
Definition
| transitional period starting as female fertility declines and extends through menopause and the postmenstrual period |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| collectively, all the female external reproductive organs: mons pubis, labia majora and minora, clitoris, structures of vestible and perineum |
|
|
Term
|
Definition
|
|
Term
are the labia minora covered in hair
? |
|
Definition
| no they are highly vascular and respond to stimulation by becoming engorged in blood |
|
|
Term
|
Definition
| organs enclosed by the labia minora such as urinary meatus, vaginal introitus, and ducts of Skene's and Bartholin's glands |
|
|
Term
| Skene's or periurethral glands |
|
Definition
| provide lubrication for the urethra |
|
|
Term
|
Definition
| provide lubrication for the vaginal introitus, particularly during sexual arousal |
|
|
Term
|
Definition
| area from the forchette to the anus |
|
|
Term
| internal female reproductive organs |
|
Definition
| vagina, uterus, fallopian tubes,and ovaries |
|
|
Term
| all of the internal female reproductive organs are supported by the |
|
Definition
|
|
Term
|
Definition
| pouch like structure where the vagina meets the uterine opening (cervix) there are three: ant, post, lat |
|
|
Term
| T or F each month the uterus prepares for pregnancy even if it does not occur |
|
Definition
|
|
Term
| three divisions of the uterus |
|
Definition
|
|
Term
|
Definition
| body or upper portion of the uterus, the upper corpus is the fundus |
|
|
Term
|
Definition
| narrower transition zone that is between the corpus and cervix, during pregnancy it elongates and becomes the lower uterine segment |
|
|
Term
|
Definition
| tubular neck of the lower uterus that will thin and dilate during labor to allow the fetus to leave the uterus and enter the vaginal canal, has 2 os or openings, the internal os then the cervical canal, then the external os |
|
|
Term
| before and after birth what is the condition of the external os of the cervix? |
|
Definition
before round and smooth
after irregular, slitlike with tags of scar tissue |
|
|
Term
|
Definition
| endo,myo, and perimetrium |
|
|
Term
|
Definition
| outer peritoneal serous tissue that is laterally continuous with the broad ligaments |
|
|
Term
|
Definition
| muscular layer of the uterus, more muscle is concentrated towards the top and decreases towards the cervix |
|
|
Term
| layers of muscle in the myometrium |
|
Definition
outer: longitudinal fibers-found mostly in the fundus and work to expel the fetus toward pelvic outlet
middle: figure 8 fibers that contract AFTER birth to compress blood vessels that pass between them to limit blood loss
inner layer:circular fibers that form contrictions where the fallopian tubes enter the uterus and surround the internal cervical os and promote normal implantation |
|
|
Term
|
Definition
1. basal layer is closest to the myometrium and regenerates the functional layer after each period or childbirth
2. functional layer is above the basal layer and vessels, and glands are in it and are all expelled shed during the period or after child birth in lochia |
|
|
Term
|
Definition
|
|
Term
|
Definition
| form a pathway for ovum to travel from the ovary to the uterus |
|
|
Term
| where does fertilization occur? |
|
Definition
|
|
Term
| female gonads or sex glands |
|
Definition
|
|
Term
|
Definition
| release of sex hormones such as estrogen and progesterone and maturation of the ovum during each reproductive cycle |
|
|
Term
| why do the ovaries secrete estrogen and progesterone each cycle? |
|
Definition
| to prepare the uterine lining |
|
|
Term
| t or f: at birth the ovaries contain all the ova ever needed? |
|
Definition
|
|
Term
| why is the menstrual cycle an important marker for the reproductive cycle? |
|
Definition
| it marks the beginning and the end if pregnancy does not occur |
|
|
Term
| duration of female reproductive cycle |
|
Definition
|
|
Term
| the female reproductive cycle is divided into two cycle what are they? |
|
Definition
ovarian
uterine endometrium |
|
|
Term
|
Definition
| when GnRH is released from the hypothalamus, it stimulates the release of LH and FSH from the ant-pituitary gland which stimulates the ovaries to mature and release an ovum and secrete additional hormones to prepare the endometrium for implantation with a fertilized egg there are 3 phases to the ovarian cycle: follicular, ovulatory, and luteal |
|
|
Term
| three phases of the ovarian cycle: |
|
Definition
| follicular, ovulatory and luteal |
|
|
Term
| follicular phase of the ovarian cycle |
|
Definition
| is the first phase; involves maturation of an ovum and occurs on the first day of menstrauation and lasts to day 14 of a 28 day cycle |
|
|
Term
| ovulatory phase of the ovarian cycle |
|
Definition
| occurs around midway (day 14) of the 28 day cycle, includes release of the mature ovum through the rupturing of a mature follicle |
|
|
Term
| ovulation marks the beginning of what phase? |
|
Definition
| luteal phase of the ovarian cycle |
|
|
Term
|
Definition
occurs from day 14 of the 28 day cycle. the remaining cells of the old follicle persist for 12 days as a corpus luteum. the corpus luteum secretes estrogen and progesterone to prepare the endometrium for a fertilized ovum.
if the ovum is fertilized then it releases chorionic gonadotropin to cause the corpus luteum to persist to maintain an early pregnancy
if ovum is not fertilized then all levels fall and menstruation will occur and the uterine lining will break down |
|
|
Term
|
Definition
| replaces the corpus luteum and is a fibrous tissue |
|
|
Term
| three phases of the uteral endometrium during the female reproductive cycle |
|
Definition
proliferative
secretory
menstrual |
|
|
Term
| proliferative phase of the endometrial cycle |
|
Definition
| occurs as the ovum matures and is released. occurs during the first half of the ovarian cycle. is when the basal layer of the endometrium mutiply to form new endometrial epithelium, glands and vessels and as ovulation approaches the endometrial glands will secrete a thin stringy mucus that aids in the entry of sperm into the uterus |
|
|
Term
| secretory phase of the endometrial cycle |
|
Definition
| occurs during the last half of the ovarian cycle as the endometrium is prepared to recieve a fertilized ovum with stores of glycogen, protein, and lipids and minerals |
|
|
Term
| menstrual phase of the endometrial cycle |
|
Definition
| if fertilization does not occur then the corpus luteum will regress and the endometrium will become ischemic and necrotic and begin to slough off while the basal layer remains. this produces the menstrual flow and lasts about 5 days |
|
|
Term
| about how many cc of blood does a woman lose in a menstrual cycle? |
|
Definition
|
|
Term
| during most of the female reproductive cycle the mucus of the cervix is thick, scant and sticky. but just before ovulation it becomes |
|
Definition
| thin, clear and elastic to promote the entrance of sperm |
|
|
Term
|
Definition
| elasticity of the cervical mucus; woman can assess to either avoid or promote contraception |
|
|
Term
| are the breasts involved in reproduction? |
|
Definition
| no but they secrete milk through the milk ducts to nourish the infant after birth |
|
|
Term
|
Definition
| small sacs that contain acinar cells to secrete milk |
|
|
Term
|
Definition
| extract necessary nutriets from maternal blood and manufacture milk when it receives message from ant pit gland |
|
|
Term
| what surrounds the alveoli to contract and eject the milk into the ductal system when signaled by secretion of the hormone oxytocin from the posterior pituitary gland |
|
Definition
|
|
Term
|
Definition
|
|
Term
| when the lactiferous ducts come under the areola they are larger and are called |
|
Definition
|
|
Term
| what are the effects of estrogen, progesterone, and prolactin during and after pregnancy in regards to milk production? |
|
Definition
| during pregnancy high levels of estrogen and progesterone from the placenta stimulate growth of alveoli and duct system. prolactin stimulates milk production but the est and pro inhibit it but this stops after birth where active milk response takes place in response to the infant's suckling while breast feeding |
|
|
Term
| external male reproductive organs |
|
Definition
|
|
Term
|
Definition
urination
deposits semen in vagina during coitus |
|
|
Term
| main function of the scrotum |
|
Definition
| keep the testes cooler than the rest of the body |
|
|
Term
| muscle that contracts and dilates to move testicles too and from the body for warmth and coolness |
|
Definition
|
|
Term
| what is the time frame that a woman has to get pregnant and NOT place her baby at risk for Rubella? |
|
Definition
| after 28 days of getting a Rubella vaccine the chance of the baby getting Rubella is unlikely |
|
|
Term
| to avoid malignant hyperthermia, what are some guidelines? |
|
Definition
no more than 10 minutes in a sauna or hottub
being is exposed to temperatures of 100 F or higher is bad |
|
|
Term
| all women of childbearing age should take how much mg of folic acid a day even before conception? |
|
Definition
|
|
Term
| genetic counseling is directive? |
|
Definition
|
|
Term
| the ideal time to provide genetic counseling |
|
Definition
| before conception so that the childbearing couple has more options if risks are identified |
|
|
Term
|
Definition
| small sac within the ovary that contains the maturing ovum |
|
|
Term
|
Definition
| Graafian follicle cells remaining after ovulation that produce estrogen and progesterone |
|
|
Term
|
Definition
| implantation of the fertilized ovum (zygote) in the uterine endometrium |
|
|
Term
|
Definition
| formation of a gametes (ova) in the female and sperm in the testes of a male |
|
|
Term
| release of a mature ovum from the ovary |
|
Definition
|
|
Term
| fetal structure that provides nourishment and removes wastes from the developing baby and secretes hormones necessary for the continuation of pregnancy |
|
Definition
|
|
Term
| gametogenesis requires what type of division? |
|
Definition
| meiosis; reduction division resulting in haploids |
|
|
Term
| contents of a haploid gamete cell |
|
Definition
| 22 autosomes and 1 sex chromosome |
|
|
Term
|
Definition
| the exchange of material between two gametes from the mom and dad to allow genetic variation |
|
|
Term
| when the sperm and ovum unite what happens to the halves? |
|
Definition
| they unite as one to produce 23 PAIRS of chromosomes |
|
|
Term
|
Definition
|
|
Term
|
Definition
| begins during prenatal lfe when primitive ova (oogonia) multiply by mitosis. each oogonium contains 46 chromosomes. before birth these oogonia enlarge to form primary oocytes that are each surrounded by follicular cells.these are called primary follicles. the primary oogonium begins its first meiotic division during fetal life but does not complete it until puberty. the primary follicle and its oogonium still has 46 chromosomes and will remain dormant during childhood. by the 30th week of gestation the female fetus has all the ova she will ever have and many of them will regress during childhood, but at puberty some prmary follicles present at birth will begin maturing this will continue on into climacteric |
|
|
Term
| in oogenesis, one primary oocyte results in a |
|
Definition
|
|
Term
| when a mature ovum is released from the ovary, it is surrounded by what 2 layers? why? |
|
Definition
| zona pellucida and cells of the corona radiata to protect the ovum from being penetrated by more than one sperm |
|
|
Term
| for fertilization to occur the sperm must penetrate the |
|
Definition
| zona pellucida and cells of the corona radiata to reach the ovum's nucleus |
|
|
Term
| spermatogenesis begins and is completed... |
|
Definition
| during puberty and takes 70 days to complete |
|
|
Term
| how long can ovum survive after ovulation? sperm? |
|
Definition
| both about 24 hours but sperm can spend up to 80 hours |
|
|
Term
| fertilization usually occurs where? |
|
Definition
| in the distal third of the fallopian tube or the ampulla near the ovary |
|
|
Term
| whether it is fertilized or not, when will the ovum enter the uterus? |
|
Definition
|
|
Term
| explain the preparation for conception in a female |
|
Definition
| several oocytes begin to mature under he influence of FSH and LH from the ant pit. each maturing oocyte is contained within a sac called a graafian follicle which produces estrogen and progesterone to prepare the endometrium. one follicle will outgrow the others and be released and leave behind the graafian follicle which will develop into the corpus luteum which will maintain high estrogen and progesterone levels to make final prep for uterine lining |
|
|
Term
|
Definition
| protects and nourishes the sperm from the acidic environment of the vagina |
|
|
Term
| t or f, seminal fluid enters the vagina |
|
Definition
| false, only sperm cells enter the vagina, seminal fluid remains at the cervix |
|
|
Term
|
Definition
sperm are not automatically ready to penetrate the ovum,they undergo changes while they are traveling to be able to penetrate the layers.
a glycoprotein coat and seminal proteins are removed from the acrosome |
|
|
Term
|
Definition
|
|
Term
|
Definition
| the sperm are more active and can penetrate the 2 outside layers of the ovum although they look the same |
|
|
Term
| besides capacitation, what else must the sperm do? |
|
Definition
| release hyaluronidase and acrosin to digest through the two layers surrounding the ovum |
|
|
Term
| what are the 3 things that happen after the entry of a spermatozoon into the ovum? |
|
Definition
1. the zona pellicuda changes due to the zona reaction to prevent other sperm from entering
2. cell membranes of the ovum and sperm fuse and breakdown to allow the contents of the sperm head to enter the cytoplasm of the ovum
3. ovum will complete meiosis |
|
|
Term
| when is a fertilized egg considered a zygote? |
|
Definition
|
|
Term
|
Definition
| solid ball of 12-16 cells |
|
|
Term
| the outer cells of the morula secrete fluid forming a what? |
|
Definition
| blastocyst which is sac of cells with an inncer cells mass placed off center |
|
|
Term
| in a blastocyst, what will the inner and outer cells develop into |
|
Definition
inner-fetus
part of the outer-placenta and fetal membranes |
|
|
Term
| when the blastocyst contains about 100 cells it enters the |
|
Definition
|
|
Term
| after the 100-cell blastocyst enters the uterus, how long will it linger before implantantion? why? |
|
Definition
| 2-4 days; because the endometrium is in the secretory phase, secreting rish fluids to nourish the conceptus before placental circulation is established |
|
|
Term
| nidation is a gradual process that occurs between days |
|
Definition
|
|
Term
|
Definition
| the corpus luteum to continue secreting estrogen and progesterone until the placenta takes over this function |
|
|
Term
| where should nidation ideally occur? |
|
Definition
| in the upper posterior uterus |
|
|
Term
| chorionic villi and decidua basilis and their relation to the placenta |
|
Definition
| chorionic villi are tiny projection on the surface of the conceptus extending into the decidua basilus (endometrium). this will become the fetal side of the placenta and the decidua basilis will become to maternal side of the placenta |
|
|
Term
| before the placenta develops how is the embryo nourished? |
|
Definition
|
|
Term
|
Definition
| small amount of bleeding that occurs near the time of expected menstruation but is really due to nidation |
|
|
Term
| basic structures of all major body organs are completed during this period |
|
Definition
|
|
Term
| when does conception occur in relation to the LMC? |
|
Definition
|
|
Term
| the fertilization age is how much shorter than the gestational age? |
|
Definition
|
|
Term
| maternal corticosteroids may be given such as ________ before birth to accelerate surfactant production in the preterm fetus likely to be born before 34 weeks |
|
Definition
|
|
Term
| axillary structures that sustain pregnancy and maintain prenatal development |
|
Definition
placenta
umbilical cord
fetal membranes |
|
|
Term
|
Definition
metabolic
endocrine
transfer |
|
|
Term
| where is the umbilical cord usually inserted? |
|
Definition
| in the center of the fetal side o the placenta |
|
|
Term
| 3 layers of the decidua (formerly the endometrial lining |
|
Definition
decidua basilis: maternal placenta
decidua capsularis and parietalize |
|
|
Term
| do fetal and maternal blood mix? |
|
Definition
| no, but they pass near each other, exchange of substances occur within the intervillous spaces through the spiral arteries |
|
|
Term
|
Definition
| fetal and maternal blood may not be compatible |
|
|
Term
| substances that the placenta synthesizes for the embryo |
|
Definition
glycogen
cholesterol
fatty acids |
|
|
Term
| types of antibodies transferred from mother to fetus via the placenta |
|
Definition
|
|
Term
| when does the newborn begin to produce antibodies? |
|
Definition
|
|
Term
| type of immunity involving IgG transfer from the placenta to embryo |
|
Definition
| passive immunity that protects baby from diseases that the mother is immune to such as measles |
|
|
Term
| most plentiful estrogen produced during pregnancy |
|
Definition
|
|
Term
| several hormones produced by the placenta necessary for normal pregnancy |
|
Definition
hCG: causes the corpus luteum to keep producing estrogen and progesterone
testosterone: if a Y chromosome is present
human placental lactogen or human chorionic somatomammotropin promotes normal nutrition and fetal development and decreases insulin sensitivity and glucose use in mother to give more glucose supply to fetus
estrogen: enlargement of uterus, breasts and growth of ductal systems
progesterone: secretory changes in endometrium, change in decidua or endometrial cells, reduces muscle contraction to prevent spontaneous abortion |
|
|
Term
| amnion and chorion relative locations |
|
Definition
amnion is the inner
chorion is outer |
|
|
Term
| runs continuous with the umbilical cord |
|
Definition
|
|
Term
| functions of the amniotic fluid |
|
Definition
cushion
temperature stability
allowing symmetric development
preventing membrane adhesion to body parts of fetus
allwing room and buoyancy |
|
|
Term
| course of fetal blood circulation |
|
Definition
| from the fetal heart to the placenta for exchange of nutrients, gases, and wastes and then back to the fetus for delivery to fetal tissues |
|
|
Term
| cushions the umbilical cord to prevent obstruction due to pressue |
|
Definition
|
|
Term
|
Definition
| time of pregnancy before labor |
|
|
Term
| reasons for antepartum fetal assessment |
|
Definition
detect congenital anomalies
evaluate condition of fetus |
|
|
Term
| levels of obstetric ultrasound |
|
Definition
standard (basic): general survey of fetus, placenta, and amniotic fluid
specialized (comprehensive): done if abnormalities are found during standard scan
limited: done to address a specific question like fetal presentation |
|
|
Term
| when can an embryo be seen after the LMC |
|
Definition
|
|
Term
|
Definition
|
|
Term
| fetal viability is confirmed by observation of the fetal heartbeat which is visible with the CRL is about |
|
Definition
|
|
Term
| what position must the woman be in for a transvaginal ultrasonography? |
|
Definition
|
|
Term
| which type of ultrasonography are more commonly used in the 2nd and 3rd trimesters? |
|
Definition
|
|
Term
| is it very accurate to try to determine gestational age after the 1st trimester? what can be done instead? |
|
Definition
not really.
1. multiple measurements can be calculated by a computer
2. if 24-32 weeks, 2 or 3 ultrasounds can be taken to measure growth curve |
|
|
Term
| why is an accurate gestational age necessary for testing the level of maternal serum alpha-fetoprotein (MSAFP)? |
|
Definition
| because the level of AFP is altered by fetal age and number of fetuses |
|
|
Term
|
Definition
| an ultrasound assessment of blood flow to identify abnormalities |
|
|
Term
|
Definition
| alpha fetal protein is the predominant protein in the fetal plasma and is synthesized in the embryonic yolk sac, developing fetal liver, and GI tract |
|
|
Term
| most common open NTD: neural tube defects: |
|
Definition
anacephaly: cranial vault is absent and mose the brain is undeveloped
spina bifida: includes
meningocele: the meninges protrude from the spinal canal
myelomeningocele: the spinal cord and meninges protrude through the defect and extensive nerve damage is expected |
|
|
Term
| is spina bifida occulta an open NTD? |
|
Definition
| no and it may cause no problems |
|
|
Term
| is MSAFP testing diagnostic or screening? |
|
Definition
| screening, if results are abnormal then further testing will take place |
|
|
Term
| low levels of AFP is associated with |
|
Definition
| chromosome defects such as trisomy 21 (Down's syndrome) |
|
|
Term
| the risk of having a child with a chromosome defect rises sharply after age |
|
Definition
|
|
Term
| what other two markers have been added to MSAFP testing to screen for chromosomal abnormalities? |
|
Definition
| unconjugated estroil and hCG |
|
|
Term
|
Definition
| screening for trisomy 21, and 18 by testing levels of MSAFP, unconjugated estroil and hCG also placental hormone inhibin A is being added |
|
|
Term
| a triple screen is considered positive if |
|
Definition
| MSAFP and estriol are low and hCG is high |
|
|
Term
| in what methods can CVS occur? |
|
Definition
| transabdominal or transcervical however transcervical is more comfortable but produces light bleeding |
|
|
Term
| position to perform a CVS transcervically? |
|
Definition
|
|
Term
| patient education after a CVS |
|
Definition
-may need to rest for a few hours after
-sex may be limited for a few days
-light spotting may occur
-may be given RhoGAM afterwards |
|
|
Term
| purpose of amniocentesis midtrimester vs in the 3rd trimester |
|
Definition
mid: identify chromosomal abnormalities
3rd: determine fetal lung maturity ande evaluate condition when the woman has Rh isoimmunization |
|
|
Term
|
Definition
| percutanous umbilical blood sampling or cordocentesis involves the aspiration of fetal blood from the umbilical cord from prenatal diagnosis and therapy |
|
|
Term
| antepartum assessment goals |
|
Definition
-estimate delivery date or EDD/EDC
-evaluate treatment plan and risk level |
|
|
Term
|
Definition
presumptive
probable
positive |
|
|
Term
|
Definition
subjective explanations of how she feels
they are the least reliable since they can caused by other reasons besides pregnancy
they are:
amenorrhea
n/v
fatigue
urinary frequency
breast and skin changes
fetal movement "feeling" |
|
|
Term
|
Definition
are objective
are documented by examiner
are:
cervical changes (Chadwick's sign)
cervical softening (Goodell's sign)
ability to move cervix (McDonald's sign)
ability to palpate fetal outline
home pregnancy tests
can still be caused by other factors |
|
|
Term
|
Definition
auscultation of fetal heart with Doppler at 10-12 weeks or with fetoscope at 18-20 weeks
fetal movement felt by examiner
visualization by sonographer |
|
|
Term
|
Definition
| a woman who is or has been pregnant |
|
|
Term
|
Definition
| number of pregnancies that have gone past 20 weeks |
|
|
Term
|
Definition
| birth that occurs between 38-42 weeks |
|
|
Term
|
Definition
| birth that occurs between 20-37 weeks |
|
|
Term
|
Definition
| termination that occurs before 20 weeks |
|
|
Term
|
Definition
| pregnancy carried beyond 24 weeks |
|
|
Term
|
Definition
|
|
Term
|
Definition
gravida
term
parity
abortion
living |
|
|
Term
| normal or average pregnancy duration |
|
Definition
| from LMP is 40 weeks of 280 days |
|
|
Term
|
Definition
is used to calculate EDD
LMP-3 months+ 7 days |
|
|
Term
| psychological variables during the trimesters |
|
Definition
1st:
M: may be ambivalent or worried about self. Accepts fetus
D: accept pregnancy
2nd:
M: baby is primary focus and seen as a separate entity their may be introversion. body and sexuality changes
D: Accepts fetus
3rd:
M: Vulnerable, dependence on support person
D: developing and accepting role as a father |
|
|
Term
|
Definition
-seeking safe passage for her and baby: obtaining care of qualified provider and their advice
-securing acceptance
-learning to give up self
-commitment to child |
|
|
Term
|
Definition
| nausea and weight gain and other s/s that mother feels in first trimester |
|
|
Term
| effective antepartum care should begin when? |
|
Definition
| in the 1st trimester until birth |
|
|
Term
| initial assessment of antepartum mother |
|
Definition
LMP and EDD
childhood disease
immunizations
allergies
contraceptive use
med/surg history
past pregnancies
labs
physical assessment
socioeconomic status |
|
|
Term
| subsequent visits of antepartum mother |
|
Definition
0-28 weeks is q4weeks
29-36 weeks q2-3weeks
37+ weeks is weekly |
|
|
Term
| with each visit what must you collect from an antepartum mother? |
|
Definition
VS
Wt
UA: Ck glucose/protein
glucose testing 1 hr tolerance
fundal height
monitor fetal HR and activity |
|
|
Term
| insufficient weight gain can cause |
|
Definition
low birth weight
fetal & newborn mortality
preterm labor |
|
|
Term
| causes of insufficient weight gain |
|
Definition
poor caloric/nutrient intake
smoking or drug abuse
hypemesis |
|
|
Term
| at risk for insufficient weight gain |
|
Definition
young
unmarried
uneducated
poor |
|
|
Term
| excessive weight gain can cause |
|
Definition
macrosomia: large baby
prolonged labor
birth trauma
cesarean birth |
|
|
Term
| infant weight of 6.5-8.8 lbs |
|
Definition
|
|
Term
| recommended weight gain for a person with a normal BMI of 19.8-26? how is this weight gain distributed per trimester? |
|
Definition
25-35 lbs.
1st: 3.5 lbs
2nd & 3rd: 0.88 lbs a weeks |
|
|
Term
| dietary needs of pregnant woman |
|
Definition
2200-2500 cal/day
protein: 71 g/day: fish,meat, tofu, poultry, rice and beans
carbs: 175 g from complex carbs, high fiber |
|
|
Term
| special vitamins and minerals |
|
Definition
vitamin A
folic acid
iron
calcium |
|
|
Term
|
Definition
fat soluble
so it is stored so there is a risk for too much
vegeterians need to be careful to avoid fetal defects due to too much |
|
|
Term
|
Definition
| beans, peanuts, oranges, asparagus |
|
|
Term
|
Definition
30 mg to increase RBC and increase Fe stores for baby.
may cause n/v
dont take with coffe, tea, or with Ca to prevent inhibition
best absorbed during sleep
increased absorption with Vitamin C |
|
|
Term
|
Definition
meats
legumes
eggs
grains
raisins
spinach |
|
|
Term
|
Definition
needed for bone formation and cellular and neuromuscular function. transferred to fetus in 3rd trimester
1300 mg if under 19
1000 is older than 18 |
|
|
Term
|
Definition
| dairy, legumes, nuts, dried fruits, dark leafy vegetables, blackstrap molasses, soy |
|
|
Term
|
Definition
-adolescent:
be careful of junk food and non-compliance and assess peer pressure
-vegetarian: is possible healthily
know the specific restrictions.
high fiber foods can cause GI upset
assess for complete protein: legumes and grains
can get calcium from veggies and soy and iron from soy but may have decreased absorption due to lack of heme
may lack zinc and vit b12 and may need supplements |
|
|
Term
| uterus changes during pregnancy |
|
Definition
60 g,10 ml
to
1000 g, 5000 ml |
|
|
Term
| uterus reaches its highest size around? drops? |
|
Definition
|
|
Term
| ovaries changes during pregnancy |
|
Definition
| increase production of estrogen and progesterone which inhibit FSH and LH, ovaries cease ovulation |
|
|
Term
| effects of estrogen and progesterone on LH and FSH |
|
Definition
| inhibit their effects and during prgnnancym no ovulation can occur |
|
|
Term
| cervical changes during pregnancy |
|
Definition
color-bluish (Chadwick's sign)
consistency-softening (Goodell's sign)
both are probable signs
mucus plug to protect fetus and membranes from infection |
|
|
Term
| vaginal and vulvar changes during pregnancy |
|
Definition
softening and bluish discoloration, vaginal folds (rugae) become more prominent
mucus thickens
leukorrhea appearance to mucus due to WBC to protect cervix and uterus from infection
glucose levels increase which increases risk for vaginal and yeast infections |
|
|
Term
| breast changes during pregnancy |
|
Definition
-increase in estrogen and progesterone
-increase in mammary ductal tissue causing breast to get larger
-increase in vascular prominence
-stretch marks
-nipples and areolae enlarge and erect
-montgomery tubicles produce sebaceous material which are a natural lubricant for breast |
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Term
| cardiac changes during pregnancy |
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Definition
-minor and non-permanent
-heart muscle enlarges
-heart sounds change: systolic murmur/split of S1
-blood volume increases from 1200-5000 ml
-RBC mass increases from 250 to 450 ml
-plasma volume increases to meet oxygen and nutrient demands from placenta. this increase is more pronounced than RBC mass, causing a pseudoanemia, Fe supp may be needed
-WBC increase during and after delivery
-CO increases
-peripheral vascular resistance is reduced
-diastolic BP drops |
|
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Term
| pulmonary changes due to pregnancy |
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Definition
result of:
increased O2 consumption
hormonal changes
enlarging uterus
respiration depth and rate increase to meet needs of fetus
-increased progesterone causes minor hyperventilation, reduces airway resistance, increases sensitivity to CO2
-estrogen increases vascularity in mucus membrane and edema in nose: congestion and nose bleeds
-ribs flare due to the diaphragm be pushed up
-breathing more thoracic causing dyspnea t times |
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Term
| GI changes due to pregnancy |
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Definition
-increased estrogen levels causes hyperemia: bleeding of the gums and increased salivation
-increased progesterone relaxes smooth muscle causing constipation, heartburn and nausea |
|
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Term
| urinary tract changes due to pregnancy |
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Definition
-freq and urgency of urination
-progesterone relaxes smooth muscle tone
-GFR increases
-weight of baby puts pressure on bladder |
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Term
| skin changes due to pregnancy |
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Definition
-increased circulation which encourages sweat and sebaceous activity, causing the glow
-hormone changes can cause chloasma or the mask of pregnancy from increased pigmentation of the skin
-linea negra: line from umbilicus down to symphysis pubis and is temporary and will fade after pregnancy
variscosities may develop from the weight and pressure of the baby |
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Term
| MS changes due to pregnancy |
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Definition
-relaxin and progesterone will relax joints and ligaments giving woman an altered sense of gravity, increasing frontal pressure making walking difficult, low back pain, lordosis of lower spin
fetal growth may cause diastesis recti or separation of abdominal muscles |
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Term
| glucose and insulin changes due to pregnancy |
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Definition
1st T:
F: fetus draws glucose and amino acids from mother
M: mother has decreased ability to synthesize glucose and insulin and blood sugar levels drop
2nd & 3rd:
F:placenta produces insulinase which reaks down insulin so more glucose is available to fetus for growth and carb matabolism
M: mother needs more glucose so glucose increases and pancreas produces more insulin. peak of insulin resistance is at 24-28 weeks so you need to perform a glucose screen |
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Term
| danger signs to tell MD right away |
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Definition
vaginal bleeding
mmbrane rupture
swelling of fingers/face
continuous pounding headache
visual distubances: floating spots, blurred vision
chills or fever
painful urination
persistent or severe abdominal pain
change in frequency or strength of fetal movements |
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Term
|
Definition
used to assess fetal well being by measuring response of fetal heart to fetal movement
noninvasive
30-40 min
results are better if mom has not smoked recently
positioned in reclining chair or bed that is elevated at HOB and lying on left side and knees are bent
gather baseline VS
apply external monitoring equipment: ultrasound, tocotransducer
and event marker
data:
reactive: baseline of 110-160, long term variability, more than 2 accelerations of 15 bpm for 15 seconds in a 20 minute strip
nonreactive: does not meet reactive criteria in appropriate time
equivocal: adequate but not the criteria for reactive |
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Term
| non stress testing interpretation |
|
Definition
|
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Term
|
Definition
pros:
noninvasive
painless
no risk
cons:
false positive if baby is sleeping and healthy; if sleeping give mom organze juice, move into new position, or use sound |
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Term
| vibroacoustic stimulation |
|
Definition
can awaken baby
confirm nonreactive stress test
use ultrasound:
monitor fetal HR
apply artificial larnyx stimulation for 1 sec, if no response, repeat in 10 seconds |
|
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Term
| vibroacoustic stimulation may not work if |
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Definition
| may not work if there is a suspected hearing loss, test has been done to often, baby is exposed to too much sound |
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Term
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Definition
indirectly evaluate fetal oxygenation to further evaluate nonreactive nonstress test
goal is to get 3 recordable contractions that last 40-60 seconds in a 10 minute period
avoid contractions that are over 90 sec in freq and less than 2 minutes in frequency
can use possible unilateral nipple stimulation to trigger contraction or oxytocin challenge to cause contraction |
|
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Term
| results interpretation of CST |
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Definition
negative- no late deceleration and this is reassuring
positive- greater than 50% have late decelerations
equivocal- not quite 50% have late decelerations, the uterus could be overstimulated |
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Term
|
Definition
pros:
reassurance of NST findings
evaulate needs of compromised fetus
cons:
time consuming to get 3 contractions
tedious
errors in data interpretation
high cost |
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Term
| biophysical profile (BPP) |
|
Definition
uses ultrasound to assess 6 parameters of fetus include acute and chronic markers:
acute:
fetal HR
breathing movements
gross fetal movements
fetal tone
amount of amniotic fluid: long term chronic
placental grading
helps ID hypoxia and acidemia |
|
|
Term
| what does the BPP help identify |
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Definition
| the biophysical profile (BPP) helps identify hypoxia and acidemia |
|
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Term
| sequence of development for biophysical profile (BPP) |
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Definition
tone
movement
breathing
fetal HR |
|
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Term
| sequence of actions when fetus under stress |
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Definition
is the reverse of sequence of development for biophysical profile (BPP):
late deceleration
accelerations disappear
no breathing movement
no gross movement
loss of tone |
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Term
| strong indicator of prolonged fetal hypoxia |
|
Definition
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Term
|
Definition
pros
noninvasive
moderate cost
immediate results
cons
needs refined interpretation
application to outcomes need more establishment |
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Term
|
Definition
needle is inserted into umbilical vein
ultrasound is used to guide
Fetal HR monintored for 30-60 minutes
Rh- woman is given RhoGAM to prevent sensitization |
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Term
| maternal assessment of fetal movement or kick count |
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Definition
counts for 30 minutes 3 times a day lying on her side
notify MD if she has fewer than in 1 of the 30 minutes of a change in the type or characters |
|
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Term
| maternal assessment of fetal movement or kick count pros and cons |
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Definition
pros:
noninvasive
not costly
early detection
mother participation
cons:
subjectivity
variables: fetal sleep, maternal drugs, time of day |
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Term
| pain methods used in lamaze teaching |
|
Definition
positioning:
-side lying
-standing up
-lying on back
-slow dancing
-rocking
-walking
relaxation
-effleurage
-massage
mental stimulation
-focal point/imagery/music
breathing
-slow paced breathing during 1st stage
-modified paced as contractions get stronger
-pattern paced involving blowing out to prevent pushing
-breath holding begins in 2nd stage of labor when we want the mom to push and hold breath |
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Term
| maternal infections with greatest risk for fetal and neonatal harm |
|
Definition
cytomegalovirus (CMV)
rubella
varicella sozter virus
hep B
HIV |
|
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Term
| transmission types for viruses |
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Definition
|
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Term
| vertical viral transmission |
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Definition
in utero by crossing placenta or during birth as ascending infection after rupture of membrane
include
-toxoplasmosis
rubella
CMV
herpes
hepatitis
outcomes:
birth defects
long term consequences |
|
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Term
| horizontal viral transmission |
|
Definition
acquired from family/staff/others or equipment
include:
staphylococcal
TB
CMV |
|
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Term
CMV
transmission
effect
nursing consideration |
|
Definition
infection that usually occurs in females between ages of 15-35
transmission: transplacental, during birth, in breast milk
effect:
deafness, blindness in fetus/neonate, seizures, and mental retardation
nursing consideration:may not show s/s for months to years, there is ONLY supportive treatment, if if Dx in the first 20 weeks than a therapeutic termination may be considered |
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Term
rubella
transmission
effect
nursing consideration |
|
Definition
transmission: transplacental
effect: deafness, mental retardation, cataracts, cardiac defects, IUGR: intrauterine growth retardation, microencephaly
nursing consideration: greatest risk for transmission is during the first trimester when organs are developing. if mother becomes pregnant this time, then 1/3 of mothers will have spontaneous abortion. infants of mothers with the virus during pregnancy can shed the virus for several months after birth
treatment: prevention!!!!!!!!! if a mother is non-immune she will receive a vaccine after she delivers and will need contraceptives to prevent pregnancy in the first month after receiving the vaccine |
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Term
|
Definition
|
|
Term
varicella zoster
transmission
effect
nursing consideration |
|
Definition
transmission: direct contact, resp tract, transplacental
effect:
1st TRI: small chance of congenital varicella syndrome
13-20 weeks:
limb hypoplasia
cutaneous scars
chorioetinitis
cataracts
microencephaly
IUGR
nursing consideration: in 1st trimester there is a small risk, greatest risk at 13-20 weeks: 1/3 will spontaneously abortion. infant with mothers with virus during pregnancy may shed virus for several months after birth. If maternal varicella develops more than 6 days before birth then maternal antibodies will protect fetus, however if less than 6 days before or 2 days after than antiobodies in neonate won't have time to develop and they may develop neonata varicella infection which is life threatening
PREVENTION:
immune globulin to mom and baby within 72 hours of birth and isolation if born to a mother + for varicella zoster |
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Term
herpes 1 and 2
transmission
effect
nursing consideration |
|
Definition
transmission: vertical: transplacental and after ROM or during delivery
effects:
primary infections are more serious:
spontaneous abortion
IUGR
preterm labor
nursing consideration: if reccuring infection, complications for fetus are rare. no cure, may take acyclovir dueing preganncy, but it is taken with great caution. but primary infections can have devastating effects. if there are active lesions then c-section is recommended |
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Term
|
Definition
| cat. c drug used for herpes 1 and 2 |
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|
Term
neonatal herpes:
transmission
effect
nursing consideration |
|
Definition
transmission
effect: rapid disease progression, infection with skin lesions. or may develop systemic herpes
those who develop systemic herpes are at a 50% risk for developing serious neuro complications
nursing considerations:
no cure
acyclovir therapy
post delivery observe infant for s/s infection, isolated (not from mother), avoid contact with lesions, do handwashing, prevent spreading! may breastfeed if there are no lesions on the breast |
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|
Term
hepatitis B
transmission
effect
nursing consideration |
|
Definition
transmission: blood, saliva, semen, vaginal secretions, breast milk, transplacental
effect:newborns and children infected before 5 yo will become chronic carriers. chronic B infection develops in 90% of newborns. greater risk for chronic liver disease
nursing considerations:baby born with mom who is hep b+ will receive immunoglobulin as well as first HBV immunization, bath before injection, breast feeding is safe after vaccinations |
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|
Term
HIV
transmission
effect
nursing consideration |
|
Definition
transmission: transplacental, during birth: infected blood and secretions, breast milk
effect: infants with a mother that is HIV+ have a 20-40% risk for developing the disease. s/s usually occur within the 1st year and include an enlarged liver/spleen and lymph nodes, failure to thrive, opportunistic infections, and bacterial infections
nursing considerations: will progress from HIV to AIDS more rapidly than in the adult.increase medications. breastfeeding is CONTRAINDICATED. education: encourage a healthy lifestyle for parents and for detox for drug abuse, or at least washing needles with soap, water, and bleach. mother should understand medication regime to slow progression and reduces risk for vertical transmission, deal with social isolation |
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|
Term
toxoplasmosis
transmission
effect
nursing considerations |
|
Definition
a protozoan infection caused by toxoplasma gandhi
transmission: transplacental, poorly cooked meat, cat feces, and infected soil
effect:
maternal complaints: vague and sound like the flu
fetal: spontaneous abortion, 50% for developing congenital toxoplasmosos,may be no s/s at birth with a late onset of: chorioretinitis, deafness, neuro damage such as seizures, hydrocephalus, microcephaly
nursing considerations: educate mom on contaminants and instruct her to avoid touching the mucous membranes of the mouth and nose. some symptoms in neonate may take years to develop
therapeutic management:
prevention
hand washing
avoid contaminants
treatment during pregnancy to reduce infection risk
sulfonamides are most effective in a combination therapy |
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|
Term
group B strep
transmission
effect
nursing consideration |
|
Definition
leading of life threatening perinatal infection in US
transmission:
effect:
early onset:
1st seven days of birth
can cause: sepsis, pneumonia, meningitis
late onset:
occurs after first 7 days
meningitis is most common form of infection and can cause permanent neuro damage
nursing considerations:
prevention:
taking maternal vaginal and anal cultures at 35-37 weeks, if + then give abx at least 2 doses before delivery, during delivery, abx given q4h
prenatal screening for any of these criteria:
-previous infant with GBS
-GBS in urine during preg.
-birth before 37 weeks
-maternal fever during labor over 100.4
-ROM greater than 18 hours
if present then treat with abx during labor |
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|
Term
TB
transmission
effect
nursing consideration |
|
Definition
transmission airborne droplets
effect:
nursing consideration: screen with PPD if + they will receive INH/rifampin qday for 9 months. must be tx with multiple drugs for a prolonged time. if there is drug resistance than ethambutol will be added and vitamin B6/periodoxine to prevent fetal neurotoxicity while receiving medications
post delivery: infant skin test, prophylactic INH, repeat the test in 3 months, if - then INH is stopped, if + then give full course. isolation from mother is not necessary if mom's sputum is free of organisms. breastfeeding is ok, but check drug levels since the drugs are secreted in breast milk |
|
|
Term
| main goal with STD or STI |
|
Definition
| prevent further infection to newborn |
|
|
Term
| with chlamydia and gonorrhea we want to prevent |
|
Definition
| opthalmia neonatorium, so we out abx ointment in newborn eyes to prevent transmission |
|
|
Term
candidiasis
transmission
effect
nursing considerations |
|
Definition
transmission: at birth
effect: thrush, bacterial vaginosis (no none fetal effect) but is associated with preterm birth and postpartum endometritis
nursing considerations |
|
|
Term
UTI
types
effect
nursing considerations |
|
Definition
types:
asymptomatic bacteriuria
cystitis
acute pyelonephritis (more serious)
effect: can increase risk for preterm labor, develop septic shock, and adult respiratory distress syndrome. may worsen without treatment
nursing considerations: treat to prevent progression to more dangerous or fatal disease |
|
|
Term
|
Definition
|
|
Term
|
Definition
bacteria in bloodstream, is systemic and can be caused by group B strep, hemolytic strep, E.coli.
infants are already vulnerable due to their immature immune system, decreased reaction, and limited antibodies, spreads throughout the body. preterm and low birth weight makes them MORE susceptible
types:
early: develops within the first week and usually in 1st 24 hours. acquired through vertical transmission or labor complication. rapid progression and cause cause resp infections such as pneumonia and meningitis and other long term effects
late: develops after 1st week through horizontal transmission or exposure to organism, slower progression with lower mortality, often affects CNS
s/s:
-obscure
-low grade temp less than 97.6
-feeding and behavior changes
-resp problems |
|
|
Term
| sepsis neonatorium diagnostic tests and interventions |
|
Definition
Dx tests: culture of blood and urine, CBC, glucose, CXR, IgM increase could indicate an infection in utero
Interventions: administering fluids IV, abx, O2, vent support, temp regulation, gavage feedings, glucose monitoring, prevent infection spread |
|
|
Term
| Braxton Hicks contractions |
|
Definition
| irregular, usually mild uterine contractions that occur throughout pregnancy and become stronger in the last trimester |
|
|
Term
|
Definition
| bluish purplish discoloration of the cervix, vagina, and labia during pregnancy and become stronger in the last trimester |
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