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68WM6 MaternalChild
Maternal Child
| Question | Answer |
|---|---|
| what is the purpose of meiosis? | to reduce the diploid number (46) to the haploid (23) for reproduction |
| how many mature ova can be produced by each oogonium? | 1 |
| when does meiosis occur in the female? | partially in utero, before 30 weeks gestation, completes at fertilization |
| when does meiosis occur in the male? | constantly after puberty |
| how many mature spermatozoa are produced from each spermatogonium? | 4 |
| where does fertilization usually occur? | distal 1/3rd of the fallopian tube |
| what are the purposes of seminal fluid? | nourishment, protection, and transport of sperm to the cervix |
| what three things happen when the spermatazoon enters the ovum? | 1)zona pelucida changes to prevent entrance of other sperm 2)2nd polar body is expelled from ovum 3) cell membranes break down to allow mixing of chromosomes from parents |
| when is fertilization complete? | when the chromosomes complete recombination from haploid to diploid (46) |
| when does implantation occur? | by the 10th day |
| what are advantages of implantation in the upper uterus? | larger supply of blood, thicker uterine lining, limits blood loss during childbirth |
| how is the embryo nourished before the development of the placenta? | diffusion, pinocytosis |
| why is the embryo (as opposed to the fetus) particularly susceptible to damage from teratogens | because development is occuring at a rapid rate |
| how does the lower respiratory tract develop? | starts as a branch of the GI tract, separates from esophagus, and then branches to form bronchus, bronchioles, and eventually alveoli |
| why are the intestines contained withing the umbilical cord until the 10th week? | they develop faster than the abdominal cavity and there is not room for them |
| the term for age calculated in weeks from the time of conception | fertilization age |
| the term for age calculated in weeks from the last menstrual period | gestational age |
| which is used more commonly, fertilization age or gestational age, and why? | gestational age because more women know when their last period was than know the exact time of conception |
| what postition does the fetus assume in late pregnancy? | head down |
| thick whitish substance secreted by fetus to protect skin from prolonged contact with amniotic fluid | vernix |
| soft, downy hair that helps adhere vernix to the skin | lanugo |
| heat producing fat stored in back of neck, behind sternum, and around kidneys to help regulate temperature in neonates | brown fat |
| lubricant produced in the lung that prevents the collapse of alveoli; important in determining viability of the fetus in case of early delivery | surfactant |
| which function takes over the endocrine functions of the corpus luteum during pregnancy | placenta |
| what happens in the intervillous spaces of the placenta? | exchange of oxygen, nutrients and waste |
| why should fetal and maternal blood not mix? | non compatible blood types can result in sensitization of mother and spontaneous abortion of subsequent pregnancies |
| what factors allow the fetus to thrive in a low oxygen environment? | more effecient hemoglobin, higher hct and hgb, lower CO2 in fetal blood |
| causes corpus luteum to persist for 6-8 weeks and causes fetal testes to secrete testosterone | hCG |
| promotes fetal growth and nutrition, decreases maternal sensitivity to insulin, and promotes maternal breast development for lactation | human placental lactogen |
| promotes enlargement of the uterus and breasts as well as the ductal system of the breasts and the external genitalia | estrogen |
| promotes changes in endometrium to allow pregnancy, reduces muscle contractions in the uterus to prevent spontaneous abortion, and may promote immune tolerance in the mother to allow pregnancy | progesterone |
| what is the purpose of the fetal membranes? | to contain amniotic fluid |
| what are the functions of amniotic fluid? | protection, cushioning, temperature stability, promote symmetric development, prevent membranes from adhering to fetus |
| shunts oxygenated blood from umbilical vein to inferior vena cava | ductus venosus |
| shunts blood from right to left atrium | foramen ovale |
| shunts blood from right ventricle directly into the aorta | ductus arteriosus |
| carry oxygenated blood from placenta to fetal circulation | umbilical veins |
| carry deoxygenated blood from fetus to placenta | umbilical arteries |
| key sign of threatened abortion | bleeding |
| key signs of inevitable abortion | cervical dilation and membrane rupture (evidenced by loss of amniotic fluid) |
| causes of spontaneous abortion | genetic/chromosomal abnormalities; incompetent cervix; bicornuate uterus; hormonal deficiencies; immunologic factors; systemic disease (diabetes mellitus, lupus); Rh incompatibility |
| appropriate nursing interventions for grief following spontaneous abortion | listening, acceptance, provide information |
| inappropriate initiation of clotting factors caused by a variety of factors during pregnancy | DIC (disseminated intravascular coagulation) |
| causes of disseminated intravascular coagulation | abruptio placentae, missed abortion, crossover of thromboplastin from placenta, endothelial damage (preeclampsia, HELLP syndrome), sepsis, amniotic fluid embolism |
| how is disseminated intravascular coagulation treated | supportive treatment until underlying cause can be corrected |
| known as a "disaster of reproduction" because if undetected it can lead to death or subsequent infertility | ectopic pregnancy |
| causes of increased rates of ectopic pregnancy in the united states | increased rates of pelvic infection, inflammation, and surgery |
| how is ectopic precnancy treated? | methotrexate to prevent cell division at early stages, linear salpingostomy to remove pregnancy, or salpingectomy if too far progressed |
| abnormal trophoblast development with or without partial fetus | hydatiform mole |
| what are the two phases of treatment for molar pregnancy? | evacuation of abnormal tissue, continuous followup to detect malignant changes |
| what is the most common sign of placenta previa | painless uterine bleeding |
| how is placenta previa diagnosed | ultrasound |
| treatment of placenta previa | bedrest, pt teaching (of warning signs), delivery by c section in placenta is completely blocking the cervix |
| bleeding, uterine tenderness, contractions, abdominal or low back pain, and high uterine resting tone are signs of | abruptio placentae |
| major concerns with placental abruption include | maternal hemorrhage, fetal death |
| uncontrollable vomiting resulting in weight loss, dehydration, acid/base/electrolyte imbalances, low vitamin k (coagulation disorders) and low thiamine (encephalopathy) | hyperemisis gravidarum |
| hyperemisis gravidarum begins before what week of pregnancy | 20th |
| what are the goals of hyperemesis gravidarum management? | maintain hydration and nutrition |
| BP greater than 140/90 with proteinuria beginning after the 20th week of pregnancy | preeclampsia |
| BP greater than 140/90 with proteinuria beginning after the the 20th week of pregnancy and resulting in seizures | eclampsia |
| BP greater than 140/90 without proteinuria beginning after 20th week of pregnancy | gestational hypertension |
| BP greater than 140/90 existing before pregnancy or manifesting before 20th week | chronic hypertension |
| preexisting hypertension with proteinuria that develops or increases significantly after the 20th week | preeclampsia superimposed on chronic hypertension |
| results in decreased placental circulation, decreased O2 availability to fetus, decreased nutrient and waste exchange in placenta | vasospasm |
| is reduced activity beneficial after diagnosis of preeclampsia | yes, lying down for periods during the day reduces pressure on the vena cava and increases cardiac return leading to better perfusion |
| causes decreased cranial perfusion, altered mental status, and seizures in mother | vasospasm |
| what is the primary adverse effect of magnesium sulfate? | CNS depression, resulting in respiratory depression |
| the antidote to magnesium sulfate | calcium gluconate |
| possible complications of eclampsia | HELLP, DIC, abruptio placentae |
| what assesments should be frequently completed on mother with preeclampsia? | DTR, vitals, chest auscultation, edema evaluation, protein in urine, daily weights |
| what is the preferred medical management of seizures during pregnancy | magnesium sulfate |
| what are some nursing interventions appropriate for a woman with preeclampsia? | calm, quiet, relaxing environment with minimal light and sound, limit visitation, avoid disturbing when possible |
| causes of disseminated intravascular coagulation | abruptio placentae, missed abortion, crossover of thromboplastin from placenta, endothelial damage (preeclampsia, HELLP syndrome), sepsis, amniotic fluid embolism |
| causes of disseminated intravascular coagulation | abruptio placentae, missed abortion, crossover of thromboplastin from placenta, endothelial damage (preeclampsia, HELLP syndrome), sepsis, amniotic fluid embolism |
| how is disseminated intravascular coagulation treated | supportive treatment until underlying cause can be corrected |
| causes of increased rates of ectopic pregnancy in the united states | increased rates of pelvic infection, inflammation, and surgery |
| known as a "disaster of reproduction" because if undetected it can lead to death or subsequent infertility | ectopic pregnancy |
| causes of increased rates of ectopic pregnancy in the united states | increased rates of pelvic infection, inflammation, and surgery |
| abnormal trophoblast development with or without partial fetus | hydatiform mole |
| how is ectopic precnancy treated? | methotrexate to prevent cell division at early stages, linear salpingostomy to remove pregnancy, or salpingectomy if too far progressed |
| what is the most common sign of placenta previa | painless uterine bleeding |
| abnormal trophoblast development with or without partial fetus | hydatiform mole |
| how is placenta previa diagnosed | ultrasound |
| what are the two phases of treatment for molar pregnancy? | evacuation of abnormal tissue, continuous followup to detect malignant changes |
| treatment of placenta previa | bedrest, pt teaching (of warning signs), delivery by c section in placenta is completely blocking the cervix |
| what is the most common sign of placenta previa | painless uterine bleeding |
| bleeding, uterine tenderness, contractions, abdominal or low back pain, and high uterine resting tone are signs of | abruptio placentae |
| how is placenta previa diagnosed | ultrasound |
| major concerns with placental abruption include | maternal hemorrhage, fetal death |
| treatment of placenta previa | bedrest, pt teaching (of warning signs), delivery by c section in placenta is completely blocking the cervix |
| uncontrollable vomiting resulting in weight loss, dehydration, acid/base/electrolyte imbalances, low vitamin k (coagulation disorders) and low thiamine (encephalopathy) | hyperemisis gravidarum |
| bleeding, uterine tenderness, contractions, abdominal or low back pain, and high uterine resting tone are signs of | abruptio placentae |
| major concerns with placental abruption include | maternal hemorrhage, fetal death |
| BP greater than 140/90 with proteinuria beginning after the 20th week of pregnancy | preeclampsia |
| uncontrollable vomiting resulting in weight loss, dehydration, acid/base/electrolyte imbalances, low vitamin k (coagulation disorders) and low thiamine (encephalopathy) | hyperemisis gravidarum |
| BP greater than 140/90 with proteinuria beginning after the the 20th week of pregnancy and resulting in seizures | eclampsia |
| hyperemisis gravidarum begins before what week of pregnancy | 20th |
| BP greater than 140/90 without proteinuria beginning after 20th week of pregnancy | gestational hypertension |
| what are the goals of hyperemesis gravidarum management? | maintain hydration and nutrition |
| BP greater than 140/90 with proteinuria beginning after the 20th week of pregnancy | preeclampsia |
| BP greater than 140/90 with proteinuria beginning after the the 20th week of pregnancy and resulting in seizures | eclampsia |
| BP greater than 140/90 without proteinuria beginning after 20th week of pregnancy | gestational hypertension |
| BP greater than 140/90 existing before pregnancy or manifesting before 20th week | chronic hypertension |
| causes decreased cranial perfusion, altered mental status, and seizures in mother | vasospasm |
| preexisting hypertension with proteinuria that develops or increases significantly after the 20th week | preeclampsia superimposed on chronic hypertension |
| what is the primary adverse effect of magnesium sulfate? | CNS depression, resulting in respiratory depression |
| results in decreased placental circulation, decreased O2 availability to fetus, decreased nutrient and waste exchange in placenta | vasospasm |
| the antidote to magnesium sulfate | calcium gluconate |
| is reduced activity beneficial after diagnosis of preeclampsia | yes, lying down for periods during the day reduces pressure on the vena cava and increases cardiac return leading to better perfusion |
| possible complications of eclampsia | HELLP, DIC, abruptio placentae |
| causes decreased cranial perfusion, altered mental status, and seizures in mother | vasospasm |
| what assesments should be frequently completed on mother with preeclampsia? | DTR, vitals, chest auscultation, edema evaluation, protein in urine, daily weights |
| what is the primary adverse effect of magnesium sulfate? | CNS depression, resulting in respiratory depression |
| the antidote to magnesium sulfate | calcium gluconate |
| possible complications of eclampsia | HELLP, DIC, abruptio placentae |
| what assesments should be frequently completed on mother with preeclampsia? | DTR, vitals, chest auscultation, edema evaluation, protein in urine, daily weights |
| what are some precautions that can help prevent injury during a seizure? | pad side rails, have O2 and suction on hand |
| what is the preferred medical management of seizures during pregnancy | magnesium sulfate |
| what are some nursing interventions appropriate for a woman with preeclampsia? | calm, quiet, relaxing environment with minimal light and sound, limit visitation, avoid disturbing when possible |
| what are some precautions that can help prevent injury during a seizure? | pad side rails, have O2 and suction on hand |
| what are some signs and symptoms of magnesium toxicity? | decreased respirations, decreased SPO2, absent deep tendon reflexes, sweating and flushing |
| what is the antidote for magnesium? | calcium gluconate |
| what does HELLP stand for? | Hemolysis, Elevated liver enzymes, Low platelets |
| what is the perferred medication for HTN during pregnancy? | methyldopa (Aldomet) |
| if methyldopa is ineffective, what classes of medication can be used to prevent HTN during pregnancy? | beta blockers and calcium channel blockers |
| what is a vassodialator used for HTN crisis during pregnancy? | hydralazine |
| which diuretics are considered safe to use during pregnancy? | thyazide diuretics |
| who receives Rhogan followed by or during pregnancy? | all RH negative mothers |
| how can an ABO incapability effect the fetus? | results in hemolysis resulting in jaundice in newborn |
| why is ABO incapability not as serious as RH incapability during pregnancy? | ABO antibodies do not cross the placenta very easily |
| which is more likely to cause birth defects, gestational diabetes or prepregnancy diabetes? | prepregnancy diabetes |
| what is the gold standard for diabetes diagnosis? | oral glucose tolerance test |
| why do many heart defects do not manifest until pregnancy? | increased cardiovascular workload |
| two major categories of heart disease during pregnancy | congenital and rhuematic |
| during labor the nurse should be cautious about administration of fluid to a patient with heart disease for what reason? | fluid overload during contractions can lead to congestive heart failure |
| how much blood is added to intravascular volume following placenta delivery? | 500ml |
| the supplement helps prevent anemia during pregnancy | iron |
| a deficency in this can lead to maternal magaloblastic anemia and nuero tube defects in the fetus? | folic acid |
Created by:
ewoff85
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