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212 Cards in this Set

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The production of what is crucial to keeping the lungs expanded during expiration by reducing alveolar surface tension
surfactant
What are normal respiration rates for newborns?
30-60 bpm
What is the normal heart rate for a newborn?
120-160bpm
What is the difference between HbF (fetal hemoglobin) and HbA (adult hemoglobin)?
HbF holds oxygen more efficiently but releases it to the body tissues at low PO2 levels
The newborn is considered to have establishhed thermoregulation when ___
oxygen consumption and metabolic activity are minimal
What is the primary source of heat in the cold-stressed newborn?
brown adipose tissue
When should BGLs reach a steady state
By 3 hours of age
Most newborns void and pass stool by when
48 hours after birth
Why does the second period of reactivity require close monitoring by the nurse?
apnea, decreased heart rate, regurgitation, and choking are likely to occur
What is important about the first period of reactivity?
The newborn is alert and hungry, making this a good opportunity to promote attachment
What is the normal blood pressure for a newborn?
72/47
Once the infant has been dried after birth, the highest losses of heat generally result from
radiation and convection
What is a normal temperature for a newborn?
36.4- 37.2 C
Commonly elicited newborn reflexes are ___
tonic neck
moro
grasping
rooting
sucking
blink
What is normal gestation?
38-42 weeks
What is full term resting posture?
hypertonic flexion of all extremities
What is full term sole creases?
deep creases from sole to heels
What is full term brest tissue?
10mm.
What is full term ear form and cartlige?
incurving of the entire pinna, auricle returns quickly when it is pressed down
Full term male genitals
fully descended testes and scrotum covered by rugae
Full term female genitals
large labia majora that covers clitoris and labia minora
Full term square window sign
0 degree angle
Full term scarf sign
elbow will not reach midline
Full term ankle dorsiflexion
0 degree angle
What is the normal range of newborn weight?
5 lb 8 oz- 8 lb 13 oz
What is the normal range for newborn length?
48-52 cm
What is the normal range for newborn head circumfrence?
32-37 cm
What is the normal range for newborn chest circumfrence?
30-35 cm
How do you calculate gestational age
1st day of last menstrual period
What is the timing of an embryo? (most vulnerable to birth defects)
15 days- end of week 8
Where does fertilization normally occur
ampulla (outer third of the fallopian tube)
What is nidation?
when the trophoblast attaches to the uterine wall
When does the fetal heart begin to beat?
4 weeks
When can you first hear the fetal heart beat with a doppler?
8-12 weeks
When do women start to feel quickening?
20 weeks
When can fetal respiratory movements begin to be seen on ultrasound?
28 weeks
When is there suffiecient lung development for easy transition to extrauterine life?
38 weeks
When do the eyes begin to open?
28 weeks
When does placental circulation begin
3 weeks
When do breasts start producing colostrum
12th week
increased or decreased respiratory volume during pregnancy
increased
increased or decreased airway resistance during pregnancy
decreased
increased or decreased blood volume during pregnancy?
increased
increased or decreased hemoglobin during pregancy?
may slightly decrease
Increased or decreased hct during pregnancy
decreased
increased or decreased pulmonary and peripheral vascular resistance?
decreased
increased or decreased cardiac output during pregnancy
increased
increased or decreased pulse in pregnancy
increased 10-15 beats
increased or decreased BP during pregnancy
slight decrease
increased or decreased clotting factors during pregnancy
increased
increased or decreased leukocytes during pregnancy
increased
increased or decreased gastric emptying during pregnancy
decreased
increased or decreased GFR during pregnancy
increased
increased or decreased BUN during pregnancy
decreased
increased or decreased serum creatinine during pregnancy
decreased
increased or decreased intraoccular pressure during pregnancy
decreased
increased or decreased RBC production during pregnancy
increased
increased or decreased T4 during pregnancy
increased
oncreased or decreased TSH during pregnancy
decreased
increased or decreased BMR during pregnancy
increased
increased or decreased parathyroid hormone during pregnancy
increased
GTPAL stands for
Gravida
Term deliveries
Premature deliveries
Abortions
Living children
Calculation of EDC
first day of LMP minus 3 months plus 7 days
McDonalds method for calculating gestation
measure from symphasis pubis to top of fundus in cm.
Must have a full bladder to raise the uterus during___
transabdominal ultrasound
A diagnostic procedure that uses high-frequency sound waves to produce an image based on the density of the structure
ultrasound
Aspiration of a small amount of amniotic fluid obtained via a sterile needle inserted through the abdominal wall into the uterine cavity
amniocentesis
When is amniocentesis performed for genetic testing?
15-20 weeks
When is amniocentesis performed for fetal lung maturity?
30-35 weeks
Taking sample tissue from chorionic villi at edge of the developing placenta
chorionic villus sampling
What is chorionic villus sampling for?
to detect genetic, metabolic, and DNA abnormalities
What is amniocentesis for?
for genetic testing or assess fetal lung maturity
What is alpha-fetoprotein
tests for neural tube defects
What is the most common serious birth defect in the US?
neural tube defect
What are the parts of the "triple check"
AFP, hCG, urine estriol
What is the "triple check for"
to check for neural tube defects, trisomy 21 and trisomy 18
what is considered moderate variability during FHR monitoring
6-25 bpm
What do you do if you see decels on the FHR trace?
LIONS
lay mom on Left side
IV fluids
Oxygen 8-10 liters/min.
Notify physician
Stop labor stimulating meds
What is IV oxytocin in lactated Ringers used for
Contraction stress test
What is a positive interpretation of a contraction stress test?
late decels observed with more than 50% of contractions
Goal of a contraction stress test
to stimulate three contractions of 40 seconds duration in a 10 minute period
Occurs when the largest diameter of the presenting part reaches or passes through the pelvic inlet
engagement
the relationship of fetal parts to one another
attitude
relationship of cephalocaudal axis of the fetus to the cephalocaudal axis of the mother
lie
What is a transverse lie?
spines cross eachother
refers to the relationship of the landmark on the presenting part to the four quadrants of the maternal pelvis
position
Less common positions
RST and LAA
Involuntary or primary powers
uterine muscle contraction
voluntary or secondary powers
pushing with abdominal muscles
refers to the relationship of the presenting part to an imaginary line drawn between the ischial spines of the mother's pelvis
station
"0" station
ischial spines
above the spine is __ station
-1 to -5 cm
below the spine is __ station
+1- + 4cm
Cervix becomes shorter and thinner until it is nondetectable
cervical effacement
signs of impending labor
lightening
braxton hicks contractions
cervical changes
blood show
loss of mucous plug
ROM
burst of energy
active phase of labor
6-7 cm dilation
ctx q 2-5 minutes lasting 40-60 seconds
What might the IUPC read during latent phase of labor
25-40
What might the IUPC read during active phase of labor
50-70
latent phase of labor
0-3 cm dilation
ctx q 3-30 minutes lasting 20-40 seconds
transition phase of labor
8-10 cm dilation
ctx q 1 1/2-2 minutes lasting 60-90 seconds
What might the IUPC read during transition phase of labor
70-90
second stage of labor
10 cm until birth of baby
ctx q 1 1.2 min. lasting 60-90 seconds
What might the IUPC read during second stage of labor
70-100
third stage of labor
birth of the baby until birth of placenta
5-30 minutes
presumptive, probable or positive sign of pregnancy: amenorrhea
presumptive
presumptive, probable or positive sign of pregnancy: N/V
presumptive
presumptive, probable or positive sign of pregnancy: fatigue
presumptive
presumptive, probable or positive sign of pregnancy:urinary frequency
presumptive
presumptive, probable or positive sign of pregnancy: breast changes
presumptive
presumptive, probable or positive sign of pregnancy: quickening
presumptive
presumptive, probable or positive sign of pregnancy: Goodell's sign
probable
presumptive, probable or positive sign of pregnancy: Chadwick's sign
probable
presumptive, probable or positive sign of pregnancy: Hegar's sign
probable
sift isthmus us called
Hegars sign
when body of uterus flexes against cervix
McDonalds sign
presumptive, probable or positive sign of pregnancy: uterine enlargement
probable
presumptive, probable or positive sign of pregnancy: Braxton-hicks contractions
probable
presumptive, probable or positive sign of pregnancy: Uterine souffle
probable
presumptive, probable or positive sign of pregnancy: skin changes
probable
presumptive, probable or positive sign of pregnancy: ballottable head
probable
presumptive, probable or positive sign of pregnancy: positive pregnancy test
probable
presumptive, probable or positive sign of pregnancy: fetal heart tones
positive
presumptive, probable or positive sign of pregnancy: fetal movement felt by examiner
positive
presumptive, probable or positive sign of pregnancy: visualization of fetus via ultrasound
positive
increased or decreased fluids and electrolytes during pregnancy
decreased
increased or decreased serum lactate levels during pregnancy
increased
increased or decreased respiratory rate during pregnancy
increased
increased or decreased CO2 levels during pregnancy
increased
increased or decreased renin,plasma renin, and angiotensionogen during pregnancy
increased
increased or decreased WBC during pregnancy
increased
increased or decreased blood glucose during pregnancy
decreased
Pre regional anesthesia care
bolus with 1000-1500 IV
An encephalopathy caused by deposits of unconjugated bilirubin in the brain cells
kernicterus
It is normal to lose __ % of birth weight
10
newborn immunological adaptations
IgG and IgA
deficiency of liver enzyme needed to convert the amino-acid phenylalinine to tyrosine; leads to brain damage
phenylketonuria
How often uterus contracts
frequency
strength of contraction
quality
length of time contraction lasts
duration
uterine relaxation between contractions
resting tone
If the uterus feels like your cheek:
no contraction
If the uterus feels like your nose:
mild contraction
If the uterus feels like your chin:
moderate contractions
If the uterus feels like your forhead:
strong contraction
Accelerations
FHR increases at leadt 15 beats above the baseline and remains above the baseline for at least 15 seconds
Early decels are caused by
head compression
how much does the FHR decelerate during early decels
> 30 bpm
Variable decelerations are caused by
umbilical cord compression
how much do variable decels decelerate to
decrease of > 15 bpm lasting >15 seconds
Late decelerations are caused by
placental insufficiency
how long are late decels
gradual decrease > 30 seconds
What are the nursing interventions for late decelerations
Stop pitocin
Lay on left side
Iv fluids
Oxygen 10l./min.
Notify physician
primitive eggs produced by the ovaries
oocytes
the production of eggs by the ovaries
oogenesis
male gametes produced by the testes
spermatozoa
the production of male gametes by the testes
spermatogenesis
What is gonadotropin-releasing hormone (GnRH)
produced by the hypothalamus and transmitted to the pituitary where it causes the synthesis of FSH and LH
What do FSH and LH do?
stimulate increased secretions of estrogens and androgens and stimulate the process of spermatogenesis and maturation of the ova
What do androgens and estrogens do?
influence the development of secondary sex characteristics
the femae external genitals
vulva
A muscular and membranous tube that connects the external genitals with the uterus
vagina
a hollow, muscular, thick-walled organ in which fertilized ovum is implanted and in which the developing fetus is nourished until birth
uterus
The uterine corpus is made up of three layers:
perimetrium, myometrium, endometrium
the "neck" between the external os and the body of the uterus. The lower end extends into the vagina
cervix
parts of the fallopian tubes
isthmus, ampulla and fimbria
parts of the uterus
corpus, fundus, and cornua
Where are the ischial spines located?
at the junction of the ilium and the ischium
What is the most common pelvic classification for women?
gynecoid
controls the development of secondary sex characteristics. Assists with maturation of ovarian follicles and cause the endometrial mucosa to proliferate following menstruation. Also increase the size of the uterus and libido
estrogen
decreases uterine motility and contractility , thereby preparing the uterus for implantation after the ovum is fertlized
progesterone
"hormone of pregnancy"
progesterone
essential to ovulation
prostaglandins
responsible for developmental of secondary male characteristics and certain behavioral patterns
testosterone
How many chromosomes do humans have?
46
22 pairs of autosomes and 1 pair of sex chromosomes
the process by which additional somatic body cells are formed. It provides growth and development of the organs and replacement of body cells
mitosis
the process by which gametes are formed; produces the haploid number of chromosomes
meiosis
Fertilization usually takes place in what part of the fallopian tube?
ampulla
the removal of the plasma membrane, which exposes the acrosomal covering of the sperm head
capacitation
the deposit of hyaluronidase in the corona radiate, which allows the sperm head to penetrate the ovum
acrosomal reaction
What must occur for the sperm to fertilize the ovum
capacitation and acrosomal reaction
___ twins arise from two seperate ova fertilized by two seperate spermatozoa
dizygotic
___ twins develop from a single ovum fertilized by a single spermatozoa
monozygotic
a specialized connective tissue that prevents compression of the umbilical cord
Whartons jelly
What is the diagonal conjugate?
the distance from the lower posterior border of the symphysis pubis to the sacral promotory
How is the obstetrical conjugate established?
by subtracting 1.5- 2 cm form the length of the diagonal conjugate
Substances that adversely affect the normal growth and development of the fetus
teratogenic substances
the outer two thirds of the fallopian tube; fertilization of the ovum by a spermatozoon usually occurs here
ampulla
pigmented ring surrounding the nipple of the breast
areola
mammary glands
breasts
the true conjugate, which extends from the middle of the sacral promotory to the middle of the pubic crest
conjugate vera
the elongated portions of the uterus where the fallopian tubes open
cornua
the upper two thirds of the uterus
corpus
the fringlike extremity of the fallopian tubes
fimbria
a small yellow body that develops within a ruptured ovarian follicle; if pregnancy occurs it continues to produce progesterone until the placenta takes over
corpus luteum
the upper portion of the uterus between the fallopian tubes
fundus
a hormone produced by the chorionic villi and found in the urine of pregnant women
hCG
upper border of the true pelvis
pelvic inlet
lower body of the true pelvis
pelvic outlet
a fertilized egg
zygote
violet bluish color of the vaginal mucous membrane caused by increased vascularity
Chadwicks sign
brownish pigmentation over the bridge of the nose and the cheeks during pregnancy
chloasma
secretion of the breast before the onset of true lactation; it is high in protein content, provides some immune properties, and cleanses the newborn's intestinal tract of mucus and meconium
colostrum
softening of the cervix
Goodell's sign
the line of darker pigmentation exending form the umbilicus to the pubis noted in some women during the later months of pregnancy
linea nigra
a collection of thick mucus that blocks the cervical canal during pregnancy
mucous plug
What is the reason for the physiologic anemia of pregnancy
because during pregnancy the plasma volume increases more than the erythrocytes increase
stretch marks
straie gravidarum
Why do women experience supine hypotensive syndrome
the uterus outs pressure on the vena cava
measures fetal heart rate during fetal activity
nonstress test
provides a method for observing the response of the fhr to the stress of the uterine contractions
contraction stress test
What five variables does the biophysical test?
breathing movements, body movemnt, tone, amniotic fluid, and FHR reactivity
a cone-shaped indentation in the cervical os which is commone in cases of cervical incompetence
cervical funneling