Ch25~ Health Promotion And Pregnancy

Front 1

What is the function of the placenta?

Back 1

The placenta acts as an endocrine gland, secreteing hormones (HCG, estrogen, progesterone). It is also the site for nutrient/waste exchange between the mother and the fetus. It also blocks the fetus from danger, using the placenta barrier which blocks certain substances/viruses from passing to the fetus.

Front 2

How do you assess for fetal heart tones?

Back 2

Depending on how far along the pregnancy, you can use a fetoscope, ultrasound stethescope, or a doppler (doppler can be used between 12-20weeks).

Front 3

What conditions does an amniocentisis used to indentify?

Back 3

An amniocentisis can identify the gender of a baby, as well as chromosomal abnormalities (spinal disorders, down syndrome), health status, and maturity of the fetus, lung maturity, presence of intrauterine infection or fetal distress.

Front 4

What are the nurses responsibilities during an amniocentisis?

Back 4

The nurse should explain to the patient what she can expect during the procedure, make sure she understands what the doctor has told her about the procedure, then obtain informed consent, she should instruct the patient to empty her bladder, place the pt in a supine position, wedge her right hip with pilows and drape her abdomen. The nurse shold obtain baseline vitals, FHR, cleanse abdomen with aniseptic solution, and if needed administer Rhogam, after the procedure obtain vitals, encourage the pt to drink water!

Front 5

What are the risks of an amniocentisis?

Back 5

Risks include amniotic emboli, maternal or fetal hemmorage, infection, fetal damage (limb complications).

Front 6

Describe the effects of hormones during pregnancy on the uterus and breasts.

Back 6

Hormones cause the uterus to enlarge and change the consitency of tissues. The change in breasts include increased vascularation, increased size, change in pigmentation, prominence of areola and nipples.

Front 7

What are the presumptive signs of pregnancy?

Back 7

These signs indicate that pregnancy is possible, but are not defenitive, amenorrhea, nausea, vomitting, frequent urination, breast changes, changes in size of the abdomen, quickening, skin changes, and Chadwicks sign,

Front 8

What are the probable signs of pregnancy?

Back 8

These signs indicate that a woman is probably pregnant, but not definative: Changes in reproductive organs (enlarged uterus), Hegar adn Goodell's sign, ballotment, positive pregnancy test,

Front 9

What are the positive signs of pregnancy?

Back 9

Positive signs of pregnancy occur ONLY IN PREGNANCY, there for they are definitive signs of pregnancy, visualization, fetal movement, ausulation of fetal heart beat.

Front 10

Explain Nagele's rule.

Back 10

Nagele's rule is used to estimate a due date, You start with the first dat of the last menstural cycle, count back 3 months, then add 7 days. Most babies are born within 10 days before or after EDB.

Front 11

What danger signs during pregnancy may indicate a need for immediate medical attention?

Back 11

These signs are reasons to seek immidiate medical attention during pregnancy: diplopia, bluring vision or seeing spots, headaches (severe, sudden ot continuous), edema of the face, presacral area, or fingers, rapid wieght gain, severe abdominal or epigastric pain, signs of infection (fever, chills, diahrrea), changes in vaginal discharge, pain or burning with urrination, vagninal bleeding, presistant vomitting, muscular irratability or convulsions. absence or decrease in fetal movement (once its felt).

Front 12

Describe the musculoskeletal changes that women experience during pregnancy.

Back 12

Muscoskeletal changes during pregnancy may include postural changes, a forward tilted pelvis, decreases muscular tone. The spine can realign, center of gravity shifts, the ulmbosacral curve increases, and a compensatory curve in the cervicodorsal develops to help maintain balance. The ligaments and muscular structures of the middle and lower spine become very stressed, Pelvic joints become relaxed and increase mobility. Connective tissues become exaggerated, elasticity amd softening increase.

Front 13

When do breast changes occur in pregnancy?

Back 13

Breast changes occur early in pregnancy, they include, tingling, a feeling of fullness, increased sensitivity, increased size, nipples and areolas darken in late pregnancy, colustrum may be secreted.

Front 14

What are some comman methods of preparing for childbirth?

Back 14

Comman methods of prepared childbirth include:
Dick Read~ progressive relaxation, avoiding analgesics.
Bradley ~ stresses control of enviroment,
Leboyer~ warm, water bath
Lamaze~ breathing, distraction and focusing techniques,
It is important for a woman to be prepared, it will decrease anxiety during labor and birth.

Front 15

Name 5 discomforts of pregnancy and the physiological reasons behind them.

Back 15

Any of the discomforts on your worksheet are acceptable, here are a few:
Constipation~ smooth muscles relax in preperation for labor, baby presses on the colon, as well as iron supplemnts.
Headache~ the body is adjusting to changes in blood volume, and vascular tone,
Heart burn~ pressure on the throat due to the baby getting bigger, increased progesterone levels.
Shortness of breath~ uterus enlarges and pushes diaphram upward.
Varicose veins~ pressure on the veins that carry blood bacl to the heart from the enlarging uterus.

Front 16

When does conception (fertilization) take place?

Back 16

Conception occurs when the sperm joins or fuses with the ovum

Front 17

Where does conception normally occur?

Back 17

Conception normally occurs in the outer 1/3rd portion of the tube.

Front 18

After fertilization occurs, what is the new cell called?

Back 18

After conception until implantation, the cell mass is refered to a zygote.

Front 19

Implantion normally occurs in the __________________.

Back 19

Implantion normally occurs in the fundus of the uterus on either the anterior or posterior surfaces.

Front 20

What is an eptopic pregnancy?

Back 20

Eptopic pregnancies occur when implantation occurs outside of the uterine cavity.

Front 21

Hormone levels are extremely important in pregnancy, in early pregnancy __________ is the most important to maintain the pregnancy.

Back 21

Hormone levels are extremely important in pregnancy, in early pregnancy progesterone is the most important to maintain the pregnancy.

Front 22

What provides noursihment to the zygote before the placenta is formed?

Back 22

The yolk sac provides the nourishment

Front 23

When does the embryo turn from a zygote into a fetus?

Back 23

As soon as a zygote implants, it is then considered an fetus.

Front 24

How long does the embryonic stage last?

Back 24

Embryonic stage lasts approximately 8 weeks.

Front 25

During the first 8 weeks of pregnancy (the embryonic stage), what kind of development does the embryo go through?

Back 25

During the embryonic stage a simple heart beat begins, and primary forms of all the major organs are developed, by the end of this stage the embryo has a acquired a human appearance.

Front 26

Starting with the 9th week, the embryo is referred to as a _______, and the ________ stage begins.

Back 26

Starting with the 9th week, the embryo is referred to as a fetus and the fetal stage begins.

Front 27

What is a teratogenic agent?

Back 27

Any drug, virus, or irradiation that can cause malformations of the fetus.

Front 28

The placenta develops and takes over nutrition of the developing embryo at the ____-_____ week of pregnancy.

Back 28

The placenta develops and takes over nutrition of the developing embryo at the 12-14th weeks of pregnancy.

Front 29

If a pregnant mother is diabetic, can she continue to take her oral hypoglycemics?

Back 29

No, most oral hypoglycemics can cross the placental barrier, but insulin DOES NOT, so alot of time diabetic mothers are switched to insulin during pregnancy.

Front 30

The umbilical cordis normally ___-___inches long and less than ___inch in diameter at the time of delivery.

Back 30

The umbilical cordis normally 20-22 inches long and less than 1 inch in diameter at the time of delivery.

Front 31

What is Wharton's jelly?

Back 31

Wharton's jelly is gelatinous-mucoid substance that remains when the embryonic body stalk blends with the yolk sac withing the umbilical cord, it is the major part of the umbilical cord.

Front 32

The umbilical cord is made up of 2 __________ and 1 ______, whcih gives it a rope like appearance.

Back 32

The umbilical cord is made up of 2 arteries and 1 vien, whcih gives it a rope like appearance.

Front 33

What is the purpose of amniotic fluid?

Back 33

Amniotic fluid acts as a cushion against injury, helps regulate temperature, and allow room for growth.

Front 34

At the time of delivery, there is aproximetly ____ liter of amniotic fluid.

Back 34

At the time of delivery, there is aproximetly 1 liter of amniotic fluid.

Front 35

What is lanugo?

Back 35

Lanugo is the downy, fine heair charecteristic of fetuses between 20 weeks if gestation and birth.

Front 36

Describe what the maternal serum alpha-fetoprotien screening test for?

Back 36

The maternal serum alpha-fetoprotien screening is a blood test used to identify birth defects and abnormalities such as down syndrome or neural tube defects.

Front 37

When screening for abnormalities, an amniocentisis is done at aproximately _____ weeks of pregnancy.

Back 37

When screening for abnormalities, an amniocentisis is done at aproximately 16 weeks of pregnancy, this is before the legal point of viability at 22 weeks, to give the mother time to consider options.

Front 38

What is a normal score of a biophysical profile?

Back 38

A score of 8-10 is considered normal, 6 is evuivocal, 4 or less is abnormal.

Front 39

During the first 8-10 weeks of pregnancy levels of ________ and ___________ stay high, which in turn FSH, LH, and ovulation are supporessed, as well is _______.

Back 39

During the first 8-10 weeks of pregnancy levels of estrogen and _progesterone stay high, which in turn FSH, LH, and ovulation are supporessed, as well is menstration.

Front 40

What is done at a basic prenatal physical examination?

Back 40

At a prenatal exam the following will be done:
~measurment of vital signs, height and weiht,
~ assessment of heart, lungs, and reflexes
~inspection of the skin and mobility
~basic blood work
~Routine urinalysis for glucose, protein, ketones

Front 41

What blood work is done at the prenatal appointment?

Back 41

Blood work includes, hemoglobin, hematocrit, serology tests for syphilis, HIV, and hepitius virus, blood typing, Rh factor, rubella titer.

Front 42

During a gynecologic examination what is done?

Back 42

During a gynecologic exam palpation and auscultation, visualization of the cervix and vagina, evaluation of bony pelvis, palpation of the uterus exteranally, examination of the vulva, perineum, anus, and rectum, sometimes a PAP smear is done.

Front 43

What is gravida?

Back 43

Gravida is a word that indicates that a woman is pregnant. Then numerical prefixes are added to indicate muber of pregnancies. (primigravida, nuligravida, multigravida).

Front 44

How often are prenatal appointments recommended?

Back 44

Prenatal appointments should be scheduled once a month through the 7th month, then once every 2 weeks for the next month, then once a week until delivery.

Front 45

What is pica?

Back 45

Pica is the craving and eating of substances that are not normally considered edible.

Front 46

Pregnant women should increase their prepregnant caloric intake by ____-____ calories and breastfeeding mothers should increase prepregnancy calories by _____.

Back 46

Pregnant women should increase their prepregnant caloric intake by 300-500 calories and breastfeeding mothers should increase prepregnancy calories by 500.

Front 47

What is physiological anemia?

Back 47

Physiological anemia is when, due to a pregnancy, the mother's fluid volume increases before the RBC can rise to the new levels.

Front 48

Blood volume increases ___-___% above prepregnancy levels

Back 48

Blood volume increases by 40-50% above prepregnancy level.

Front 49

TRUE OR FALSE:
Once a woman finds out that she is pregnant, she should stop exercising immidiately.

Back 49

FALSE, A woman can maintain normal physical activity as long as she has an uncomplicated pregnancy. She should aviod high risk activities, that require a great deal of balance and coordination.

Front 50

TRUE OR FALSE:
There is no physiologic reason to limit sex during pregnancy.

Back 50

TRUE:
Unless there are complications in the pregnancy or the bag of waters has ruptured.