Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/162

Click to flip

162 Cards in this Set

  • Front
  • Back
All somatic cells contain ____ chromosomes
46
Union of a normal egg or sperm with one that contains an extra chromosome – down syndrome is most common = 47 chromosomes
Trisomy
When a normal gamete unites with one that is missing a chromosome=45
Monosomy
Condition in which one of the 2 X chromosomes becomes inactive (female)
Barr Body
Genes responsible for observable expressions (brown eyes, dark skin)
Phenotype
Total genetic makeup
Genotype
Earlier diagnostic test (8-12 weeks gestation)
Chorionic Villus Sampling (CVS)
Allows for rapid chromosome dx, genetic studies or transfusion for Rh isoimmunization
Percutaneous Umbilical Blood Sampling (PUBS)
Elevated in infants w/ open neural tube defect, anencephaly, omphalocele, gastroschisis, or multiple gestation
Alpha Fetoprotein (AFP & AFP3)
Ashkenazi Jewish (at risk for which specific disorder)
Tay-Sachs Disease
African; Hispanic from Caribbean, Central/South Americas (at risk for which specific disorder)
Sickle Cell Anemia
Greek, Italian (at risk for which specific disorder)
beta-thalassemia
SE Asia - Vietnamese, Laotian, Cambodian, Philippine (at risk for which specific disorder)
alpha-thalassemia
Women over age 35 (at risk for which specific disorder)
Chromosomal trisomies
Subjective changes in pregnancy
amenorrhea,
N/V (r/t increase hCG and change in carb metabolism) aka morning sickness
urinary frequency
excessive fatigue
breast tenderness
quickening (perception of fetal movement 18-20wks)
Softening of the cervix
Goodell's Sign
Vagina, cervix, and vulva with purplish discoloration
Chadwick's sign
Softening of uterine isthmus (6-8 weeks)
Heger's sign
Soft spot anteriorly in the middle of the uterus
Ladin's sign
An ease in flexing the body of the uterus against the cervix
McDonald's sign
5th week - Irregular softening & enlargement at site of implantation
Broun von Fernwald's sign
Occasional almost tumor-like asymmetric enlargement
Piskacek's sign
Soft blowing sound at pulse rate on auscultation
Uterine Soufflé
Passive fetal movement by pushing up against the cervix with 2 fingers
Ballottement
Reproductive system changes
uterine growth
amenorrhea
suppression of FSH
cervical & vaginal changes
color & production of colostrum
Integumentary changes
striae gravidarum
separation of rectus muscles
melasma or chloasma
Respiratory changes
SOB in late pregnancy
Temperature changes
increase due to progesterone secretion
Cardiovascular changes
increased blood volume (30%)
increased cardiac output (25-50%)
increased HR by 10
GI Changes
N/V
heartburn
increased saliva
Urinary changes
fluid retention
change in renal, ureter, & bladder function
Hormonal Changes
increased estrogen & progesterone cause thickening of uterine walls
cervix cells proliferates & secretes thick, tenacious mucus
The expectant father develops physical symptoms of pregnancy: fatigue, depression, HA, backache, and nausea
Couvade Syndrome
Nagele's Rule
First day of last menses, subtract 3 months, add 7 days
Common Discomforts During 1st Trimester
Leukorrhea (high risk for yeast infection)
Nasal stuffiness & Epistaxis
Ptyalism (excessive often bitter saliva)
Common Discomforts During 2nd & 3rd Trimesters
Heartburn
Ankle edema
Varicose Veins
Leg Cramps
Carpal Tunnel Syndrome
When to administer rubella vaccine for pregnant patient?
Until after birth
Reason for taking pre-natal vitamins
Prevent neural tube defects (folic acid)
Pre-term labor MgSO4 dose
Loading: 4-6g over 30 minutes
Maintenance: 2-4g/hr
Pre-eclampsia MgSO4 dose
Loading: 6g IV over 15 minutes
Maintenance: 2g/hr
Ritodrine
Relaxes uterine muscle through beta-2 receptor sites
Terbutaline sulfate
to maintain uterine inactivity
Betamethasone sodium phosphate (Celestone)
corticosteroid administered to accelerate lung surfactant formation in the fetus. (Takes 24 hours to be effective)
Recommended total weight gain for Normal BMI
25-35 lbs
Excessive vomiting - can progress to dehydration, electrolyte imbalance, acidosis, wt loss, ketonuria, hepatic & renal damage (rare)
Hyperemesis gravidarum
Tubal damage r/t PID, previous pelvic or tubal surgery, endometriosis, IUD (50% of cases referred shoulder pain
Ectopic Pregnancy
Hydatidiform mole - molar pregnancy - abnormal development of the placenta resulting in fluid filled grapelike clusters & trophoblastic tissue proliferates
Gestational trophoblastic disease (GTD)
Placenta is improperly implanted in lower uterine segment
Placenta Previa
Premature separation of a normally implanted placenta
Abruptio Placentae
Painless dilation of the cervix without contraction
Incompetent Cervix
Dx of chorioamnionitis in 10% of cases
Responsible for 1/2 of all preterm babies
Premature Rupture of Membranes (PROM)
Labor that occurs between 20-37 weeks
Preterm labor
Most common developement of HTN, proteinuria, and edema
Define as increase in SBP of 30 mmHg or DBP of 15mmHg
Pre-eclampsia
Convulsion - high risk for seizure or coma
Eclampsia
When BP is 140/90 or higher before pregnancy or before 20th week
Chronic Hypertensive Disease
When transient elevation of BP occurs during labor or in early post-partal period, returning to normal within 10 days postpartum
Later or Transient HTN
An antigen-antibody immunologic reaction within the body
Rh Sensitization
TORCH
Toxoplasmosis
Rubella
Cytomegalovirus
Herpes simplex virus
Indicator of fetal well-being (AFV and AFI)
Amniotic Fluid Assessment
*****: Breathing movement, body movement, tone, AFV, and FHR
Biophysical Profile
Study of non-invasive blood flow changes
Doppler Velocimetry
Spontaneous or induced by Oxytocin, test evaluates placental function & fetal health
Contraction Stress Test
Assesses FHR related to fetal movement
Non-Stress Test
Can make chromosomal & biochemical determinations as early as 1-18 weeks
Amniocentesis
Test that allows for rapid chromosome dx
Percutaneous Umbilical Blood Sampling
Refers to relation of the fetal parts to one another
Fetal Attitude
Relationship of the cephalocaudal axis of fetus to that of mother
Fetal Lie
Most common fetal position
LOA (Left, occipito-anterior)
Second most common fetal position
ROA (Right, occipito-anterior)
When the largest diameter of the presenting part reaches or passes through the pelvic inlet
Engagement
Relationship of the presenting part of the imaginary line between the ischial spines of the maternal pelvis
Station
Landmark on the presenting fetal part to the front, back, or sides of the maternal pelvis
Fetal Position
Uterine muscular contractions which cause the changes in the 1st stage of labor - complete effacement & dilation of the cervix
Primary Force
Use of abdominal muscles to push during the 2nd stage of labor
Secondary Force
3 Phases of Contractions
Increment
Acme (peak)
Decrement (letting up)
Time between beginning of one to the beginning of next contraction
Frequency of contractions
Measured from the beginning of the contraction to the end of said contraction
Duration
Strength of the contraction
Intensity
Labor that produces progressive dilation & effacement of the cervix
Contraction intervals are regular & gradually shorten
True Labor
Irregular, intermittent contractions, may be uncomfortable & exhausting
Braxton Hicks
Fetus settles into pelvic inlet - mother can breathe more easily
Lightening
Softening of the cervix
Ripening
Begins with contractions & ends with fully dilated cervix (10cm)
First stage of labor
Onset to rapid cervical dilatation (1-4cm), contractions every 10-30 min, 10-20 sec duration
Latent Phase
Cervical dilation 4-7 cm. Stronger contractions lasting 40-60 sec every 2-3 minutes
Active Phase
Maximum dilation 8-10 cm - Contractions reach their intensity, complete cervical effacement. Phase ends with irresistible urge to push
Transition Phase
Full dilation to birth of infant. Crowning to pushing the fetus out of the birth canal
Second Stage of Labor
Begins with expulsion of the infant & placenta
Third Stage of Labor
1-4 hours after expulsion of placenta
Fourth Stage of Labor
Viewed as normal, normally occurs late in labor when the head is fairly low, represents pressure on the fetal head during contractions
Early decelerations
Delayed 30-40 sec after contraction onset & continue after contraction. Suggests uteroplacental insufficiency or decreased blood flow
Interventions?
Late decelerations
Maternal position should be lateral, slow/stop oxytocin, administer O2 and prepare for prompt delivery
Unpredictable and indicates compression of the cord.
Interventions?
Variable decelerations
Change position to lateral or trendelenberg, administer O2, possible amnioinfusion with NS or LR
Sluggish contractions, dysfunctional labor
Inertia
Artificial rupturing of membranes with woman in dorsal recumbent position
Amniotomy
Surgical incision of perineum done to allow fetal head to pass, preventing a tear to the perineum
Episiotomy
Artificially starting laborat term.
Induction
Disk-shaped cup pressed against the fetal scalp to help pull fetus out
Can cause marked caput (contraindicated in pre-term)
Vacuum
Medication to soften cervix to prepare for labor induction
Prostaglandins
Synthetic form of posterior pituitary hormone used to initiate uterine contractions
Oxytocin
Return of reproductive organs to pre-pregnancy size & condition
Involution
Descends @ 1cm/day for 10 days after birth.
Fundal Descent
Organ that regains its shape by 18 hours after birth
Cervix
Lochia Rubra
First 3 days, mostly blood with pieces of decidua and mucus
Lochia Serosa
4th day amount decreases and color changes to pink/pinkish brown
Lochi Alba
After 10th day discharge becomes yellowish white (may last for 6 weeks or more)
Mother's need for food, fluid, & sleep. Phase of nurturing & protective care
Taking-in phase
Mother becomes more independent & takes responsibility for her care & shifts focus to the care of the infant (@10 days)
Taking-hold phase
Role change from carefree lifestyle to being on a couple. The parents move forward as a unit with a new member
Letting-go phase
Difficult labor - most common is dysfunctional uterine contractions that result in a prolongation of labor
Dystocia
Rapid labor & birth within 3 hours
Precipitate Labor & Birth
Pregnancy that extends more than 294 days or 42 weeks
Post-term pregnancy
Occiput-posterior position - causes mother severe pain
Fetal Malposition
Forehead becomes the presenting part, head slightly extended instead of flexed
Brow Presentation
C-Section necessary
Most common malpresentation
Breech Presentation
Emergency C-Section
Weight of more than 4000 g (8lb 14oz)
Macrosomia
One or more accessory lobes of fetal villi will develop on the placenta
Succenturiate Placenta
Double fold of chorion & amnion form a ring around cord on fetal side
Cicumvallate placenta
Umbilical cord is inserted at or near the placental margin
Battledore placenta
Vessels of the cord divide some distance from the placenta
Velamentous insertion of the umbilical cord
Bolus of amniotic fluid enters the maternal circulation & cord is compressed
Amniotic Fluid Embolism/Anaphalactoid Syndrome of Pregnancy
Occurs when there is > 2000ml of amniotic fluid during 2nd half of pregnancy
Hydramnios
Turning the fetus
Version
Presentation is changed from breech to cephalic by externa manipulation of the abdomen
External cephalic version (ECV)
Obstetrician places hand inside uterus & turns from transverse
Internal version or podalic
Technique where a volume of warmed, sterile NS or LR is introduced in to the uterus to increase the volume of fluid
Amnioinfusion
Covers the preterm newborn
Vernix
Flexing the baby's hand toward the ventral forearm until resistance is felt - angle is measured
Square window sign
Test of flexion development
Recoil
Degree of knee flexion
Popliteal angle
Placing the baby in supine & drawing an arm across the chest
Scarf sign
Gently drawing the foot toward the ear
Heel to ear extention
Infant turns head to side when corner of mouth is stroked
Rooting
Elicited by touching the newborn's lips
Sucking
Infant forces the tongue outward when the tip is depressed or touched
Extrusion
Fingers flex & grasp a finger placed across their palm
Palmar grasp
Fencing reflex - flexing & extension of limbs dependent of turning of the head
Tonic neck
Startle reflex - response may be asymmetrical due to injury of the clavicle, humerus, or brachial plexus
Moro reflex
An infant lying prone will turn shoulder & pelvis to the stimulated side when skin near spine is stroked
Gallant reflex
Stroking the plantar surface of an infants food upward causes great toe dorsiflexion
Babinski's Reflex
Bluish dsicoloration of hand & feet
Acrocyanosis
Lacy pattern of dilated blood vessels under the skin
Mottling
Color change, deep color develops over one side while other side remains pale
Harlequin sign
Evaluated by blanching the tip of the nose, forehead, or gum line
Jaundice
Firm lesion 103 cm whtie or pale yellow papule
Erythema Toxium
Exposed sebaceous glands - raised white spots on face
Milia
White cheese-like substance
Vernix caseosa
Blood between the periosteum of the skull bone & bone itself due to ruptured capillaries at birth
Cephalhematoma
Edema of scalp at the presenting part of the babies head - crosses suture line
Caput succedaneum
Normal neonate BP
60/40
Normal neonate pulse
120-160, >180 if crying
Normal neonate respirations
30-60
Vitamin K (AquaMEPHYTOIN) given why?
To prevent hemorrhage d/t low prothrombin levels
Why apply ophthalmic oint to neonates eye?
Prophylaxis against Chlamydia
S/S of Neonatal Distress
Sternal retractions, nasal flaring, grunting excessive mucus, cyanosis, vomiting of bile, absence of meconium, and temp instability
yellowish or creamy fluid thicker than later milk, and contains more protein, fat-soluble vitamins & minerals, high levels of antibodies
Colostrum
Recurrence of ovulation & menstruation?
non-nusring mothers 7-9 weeks
90% resume in 12 weeks
A mild, transient condition in which mother cries for no apparent reason, fatigued, anxiety, restlessness, letdown feeling
Postpartum blues
Serious, intense persistent feelings characterized by inability to feel loved, irritability, guild, shame, disinterest in infant, and thoughts of harming infant
Postpartum depression
Rhogam
Given within 72 hours of birth to prevent sensitization of Rh negative moms who have given birth to Rh positive infants
Uterus Compresses the aorta & vena cava when mother is supine, decreasing fetoplacental blood flow
Venal Caval Syndrome - Change position of mother, elevate one hip in side-lying position
What should you keep at bedside if administering Mg Sulfate?
Calcium gluconate
Gravida TPAL
G: # of pregnancies regardless of duration
T: # of term infants
P: # of preterm infants
A: # of pregnancies ending in abortion
L: # of currently living children