WH Exam 1

How many deaths per 100,000 live births?

How many are preventable?

19, ½

___ women die every day during pregnancy and childbirth in the US

2-3

Normal menstrual cycle duration ___ days. Can vary: ___

28; 21-35

__ phase involves forming a mature egg.

Follicular

__ phase lasts 10-14 days

Follicular

During the follicular phase, ___ is released.

FSH

__ phase lasts 1 day

Ovulation

During ___, the mature follicle ruptures in response to a surge in LH.

ovulation

during ovulation, an ____ is released

ovum

The ___ begins at ovulation and lasts until the menstrual phase of the next cycle.

luteal

The follicle after rupturing forms the ___ which secretes progesterone.

corpus luteum

During luteal phase, the body temp increases ___ F

0.5-1

What hormone is involved in maintaining a pregnancy?

progesterone

__ preserves the corpus luteum and progesterone production

hCG

What is a zygote?

Fertilized ovum

hCG levels __ every 48-72 hours in the early weeks of pregnancy

doubles

amniotic fluid is composed of:

98% water and 2% organic matter

__ contains albumin, urea, uric acid, creatinine, bilirubin, lecithin (mix of fats), sphingomyelin (lipid found in myelin sheath), epithelial cells, vernix & lanugo

amniotic fluid

< 500 mL of amniotic fluid is referred to as ___

oligohydraminos

>2000 mL of amniotic fluid is referred to as ___

polyhydramnios

oligohydramnios is associated with: ___

uteroplacental insufficiency and renal insufficiency

polyhydramnios is associated with: __

maternal diabetes, neural tube defects, chromosomal variations, malformations of the CNS, GI alterations

__ is a polyploidy condition that is diagnosed by genetic testing

Down syndrome

Patient presents with small, low set ears, hyperflexibility, muscle hypotonia , wide spaced eyes , ulnar loop on the second digit , simian crease , fat facial profile, small white spots on irises, open mouth with protruding tongue. What is the most likely diagnosis?

Down Syndrome

This condition follows an autosomal recessive inheritance that is characterized insufficient activity of the enzyme hexosaminidase A.

Tay Sachs Disease

Immunoglobulin that crosses the placenta is called __

IgG

What immunoglobulin is found in the colostrum?

IgA

The __ is made up of 1 large vein (O2) and 2 small arteries (CO2) surrounded by Wharton's Jelly

umbilical cord

__ is made by the placenta and functions to maintain endometrium, decrease contractility of the uterus, stimulate maternal metabolism & breast development

progesterone

__ preserves the corpus luteum and its progesterone production

hCG

__: enlargement of the women’s breast, uterus, and external genitalia.

Estrogen

___ Stimulates myometrial contractility (Braxton Hicks)

estrogen

__ relaxation of the pelvic ligaments, softens the cervix in preparation of birth

Relaxin

__ regulates fetal and maternal metabolism, development of breast for lactation, decreases maternal glucose utilization (increase glucose avail to fetus)

hPL/hCS

Protecting the fetus from immune attack by mothers immune system is a function of the __

placenta

Weeks of gestation for full term

37-42 weeks

number of times a woman has been pregnant

G

term births (after 37 weeks)

T

pregnancies delivered from 20-37 weeks

P

number of miscarriages ending before 20 weeks

A

number of living children

L

First day of LMP - 3 months + 7 days + 1 year

Naegele’s rule

How to determine delivery day if the patient has irregular periods?

Ultrasound

CBC, blood typing, Rh factor, rubella titer, urinalysis, renal function, pap smear are all __

prenatal labs

tuberculin skin test, STI, HIV, hep B surface antigen, VDRL, RPR testing, glucose tolerance are all __

prenatal tests

Pregnant blood volume should increase 50% above non pregnant levels by the __th week

30

Increase in blood volume begins at __ weeks and peaks at __ weeks.

10-12, 32-34

Maternal HR should increase __ bpm

10-15

BP should decrease 5-10 mm Hg by the __ trimester.

2nd

Pregnancy makes the woman __ due to an increase increase in fibrin, plasma, fibrinogen levels.

hypercoagulable

Amenorrhea, fatigue, breast tenderness, n/v, urinary frequency are all __

presumptive signs

hyperpigmentation, fetal movement, uterine enlargement, & breast enlargement are all __

presumptive signs

braxon hicks contraction, abdominal uterine enlargement and positive pregnancy test are all __

probable signs

Ballottement can be done in how many weeks?

16-28

Ballottement is a

probable sign

Hegar sign can be done in how many weeks

6-12

Hegar sign is a

probable sign

Chadwick’s sign can be checked in how many weeks?

6-8

Chadwick’s sign is a

probable sign

Goodell's sign can be checked at how many weeks

5

Goodell's sign is a

probable sign

What is this

Ballottement

What this

Hegars sign

What is this

Chadwick’s sign

What is this

Goodell’s sign

Ultrasound, fetal movement felt by experienced clinician, and auscultation of fetal heart tones via doppler are all

positive signs

Measuring __ involves using a tape measure and measuring from the top of the uterus to top of pubic bone

fundal height

__ presents as decreased CO, BP, and increased orthostatic stress. Advised to encourage patient to lay on her side.

Vena cava syndrome

Excessive salivation or __ is one of the GI signs during pregnancy

Ptyalism

__ conflicting feelings is the most common in the first trimester

Ambivalence

__: mother become increasingly preoccupied with herself and her fetus (early part of pregnancy)

Introversion

__: physical changes of the growing fetus, enlarging abdomen and fetal movement, bring reality and validity to the pregnancy (second semester)

Acceptance

__: Emotional lability is characteristic throughout most pregnancies

Mood swings

__: pregnancy affects a woman’s body image varies greatly from person to person

Changes in body image

__ occurs d/t progesterone, estrogen, and melanocyte stimulating hormone levels

Hyperpigmentation

__ aka mask of pregnancy occurs in about 70% of pregnant women

melasma

__: pigmented line down middle of abdomen

Linea nigra

__: stretch marks reduce connective tissue strength at 6-7 months

Striae gravidarum

__ occur due to poor circulation and uterus compression

Varicose veins

__ refers to spontaneous, irregular, painless contractions

Braxton hicks contractions

Advise a patient to hydrate, rest in side lying position, and teach breathing techniques if they are experiencing

braxton hicks

Amount of water recommended per day for pregnant women

8 glasses

Fetal movement starts in ___ weeks

16-20

If fetal movement lasts longer than __ call the HCP

2 hours

decrease fluid intake before bedtime, reduce caffeinated beverages, and kegel exercises are all interventions for ___

Urinary frequency/incontinence

Side lying position, release pressure in blood vessels is a recommendation for a pregnant woman experiencing

Fatigue

Eat small frequent meals, bland, low fat is a recommendation for a pregnant woman experiencing

N/V

Wear larger bra with good support is a recommendation for pregnant woman experiencing

breast tenderness

__ is the flow of a whitish, yellowish, or greenish discharge from the vagina of the female that may be normal or that may be a sign of infection

Leukorrhea

shark, swordfish, king mackerel, orange roughy, ahi tuna, tilefish are all things that should be __ during pregnancy

avoided

Hot dogs, lunch meat, deli meat should be __ during pregnancy

avoided

soft cheese should be __ during pregnancy

avoided

Refrigerated pate or meat spreads should be __ during pregnancy

avoided

Refrigerated smoked seafood should be __ during pregnancy

avoided

Refrigerated smoked seafood should be __ during pregnancy

avoided

artificial sweeteners should be __ during pregnancy

avoided

 shrimp, canned light tuna, salmon, pollock, catfish, tilapia, cod should be __ during pregnancy

eaten

Peanuts, almonds, sunflower seeds, broccoli, salmon, kale, and molasses all include __

calcium

Lactose free dairy products or calcium enriched orange juice or soy milk should be given as a Ca replacement for __

lactose intolerance

__: omit red meat, fish, and poultry but eat eggs, milk, and dairy products along with plant-based foods.

Lacto-ovo-vegetarians