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NURS 376 (2025) EXAM 1 Questions with
Correct and Accredited Answers 100% Accurate
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infertility definition
- a woman 34 or < has not conceived in 12 mo. (35 >6mo) of actively attempting pregnancy treatment options for infertility (4)
- medications
- surgical procedures
- therapeutic insemination
- assisted reproductive technologies Gamete intrafallopian transfer (GIFT) 3 to 5 oocytes are harvested from the ovary and placed in a catheter with washed motile partner or donor sperm; then injected into ends of the fallopian tube - fertilization occurs in the fallopian tube, NOT outside the womans body
Zygote intrafallopian transfer (ZIFT) following ovulation induction, retrieved oocytes are fertilized outside the womans body and the zygotes are placed in the fallopian tube In Vitro Fertilization (IVF) Retrieval of the oocytes from the ovaries, then combined with partner or donor sperm in the lab - after fertilized embryos are placed in the uterus major functions of the placenta (4)
- oxygenation
- nutrition
- waste elimination
- secretion of hormones four major hormones secreted by the placenta hCG hPL progesterone estrogen
the umbilical cord attaches from the yolk sac to the _____________ and contains blood vessels that connect to the ______________ embryo, chorionic villi how many veins and arteries make up the umbilical cord? 2 arteries and 1 vein maternal blood flows through the umbilical _______________to the placenta. blood returns through the umbilical ______________ and into fetal circulation arteries, vein fundus of the uterus top, uppermost portion body of uterus middle, main portion cervix opening ("os") of the uterus into the vagina
perimetirum outer layer of the uterine body myometrium middle layer of the uterine body (contains tri-directional muscle layers which facilitate uterine contractions) endometrium the inner most layer of the uterine body what is the purpose of the pelvis? to support and protect pelvic contents and to form a relatively fixed axis for birth passage where does fertilization occur in the ampulla of the fallopian tube
- protects against injury
- symmetrical fetal growth
- aids in musculokeletal development, freedom of movment
- prevents adherence of amnion to fetus
- essential for normal fetal lung development pre embryonic stage the first 2 weeks of development after conception pre-embryonic stage changes (3)
- rapid cellular multiplication
- cell differentiation
- establishment of embryonic membranes embryonic stage 3rd-8th weeks following pre-embryonic stage embryonic stage changes (3)
- cleavage of the zygote
- blastogenesis (early development and formation of germ layers to develop into tissues and organs later)
- early development of major systems fetal stage 9th-40 weeks fetal stage changes (2)
- rapid body growth
- differentiation of tissues, organs and systems what is a teratogen any factor which may cause an adverse effect to the embryo or developing fetus which developmental stage of baby do teratogens pose the greatest risk? embryonic stage - because of organogenesis, rapid growth and differentiation teratogen effects of alcohol
- current recomendatin of no alcohol during pregnancy
- fetal death, intrauterine growth restriction, perinatal asphyxia, prematurity, intellectual impairment, infection teratogen effects of marijuana
- active component passes through placenta and may remain in fetus up to 30 days
- CO levels 5x higher than cigarettes
- causes intrauterine growth restriction, negative neonatal neurobehaviors and negative cognitive/language development TORCH infections group of infections that can infect and have harm to the developing fetus Toxoplasmosis Other transplancental infections (varicella/zoster, hepatitis B, human parvovirus B19) Rubella Cytomegalovirus Toxoplasmosis acquired by eating raw or uncooked meat and contact with feces from an infected animal (usually cats) infection to fetus causes damage to eyes and brain or early in gestation fetal death
Varicella/Zoster virus (chickenpox) fetal/neonatal effects: skin lesions, ocular defects, limb and CNS abnormalities HIV
- transmitted transplacentally
- fetal effects include preterm birth, intrauterine growth restriction, and mortality Hepatitis B
- increased risk for stillbirth and preterm birth
- infants infected transplacentally, serum to serum, or after birth
- rate of transmission highest when mother contracts the virus immediately before birth Human parvovirus B
- effects to fetus include anemia, miscarriage, intrauterine growth restriction Syphilis
- fetal effects include stillbirth, IUGR, prematurity, anemia and bone lesions
- adequate treatment can prevent placental transfusion
- bluish/purple color change (Chadwick's sign)
- increased stimulation of cervical glandular tissue (mucus fills the endocervical canal called a mucus plug)
- cervical softening (Goodell's sign) what is the purpose of the mucus plug? to keep harmful agents out of the uterus hormone responsible for changes to cervix estrogen and progesterone changes to vagina during pregnancy (3)
- increased vaginal discharge call Leukorrhea
- increased glycogen levels: increased suseptibility to candida albicans
- the pH of the vaginal fluids become more acidic to control vaginal growth of pathogens hormones responsible for vagina changes estrogen and hPL
changes to breasts during pregnancy
- enlargement, fullness, tingling, sensitive
- melanotropin causes nipple to be tender and areola darkened
- as stretching occurs develop striae gravidarum
- premilk substance pre-colostrum secreted during 2nd trimester hormones responsible for changes to breasts estrogen and progesterone how much does blood volume increase during pregnancy 40 - 50% to perfuse the enlarging uterus and meet increased mother metabolic needs what happens to cardiac output during pregnancy? BP, and pulse? cardiac output increases (30-40%), BP is decreased and pulse is increased what happens to the number of RBCs during pregnancy number of RBCs increases (30%), necessary to transport additional oxygen
hypertrophy and hyperplasia of lung tissues, relaxation of bronchi, bronchioles, and alveoli - increases oxygen consumption 15-20% which hormones cause respiratory system changes estrogen and progesterone what changes occur with the GI system during pregnancy (2)
- inflammation of gums, excessive saliva production (ptyalism)
- smooth muscle relaxation of esophagus and intestines, slower movement of food and less efficient closure of stomach contests emptying which hormones cause GI changes during pregnancy hCG, progesterone, estrogen, increased blood supply, growing fetus changes to urinary system during pregnancy (4)
- bladder compressed by weight and growing size of fetus
- relaxation of urethra and sphincter muscles
- stagnation of urine flow
- GFR increase up to 50%, greatly increased load of glucose to the renal tubules
which hormones cause the urinary system changes during pregnancy progesterone, estrogen hPL what causes diastasis recti? increasing growth of fetus creates pressure on the weakened abdominal wall what creates lumbar lordosis shifting weight of the uterus upward and outward affecting the spine what happens to the ligaments during pregnancy laxity of ligaments and unsteady gait hormones causing musculoskeletal changes progesterone, relaxin, growth of fetus where to pigmentation changes in the skin occur? nipples, areola, axxillae, vulvar area, perineum
wants child, tired of being pregnant, increased vulnerability, more dependent on partner acceptance of infant first trimester seeks acceptance of the baby in self and others, positive responses from others is important reassurance acceptance of infant second trimester relate to fetus as family member, acceptance by mother very important, increased closeness with own mother, grandmothers reaction important acceptance of infant third trimester important to develop an unconditional acceptance of the infant or she/others may reject the infant for not meeting expectation reordering relationships first trimester examine what must be given up, grieve loss of carefree life reordering relationships second trimester identifies with the infant, reflective of life, things to give up/changes to be made, grief the loss of her current lifestyle
reordering relationships third trimester makes plans for life with the new baby, may have doubts about her ability to be a good mother, support from others is valuable ensuring safe passage first trimester primarily focuses on self needs not fetus, dealing with discomforts ensuring safe passage second trimester focuses on fetus, conceptualized as separate being, values relationship with own mother ensuring safe passage third trimester focuses on fetus, conceptualized as separate being, experience anticipation with impeding labor, yet prepares for labor paternal "observer" quiet, passive, more detached
