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reproduction 1 test 1 Questions With
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what are some things we teach patients about baby? correct answer: cord care, circumcision care, safe to sleep on back prevent of abduction and care safety, infection prevention and bonding physiological changes occur when? what about psychological change? physiological changes? correct answer: gradually; changes occur in response to the physiological changes as well to the increased responsibility associated with childbirth; are temporary and simply an extension of normal physiology with confirmation of the diagnosis, the mother can experiences feelings that are what? correct answer: either good or bad, depending on the circumstances what diagnosis is important, especially if the mother is considering terminating the pregnancy correct answer: early what vital sign can change until after delivery? correct answer: temperature what is the shape and size of the uterus before pregnancy? correct answer: shape of a pear and 10ml capacity, weight 50- 70 grams (2.5 oz)
what is the size and capacity of the uterus during pregnancy? correct answer: 5000ml and weights 2.4-2.6 lbs or 1100- grams why does the uterus grow in size during pregnancy? correct answer: bc of the development of new fibre elastic tissue between bands helps with growth. cells increase in size related to estrogen and the growing fetus is the pattern of growth predictable? correct answer: yes; lightening occurs when the fetal presenting part descends into the pelvis in preparation for labor and reduces the pressure on the diaphragm is the fundal heigh predictable? correct answer: yes; distance from the symphysis to top of funds in cm equals the number of weeks from 16- fundal height: 12 weeks? correct answer: at the pubis symphasis fundal heigh at 20 weeks? correct answer: at the umbilicus fundal height at 40 weeks? correct answer: just below xiphoid process (2-3cm) when are Braxton hicks notable and then not noticeable? correct answer: not noticeable during 1 and 2 trimester but frequent in 3; for some clients they are uncomfortable and may be mistaken for real labor
what are some breast changes when pregnant? correct answer: increase size and vascularity- warm, tense and tender, increased pigmentation of the nipple and areola, a secondary areola may appear (light pigmentation around the 1st areola), Montgomery tubercles appear on areola (dilated sebaceous glands) and colostrum like fluid is expressed at the end of the 3rd month these breast changes are because of what hormones? correct answer: increased estrogen and progesterone- estrogen stimulate mammary gland growth and progesterone grows alveoli and lobes when can u usually feel the funds? correct answer: 20 weeks the ovaries secrete progesterone then what happens? correct answer: secrets it for first 6-7 weeks then corpus luteum secrets progesterone then finally the placenta ovulation ceases due to high progesterone and estrogen levels which inhibit what? correct answer: the release of FSH what happens to the heart during pregnancy in regards to sounds and size? correct answer: myocardia enlarges bc of work load, its pushed up and toward the left bc the uterus elevates the diaphragm during third trimester; sounds-things can be heard between 12-20 weeks and regress 1 week after birth- u can hear a split of the 1st and 3rd sound or systolic murmer what is bloody show? correct answer: It is a small amount of blood at the vagina that appears at the beginning of labor and
may include a plug of pink-tinged mucus that is discharged when the cervix begins to dilate. what happened in regard to blood volume with the heart? correct answer: TBV increased by 45%; plasma is increased by 40-60% from pre pregnancy values and peaks at 32 weeks; this is bc it transports nutrients and 02 to the placenta and fetus, assists in meeting demands of expanded maternal tissue and provides a reserve to compensate for the blood loss during childhood what about the RBC, WBS and cardiac output as a result of pregnancy? correct answer: RBC- increase by 20-30 precent, wbc- 5000-15000 during pregnancy or even 25000 during labor cardiac output- bc of higher blood volume- it increased CO by 50% and heart rate by 15-20 bpm hematocrit and hemoglobin decrease due to dilution of the red blood cells by the increase in plasma volume. correct answer: Physiologic anemia- is diagnosed when the Hgb is ≤11g/Dl. Supplememt with iron correct answer: Iron deficiency anemia- when it comes to peripheral vascular resistance what happens with pregnancy? correct answer: low pvr related to vessel wall relaxation bc of progesterone and greater circulating area related to uteroplacental unit, and high prostaglandins This decrease in PVR is actually a compensatory mechanism for the increased blood volume and is why not all pregnant women develop pre-
what hormonal changes does the respiratory system make? correct answer: progesterone decreases air way resistance bc the smooth muscles relax, and estrogen causes increase vascularity of mucus membrane which causes engorded capillaries which leads to edema of the sinuses and epistaxis (nose bleed) why physical changes does the respiratory system make? correct answer: diaphragm is elevated bc of increased tidal volume (amount of air moving in or out of lungs); total lung capacity is decreased by 5% and the chest circumference can expand laterally as much as 6 cm what changes in regards to pco2? correct answer: PCO2 levels are also affected. Progesterone signals the hypothalamus to reset the PCO2 levels. These lower levels allow for the CO2 to cross the placenta from the fetus to the mom for excretion. non- pregnant PCO2 level is 40mmHg pregnant- PCO2 level is 32mmHg why does pco2 level decrease when pregnant? correct answer: it allows us to get rid of baby waste material what happens to the gi tract during pregnancy? correct answer: increased estrogen causes hyperemia (bleeding gums), increased salivation (ptyalism), bc of the reduced muscle tone it causes heartburn, the increased progesterone relaxes all smooth muscles, decrease tone and motility, and bc of decreased motility can lead to hemorrhoids, and constipation; also the liver and gallbladder become hypotonic and causes prolonged emptying leading to gallstones
what happened to the bladder during pregnancy? correct answer: frequency and urgency related from pressure from the uterus and noctoria is common; what happens to the kidneys and ureter during pregnancy? correct answer: increased risk for UTI, higher blood flow 50- 80% and higher GFR bc of increased plasma volume and cardiac output, needed for excreting additional metabolic waste from fetus= ureters can increase in diameter and elongate bc of progesterone what is normal in relationn to glucosuria, proteinuria and BUN? correct answer: +1 is normal, trace protein is normal and bun is decreased what happened to mom skin during pregnancy? correct answer: bc of higher cirulation= high perspiration ; hyperpigmentation= chloasma, lines nigra, striae gravidarum and hair grows more rapidly with less hair loss "Mask of pregnancy", patchy tan to dark brown discoloration of the face and increased with sun exposure correct answer: chloasma dark pigmentation line from the symphysis to the top of the fundus correct answer: linea nigra stretch marks- appear red but will turn silver, never completely go away correct answer: striae gravidarum
Pituitary gland secretes what two hormones? correct answer: prolactin and oxytocin lactation correct answer: Prolactin- Stimulates milk ejection reflex; - stimulates uterine contractions correct answer: oxytocin ______ trimester: ↑glucose demand >↓maternal serum glucose > ↓maternal insulin production. _____ trimester- hormones reduce maternal tissue sensitivity to insulin>↑glucose> ↑maternal insulin production. correct answer: 1 AND SECOND ______ needs decrease during 1st trimester. The increased amount of glucose is being utilized by the fetus > maternal glucose levels drop correct answer: Insulin Maintains endometrial layer for implantation Smooth muscle relaxant Decreases bowel motility Dilation of the ureters Preparation for lactation Facilitates maternal deposits of fat stores correct answer: progesterone what else gets stronger bc of hormones? correct answer: nails does the need for fetal demands for calcium come from mom or no? correct answer: no
what hormones relax , joints and pelvis? correct answer: relaxin what hormone is responsible for hyperpigmentation? correct answer: estrogen why does the need for insulin decrease in first trimester? correct answer: bc baby uses lots of the glucose what feelings does mom have during first trimester? correct answer: uncertainty, ambivalence-mood swings or mixed feeling, self as a primary focus and how its going to change her or her life, they have fears- decisions that need to change and 50% of them are surprised their pregnant conflicting feelings; may be the wrong time, career issues have changes, how will the partner respond, what about the relationship they have with their own mother, they become introspective and passive with their major concern focus on themselves correct answer: first trimester ambivalence what feelings or things change in second trimester? correct answer: physical evidence of pregnancy, quickening or first baby movement, introspection, body image changes- feel self conscious, and change in sexuality- they get horny, and the accept the pregnancy usually once they can feel baby 12- weeks, Acceptance of the pregnancy usually occurs with _________. Once they feel the baby move, they begin to recognize the fetus as a separate individual. _______- continues as she begins to see
what are some maternal tasks? correct answer: seeking safe passage, securing acceptance , learning to give to self and committing self to unknown child Alter primary support groups tends to alter network to meet needs of pregnancy partner is most important. correct answer: Securing acceptance Seeks competent care looks for all available information observes others, engages in self care, more aware of environment correct answer: Seeking safe passage Begins to develop capacity for self denial and delayed gratification. Committing self to unknown child Realization of the fetus as a separate being forms a bond. Motivates her to become competent in her role. correct answer: Learning to give of self Realization of the fetus as a separate being forms a bond. Motivates her to become competent in her role. correct answer: Committing self to unknown child what are some things that happen to dad during pregnancy? correct answer: May be stressful. Must transition as well from non parent to parent. Most adapt well, but anxieties are usually missed parentally. They tend to be more observers once the pregnancy is diagnosed, because thee focus is on the mother and baby.
A lot of times they feel left out and confused about the massive mood swings. Also concerned about their ability to be a father. Role is still vague into the _____ trimester, but more involved. Can hear the heartbeat, feel the baby move. Will need to address any concerns with their own childhood: stress about their responsibilities, and changes in partners body image. In ______- trimester, attend classes, help prepare for baby and start to worry about the wellbeing of mom and baby. ________- unintentional development of physical symptoms of pregnancy by the partner. correct answer: 2 and 3rd; Couvade how might toddlers, school age and adolescent feel about the baby? correct answer: toddler have no sense of time so make sure the transitions are done in advance of the baby; school age kids see it as a family even so they might wanna attend classes or hear heartbeat and feel baby and then adolescents are embedded bc their parents has sex how might the grandparents feel? correct answer: depends on their age, number and spacing of the kid and perceptions of the role; if they're young they might not be ready to be a grandma vs older is or if its first grand baby vs third or their perception of the role like them reading their grandkids what things do we find out at a first prenatal visit? correct answer: Establishment of trusting relationship Focus on education for overall wellness Detection and prevention of potential problems Comprehensive health history, physical examination, and laboratory tests
- Signs: amenorrhea, breast changes & tenderness, nausea
- Symptoms: N/V, urinary freq, weight gain, fatigue, quickening (fetal movement) least reliable may be cause of something else Chadwick sign bc other things can cause vasularity what are probable causes of pregnancy? correct answer: objective indications that can be documented by an examiner, and may be cause by other conditions-pos preg test, Goodall or nagar sign, dr or nurse said what are positive pregnancy signs? correct answer: fetal movement, ultrasound-visual and hearing, delivery of baby number of times she pregnant correct answer: gravida the number of pregnancies past 20 weeks the women has delivered correct answer: para ___ (gravida): the current pregnancy ___(term births): the number of pregnancies ending >37 weeks' gestation, at term __ (preterm births): the number of preterm pregnancies ending
20 weeks or viability but before completion of 37 weeks ___(abortions): the number of pregnancies ending before 20 weeks or viability ___(living children): number of children currently living correct answer: G;T;P;A;L
during a physical exam what takes place? correct answer: vital signs for baseline and then head to toe (head and neck, chest, abdomen including fundal heigh is app, and extremities, heart tones, fetal movement what labs are usually drawn? correct answer: UA-protein, glucose, ketones and nitrites, CBC, blood type, RH, rubella times, hep b surface antigen, HIV AND RPR, cvervical smear, paps and GBS what are the visit schedules when pregnant to the dr? correct answer: every 4 weeks up to 28 weeks, then every 2 weeks from 29-36 then every week from 37 to birth what are bad sx? correct answer: Vaginal bleeding Rupture of membranes Edema in face and/or hands Continuous, pounding headache Visual disturbances Persistent or severe abdominal pain Chills or fever Painful urination Persistent vomiting Change in frequency or strength of fetal movements Many distinct cultures live within the US Each culture has its own health and healing belief system Many variations within each culture Must be careful not to ________
what is an initial newborn assessment? correct answer: Apgar, length and weight, vital signs and then gestational age assessment what do they do for gestational age assessment? correct answer: Physical maturity (skin texture, lanugo, plantar creases, breast tissue, eyes & ears, genitals) Neuromuscular maturity (posture, square window, arm recoil, popliteal angle, scarf sign, heel-to-ear) what is Apgar stand for? correct answer: Appearance- color Pulse- > 100 bpm Grimace-cried and pull away Activity- active movement Respirations- crying and breathing what are immediate newborn period care? correct answer: Maintaining airway patency Ensuring proper identification Administering prescribed medications Vitamin K Eye prophylaxis Hepatitis B Maintaining thermoregulation Immediately after birth, a newborn is suctioned to remove fluids and mucus from the mouth and nose. Typically, the newborn's mouth is suctioned _______ with a bulb syringe to remove debris and then the ______ is suctioned. Suctioning in this
manner helps to prevent aspiration of fluid into the lungs by an unexpected gasp. The newborn needs to dried off immediately to prevent what? correct answer: first; nose; heat loss. what are newborn VS? correct answer: 97.7-99.5; 110- BPM; 30-60 breaths- 50-75 systolic 30-45 diastolic What is cold stress? correct answer: heat loss through convection, conduction, evaporation and radiation Preterm or premature: prior to 37 weeks' gestation Term: 38 to 42 weeks' gestation Post-term or postdates: after week 42 gestation Post-mature: after week 42 gestation/placental aging Small for gestational age (SGA)- below 10th percentile Appropriate for gestational age (AGA)- between 10th-90th percentile Large for gestational age (LGA)- above the 90th percentile correct answer: Gestational age assessment is important because it allows the nurse to plot growth parameters and to anticipate problems related to prematurity, post maturity, and growth abnormalities. correct answer: First period of reactivity Birth to ____ minutes to ___ hours after birth Newborn is alert, moving, may appear hungry
