NUR 322 exam 1
Terms
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- The production of what is crucial to keeping the lungs expanded during expiration by reducing alveolar surface tension
- surfactant
- What are normal respiration rates for newborns?
- 30-60 bpm
- What is the normal heart rate for a newborn?
- 120-160bpm
- What is the difference between HbF (fetal hemoglobin) and HbA (adult hemoglobin)?
- HbF holds oxygen more efficiently but releases it to the body tissues at low PO2 levels
- The newborn is considered to have establishhed thermoregulation when ___
- oxygen consumption and metabolic activity are minimal
- What is the primary source of heat in the cold-stressed newborn?
- brown adipose tissue
- When should BGLs reach a steady state
- By 3 hours of age
- Most newborns void and pass stool by when
- 48 hours after birth
- Why does the second period of reactivity require close monitoring by the nurse?
- apnea, decreased heart rate, regurgitation, and choking are likely to occur
- What is important about the first period of reactivity?
- The newborn is alert and hungry, making this a good opportunity to promote attachment
- What is the normal blood pressure for a newborn?
- 72/47
- Once the infant has been dried after birth, the highest losses of heat generally result from
- radiation and convection
- What is a normal temperature for a newborn?
- 36.4- 37.2 C
- Commonly elicited newborn reflexes are ___
-
tonic neck
moro
grasping
rooting
sucking
blink - What is normal gestation?
- 38-42 weeks
- What is full term resting posture?
- hypertonic flexion of all extremities
- What is full term sole creases?
- deep creases from sole to heels
- What is full term brest tissue?
- 10mm.
- What is full term ear form and cartlige?
- incurving of the entire pinna, auricle returns quickly when it is pressed down
- Full term male genitals
- fully descended testes and scrotum covered by rugae
- Full term female genitals
- large labia majora that covers clitoris and labia minora
- Full term square window sign
- 0 degree angle
- Full term scarf sign
- elbow will not reach midline
- Full term ankle dorsiflexion
- 0 degree angle
- What is the normal range of newborn weight?
- 5 lb 8 oz- 8 lb 13 oz
- What is the normal range for newborn length?
- 48-52 cm
- What is the normal range for newborn head circumfrence?
- 32-37 cm
- What is the normal range for newborn chest circumfrence?
- 30-35 cm
- How do you calculate gestational age
- 1st day of last menstrual period
- What is the timing of an embryo? (most vulnerable to birth defects)
- 15 days- end of week 8
- Where does fertilization normally occur
- ampulla (outer third of the fallopian tube)
- What is nidation?
- when the trophoblast attaches to the uterine wall
- When does the fetal heart begin to beat?
- 4 weeks
- When can you first hear the fetal heart beat with a doppler?
- 8-12 weeks
- When do women start to feel quickening?
- 20 weeks
- When can fetal respiratory movements begin to be seen on ultrasound?
- 28 weeks
- When is there suffiecient lung development for easy transition to extrauterine life?
- 38 weeks
- When do the eyes begin to open?
- 28 weeks
- When does placental circulation begin
- 3 weeks
- When do breasts start producing colostrum
- 12th week
- increased or decreased respiratory volume during pregnancy
- increased
- increased or decreased airway resistance during pregnancy
- decreased
- increased or decreased blood volume during pregnancy?
- increased
- increased or decreased hemoglobin during pregancy?
- may slightly decrease
- Increased or decreased hct during pregnancy
- decreased
- increased or decreased pulmonary and peripheral vascular resistance?
- decreased
- increased or decreased cardiac output during pregnancy
- increased
- increased or decreased pulse in pregnancy
- increased 10-15 beats
- increased or decreased BP during pregnancy
- slight decrease
- increased or decreased clotting factors during pregnancy
- increased
- increased or decreased leukocytes during pregnancy
- increased
- increased or decreased gastric emptying during pregnancy
- decreased
- increased or decreased GFR during pregnancy
- increased
- increased or decreased BUN during pregnancy
- decreased
- increased or decreased serum creatinine during pregnancy
- decreased
- increased or decreased intraoccular pressure during pregnancy
- decreased
- increased or decreased RBC production during pregnancy
- increased
- increased or decreased T4 during pregnancy
- increased
- oncreased or decreased TSH during pregnancy
- decreased
- increased or decreased BMR during pregnancy
- increased
- increased or decreased parathyroid hormone during pregnancy
- increased
- GTPAL stands for
-
Gravida
Term deliveries
Premature deliveries
Abortions
Living children - Calculation of EDC
- first day of LMP minus 3 months plus 7 days
- McDonalds method for calculating gestation
- measure from symphasis pubis to top of fundus in cm.
- Must have a full bladder to raise the uterus during___
- transabdominal ultrasound
- A diagnostic procedure that uses high-frequency sound waves to produce an image based on the density of the structure
- ultrasound
- Aspiration of a small amount of amniotic fluid obtained via a sterile needle inserted through the abdominal wall into the uterine cavity
- amniocentesis
- When is amniocentesis performed for genetic testing?
- 15-20 weeks
- When is amniocentesis performed for fetal lung maturity?
- 30-35 weeks
- Taking sample tissue from chorionic villi at edge of the developing placenta
- chorionic villus sampling
- What is chorionic villus sampling for?
- to detect genetic, metabolic, and DNA abnormalities
- What is amniocentesis for?
- for genetic testing or assess fetal lung maturity
- What is alpha-fetoprotein
- tests for neural tube defects
- What is the most common serious birth defect in the US?
- neural tube defect
- What are the parts of the "triple check"
- AFP, hCG, urine estriol
- What is the "triple check for"
- to check for neural tube defects, trisomy 21 and trisomy 18
- what is considered moderate variability during FHR monitoring
- 6-25 bpm
- What do you do if you see decels on the FHR trace?
-
LIONS
lay mom on Left side
IV fluids
Oxygen 8-10 liters/min.
Notify physician
Stop labor stimulating meds - What is IV oxytocin in lactated Ringers used for
- Contraction stress test
- What is a positive interpretation of a contraction stress test?
- late decels observed with more than 50% of contractions
- Goal of a contraction stress test
- to stimulate three contractions of 40 seconds duration in a 10 minute period
- Occurs when the largest diameter of the presenting part reaches or passes through the pelvic inlet
- engagement
- the relationship of fetal parts to one another
- attitude
- relationship of cephalocaudal axis of the fetus to the cephalocaudal axis of the mother
- lie
- What is a transverse lie?
- spines cross eachother
- refers to the relationship of the landmark on the presenting part to the four quadrants of the maternal pelvis
- position
- Less common positions
- RST and LAA
- Involuntary or primary powers
- uterine muscle contraction
- voluntary or secondary powers
- pushing with abdominal muscles
- refers to the relationship of the presenting part to an imaginary line drawn between the ischial spines of the mother's pelvis
- station
- "0" station
- ischial spines
- above the spine is __ station
- -1 to -5 cm
- below the spine is __ station
- +1- + 4cm
- Cervix becomes shorter and thinner until it is nondetectable
- cervical effacement
- signs of impending labor
-
lightening
braxton hicks contractions
cervical changes
blood show
loss of mucous plug
ROM
burst of energy - active phase of labor
-
6-7 cm dilation
ctx q 2-5 minutes lasting 40-60 seconds - What might the IUPC read during latent phase of labor
- 25-40
- What might the IUPC read during active phase of labor
- 50-70
- latent phase of labor
-
0-3 cm dilation
ctx q 3-30 minutes lasting 20-40 seconds - transition phase of labor
-
8-10 cm dilation
ctx q 1 1/2-2 minutes lasting 60-90 seconds - What might the IUPC read during transition phase of labor
- 70-90
- second stage of labor
-
10 cm until birth of baby
ctx q 1 1.2 min. lasting 60-90 seconds - What might the IUPC read during second stage of labor
- 70-100
- third stage of labor
-
birth of the baby until birth of placenta
5-30 minutes - presumptive, probable or positive sign of pregnancy: amenorrhea
- presumptive
- presumptive, probable or positive sign of pregnancy: N/V
- presumptive
- presumptive, probable or positive sign of pregnancy: fatigue
- presumptive
- presumptive, probable or positive sign of pregnancy:urinary frequency
- presumptive
- presumptive, probable or positive sign of pregnancy: breast changes
- presumptive
- presumptive, probable or positive sign of pregnancy: quickening
- presumptive
- presumptive, probable or positive sign of pregnancy: Goodell's sign
- probable
- presumptive, probable or positive sign of pregnancy: Chadwick's sign
- probable
- presumptive, probable or positive sign of pregnancy: Hegar's sign
- probable
- sift isthmus us called
- Hegars sign
- when body of uterus flexes against cervix
- McDonalds sign
- presumptive, probable or positive sign of pregnancy: uterine enlargement
- probable
- presumptive, probable or positive sign of pregnancy: Braxton-hicks contractions
- probable
- presumptive, probable or positive sign of pregnancy: Uterine souffle
- probable
- presumptive, probable or positive sign of pregnancy: skin changes
- probable
- presumptive, probable or positive sign of pregnancy: ballottable head
- probable
- presumptive, probable or positive sign of pregnancy: positive pregnancy test
- probable
- presumptive, probable or positive sign of pregnancy: fetal heart tones
- positive
- presumptive, probable or positive sign of pregnancy: fetal movement felt by examiner
- positive
- presumptive, probable or positive sign of pregnancy: visualization of fetus via ultrasound
- positive
- increased or decreased fluids and electrolytes during pregnancy
- decreased
- increased or decreased serum lactate levels during pregnancy
- increased
- increased or decreased respiratory rate during pregnancy
- increased
- increased or decreased CO2 levels during pregnancy
- increased
- increased or decreased renin,plasma renin, and angiotensionogen during pregnancy
- increased
- increased or decreased WBC during pregnancy
- increased
- increased or decreased blood glucose during pregnancy
- decreased
- Pre regional anesthesia care
- bolus with 1000-1500 IV
- An encephalopathy caused by deposits of unconjugated bilirubin in the brain cells
- kernicterus
- It is normal to lose __ % of birth weight
- 10
- newborn immunological adaptations
- IgG and IgA
- deficiency of liver enzyme needed to convert the amino-acid phenylalinine to tyrosine; leads to brain damage
- phenylketonuria
- How often uterus contracts
- frequency
- strength of contraction
- quality
- length of time contraction lasts
- duration
- uterine relaxation between contractions
- resting tone
- If the uterus feels like your cheek:
- no contraction
- If the uterus feels like your nose:
- mild contraction
- If the uterus feels like your chin:
- moderate contractions
- If the uterus feels like your forhead:
- strong contraction
- Accelerations
- FHR increases at leadt 15 beats above the baseline and remains above the baseline for at least 15 seconds
- Early decels are caused by
- head compression
- how much does the FHR decelerate during early decels
- > 30 bpm
- Variable decelerations are caused by
- umbilical cord compression
- how much do variable decels decelerate to
- decrease of > 15 bpm lasting >15 seconds
- Late decelerations are caused by
- placental insufficiency
- how long are late decels
- gradual decrease > 30 seconds
- What are the nursing interventions for late decelerations
-
Stop pitocin
Lay on left side
Iv fluids
Oxygen 10l./min.
Notify physician - primitive eggs produced by the ovaries
- oocytes
- the production of eggs by the ovaries
- oogenesis
- male gametes produced by the testes
- spermatozoa
- the production of male gametes by the testes
- spermatogenesis
- What is gonadotropin-releasing hormone (GnRH)
- produced by the hypothalamus and transmitted to the pituitary where it causes the synthesis of FSH and LH
- What do FSH and LH do?
- stimulate increased secretions of estrogens and androgens and stimulate the process of spermatogenesis and maturation of the ova
- What do androgens and estrogens do?
- influence the development of secondary sex characteristics
- the femae external genitals
- vulva
- A muscular and membranous tube that connects the external genitals with the uterus
- vagina
- a hollow, muscular, thick-walled organ in which fertilized ovum is implanted and in which the developing fetus is nourished until birth
- uterus
- The uterine corpus is made up of three layers:
- perimetrium, myometrium, endometrium
- the "neck" between the external os and the body of the uterus. The lower end extends into the vagina
- cervix
- parts of the fallopian tubes
- isthmus, ampulla and fimbria
- parts of the uterus
- corpus, fundus, and cornua
- Where are the ischial spines located?
- at the junction of the ilium and the ischium
- What is the most common pelvic classification for women?
- gynecoid
- controls the development of secondary sex characteristics. Assists with maturation of ovarian follicles and cause the endometrial mucosa to proliferate following menstruation. Also increase the size of the uterus and libido
- estrogen
- decreases uterine motility and contractility , thereby preparing the uterus for implantation after the ovum is fertlized
- progesterone
- "hormone of pregnancy"
- progesterone
- essential to ovulation
- prostaglandins
- responsible for developmental of secondary male characteristics and certain behavioral patterns
- testosterone
- How many chromosomes do humans have?
-
46
22 pairs of autosomes and 1 pair of sex chromosomes - the process by which additional somatic body cells are formed. It provides growth and development of the organs and replacement of body cells
- mitosis
- the process by which gametes are formed; produces the haploid number of chromosomes
- meiosis
- Fertilization usually takes place in what part of the fallopian tube?
- ampulla
- the removal of the plasma membrane, which exposes the acrosomal covering of the sperm head
- capacitation
- the deposit of hyaluronidase in the corona radiate, which allows the sperm head to penetrate the ovum
- acrosomal reaction
- What must occur for the sperm to fertilize the ovum
- capacitation and acrosomal reaction
- ___ twins arise from two seperate ova fertilized by two seperate spermatozoa
- dizygotic
- ___ twins develop from a single ovum fertilized by a single spermatozoa
- monozygotic
- a specialized connective tissue that prevents compression of the umbilical cord
- Whartons jelly
- What is the diagonal conjugate?
- the distance from the lower posterior border of the symphysis pubis to the sacral promotory
- How is the obstetrical conjugate established?
- by subtracting 1.5- 2 cm form the length of the diagonal conjugate
- Substances that adversely affect the normal growth and development of the fetus
- teratogenic substances
- the outer two thirds of the fallopian tube; fertilization of the ovum by a spermatozoon usually occurs here
- ampulla
- pigmented ring surrounding the nipple of the breast
- areola
- mammary glands
- breasts
- the true conjugate, which extends from the middle of the sacral promotory to the middle of the pubic crest
- conjugate vera
- the elongated portions of the uterus where the fallopian tubes open
- cornua
- the upper two thirds of the uterus
- corpus
- the fringlike extremity of the fallopian tubes
- fimbria
- a small yellow body that develops within a ruptured ovarian follicle; if pregnancy occurs it continues to produce progesterone until the placenta takes over
- corpus luteum
- the upper portion of the uterus between the fallopian tubes
- fundus
- a hormone produced by the chorionic villi and found in the urine of pregnant women
- hCG
- upper border of the true pelvis
- pelvic inlet
- lower body of the true pelvis
- pelvic outlet
- a fertilized egg
- zygote
- violet bluish color of the vaginal mucous membrane caused by increased vascularity
- Chadwicks sign
- brownish pigmentation over the bridge of the nose and the cheeks during pregnancy
- chloasma
- secretion of the breast before the onset of true lactation; it is high in protein content, provides some immune properties, and cleanses the newborn's intestinal tract of mucus and meconium
- colostrum
- softening of the cervix
- Goodell's sign
- the line of darker pigmentation exending form the umbilicus to the pubis noted in some women during the later months of pregnancy
- linea nigra
- a collection of thick mucus that blocks the cervical canal during pregnancy
- mucous plug
- What is the reason for the physiologic anemia of pregnancy
- because during pregnancy the plasma volume increases more than the erythrocytes increase
- stretch marks
- straie gravidarum
- Why do women experience supine hypotensive syndrome
- the uterus outs pressure on the vena cava
- measures fetal heart rate during fetal activity
- nonstress test
- provides a method for observing the response of the fhr to the stress of the uterine contractions
- contraction stress test
- What five variables does the biophysical test?
- breathing movements, body movemnt, tone, amniotic fluid, and FHR reactivity
- a cone-shaped indentation in the cervical os which is commone in cases of cervical incompetence
- cervical funneling