NSG 170 reproduction

15/15 rule

15 beats with 15 seconds of fetal movement

multipara may feel movement by which week of pregnancy?

16th week

full term pregnancy

37-42 weeks (average is 40 weeks); before 37 weeks is considered premature

embryonic stage

3rd to 8th week after conception, all major body organs are completed (simple)

Chadwick's sign

Bluish purple discoloration of the cervix, vagina, and labia during pregnancy as a result of increased vascular congestion.

A (abortions)

Number of terminated pregnancies, spontaneous or induced (elective/spontaneous)

Down Syndrome

Trisomy 21

linea nigra

a dark line appearing on the abdomen and extending from the pubis toward the umbilicus

estrogen

causes uterus to increase in size and weight, expands blood supply, aids in developing ductal system in breasts, associated with hyperpigmentation and skin changes, increased activity of salivary glands, hyperemia of gums and nasal mucosa membranes

ovulation medication

clomid (clomiphine)

Goodell's sign

softening of the cervix

diagnostic testing for pregnancy

CBC, blood type, Rh factor, rubella titer, screen for STI, glucose tolerance test, triple or quad screen (MSAFP, hCG, Estriol, inhibin A)

Increased AFP

neural tube defect incorrect dating of pregnancy

the primigravida would be taught by the nurse to anticipate quickening in which week of pregnancy? 24th week 20th week 16th week 12th week

20th week

surfactant is produced around week

24

Which test would be used to determine fetal lung maturity in a client in preterm labor?

Amniocentesis (2:1 lecithin to sphingomyelin); 14 weeks gestation

decreased AFP

Down syndrome trisomy 18 (edwards syndrome)

chorionic villa

Fetal portion of the placenta, smooth, glistening

Fertilization

Fusion of an egg and sperm cell where parents DNA merges

all women of childbearing age are advised to include at least 400 micrograms of folic acid in the daily diet to lessen the risk of neural tube defects in pregnancy. What should the nurse recommend to meet the recommendation? Vitamin A Vitamin B6 Vitamin B9 Vitamin B12 Legumes, dark-green leafy vegetables, and citrus fruits Eggs, meat, and poultry

Vitamin B9 legumes, dark-green leafy vegetables, citrus fruits

Hegar's sign

softening of the lower uterine segment

P (preterm births)

- number of deliveries between 20-36 weeks

single gene abnormalities

-A person affected with an autosomal dominant disorder has a 50 % chance of transmitting the disorder -parents who carry same abnormal autosomal recessive gene have a 25% chance affected with disorder -One copy of an abnormal X-linked recessive gene is enough to produce the disorder in a male.

IVF (in vitro fertilization)

-LH and FSH are injected into the woman to stimulate multiple egg releases from the ovaries. -eggs are taken from the ovaries and fertilizaed with sperm in a petri dish.

transabdominal ultrasound

done during 2nd-3rd trimester

progesterone

hormone of pregnancy, maintains pregnancy, prepares breasts for lactation, relaxes smooth muscles, facilitates deposits of maternal fat stores which provide reserve energy for pregnancy and lactation

On her first prenatal visit, the client informs the nurse that her last period started on June 10th. Which is her expected date of birth, according to Naegele's rule?

march 17th

decidua basalis

maternal portion of placenta, beefy

L (living children)

number of children currently living

Cholasma (melasma)

brownish blotches develop on face

growth and development

cephalocaudal (head to toe), central to peripheral (center outward), simple to complex (cells), general to specific (extremities)

Which changes would the nurse explain result from melanocyte-stimulating hormone?

chloasma linea nigra

Which prenatal test provides the earliest diagnosis of fetal defects?

chorionic villus sampling (10-12 weeks gestation)

Which medication will the nurse administer to trigger ovulation? tolvaptan clomiphene conivaptan metyrapone

clomiphene (clomid)

fetal demise, neural tube defects, and esophageal obstruction

consequences of increased levels of alpha-fetoprotein

Lanugo

fine downy hair of newborn infant

Braxton Hicks contractions

intermittent painless uterine contractions that occur with increasing frequency as the pregnancy progresses

elevated blood pressure with presence of protein in the urine indicates what...

preeclampsia

Gemetogenesis

production of gametes (reproductive cells)

how would the nurse explain a contraction stress test result interpreted as negative in a client at 41 weeks gestation?

the fetus at this time is likely to tolerate the stress of labor; adequate placental support

T (term births)

the number of pregnancies ending >37 weeks' gestation, at term

Reproductive Anatomy of the Female

vagina, uterus, uterine tubes, cervix, ovaries

referral to genetic counselor

35 or older, men who father children after 40, carriers of autosomal recessive disorders, women who are carriers of x-linked disorders, family hx, multiple spontaneous disorders, teratogen exposure, other abnormalities

Clomid/clomiphene

Stimulates ovulation by increasing the production of gonadotropin releasing hormone which increases the release of LH/FSH

during a prenatal education class, the nurse discusses the importance of fetal movement awareness. Why is this an important concept to teach?

a decrease in the fetal movement necessitates an evaluation of fetal well-being

Vernix

a greasy deposit covering the skin of a baby at birth.

assisted reproductive technology (ART)

any infertility treatment in which the egg is fertilized outside the womb

triple or quad screen

done at 16 to 18 weeks, chromosomal abnormalities using maternal serum, trisomy 18 and 21, invasive

which factor indicates that an amniocentesis may be indicated?

family history of genetic abnormalities

G (gravida)

number of pregnancies

Reproductive Anatomy of the male

penis, seminal vesicles, prostate gland, vas deferens, epididymis, testes

The nurse anticipates that a child born with a missing chromosome is most likely to have which condition? cretinism Phenylketonuria down syndrome turner syndrome

turner syndrome (missing X chromosome; XO instead of XX)

best location for implantation

upper uterus (fundus)

fundal height should grow one centimeter per week

ex. 15 cm = 15 weeks 37 cm = 37 weeks

primigravida

first pregnancy

Ultrasound

presence and location of pregnancy, multifetal gestation, gestational age, viability confirmation, fetal/placental abnormalities

Implantation

process in which the blastocyst attaches to the wall of the uterus

which description explains striae gravidarum encountered in a client in her 26th week of gestation?

reddish streaks on the abdomen and breasts

Ovulation

release of the mature ovum from the ovary; occurs about 14 days before next period

a 41 year old woman is being seen for an initial visit in the infertility clinic after 3 years of trying to become pregnant. Which test or treatment would the nurse advise her would be done first? laparoscopy start fertility medication hysteroscopy semen analysis

semen analysis

The nurse is assessing a pregnant client during the third trimester. Which clinical finding is expected in the later stages of pregnancy? tachycardia dyspnea at rest Progressive dependent edema shortness of breath on exertion

shortness of breath on exertion

diabetic mothers with advanced vascular and renal disease may give birth to infants....

smaller for gestational age

Naegeles rule of EDD

subtract 3 months from LMP and add 7 days

A nonstress test evaluates the condition of the fetus by comparing the fetal heart rate with which factor?

fetal movement

Lightening occurs when

fetus's head drops low into the uterus; third trimester

Pre-embyronic period

first 2 weeks after conception, fertilization to implementation, zygotic phase

fetal stage

from 9 weeks after conception till birth, growth and refinement in structure and function of all organs

a primigravida, unsure of the date of her last menstrual period, is told by the nurse that she appears to be 22 weeks gestation. Which data support this conclusion? fundus is just above the umbilicus fundus just about the symphysis fundal height is 13 in (33 cm) fundal height is 14 in (36 cm)

fundus is just above the umbilicus

side effects of clomid

Mood swings, psychological / emotional side effects. Hot flashes. Abdominal discomfort. Visual disturbances. Ovarian cyst formation. Nausea. Thinning of the uterine endometrial lining. multiples

An increase in which factor causes urinary frequency in the first trimester?

hormones and bladder pressure from the enlarged uterus

at risk: adolscents

impaired nutrition, anemia, infection, depression, social isolation, preeclampsia, cephalopelvic disproportion, premature birth, c-section

Which direction would the nurse give a client in preparation for untrasonography at the end of her first trimester?

increase fluid intake for 1 hour before the procedure

What information about nausea and vomiting in the first trimester would the nurse provide to the pregnant client?

it may be related to an increased human chorionic gonadotropin levels (hCG)

With which problem is a low maternal serum alpha-fetoprotein associated? fetal demise down syndrome neural tube defects esophageal obstruction

down syndrome

factors contributing to male infertility

abnormalities in sperm, erections, ejaculation, seminal fluid

Which term is used to indicate an absence of menstruation?

amenorrhea

Which are presumptive signs of pregnancy that the nurse would expect when assessing a client at 10 weeks gestation? amenorrhea breast changes urinary frequency abdominal enlargement positive urine pregnancy test

amenorrhea breast changes urinary frequency

amniocentesis

aspiration of a small amount of amniotic fluid for analysis of possible fetal abnormalities 2nd trimester (15-20 weeks): chromosomal or biochemical abnormalities (neural tube defects) 3rd trimester: determine fetal lung maturity or hemolytic disease risk for fetal demise if done early

Phenylketonuria (PKU)

autosomal recessive single-gene disorder; infant lacks a liver enzyme

Which iron-rich foods would the nurse encourage the client with mild anemia in early pregnancy to eat? dark leafy green vegetables legumes dried fruits yogurt ground beef patty

dark leafy green vegetables legumes dried fruits ground beef patty

the nurse instructs a pregnant woman in labor that she must avoid lying on her back. What is the primary reason for this instruction?

decreased placental perfusion is seen in the supine position

Contraction Stress Test (CST)

determines baby's ability to handle contractions during birth; usually done after non-stress test; risk for preterm labor/membrane rupture

factors contributing to female infertility

disorders in ovulation, abnormalities of fallopian tubes or cervix, repeated pregnancy loss, abnormalities in fetal chromosomes, endocrine abnormalities, immunologic factors, environmental agents or infections

chorionic villus sampling (CVS)

done between 10-13 weeks; chromosomal/metabolic abnormalities; transvaginally or transabdominally, risk for fetal demise

Non-stress test

done during 3rd trimester; 15 beats for 15 seconds for 20 minutes, increased fetal heart rate with fetal movement means a well-oxygenated fetus

transvaginal ultrasound

done during first trimester

Biophysical Profile (BPP)

done in the 3rd trimester; ultrasound and non-stress test

decreased estriol, increased hCG/inhibin A

down syndrome

Which would the nurse expect the size of a newborn to be if the mother had inadequately controlled type 1 diabetes during her pregnancy? average for gestational age, term small for gestational age, preterm large for gestational age, postterm large for gestational age, near term

large for gestational age, near term

which is a consequence on the neonate of maternal smoking during pregnancy? low birth weight facial abnormalities chronic lung problems hyperglycemic reactions

low birth weight (small for gestational age)