Maternity and Child Bearing Test #1

What is the largest transverse diameter?

the occipitomental diameter at 13.5cm

A pregnant woman's diet may not meet her increased need for folates. Which food is a rich source of this nutrient?

-green leafy vegetables -fortified cereals/grains -oranges -broccoli -asparagus -artichokes -liver

Possible cause of severe vomiting in early pregnancy

-hyperemesis gravidarum

Possible cause of epigastic pain in late pregnancy??

-hypertension, preeclampsia

Autosomal dominant genetics: describe? give an example

-Autosomal dominant is passed and shown with the passing of a single gene from one of the parents. -Huntington's disease, which if you carry the gene, you do have it!

What are the maternal Cardiovascular changes DURING labor? (3)

-Cardiac output increased 10% to 15% in first stage, 30% to 50% in second stage -HR increases slightly in first & second stages -BP increases during contractions and returns to baseline levels between contractions. Systolic values increase more than diastolic values

How do you Determine fetal position?

1. if the baby is on mom's right or left side. (R or L) 2. What is the presenting part? (occipital O, Sacrum S) 3. which direction is the fetal spine facing(back)? Posterior P, Anterior A, Transverse T

Secondary amenorrhea results from: (7)

1. lack of ovarian production 2. pregnancy 3. polycystic ovary syndrome 4. nutritional and endocrine disturbances 5. uncontrolled diabetes 6. heavy athletic activity 7. emotional distress

How does the zygote's amniotic fluid form? What is it made of?

-Derived by diffusion from maternal blood and increases weekly -It contains albumin, urea, uric acid, creatinine, sphingomyelin, lecithin, bilirubin, fructose, fate, leukocytes, proteins, epithelial cells, enzymes, lanugo hair, and fetal cells

47 y/o Sallie is interested in HRT for her hot flushes and vaginal dryness. She has high blood pressure and her LMP was 3 months ago. She asks the nurse what can she use? What is the nurse's best response?

- The nurse should explain that they will need to talk with the HCP about the proper treatment with HRT. It is beyond the nurse's scope of practice to tell the patient what HRT she should use.

What procedures require administration of RhoGAM to RH negative women post-procedure to prevent antibody formation?

- Truthfully, any procedure in which the infant blood could potentially come in contact with the mothers. 1. percutaneous umbilical blood sampling or fetal blood sampling (PUBS) 2. Amniocentesis 3. Chorionic villi samplic (CVS)

Autosomal Recessive genetics: describe give an example

- autosomal recessive is where two copies of a genetic abnormalities are required for the trait or gene to develop. (25% chance) -Cystic fibrosis

When does the human embryo become a fetus? How long will the fetal period last?

-Embryo becomes a fetus at 9 weeks gestation and stays a fetus till birth

The nurse should be aware of what important information regarding systemic analgesics administered during labor

- fetus/newborn can have decreased alertness, delayed sucking, respiratory depression, neurobehavioral changes for 2-3 days

What is the purpose of the prenatal test : 1hour GTT

- it is a prenatal 1 hour glucose tolerance test to screen for gestational diabetes

What happens to FSH during pregnancy?

- it remains decreased throughout pregnancy

X-linked recessive genetics: describe give an example

- mode of inheritance when the mutation in the gene is on the X chromosome. These are more often seen in males because they only have 1 X chromosome. It may not present in women, since they have two Xs. -Sickle Cell -Color blindness

A gravida, G4 P1203, fetal heart rate 150s, is 14 weeks pregnant, fundal height 1 cm above the symphysis. She denies experiencing quickening. Which of the following nursing conclusions made by the nurse is correct?

- the woman is experiencing a normal pregnancy

What is the purpose of the prenatal test: GBS

-Group B strep is tested to determine if prophylactic antibiotics are indicated during labor to not pass to baby.

Possible cause of Glycosuria?

-gestational diabetes

When does the zygote become an embryo? What is happening in this stage?

- the zygote becomes an embryo around the 4th week. -During this stage, cell differentiation is occuring. The Yolk Sac produces primary RBCs until liver can take over and becomes part of the umbilical cord during fetal development. The placenta completes formation at this point at week 4 and functions as a means of metabolic exchange between mother and embryo

WHat is melasma?

--blotchy, brownish hyperpigmentation of the skin over the cheeks, nose and forehead

How many chromosomes should the human sperm have?

-23 chromosomes -22 autosomes and 1 sex chromosome

How many chromosomes should the human egg have?

-23 chromosomes- -- made of 22 autosomes and 1 sex chromosome

How many sperm are usually present with each ejaculation? WHy so many?

- 200 to 500 million sperm with each ejaculation -There are so many because many can be significantly deformed

When does embryo's heart start to beat?

- 21 days after conception

What gestation (in weeks) is most critical for the development of the human embryo's organ systems and external features? Why?

- The embryonic stage, which represents 15 days to 8 weeks gestation. This is the period of cell differentiation and organ development. This time is the most vulnerable to teratogens

How/When/Where are human sperm formed in the man's body?

-How: FSH from the brain stimulates primary spermatocytes in the testes to undergo first meiotic division that results in secondary spermatocytes. Secondary meiosis results in 4 spermatids. Through a series of changes, spermatids lose cytoplasm and become sperm with tails When: during puberty Where: testes

How/When/where are human eggs formed in the woman's body?

-How: oocytes undergo primary meiotic division and remain suspended until puberty -When: During fetal life -Where: Ovary

What consists of the third stage of labor? describe

-It lasts from the time the baby is born until the placenta is delivered -The placenta usually separates with the 3rd or 4th strong uterine contraction after the infant has been born

What consists of the second stage of labor? describe

-It lasts from the time the cervix is fully dilated to the birth of the fetus -it has a latent phase (passive fetal descent) -it has an active pushing phase (urge to bear down

A pregnant woman's WBC result is 15,000mm3 . What is the nurse's action based on this result?

-Nurse should check differential since result is a normal finding for a pregnant woman.

Trina is 16 y/o and presents to the clinic with complaint of symptoms consistent with endometriosis. She does not want to get pregnant for several years. Which of the following treatments will the physician probably implement? WHY?

-OCPs (oral contraceptive pills -She would use these because she is a teenager, does not want to get pregnant, and these have relatively fewer side effects than other medication options.

Pulmonary changes during pregnancy include which of the following? -Respiratory rate -tidal volume -vital capacity -inspiratory capacity -expiratory reserve volume -total lung capacity -minute ventilation -oxygen consumption

-RR= unchanged or slightly increased -tidal volume= increased 33% -vital capacity= unchanged -inspiratory capacity= increased 6% -expiratory reserve volume= decreased 20% -total lung capacity= unchanged or slightly decreased -minute ventilation= increased 30% to 50% -oxygen consumption- increased 20% to 40%

What are some maternal physiologic respiratory changes seen DURING labor? (1)

-Respiratory rate increases -

A nurse working in a prenatal clinic is caring for a woman who asks advice on foods that are high in vitamin C because "I hate oranges." The nurse states that 1 cup of which of the following raw foods will meet the patient's daily vitamin C needs?

-Strawberries -melons -broccoli -tomato -peppers -raw, dark green leafy vegetables

What is an example of trisomy?

-Turner -Down Syndrome

What are other possible physiologic changes that are normal to see in the mother DURING labor? (4)

-WBC count increases -temperature may be slightly elevated -proteinuria may occur -Gastric motility and absorption of solid food are decreased; nausea and vomiting may occur -Blood glucose level deecreases

What is the ferguson reflex?

-When the mother gets the urge to bear down when stretch receptors in the posterior vagina cause release of endogenous oxytocin

Maternal nutritional status is an especially significant factor of the many that influence the outcome of pregnancy. Why is this the case?

-adequate nutrition is an important preventive measure for a variety of problems

At what gestation (weeks) are the human fetus's lungs mature enough for extra-uterine life (without support)? How do we know?

-at 36-40 weeks the lungs are mature enough for extra uterine life. -Lecithin-sphyngomyelin ratio refers to a component of surfactant and fetal mature is when L/S ratio is 2:1

When does the human zygote form and what processes take place during the zygotic period?

-at fertilization (day 1) -first mitotic cell division occurs 20 hours after fertilization creating a 2 cell zygote. Zygote moves down the tube to the uterus in 3-4 days. Cleavage begins after first division and rapid mitotic division occurs to form the morula (12-16 cell ball). As the morula enters the uterus, intracellular fluid separates the cells into trophoblasts in the outer layer and blastocytes in the inner layer. Blastocytes develop into the embryonic disc

Many clients are concerned about the increased levels of mercury in fish and may be reluctant to include this source of nutrients in their diet. What is the best advice for the nurse to provide

-avoid eating shark, swordfish, king mackerel, and tilefish. -check local advisories about local fish/waters (limit to 6oz a week) -12oz a week at most of commercially caught fish/shellfish like shrimp, salmon, pollock, catfish, and canned light tuna -limit albacore and white tuna and tuna steaks

54 y/o Janice has a history of blood clots in her legs when she used birth control pills. Her hot flushes are "driving me crazy". What alternative comfort measures might be appropriate for Janice?

-avoid triggers that bring about hot flushes -wear layered clothing -avoid heavy blankets at night pg 139

What consists of the 4th stage of labor? describe?

-begins with the delivery of the placenta and includes at least the first 2 hours after birth. This phase focuses on the woman's physical recovery from birth

S/S of infection in pregnancy (4)

-chills -fever -burning on urination -diarrhea

According to the CDC, all women under the age of 26 years old should be tested for what STD?

-chlamydia

A client states that she does not eat red meat. Which foods should the nurse encourage this woman to consume in greater amounts to increase her iron intake?

-dried fruits -liver -dark green leafy vegetables -whole grains/enriched breads or cereals -legumes

For severe morning sickness, what might the nurse advise to manage nausea and vomiting during pregnancy?

-eat small, frequent amounts of food -eat toast or potatoes (dry/starchy) -avoid drinking lots of fluids early in day/or when nauseated -avoid skipping meals and thus becoming extremely hungry as this can exacerbate nausea -move slowly -decrease intake of frid/fatty foods -keep well ventilated environment -eat foods served at cool temps and ones that give off little aroma -avoid spicy -avoid brushing teeth after eating -try ginger, herbal teas, lemon slice, salt/tart food -try lollipops -wear acupressure bands on the wrist -notify HCP if severe/weight loss occurs

A woman has requested an epidural block for her pain. She is 5 cm dilated and 100% effaced. The baby is in a vertex position and is engaged. The nurse increases the woman's IV fluid for a preprocedural bolus. Before the initiation of the epidural, the woman should be informed regarding the disadvantages of an epidural block. Which concerns should the nurse share with this client? (Select all that apply.) (10)

-hypotension -local anesthetic toxicity -fever -urinary retention -pruritus -limited movement -longer second stage labor -increased use of oxytocin -increased likelihood of forceps or vacuum birth -high or total spinal anesthesia

What is Chadwick's sign?

-increased vascularity which shows as violet/blue vaginal, mucosa and cervix- 16wks +

Spinal anesthesia (block

-injected through the third, forth, or fifth lumber interspace and mixes with CSF -mostly used for cesarian birth as it proved anesthesia form the nipple to the feet. Not suitable for labor.

epidural Where is the injection? -HOw effective?

-injection is made between the fourth and fifth lumbar vertebrae -Epidural anesthesia effectively relieves the pain caused by uterine contractions. For most women, however, it does not completely remove the pressure sensations that occur as the fetus descends into the pelvis

Which are symptoms that are characteristic of premenstrual syndrome (PMS)?

-irritable and moody a week before period is suppose to start

What consists of the first stage of labor? describe.

-is considered to last from the onset of regular uterine contractions to full effacement and dilation of the cervix -this is said to be longer than both the second and third stage combined

What processes occur after the human sperm penetrates the human egg's membrane?

-once the human sperm penetrates the human egg's membrane, both sperm and ovum are within one membrane and it becomes impenetrable to other sperm The 2 nuclei fuse, chromosomes combine (46) and conception is complete: the human zygote is created

An ultrasound of a fetus' heart shows that "normal fetal circulation is occurring." -What is happening with...heart and shunting? placenta? umbilical vein?umbilical arteries?

-oxygenated blood enters the fetal circulatory system via the umbilical vein -blood is seen moving from right to left atria via the foramen ovale, allowing for oxygenated blood to be shunted right to left -the umbilical arteries returns deoxygenated blood to the placenta

How does the placenta implant into the uterus? How does it form? What will it do for the human zygot? What does the umbilical cord do?

-placenta begins to form at implantation -the trophoblasts burrow into the endometrium -uterine capillaries are tapped by chorionic villa and endometrial spinal arteries fill with maternal blood that provide O2 and nutrients to the zygote/fetus and allow for removal of carbon dioxide and waste products from the zygote/fetus -15-20 cotyledons form to create a complex system of fetal blood vessels; the maternal-placental-embryonic circulation is in place by day 17.

What s/s should a woman immediately report to her health care provider?

-rupture of membranes -heartburn accompanied by severe headache -vaginal bleeding -severe vomiting -fever/chills -burning on urination -diarrhea -abdominal cramping -sudden discharge of fluid from vagina before 37 weeks -severe backache/ flank pain -change in fetal movements -uterine contractions -visual disturbances -swelling of face/fingers/ sacrum -muscular irritability/convulsions -epigastric/abdominal pain -glycosuria

What foods should you avoid during pregnancy to prevent listerosis?

-soft cheeses made from unpasteurized milk -raw cookie dough/cake batter -sushi -raw oysters -other raw or undercooked fish/seafood/meat -unpasteurized juice and cider (fresh squeezed) -raw or undercooked sprouts -raw egg -raw milk

What is the purpose of the prenatal test: Noninvasive prenatal screening test

-tests for cell-free fetal DNA in maternal blood

Why might it be more difficult to diagnose appendicitis during pregnancy?

-the appendix is displaced upward and laterally, high and to the right.

Who determines the sex of the fetus? What factor determines development of sex organs?

-the male (sperm) determines the sex of the fetus. -a gene called the Sex-Determining Region on the short arm of the Y chromosome activates expression of other genes and plays a major role in the development of the male sex organs; without it female sex organs develop

How to Dizygotic twins result?

-they result from release of two ovums from the ovary in one cycle and are fertilized by two different sperm.

When & Where does the human sperm meet the human egg for successful fertilization?

-usually 4-6 hours after ejaculation, the sperm meets the human egg for successful fertilization at the Ampulla of Fallopian Tube

S/S of preeclampsia or hypertensive condition during pregnancy (5)

-visual disturbances -swelling of face/fingers/sacrum -severe/frequent headaches -muscular irritability/convulsions -epigastric or abdominal pain (that feels like heartburn or severe stomach ache)

How many eggs are present at birth? At puberty? how many undergo ovulation?

-women are born with 2 million oocytes -300,000 to 400,000 left at puberty -only about 400 will undergo ovulation

What is the incidence of twinning?`

1 in 43 births

Goals for Healthy People 2020 for Maternity and Child-bearing

1) reduce the rate of fetal and infant deaths 2) reduce the rate of maternal mortality 3) reduce preterm births 4) reduce cesarean births among low risk women

What time gestation does implantation occur & establishing blood connection from mom?

1-14 days

Strategies for Care Delivery (6)

1. Break down the language barriers 2. Explain your rationale and reasons for suggestions 3. integrate folk and Western treatments 4. Enlist the family caretaker and others 5. Get consent from the CORRECT person 6. Provide language-appropriate material

On their way, sperm undergo 2 processes in preparation for fertilization 1. What are they?

1. Capacitation- which is removal of protective coating from the heads of the sperm 2. Acrosomal reaction- which is release of enzymes to break down outer layer of the egg

What is true regarding interpreter services?

1. Direct questions to the patient, not the interpreter 2. Create environment of respect and privacy

What are the top 5 causes of death in women in the U.S.?

1. Heart disease 2. malignant neoplasm (cancer) 3. Cardiovascular disease (stroke) 4. Chronic lower respiratory disease 5. Alzheimer's disease

Local Perineal infiltration Anesthesia 1. when used 2. what is it?

1. It is used post-birth for episiotomy or repairing of lacerations in women that do not have regional anesthesia. 2. It is a combo of lidocaine, chloroprocaine and epinephrine that is injected subcutaneously into the region to be anesthetized

What is effective treatment for dysmennorhea? (2)

1. Oral contraceptive pills 2. NSAIDs

Certain changes stimulate chemoreceptors in the aorta and carotid bodies to prepare the fetus for initiating respirations immediately after birth. These changes include: (6)

1. fetal lung lfuid is cleared from the air passages as the infant passes through the birth canal during labor and birth 2. fetal oxygen pressure decreases 3. Arterial carbon dioxide pressure increases 4. arterial pH decreases 5. Bicarbonate level decreases 6. Fetal respiratory movements decrease during labor

Once the placenta is implanted in the uterus, what 3 stages of development does the human zygot undergo? Define each. (3)

1. Pre-embryonic stage- conception to day 14 2. Embryonic stage- day 15 to 8 weeks; germ layers dividing 3. Fetus- 9 weeks to birth

Asian-American beliefs and practices with childbearing and parenting::::: 17)))))

1. Pregnancy is time when "there is happiness in the body" 2. natural process 3. want female health provider 4. Belief in theory of hot and cold 5. may omit soy sauce in diet to prevent dark-skinned baby 6. Prefer soup made with ginseng root as general strength tonic 7. Milk usually excluded from diet because it causes stomach distress 8. Inactivity or sleeping late may cause difficult birth 9. Labor in silence 10. Cesarean birth is not ideal, but will if necessary 11.Must protect self from cold forces 30 days postpartum 12. ambulation is limited postpartum 13. shower and bathing prohibited/ in warm room 14. Diet: warm fluid, sometimes vegetarians, seaweed soup with rice, lots of chinese hot foods. NO FRUITS AND VEGETABLES 15. birth of boy preferred 16. may delay naming child 17. Some groups believe colostrum is dirty; therefore, they may delay breastfeeding until milk comes in

African American beliefs and practices related to childbearing and parenting::::: 16))))

1. Pregnancy thought to be state of wellness 2. Old-wives tales: having a picture taken during pregnancy will cause stillbirth/ reaching up will cause cord to strangle baby 3. Cravings for chicken, greens, clay, starch, dirt 4.Pregnancy may be viewed by the men as a sign of their virility 5. Vaginal bleeding seen as sign of sickness 6. tub baths and shampooing of hair prohibited 7. Sassafras tea thought to have healing power 8. Eating liver thought to cause heavier bleeding because of its high blood content 9. "Good" baby thought to eat well!! 10. Early induction to solid foods 11. May bottle or breastfeed/ breastfeeding may be considered embarrassing 12.Parents fearful of spoiling baby 13. Baby often has . Strnicknames 14. Belly band used to prevent umbilical hernia 15. Strong feeling of family, community, and religion 16. abundant use of oil on baby's scalp and skin

What are the interventions for uterine resuscitation? (5)

1. Reposition 2. Increase/ or start IV 3. Administer oxygen 4. Reduce or discontinue Pitocin 5. Call provider

What can cause menorrhagia? (6)

1. anovulatory cycle 2. fibroids 3. inflammatory disease (metritis or Saplingitis) 4. Infectious disease 5. endometrial issues 6. IUD

When providing appropriate care, what should you ask the woman about her preferences? (5)

1. ask about traditional beliefs, such as the role of hot and cold 2. be sensitive regarding interpreters and language barriers 3. Ask about important dietary practices, particularly those related to events such as childbirth 4. ask about group practices and beliefs 5. Ask about a woman's fears and those of her family, regarding an unfamiliar care setting

What are the seven cardinal movements of the mechanism of labor that occur in a vertex presentation?

1. engagement 2. descent 3. flexion 4. internal rotation 5. extension 6. external rotation 7. birth by expulsion

A 27-year-old pregnant woman had a preconceptual body mass index (BMI) of 29. What is this client's total recommended weight gain during pregnancy?

15-25 pounds

Signs preceding labor: (9)

1. lightening 2. return of urinary frequency 3. backache 4. stronger braxton hicks 5. wight loss of 0.5 to 1.5kg 6. surge of energy 7. increased vaginal discharge, bloody show 8. cervical ripening 9. possible rupture of membranes

What are some characteristics of a potential male batterer?

1. low self esteem 2. problems with abandonment, loss, helplessness, dependency, insecurity, intimacy 3. Inadequate verbal skills/ difficulty expressing feelings 4. deficits in assertiveness 5. personality disorders 6. low frustration tolerance 7. Higher incidence of growing up in abusive/violent home 8. Denies, minimizes, blames, and lies about own actions 9. violence is consistent with his view of himself and the world 10. inability to empathize 11. rigidity in male and female roles 12. perception that self is higher 13. substance abuse is common 14. Displays of an unusual amount of jealousy

Umbilical cord 1. structure 2. function

1. made up of 2 arteries and 1 vein, and wharton's jelly 2. Vein takes blood/nutrients from mom into the placenta/embryo. Arteries take deoxygenated blood from the fetus back to the mom. Wharton's jelly is connective tissue of the umbilical cord that prevents compression of the vessels

What are the functions of amniotic fluid? (5)

1. maintains constant temp 2. source of oral fluid and excretion of water for the zygote/fetus 3. cushions zygote/fetus from trauma 4. provides freedom of fetal movement and symmetrical growth 5. Acts as a barrier to infection and allows fetal lung development

What all does endometriosis affect for a woman? (3)

1. mental health affected from anger/grief r/t loss of fertility 2. pain r/t condition to interfere with social activity 3. Dyspareunia can have an effect on intimate relationships

Hispanic Cultural beliefs and practices related to childbearing and parenting 16))

1. mother influenced by mother & mother-in-law 2. Cool air in motion considered dangerous during pregnancy 3. unsatisfied food cravings thought to cause a birthmark 4. Some pica of ashes or dirt (not common) 5. Drinking chamomile tea thought to ensure effective labor 6. May wear ribbon or band around pregnant belly that baby will be born healthy 7. Mothers legs brought together after birth to prevent air from entering uterus 8. First 2 days postpartum, diet may be just boiled milk and toasted tortillas to restore warm to the body 9. Bed rest for 3 days after birth 10.No bathing for 14 days and sex restriction for 40 days 11. Mother may want baby's first wet diaper to wiper face "mask of pregnancy" 12. Breastfeeding started 3rd day as colostrum may be considered "filthy" or "spoiled" 13. Olive oil or castor oil given to stimulate passage of meconium 14. no circumcision 15. religious medal worn by mom during pregnancy and put on newborn 16. Infant protected from mal de ojo

What are common symptoms for gonorrhea? (3)

1. no symptoms 2. pelvic pain 3. rectal discharge

Native American beliefs and practices of childbearing and parenting:::: 12)))

1. pregnancy is normal or natural process 2. late prenatal care 3. avoid heavy lifting 4. herbal teas encouraged 5. Prefers female attendant, although husband, mother, or father may assist with birth/ Birth may be attended by whole family 6. Herbs may be used to promote uterine activity 7. Birth may occur in squatting position 8. Postpartum herbal teas believed to stop bleeding 9. infant is not fed colostrum 10. Use of herbs to increase flow of milk 11. Babies are not handled often 12. Use of cradle boards for infant

What are the most relevant types of prevention during pregnancy?

1. primary 2. secondary

Functions of the placenta (3)

1. produces 4 hormones that maintain the pregnancy and zygote/fetus (hCG, hCS, progesterone, estrogen 2. provides metabolic functions, which include: respiration, nutrition, excretion and storage, storage for carbs proteins calcium and iron 3. O2 and nutrients go to the zygote/fetus via the umbilical vein and the fetus excretes CO2 and waste products via the umbilical arteries.

What are the concerns of the sperm when trying to reach the egg?

1. sperm must travel/pick the correct fallopian tube to find the egg that can be fertilized

What is true regarding chlamydial infection in young women? (3)

1. women ages 15-24 have the highest rates of infection 2.women can have it and have no symptoms 3. it can increase risk for infertility and ectopic pregnancy

Most women with uncomplicated pregnancies can use the nurse as their primary source for nutritional information. However, the nurse or midwife may need to refer a client to a registered dietitian for in-depth nutritional counseling. Which conditions would require such a consultation?

1. women with preexisting or gestational illness such as diabetes 2. obesity

European-American beliefs and practices about childbearing and parenting::::: 14))))

1.pregnancy seen as requiring medical attention to ensure health/ emphasis on prenatal care 2. emphasis on nutrition science 3. Involvement of father valued 4. Birthing process in institutional setting valued 5. physician seen as head of team 6. emphasis/focus on early bonding with baby 7. early ambulation and activity emphasized 8. Self-management valued 9. Breastfeeding is popular and begins ASAP after birth 10. Facilitate bonding with "sacred hour after birth" 11. Transition to parenthood seen as stressful time 12. nuclear family is ideal 13. Early return to pre-pregnancy activities 14. Women often deal with multiple roles

When the cervix is fully dilated...

10cm, it can no longer be palpated.

What time period is the fetus most vulnerable to the effects of teratogens?

2-8 weeks -the period of organogenesis lasts from approximately the second until the eighth week of gestation during which time the embryo undergoes rapid growth and differentiation. During this time, the embryo is extremely vulnerable to teratogens such as medications, alcohol, tobacco, caffeine, illegal drugs, radiation, heavy metals, and maternal (TORCH) infections. Structural fetal defects are most likely to occur during this period because of exposure to teratogens

How long does the transition phase of stage 1 last?

20 minutes to 40 minutes

Quickening usually occurs by which time during pregnancy?

20 weeks gestation

How many sperm are in each ejaculation?

200 to 500 million sperm with each ejaculation

How many autosomes are in humans?

22

How long after ovulation is the human egg able to be fertilized successfully by the human sperm?

24 hours to fertilize after ovulation

How much iron do you need in pregnancy?

27mg is recommended. normal woman gets 15 to 18 mg

What is the recommended amount of water intake for a pregnant woman?

3 L a day

The nurse has received a report regarding a client in labor. The woman's last vaginal examination was recorded as 3 cm, 30%, and -2. What is the nurse's interpretation of this assessment?

3 cm dilated 30% effaced and 2 cm above the ischial spine (it would be 2cm below the ischial spin if it was 2+)

How long does the active phase of stage 1 last?

3 to 6 hours

At what gestation does the fetus' spine fuse closed?

3rd to 4th week

A woman's obstetric history indicates that she is pregnant for the fifth time, an all of her children from previous pregnancies are living. One was born at 39 weeks of gestation, one was born at 34 weeks of gestation, she "lost one" at 12 weeks, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAl system?

5-1-2-1-3

How long does the latent phase of stage 1 last?

6 to 8 hours Brownish/pale pink mucus

The time from fertilization to implantation is _________days?

6-10 days

How long can sperm live in the female genital tract?

72 hours

What is (are) the most critical nursing action(s) in caring for the newborn immediately after the birth? A. Dry the baby B. Maintain open airway C. Foster bonding D. Administer Vitamin K IM in neonate's thigh E. Assist mother to breastfeed

A & B - Immediately after birth, the baby's airway should be maintained and the baby should be dried to avoid losing heat by evaporation

Alison is a 17 y/o sexually active female. She presents to the clinic with the request to be tested for STDs, but denies symptoms. She reports 4 male partners in the last year. Whcih STDs would the nurse order? (Select all that apply). A. Chlamydia B. Gonorrhea C. Herpes simlex D. Hepatitis C E. HPV

A & B - you test for HPV around 30 yrs of age with a pap smear -for herpes, you look for symptoms first. If symptoms appear, then test.

Which of the following are expected cardiac changes in a pregnant woman? Select all that apply? A. Cardiac output increases by 30-50% B. Blood volume increases by 40-50% C. Tidal volume increases by 30-40% D. B/P increases by 10%

A & B. Cardiac output will increase, as will Blood volume. Tidal volume increases by 33% but is considered a pulmonary change, as well as blood pressure.

Ellen and Rick want to get pregnant. Which of the following general facts would the nurse include in his/her advice to achieve fertilization? Select all that apply. A. Ovulation occurs 14 days prior to menses B. Sexual intercourse should occur within 24-48 hours of ovulation C. Sperm can live for approximately 150 hours in the female genital tract D. have sexual intercourse as much as possible during the follicular phase E. Women are most fertile during menses

A & B. Sperm live for 48-72 hours in the female genital tract. You want to have sex as much as you can during the ovulation phase. Women are most fertile during ovulation phase.

Which of the following labs are within normal limits for pregnancy? Select all that apply. A. WBC: 5000-15000 B. Hematocrit: 30-35 C. Platelets: 150,000-400,000 D. RBC count 1400mm^3

A & C. Hematocrit should be >33% RBC should be at 5 to 6.25 million/mm3

Which of the following are functions of the placenta? Select all that apply: A. Supplies oxygen and nutrients to the baby B. Cushions and protects the baby from injury C. Allows for limbs to form and grow D. Provides storage carbohydrates, proteins, calcium, and iron E. Maintains constant temperature for the baby

A & D - Amniotic fluid is responsible for cushioning/protecting baby from injury, allowing limbs to form, and maintaining constant temperature for the baby.

According to professional standards, which action(s) can be performed by the nonanesthetist registered nurse who is caring for a woman with epidural anesthesia? A. Stop the infusion B. INitiate epidural anesthesia C. Inject medication through the epidural catheter D. REplace epidural bag with new medication

A & D You can give a new bag of medication, but it cannot be a medication that has not already been given by the anesthetist. You are allowed to stop the infusion as the nurse

When managing the care of a woman in the second stage of labor, the nurse uses various measures to enhance the progress of fetal descent. WHich actions best assists the woman to do this? (Select all that apply) A. Encourage the patient to squat during each contraction B. Lay the patient on her back and bring knees to her chest C. Have anesthesia turn up infusion of epidural medication D. Coach the woman to use sustained open-glottis bearing-down efforts with each contraction

A & D.

What does a speculum exam allow the doctor to do?

A speculum exam is done on a pregnant woman to enable him to inspect the cervix and vaginal walls

Fertilization facts include which of the following? A. After fertilization, the chromosomes combine for a total of 46 B. The best place for fertilization to occur is in the ampulla of the fallopian tube. C. After the sperm enters the egg, the egg becomes impenetrable to other sperm D. The sperm must travel up the correct fallopian tube to fertilize the egg

A, B, C, D, (ALL OF THE ABOVE)

Which of the following lab tests are routinely performed on pregnant women? (select all that apply) A. Blood Type B. Syphilis test C. 3 hr GTT D. Rubella titer E. Genetic tsting for cystic fibrosis

A, B, D Blood type, syphilis test, and rubella titer

Which of the following patients do not need RhoGAM to prevent antibody formation? Select all that apply. A. Pt with blood type of O+ B. Pt with Rh neg blood who had an amniocentesis C. Pt with Rh neg blood who had a negative NIPT D. Pt with AB neg blood type who had a CVS procedure

A, C . NIPT is noninvasive, which is why you would not need RhoGAM for this procedure. -You should give RhoGAM at birth and for any invasive procedure in which baby blood and mother's blood may mix.

A pregnant woman at 35 weeks presents to the clinic with c/o uterine contractions. What else does the nurse ask the patient? Select all that apply. A. How frequent are the contractions? B. When was your LMP? C. Is your water broken? D. How long do the contractions last?

A, C, D.

Signs of gonorrhea include which of the following? A. pelvic pain B. Painful ulcers C. No symptoms D. Rectal discharge

A, C, D. treatment for gonorrhea include IM antibiotic and/or oral antibiotics. Rocepin / Doxycycline

Eliza presents to L&D at 37 weeks, stating she has not felt her baby move in 2 days. What is the nurse's first action to assess Eliza's concern? A. Auscultate fetal heart tones B. Perform cervical examination C. Inspect with an ultrasound D. Perform sterile speculum examination

A. -This is not normal that she has not felt the baby move, and could indicate a serious problem. Assessing FHT is the quickest way to assure the fetus is still alive before assessing further.

The nurse should be cognizant of which physiologic effect of pain? Select one: a. Predominant pain of the first stage of labor is visceral pain that is located in the lower portion of the abdomen. b. Pain during the third stage is a somewhat milder version of the pain experienced during the second stage. c. Somatic pain of the second stage of labor is more generalized and related to fatigue. d. Referred pain is the extreme discomfort experienced between contractions.

A. -pain during first stage is visceral pain over lower abdomen -pain during second stage is somatic pain that is well localized -pain during third stage/postpartum are uterine pain, similar to first stage

What should the nurse include in their documentation for IPV? Select all that apply. A. Use the patient's words B. Use legal phrases such as 'the patient claims'. C. Describe the patient's demeanor D. Do not photograph injuries causes by abuse

A. C. - you would want to take photographs

Which of the following is correct regarding endometriosis? A. The physical symptoms of endometriosis can affect the woman's mental health B. The abnormal tissue bleeds into surrounding tissue during the secretory stage of the menstrual cycle C. Endometriosis causes severe headaches D. Mentronidazole is used to treat endometriosis

A. The consistent pain & possible effects this condition can have can have effect on the woman's mental health. Abnormal tissue bleeds into surrounding tissue after the menstrual cycle

LIna is an 18-year-old woman at 20 weeks' gestation. This is her first pregnancy. Lina is complaining of fatigue and listlessness. her vital signs are within a normal range: BP=118/60, pulse = 70 and respiratory rate 16 breaths per minute. LIna's fundal height is at the umbilicus, and she states that she is beginning to feel fetal movements. Her weight gain is 25 pounds over the prepregnant weight and her height is 5 feet 4 inches. The perinatal nurse's best approach to care at this visit is to: A. Ask Lina to keep a 3-day food diary to bring in to her next visit B. Teach Lina about the expected normal weight gain during pregnancy (approximately 20 pounds by 20 weeks) C. Explain to Lina the possible concerns related to excessive weight gain in pregnancy, including the risk of gestational diabetes D. Explain to Lina that weight gain is not a concern in pregnancy, and she should not worry

A. -Lina has gained too much weight to quickly. She should keep a food diary so that the nurse can help her realize where she is going wrong and what recommendations she should make/implement

A 27-year old pregnant woman had a preconeptual body mass index (BMI) of 29. What is this client's total recommended weight gain during pregnancy? A. 15-25 pounds B. 11-20 pounds C. 25-35 pounds D. 28-40 pounds

A. Because the patient was already overweight, the recommended weight gain is 15-25. Normal weight gain= 25-35 Obese= 11-20lb weight gain

Which of the following statements is true about menopause? A. Average age of menopause in US women is 52 y/o B. Vaginal dryness is uncommon C. Mood changes are unusual in perimenopause D. All women have hot flashes in menopause

A. Menopause doesn't usually occur till women are in their 50s in the US. The use of cigarettes decreases the age of onset of menopause

The perinatal nurse providing care to a laboring woman recognizes a Category II FHR tracing. The most appropriate initial actions for uterine resuscitation include which of the following actions? Select all that apply: A. Assist repositioning of the patient B. Have the patient drink 8 glasses of water for hydration C. Call the provider D. Perform a sterile vaginal exam E. Auscultate fetal heart tones

A. repositioning the patient should be first priority as you could be getting a false reading based on position. You would not call the provider until you can indicate there is a problem.

All female clients should have a thorough abuse assessment screen that does not include which components? a. is she dressing inappropriately? b. does her partner treat her nicely? c. Does her partner hit,kick, slap, or physically hurt her? d. Is she forced to perform sexual acts against her will?

A. A dress should not ask if she is dressing inappropriately

Which nutritional recommendation regarding fluids is accurate? A. A woman's daily intake should be six to eight glasses of water, milk, and/or decaffeinated drinks B. Water with fluoride is especially encouraged because it reduces the child's risk of tooth decay C. Coffee should be limited to no more than 2 cups, but tea and cocoa can be consumed without worry D. Of the artifical sweeteners, only aspartame has not been associated with any maternity health concerns

A. A women is expected to intake 3L of water, or 6-8 glasses of liquid -anything caffeinated should be avoided in excessive amounts. There is no understanding of the effects of artificial sweeteners. -Water with fluoride is encouraged! but it reduces MOTHERS risk of tooth decay, not child's

Hereditary Breast and Ovarian Cancer is caused by which of the following gene mutations? (Select all that apply) A. BRCA1 gene B. APC gene C. MSH2 gene D. RB1 gene E. BRCA2 gene

A. BRCA1 gene E. BRCA2 gene -- both of these genes are known to cause cancer. APC is known to cause colon cancer MSH2 is known to lead to colon cancer RB1 is known to cause retino blastoma

Documentation of abuse can be useful to women later in court, should they elect to press charges. It is of key importance for the nurse to document accurately at the time that the client is seen. Which entry into the medical record would be the least helpful to the court? a. Summary of information b. Photographs of injuries c. Clear and legible written documentation d. Accurate description of the client's demeanor

A. Summary of information

Anna wants to know if her baby has trisomy 18 as early in the pregnancy as possible. She is 8 weeks pregnant. Her physician will suggest which of the following diagnostic test? A. Chorionic villi sampling (CVS) B. noninvasive prenatal screening test (NIPT) C. Amniocentesis D. Sequential integrated test

A. CVS Amniocentesis carries miscarriage risk and is not done often. It can be done at 14-15 weeks.

The clinic nurse advocates for smoking cessation. Potential harmful effects of tobacco use include (select all that apply): Select one or more: a. Infertility impairment b. Fetal Alcohol Syndrome c. Insomnia d. Low birth weight of the fetus

A. Infertility impairment D. Low birth weight of the fetus

A gravida, G41201, fetal heart rate 150s is 14 weeks pregnant, fundal height 1 cm above the symphysis. She denies experiencing quickening. Which of the following nursing conclusions made by the nurse is correct? A. The woman is experiencing a normal pregnancy B. The woman may be having difficulty accepting this pregnancy C. The woman must see a nutritionist as soon as possible D. The woman will likely miscarry the conceptus

A. The woman is experiencing a normal pregnancy - Fundal height is normal for 14 weeks, as is the FHR. Quickening usually occurs by week 16-20.

Which factors influence cervical dilation? Select all that apply. A. Pressure of presenting fetal part against the cervix B. Size of the woman C. Strong uterine contractions D. Scarred cervix E. Size of pelvis

A., C., D., -prostaglandins also are a big part of cervical dilation

Intimate partner violence against women consists of actual or threatened physical or sexual violence and psychological and emotional abuse. Screening for IPV during pregnancy is recommended for which of the following? Select all that apply A. Teenagers B. Caucasian women C. Married women who reports one partner D. High-income women E. Low-incomes women

ALL APPLY!! A,B,C,D,E

Which of the following are ethical issues regarding genetics/genomics? (Select all that apply). Select one or more: a. privacy and confidentiality of genetic information b. discrimination, psychological impact, and stigmatization regarding one's genome c. fairness and use of genetic information d. informed consent in reproductive issues and genetic testing

ALL apply; ABCD

The perinatal nurse explains to the student nurse that a goal of Healthy People 2020 is to:

Increase proportion of infants who are breastfed.

Nancy presents to the clinic Sept 14, 2018 with no period since July 4, 2018. Her pregnancy test is positive. What is her estimated due date?

April 11, 2018 Naegel's rule -3months, + 7 days.

A pregnant woman informs the nurse that her last normal menstrual period was on July 6, 2017. Using Naegele's rule, which of the following would the nurse determine to be the patient's estimated date of delivery (EDC)?

April 13, 2018

The clinic nurse recognizes that pregnant women who are in particular need of support are those who (select all that apply). A. Are experiencing a third pregnancy B. Are experiencing a first pregnancy C. Are trying to conceal this pregnancy as long as possible D. Are awaiting genetic testing results

B, C, D

Which of the following are dangers signs of pregnancy? Select all that apply. A. Early morning nausea B. Bleeding from the vagina C. Abdominal pain that does not go away D. Temperature of 99.2 E. No fetal movement at 30 weeks gestation

B, C, E - temperature would be of concern if it was 100.4

What pulmonary changes occur during pregnancy? A. Respiratory rate increases by 20% B. Tidal Volume increases by 33% C. O2 consumption decreases by 20-40% D. Diaphragm decreases up to 4cm

B. Tidal Volume increases by 33% -O2 consumption increases by 20-40% and the diaphragm increases up to 4cm

Which nursing assessment indicates that a woman who is in second-stage labor is almost ready to give birth? A. Contractions every 3 minutes and firm B. Vulva bulges C. Cervical exam indicates +2 station D. Gush of clear fluid noted from the vagina E. Patient states she has the urge to push

B. Vulva will bulge when birth is near

Cardiovascular findings normal during labor include which of the following? A. Decreased pulse rate B. Increased WBC count C. Increased cardiac output D. Increased respiratory rate

C. -B is also correct, but it is not related to the cardiovascular system

A first-time mother is concerned about the type of medications she will receive during labor. The client is in a fair amount of pain and is nauseated. In addition, she appears to be very anxious. The nurse explains that opioid analgesics are often used along with sedatives. How should the nurse phrase the rationale for this medication combination? Select one: a. "This is what your physician has ordered for you." b. "Sedatives enhance the effect of the pain medication." c. "The two medications, together, reduce complications." d. "The two medications work better together, enabling you to sleep until you have the baby."

B. -Sedatives are often given with opioids to enhace the analgesic effects of opioids, as well as to decrease anxiety and apprehension, increase sedation, and reduce nausea and vomiting. Reglan is often used to and it is an antiemetic

A woman at 24 weeks of gestation states that she has a glass of wine with dinner every evening. Why would the nurse counsel the client to eliminate all alcohol? A. The fetus is at risk for multiple organ anomalies B. The fetus is placed at risk for altered brain growth C. Daily consumption of alcohol indicates a risk for alcoholism D. She will be at risk for abusing other substances as well

B. 2nd trimester is when the brain is developed.

Rosie is 10 weeks pregnant. She tells the nurse she drank beer most every night for the past 3 months. She asks the nurse, "will this hurt my baby?" The nurse should include which of the following in their answer? A. The most vulnerable time for the baby to be affected by alcohol is after 12 weeks in pregnancy B. The most vulnerable time period for the baby to be affected by alcohol is 2-8 weeks in pregnancy C. Beer is not as bad as hard liquor D. Yes, your baby will have birth defects

B. Neural tube and organ formation is done during the weeks 2-8, which is during this time. The baby could have been harmed, but that is not definite.

A woman who is 19 weeks pregnant has come in for a follow-up visit with her significant other. To reassure the client regarding fetal well-being, which is the highest priority action for the nurse to perform? A. Assess the fetal heart tones with a stethoscope B. Offer the woman and her family the opportunity to listen to the fetal heart tones. C. Measure the girth of the woman's abdomen D. Complete an ultrasound

B. You should let the mother and family the personal experience of listening to FHTs.

Intimate partner violence (IPV) against women consists of actual or threatened physical or sexual violence and psychological and emotional abuse. Screening for IPV during pregnancy is recommended for: Select one: a. Pregnant women with a history of domestic violence b. All pregnant women c. All low-income pregnant women d. Pregnant adolescents

B. All pregnant women

Melanie wants to know if there is a chance her baby might have Down Syndrome. She is 8 weeks pregnant. Her physician will suggest which of the following screening test? A. Chorionic villi sampling (CVS) B. Cell-free DNA (Noninvasive) prental screening test C. Amniocentesis D. Alpha-feto protein test (AFP

B. Cell-free DNA (noninvasive) prenatal screening test (NIPT) - Alpha-feto protein test (AFP) looks for increased risk of spinal bifida

The nurse knows that a FHR monitor printout indicates a Category III abnormal fetal heart rate pattern when: A. Early decelerations B. Baseline variability is 6 to 25 bpm C. Baseline variability is less than 5 bpm with decels D. Periodic accelerations noted with/ without fetal movement E. Fetal heart rate of 130s-140s

B. Decels are abnormal and should be monitored, as well as HCP informed. Variability should be 6 to 25 bpm (moderate). Accelerations (periodic) can be normal, and early decels are fine. (okay to be EARLY for dinner, but not LATE)

A woman presents to a prenatal clinic appointment at 10 weeks' gestation, in the first trimester of pregnancy. Which of the following symptoms would be considered a normal finding at this point in pregnancy? Select one: a. Occipital headache b. Fatigue c. Diarrhea d. Leg cramps

B. Fatigue

15 y/o Annie tells the nurse that her boyfriend sometimes slaps her when he gets mad. What is the nurse's most appropriate response? A. That's terrible! Have you told your mother? B. Would you like to tell me more about how your partner treats you when he gets mad at you? C. Why did you make him made? D. Because you're a minor, I am required by law to report his action to the authorities because it is considered child abuse.

B. Gain trust from your patient.

A pregnant woman's diet may not meet her increased need for folates. Which food is a rich source of this nutrient? (select all that apply) A. Beef B. Green leafy vegetables C. Cheese D. Potatoes

B. Green leafy vegetables

Which of the following is an example of presymptomatic testing? a. genetic test for breast cancer b. genetic test for huntington's chorea c. newborn screening test d. genetic test for cystic fibrosis

B. Huntington's

An 18-year-old pregnant woman, gravida 1, para 0, is admitted to the labor and birth unit with moderate contractions every 5 minutes that last 40 seconds. The client states, "My contractions are so strong, I don't know what to do." Before making a plan of care, what should the nurse's first action be? Select one: a. Assess for fetal well-being. b. Recognize that pain is personalized for each individual. c. Disturb the woman as little as possible. d. Encourage the woman to lie on her side.

B. Pain is personalized for each individual

Which of the following findings seen in pregnant women in the third trimester, would the nurse consider to be within normal limits? A. Diplopia B. Pyrosis C. Bradycardia D. Oliguria

B. Pyrosis, which is heart burn -if they have heartburn, women should avoid laying down right after eating. Tums and Zantec are proper treatments

What pregnancy sign/symptoms is breast tenderness? A. common B. presumptive C. positive D. probable

B. presumptive

Ethnocentrism

Belief in the superiority of one's nation or ethnic group.

At what gestation do the respiratory bronchioles appear in the fetus' lungs?

Between weeks 16 and 24 weeks

What renal system adaptation is an anticipated anatomic change of pregnancy?

Bladder will have increased sensitivity and it will be compressed by the enlarging uterus, which will result in the urge to urinate even when the bladder is almost empty

What are milestones in the care of mothers and babies?

Box 1-1, page 2 -abortion is legalized -folic acid is recommended to prevent neural tube defects

Which of the competencies are most relevant to nurses in maternity and women's health? (Select all that apply). Select one or more: a. Refer patient to professional genetic counseling for all of their questions regarding genetics and genomics. b. Provide patient with genomic information without considering their cultural and religious beliefs c. Provide patient with accurate and appropriate genetic and genomic information d. Collect a thorough family history to include at least 3 generations. e. Determines referral of patient to the physician to discussed genetic concerns.

C & D

An 18-year-old pregnant woman, gravida 1, para 0, is admitted to the labor and birth until with moderate contractions every 5 minutes that last 40 seconds. The client states, "My contractions are so strong. I don't know what to do." Before making a plan of care, what should the nurse's first action be? A. Encourage the woman to lie on her side B. Assess for fetal well-being C. Recognize that pain is personalized for each individual D. Disturb the woman as little as possible

C.

Leopold's maneuvers are performed on a woman at 38 weeks pregnant for which of the following reasons: A. Measure the width of her pelvis B. Measure the weight and length of the baby C. Determine how the baby is positioned in the uterus D. Determine fetal well-being

C.

When the nurse is alone with a battered client, the client seems extremely anxious and says, "It was all my fault. The house was so messy when he got home, and I know he hates that." What is the most suitable response by the nurse? Select one: a. "He will never find out what we talk about. Don't worry. We're here to help you." b. "You have to remember that he is frustrated and angry so he takes it out on you." c. "No one deserves to be hurt. It's not your fault. How can I help you?" d. "What else do you do that makes him angry enough to hurt you?"

C.

While performing Leopold's maneuvers on a woman in early labor, the nurse palpates a flat area in the fundal region, a hard round mass on the left side, a soft round mass on the right side, a small parts just above the symphysis. The nurse concludes which of the following A. the fetal position is right occiput posterior B. The fetal attitude is flexed C. The fetal presentation is scapular D. The fetal lie is vertical

C.

25 y/o Susan presents to the prenatal clinic with her partner for her first prenatal visit. What is the best strategy for the nurse to implement in order to assess for IPV? A. Ask Susan if her partner hurts her while he is in the room. B. wait to ask Susan about IPV at a visit when her partner is not present C. Ask Susan about IPV while escorting her to the restroom to collect urine and her partner is in the clinic room D. No need to ask since her partner is with her

C. It is important to ask the patient during that visit and not delay till a further visit. Also, you should ask her in an instance when she is alone with you.

In which clinical situation would the nurse most likely anticipate tachycardia in the fetus? A. Fetal hypothyroidism B. Prolonged umbilical cord compression C. Maternal fever D. Maternal stress

C. Maternal fever can occur from prolonged labor due to long exposure after rupture of membranes

A G21001 patient is Rh negative and states she did not receive Rhogam after delivery of her first baby. What is the nurse's best response to the patient? A. Are you sure? B. This is not good, your current baby may be at risk for complications C. What was the blood type of your first baby? D. Did you have Rh negative blood during your first pregnancy?

C. -You need to be Rh tested each pregnancy. If blood is negative or matches mom, we are good/safe.

A positive pregnancy test is considered a _________________ sign of pregnancy. A. Positive B. Presumptive C. Probable D. True

C. A pregnancy test can be false indicative, which proves why it cannot be a positive sign of pregnancy.

The nurse is developing a plan of care for a African American client who just delivered a newborn. Which cultural variation is most important to include in the care plan? A. Male infants are typically circumcised B. Breastfeeding is encouraged immediately after birth C. Avoid offering tub baths and shampooing after delivery D. Paternal grandmother participates in the care of the mother and her infant after birth

C. Circumcision is not common for African Americans. Breastfeeding is not encouraged until colostrum has passed, if at all.

WHich of the following is the greatest risk to the mother when receiving general anesthesia? A. Maternal hypotension B. Bladder relaxation C. Difficult intubation D. Neonatal respiratory depression

C. General anesthesia can increase risk for difficult intubation and risk for aspiration of gastric contents

Which STD can be prevented by a vaccine and reduce a person's risk for certain types of cancer? A. HSV B. Hepatitis B C. HPV D. HIV

C. HPV can lead to cervical cancer

If a patient tells the nurse that her partner hits her when they get 'mad at me.' What is the nurse's first response? A. You have to get out of that relationship B. No one deserves to be treated like that- let's talk about ways to leave your partner. C. Would you like to tell me more about how your partner treats you when he/she gets mad at you? D. Why did you make him/her mad?

C. Implying that you disapprove may make the client not trust you and not want to go further into the situation

Which of the following does not place a couple at higher risk for conceiving a child with a genetic abnormality? A. maternal age over 35 years B. maternal family history of cystic fibrosis C. maternal type 1 diabetes D. paternal history of sickle cell anemia

C. The mother having diabetes does not increase the couple's risk of having a child with a genetic abnormality

The time from fertilization to implantation is? A. 1-2 days B. 3-6 days C. 6-10 days D. 10-15 days

C. 6-10 days . 3-4 days is for fertilization.

What exam does the nurse perform to determine if the pregnant woman at 36 weeks is in labor? A. Electonic fetal monitoring B. ultrasound C. cervical examination D. Non-stress test

C. Cervical exam

Which of the following is the most appropriate question to ask a patient about domestic violence? A. Your partner doesn't abuse you, right? B. Do you experience domestic violence in your relationship? C.Does your partner ever hit, hurt, kick, or throw you against the wall? D. Do you ever do anything that causes your partner to be mad at you?

C. Does your partner ever hit, hurt, kick, or throw you against the wall?

The nurse is caring for a client in early labor. Membranes ruptured approximately 6 hours earlier. What should the nurse implement to detect potential complication? A. CHeck BP for hypovolemia B. Check fetal heart rate for accelerations C. Check maternal temperature for infection D. Check cervix for fetal position

C. Prolonged labor after rupture of membranes can increase the risk of infection, which could lead to fever!

. Which of the following findings should the nurse highlight for the nurse midwife? Select one: a. Body mass index of 23 b. Blood pressure of 100/60 c. Hematocrit of 29% d. Pulse rate of 76 bpm

C. Hematocrit of 29%. The nurse would report this as Hematocrit level should be greater than 33% during pregnancy. . BMI looks good, pulse rate looks normal as it increases 10 to 15bpm (still good) and BP is low, which is normal

The nurse is working in a prenatal clinic caring for a patient at 14 weeks gestation, G21001. Which of the following findings should the nurse highlight for the nurse midwife? A. Body mass index of 23 B. Blood pressure of 100/60 C. Hematocirt of 29% D. Pulse rate of 76 bpm

C. Hematocrit should be >33% - body mass of 23 is healthy, blood pressure and pulse rate is in fine range

27 y/o Mandy tells the nurse she is thinking about leaving her partner. She is tired of the abuse. What is the nurse/s best first response? A. Great! Let's call the police. B. I think it is time. Let's contact a counsellor from the shelter and they can hellp you leave your partner ASAP. C. I am here to support you. Let's talk about a safe plan for you to prepare to leave your partner. D. It's about time. When do you want to leave?

C. I am here to support you. Let's talk about a safe plan for you to prepare to leave your partner.

Non pharmacologic pain management in labor offers which major advantage? A. Complete pain relief B. More rapid labor C. No risks to the fetus D. Maternal drowsiness

C. No risks to the fetus

Renee is 23 y/o and presents to the clinic with complaint of symptoms consistent with endometriosis. She is considering pregnancy in the next 1-2 years. Which of the following treatments will the physician probably implement? A. Surgery B. GnRH agonist C. OCPs D. Danazol

C. Oral contraceptive pills

Through a vaginal exam, the nurse determines that a woman is 8 cm dilated, 100 effaced, and 0 station. The external fetal monitor shows uterine contractions every 3 minutes. The nurse reports this as what stage of labor?

First stage: transitional phase

The perinatal nurse explains to the student nurse that _________________ is the leading cause of neonatal death in the United States. (name top 3)

Congenital malformations. 2nd) disorders related to short gestation and low birth weight 3rd) sudden infant death syndrome

Jane is pregnant, and her husband Brian has begun to put on weight. What is this a possible sign of?

Couvade syndrome -this is also called sympathetic pregnancy. It is a condition in which the partner experiences some of the same symptoms and behaviors as the expected mother

Which health care service represents a primary level of prevention: a) home care for high risk pregnancies b) blood pressure screening c) pap smear test d) immunizations

D) immunizations

Which of the following is true regarding systemic analgesics? A. IM is preferred over IV administration B. They cross the maternal blood-brain barrier as easily as they do the fetal blood-brain barrier C. IV patient-controlled analgesia results in increased use of analgesia D. Effects on the fetus and newborn can include decreased alertness and delayed sucking

D.

Which of the following best indicates effective labor? A. Rupture of membranes B. COntractions every 3-5 minutes C. Contractions palpate moderate-firm D. Cervical dilation and effacement E. Loss of mucus plug

D. Contractions (such as braxton hicks) can occur which are not indicative of labor. Rupture of membranes is indicative of labor, but does not indicate effective labor, which is the same for the loss of mucus plug.

WHich of the following is considered to be a "reassuring" or Category I Fetal Heart Rate pattern? A. Baseline rate of 120-130; minimal variability; late decelerations B. Baseline rate of 110-120; marked variability; variable decelerations present C. Baseline rate of 170-200; moderate variability; occasional accelerations; variable decelerations D. Baseline rate of 110-130; moderate variability; presence of accelerations; no late decelerations noted

D. Normal HR is 110-160 Moderate variability is normal Accelerations are okay No decelerations= normal

A gravida, G41201, fetal heart rate 150s, is 25 weeks pregnant, fundal height approx 25cm above the symphysis. She denies experiencing quickening. Which of the following nursing conclusions made by nurse is correct? A. The woman is experiencing a normal pregnancy B. The woman may be having difficulty accepting this pregnancy C. The woman must see a nutritionist as soon as possible D. The woman may have a problem with her baby

D. THis is the answer because she should be feeling quickening or moving of the baby by this point in time.

What gestation (in weeks) is most critical for development of the embryo's organ systems and external features and most vulnerable to teratogens? A. 1 day to 3 weeks B. 1-15 weeks C. 20-30 weeks D. 2-8 weeks

D. The neural tube and organs are developed during this time, and they are most effected by teratogens

A woman's position is an important component of the labor progress. Which guidance is important for the nurse to provide to the laboring client? Select one: a. The supine position, which is commonly used in the United States, increases blood flow. b. The laboring client positioned on her hands and knees ("all fours" position) is hard on the woman's back. c. In a sitting or squatting position, abdominal muscles of the laboring client will have to work harder. d. Frequent changes in position help relieve fatigue and increase the comfort of the laboring client.

D. -supine position is not recommended for long periods as the uterus can crush the vena cava and prevent blood flow to the fetus -Sitting or squatting position is not harder work on the abdominal muscles -Putting the woman on her hands and knees puts her at risk of damaging the fetus if she falls/passes out from exhaustion .

What is the recommended amount of calories needed a day for a pregnant woman?

First trimester- same as nonpregnant woman Second Trimester- needs +340kcal Third Trimester- needs +452 kcals

Susie is 9 weeks pregnant (based on her last menstrual period) on her first prenatal visit. She tells the nurse she smoked marijuana approx 2 months ago but denies any use since then. She asks "will this hurt my baby?" The nurse's best response is: a. "Yes, your baby might have significant birth defects from smoking marijuana at that time." b. "I do not know. You will need to talk to your physician about that." c. "That would have been during the most vulnerable time for fetal development so yes, there might be risk to your baby." d. "Based on your last menstrual period, the risk of harm to your baby from smoking marijuana at that time is very low."

D. 2 months= 8 weeks. Based on this info, implantation had not occurred yet; therefore, risk to fetus very low. Based on your last menstrual period, the risk of harm to your baby from smoking marijuana at that time is very low.

Regina is 39 weeks pregnant with her 3rd baby. She delivered her first baby at 40 weeks and her second baby at 39.4 weeks. She denies abortions and stillbirths, but a miscarriage prior to her current pregnancy. What is her current GTPAL? A. 3-2-0-0-2 B. 3-2-0-1-2 C. 4-1-1-1-2 D. 4-2-0-1-2

D. 42012 4- total pregnancies 2- term births 0- preterm births 1- miscarriage/abortion 2- living children

Which term is an accurate description of the process by which people retain some of their own culture while adopting the practices of the dominant society? A. Assimilation B. Ethnocentrism C. Cultural relativism D. Acculturation

D. Acculturation

Constipation is common in pregnancy. Which of the following foods best help to relieve constipation? A. Milk and meats B. Candy and cake C. Iron-fortified orange juice D. Fruits and vegetables

D. Fruits and vegetables provide fiber which helps with constipation - for constipation treatment, patient should intake more fluid, more exercise, stool softener, miralax, metamusil with lots of fiber

Genomics refers to which of the following? A. The study of particular gene B. The basic physical units of inheritance C. The use of genetic information to guide a client's drug therapy D. The study of the entire set of genetic instructions found in a cell

D. Genomics is the study of the entire set of genetic instructions found in a cell

Which of the following is true about estrogen in pregnancy? A. stimulates contractions B. Prepares breasts for lactation C. Relaxes smooth muscles, such as the uterine muscle D. Relaxes pelvic ligaments and joints E. Maintains corpus luteum production of estrogen and progesterone until approximately 14 weeks gestation

D. Progesterone relaxes pelvic ligaments and joints - oxytocin stimulates contractions -prolactin prepares breasts for lactation -HcG maintains corpus luteum production of estrogen and progesterone until approximately 14 weeks gestation

Which of the following patients will most likely experience vaginal lacerations during birth? A. G32002 woman with previous vaginal deliveries, who is in her second stage of labor, and who is attended by a midwife B. G20010 dark-skinned woman who is going through a long labor C. G42012 woman with red hair who is going through a vertex birth for the second time D. G10000 who has a rapid labor and care is overseen by an obstetrician

D. Rapid labor = biggest risk for vaginal laceration. Women who are fairskinned with red hair also are at increased risk.

The nurse takes the history of a client, G2 P1, at her first prenatal visit. The client is referred to a genetic counselor, due to her previous child having a diagnosis of ____. Select one: a. Unilateral amblyopia b. Subdural hematoma c. Sickle cell anemia d. Glomerular nephritis

D. Sickle Cell anemia

Helen is 28 weeks pregnant and her Blood Type is O positive. She wants to know if she needs a Rhogam shot now. her best friend had to have one when she was pregnant. Which of the following is the nurse's best answer? A. Yes, you need it to make sure your body does not release antibodies that can hurt your baby B. No, you usually do not need it until you are 37 weeks pregnant C. Yes, you are Rh neg and it is due today D. No, you are Rh positive and it is not necessary for you

D. Since the mom is O positive, she does not need Rh RhoGAM. -Rh negative blood should receive Rh positive blood cells because of fetomaternal hemorrhage, transfusion or accident. Given at 28 weeks

Describe the rational for the physiologic anemia that occurs during pregnancy?

Dilution of hemoglobin concentration occurs in pregnancy with physiologic anemia

Describe the Naegele's rule

Date of last menstrual period, subtract 3 months, add 7 days.

Down syndrome is an example of which of the following? A. Euploid cell B. Diploid cell C. Triploid cell D. Monosomy E. Trisomy

E. Down syndrome is an example of Trisomy 21.

An ethical dilemma unique to perinatal nursing is the:

Embryo/fetal rights

What process will the human egg undergo to prepare for fertilization?

FSH stimulates the ovaries, causing one oocyte to mature and ovulation to take place. The egg is swept up by the fimbria and tubal cilia gently push her along the fallopian tubes

At what gestation can the fetus hear?

Fetus responds to sound by 24 weeks.

Which stage of labor varies the most in length?

First stage

Through a vaginal exam, the nurse determines that a woman is 4 cm dilated, 100 effaced and -2 station. The external fetal monitor shows uterine contractions every 3 minutes. The nurse reports this as what stage of labor?

First stage, active phase

What is predictive testing?

Genetic testing used to clarify the genetic status of asymptomatic family members. - examples: These include presymptomatic and predispositional testing.

How long after conception does the human zygote's placenta implant in the uterus?

Implantation occurs 6-10 days after conception

When assessing the fetus using Leopold's maneuvers, the nurse feels a round and firm/hard feature above the symphysis pubis, fetal parts on mother's right sides, and cannot feel a long, smooth surface. What is the position of the fetus?

LOP

When assessing the fetus using Leopold's maneuvers, the nurse feels a round and firm/hard feature in the fundal portion of the uterus, fetal parts on the mother's right side, and a long, smooth surface in the mother's left side close to midline. What is the position of the fetus?

LSA

Intervention for the sexual abuse survivor is often not attempted by maternity and women's health nurses because of the concern about increasing the distress of the woman and the lack of expertise in counseling. What initial intervention is appropriate and most important in facilitating the woman's care?

Listening and encouraging therapeutic communication skills

The nurse is providing prenatal teaching to a group of diverse pregnant women. One woman, who indicates she smokes two to three cigarettes a day, asks about its impact on her pregnancy. The nurse explains that the most significant risk to the fetus is:

Low neonatal birth weight

A woman in labor has just received an epidural block. What is the most important nursing intervention at this time?

MOnitor maternal blood pressure for possible hypotension (10% to 30% of women)

A married couple lives in a single-family house with their newborn son and the husband's daughter from a previous marriage. Based on this information, what family form best describes this family?

Married-blended family

Keisha experienced a vaginal birth 45 minutes ago. Her infant is 3900 grams and a repair of a second degree laceration was needed following the birth. As part of the nursing assessment, the nurse discovers that Keisha's uterus is boggy. Furthermore, it is noted that her vaginal bleeding has increased. What is the nurse's next most appropriate action?

Massage the uterus/fundus -the nurse may also ask for an order of pitocin, as it helps the uterus stay contracted. Natural pitocin is stimulated and released in the body with stimulation of the breasts and the baby feeding on the breasts.

What is Menorrhagia?

Menorrhagia is menstrual bleeding excessive in number of days and amount of blood.

What mode of transmission is cleft lip?

Multifactorial inheritance

What is presymptomatic testing?

Mutation analysis for a disorder in which symptoms are certain to appear if the individual lives long enough. An example is HD mutation screening -these testing are used to discover gene mutations that show far after birth

A laboring woman has received meperidine (Demerol) intravenously (IV), 90 minutes before giving birth. Which medication should be available to reduce the postnatal effects of meperidine on the neonate?

Naloxone (even though the book says differently) -just know naloxone should be on hand when opioids are given

Do women need more calcium during pregnancy? if so how much?

No, women require the same amount of calcium during pregnancy as they do whne they are not pregnant (1300/1000mg)

What is the nurse's understanding of the appropriate role of primary and secondary powers?

Primary powers are responsible for the effacement and dilation of the cervix. Secondary powers are used to augment/aid the primary powers in expulsion of the fetus.

What is the most important change that happens during the secretory phase of the menstrual cycle?

Proliferation of the endometrium

What is the correct terminology for the nerve block that provides anesthesia to the lower vagina and perineum?

Pudendal nerve block -this looks painful -should be administered 10 to 20 minutes before perineal anesthesia is needed

When assessing the fetus using Leopold's maneuvers, the nurse feels a round and firm/hard feature above the symphysis pubis, movable fetal parts on mother's left side, and a long, smooth surface in the mother's right side close to midline. What is the position of the fetus?

ROA

Evidence-based practice (EBP) is the integration of the best::

Research evidence, clinical expertise, and patients' values.

Home care for high-risk pregnancies

Secondary prevention

What family form tends to be the most socially vulnerable?

Single-parent family

What process will human sperm undergo to prepare for fertilization?

Sperm must travel through the vas deferens, male urethra, receive semen from the prostate, leave the penis and enter the vagina; travel through the vagina, cervix, uterus and into the correct tube to the egg.

What is predispositional testing?

Testing for a gene mutation that indicates susceptibility for developing a condition; a positive result does not indicate a 100% risk of developing the condition An example is: BRCA1 gene mutation for cancer

What is the major advantage of nonpharmacologic pain management?

There are no side effects or risks to the fetus, and less risk for the mother

What is the usual cause of decelerations?

Uteroplacental insufficiency

A pregnant woman's diet consists almost entirely of whole grain breads and cereals, fruits, and vegetables. Which dietary requirements is the nurse most concerned about? A. Protein B. Calcium C. Folate Acid D. Vitamin B12

Vitamin B12 -this comes almost entirely from animals.

At what gestation is the fetus's kidney's able to secrete urine?

at 9 weeks, and urine is excreted into the amniotic fluid and forms a major part of the amniotic fluid volume.

What mode of transmission is hemophilia?

X linked recessive inheritance

Where should the fundal height be at 20 weeks?

at the umbilicus

Culturalism syndrome

a culture-bound syndrome, culture-specific syndrome, or folk illness is a combination of psychiatric and somatic symptoms that are considered to be a recognizable disease only within a specific society or culture.

Karyotype

a pictorial analysis of an individual's chromosomes

Which STDs poses the least danger for the fetus of a mother who has the infection? a. trichomonas vaginalis b. gonorrhea c. herpes simplex virus d. syphilis

a. Trichomonas vaginalis

What is incredible about he female reproductive system in utero?

all the eggs a female will have are developed during prenatal development

Where is the best place for fertilization to occur?

ampulla of the fallopian tube

Abortus

an embryo or fetus that is removed or expelled from the uterus at 20 weeks of gestation or less, weighs 500 g or less, measures 25 cm or less

Stillbirth

an infant who, at birth, demonstrates no signs of life, such as breathing, heartbeat, or voluntary muscle movements

At what gestation is the fetus' brain grossly formed?

at 5 to 8 weeks

The nurse is performing an initial assessment of a client in labor. What is the appropriate terminology for the relationship of the fetal body parts to one another?

attitude (flexion, non-flexion, flexion except here)

What mode of inheritance is Marfans syndrome?

autosomal dominant inheritance

What kind of inheritance is sickle cell anemia?

autosomal recessive inheritance

At what gestation does the fetus have a sense of taste?

by 5 months or 20 weeks the fetus has a sense of taste.

Which of the following vaginitis conditions is a sexually transmitted infection? a. atrophic vaginitis b. bacterial vaginosis c. trichomonas vaginitis d. monolial vaginitis (explain the transmission or cause of the other infections)

c. Trichomonas vaginitis -atrophic vaginitis- is not from spread of infection, but can occur due to onset/occurence of menopause -bacterial vaginosis- does not originate as a STI, but is rather just overgrowth or imbalance of bacterial in the vagina that can be due to a plethora of reasons -monolial vaginitis- is caused by an overgrowth of a common fungus in woman (though it can spread through sexual contact, that is not how it originates

To provide culturally competent care to an asian-american family, which questions should the nurse include during the assessment? a. "do you want music playing while you are in labor?" b. "do you have a name selected for the baby?" c. "do you prefer hot or cold beverages?" d. "Do you want some milk to drink?"

c. do you prefer hot or cold beverages?

How often do presentations of each presenting part occur?

cephalic-96% breech- 3% shoulder- 1%

What is an example of multifactorial inheritance?

cleft lip autism

Hegar's sign

compressibility and softening of isthmus

multi-generational families

consisting of three more generations of relatives. It is becoming increasingly more common

What do variable decelerations indicate?

cord compression

What would be a priority for the nurse when caring for a pregnant woman who has recently emigrated from another country?

encourage her to include her family for support

What hormone relaxes pelvic ligaments and joints?

estrogen

Married-blended families

families formed as a result of divorce and remarriage, consist of unrelated family members (step parents, step siblings, step children) who join to create a new household

No-parent family

families in which children live independently in foster or kinship care such as living with a grandparent

Single-parent families

families in which one parent resides with and cares for one or more children

Cohabiting-parent families

families which children live with two unmarried biologic parents or two adoptive parents. (very common with Hispanic families)

What would be considered a presumptive signs of pregnancy?

fatigue, breast changes, amenorrhea, nausea

What would be considered a positive signs of pregnancy?

fetal heart tones visualizing fetus

Possible cause of decreased fetal movement?

fetal jeopardy or intrauterine fetal death

What is the recommended amount of protein for a pregnant woman?

first trimester- 46g, which is same as nonpregnant second & third trimester- +71g of protein

What is secondary amenorrhea?

is no menses in 6 months in a woman who has had normal menstrual cycles.

Position is:

is the relationship of a reference point on the presenting part to the four quadrants of the mother's pelvis. It is a 3 part abbreviation 1)denotes the location of the presenting part in right or left side of mother's pelvis (R or L) 2) The middle letter stands for the specific presenting part of the fetus (O for occipital or S for sacrum, Sc for scapula (shoulder)) 3) stands for the location of the presenting part in relation to the anterior (direction it is facing (A for anterior, P for posterior, T for transverse)

What is the purpose of the prenatal test: Sequential integrated screening

it is a prenatal test that involves 2 blood tests and one ultrasound

Possible cause of severe backache and flank pain?

kidney infection or stones

First stage of labor: -stages & amount of dilation

latent (0-3cm dilated) & most of effacement active (4-7cm dilated) transition (8-10cm dilated)

Cultural Relativism

learning about and applying the standards of another's culture to activities within that culture

What is fetal bradycardia?

less than 110 for >10 minutes

INadequate weight gain:

less than 2.2lb per month for a normal weight women or less than 1.1lb per month for an obese woman

lie is:

lie is the relation of the long axis (spine) of the fetus to the long axis (spine) of the mother -cephalic/breech- 99% of longitudinal lies -shoulder- transverse or horizontal lie

Describe the Moratorium phase

moratorium is the status of individuals who are in the midst of a crisis, whose commitments are either absent or are only vaguely defined, but who are actively exploring alternatives.

Describe latent phase:

more progress in effacement of the cervix and little increase in descent

Describe active phase:

more progress in rate of descent of presenting part

Excessive weight gain:

more than 6.6 lb per month

What is lightening?

mother's experience that her baby has dropped into the pelvis

what is the operculum?

mucus plug

Autism is an example of which kind of inheritance?

multifactorial

What mode of inheritance is ovarian cancer?

multifactorial inheritance

extended family

nuclear family plus grandparents, aunts, uncles, cousins, and other people associated by blood

infant mortality rate is:

number of deaths of infants younger than 1 year of age per 1000 births

Neonatal mortality rate

number of deaths of infants younger than 28 days of age per 1000 live births

Birth Rate is:

number of live births in 1 year per 1000 population

maternal mortality rate is:

number of maternal deaths from births and complications of pregnancy, childbirth and puerperium per 100,000 live births

Perinatal mortality rate

number of stillbirths and the number of neonatal deaths per 1000 live births

How long can sperm live in the female?

sperm can live up to 72 hours in the female reproductive tract

At what gestation are the fetus' genitalia recognizable?

start to differentiate at 9 weeks, and are distinguishable at 12 weeks

What are striae gravidarum?

stretch marks

Engagement is:

term used to indicate the largest transverse diameter of the presenting part. It can be determined by abdominal or vaginal examination

What happens to the egg when the sperm enters?

the egg becomes impenetrable to other sperm, and after fertilization, the chromosomes combine for a total of 46

What hormone stimulates contractions?

oxytocin (pitocin)

What is dysmenorrhea?

painful menstruation

What is ballottement?

passive movement of the unengaged fetus

Phenotype

physical feature or psychological trait

what is linea nigra?

pigmented line extending from the symphysis pubis to the top of the fundus

Acculturation

process by which people retain some of their own culture while adopting the practices of the dominant society

What hormone relaxes the uterine muscle?

progesterone

What hormone prepares the breasts for lactation?

prolactin

What is the recommended amount of zinc for a pregnant woman?

recommended is 12/11mg from 9/8mg in normal woman

How much iodine should a pregnant woman intake?

recommended is 220mcg, and nonpregnant is 150mcg

How much magnesium should a pregnant woman intake?

recommended is 400/350-360mg , and nonpregnant is 360/310-320mg

Culture

refers to a group existing within a larger cultural system that retains its own characteristics

Dilation-

refers to the enlargement or widening of the cervical opening and the cervical canal that occurs once labor has begun

presentation is:

refers to the part of the fetus that enters the pelvic inlet first and leads through the birth canal during labor -cephalic -breech -shoulder

Effacement-

refers to the shortening and thinning of the cervix during the first stage of labor. The cervix is normally 2 to 3 cm long and about 1cm thick. Only a thin edge of the cervix can be palpated when effacement is complete.

Homosexual families

same-sex partners living together with or without children

Blood pressure screening

secondary prevention

Pap smear test is what kind of prevention?

secondary prevention

Station is: -when is birth imminent?

the relationship of the presenting fetal part to an imaginary line drawn between the maternal ischial spines and is a measure of the degree of descent of the presenting part of the fetus through the birth canal -Birth is imminent when the presenting part is at 4+ or 5+ cm below the ischial spine

in fetal circulation, the lowest level of oxygen concentration is found in:

the umbilical arteries -this makes sense as they are taking deoxygenated blood back to the placenta, where it will be taken back from the mother and reoxygenated through her heart/lungs.

How to monozygotic twins result?

these twins develop from one fertilized ovum which then divides into 2 zygotes

What is carrier testing?

this is used to identify individuals who have a gene mutation for a genetic condition but donot show symptoms of the condition because it is an autosomal recessive condition. EX: CF, sickle cell disease, Tay-Sachs

Tumor supressor genes (how they work)

this/these function(s) to inhibit cell growth and division of cells

Folic acid 400mcg a day is recommended to all women of reproductive age for what reason?

to prevent spina bifida and abdominal defects of the baby

nuclear family

traditional family of a husband, wife, and their children that live as an independent unit, sharing roles, responsibilities, and economic resources

Spermocytes undergo what/ at what place/ and after what?

under go meiosis, in the testes, after FSH stimulation

What is the weight gain for an underweight woman (BMI <18.5)? What is the weight gain for a normal weight woman (BMI 18.5-24.9)? What is the weight gain for an overweight woman (BMI 25.0-29.9)? What is the weight gain for an obese woman (BMI 30+)?

underweight- 28 to 40lb normal weight- 25-35lb overweight- 15-25lb obese- 11-20lb

Assimilation

when a cultural group loses its cultural identity and becomes part of the dominant culture. It's the process by which groups "melt" into the mainstream