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)