OBGYN Exam 1

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Author:
jwhughes
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307460
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OBGYN Exam 1
Updated:
2015-09-07 15:29:37
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nursing
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nursing
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Exam 1
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  1. What is a blue-purple discoloration of the cervix (mucus membranes) called
    Chadwicks sign
  2. What is softening of the cervix called
    Goodell sign
  3. What are purplish stretch marks that slowly turn silver after childbirth
    Striae Gradidarum
  4. What is an anti-body rich, yellow secretion, may be expressed manually by the 12th week and may leak from the breasts during the last trimester
    Colostrum
  5. What is an ease in flexing the body of the uterus against the cervix
    McDonald's sign
  6. What is the position of the fundus at 10-12 weeks? at 20-22 weeks?
    • 10-12: palpable just above the symphisis pubis
    • 20-22 weeks: at the level of the umbilicus
  7. What refers to the midline of the abdomen from the pubic area to the umbilicus and above
    Linea alba
  8. What is increased pigmentation of linea alba called when the area begins to darken
    Linea nigra
  9. What is irregular pigmentation of the cheeks, forehead, and nose accompanied by sun exposure (mask of pregnancy)
    Chloasma
  10. What is gravida
    any pregnancy regardless of duration, including the present
  11. What is para
    birth after 20 weeks regardless of whether infant lived or died
  12. How is EDB
  13. When is fundal height a good indicator of uterine size? How big should it be in correlation wth weeks gestation?
    • 22-34 weeks
    • (if 34 weeks, then 34 cm etc)
  14. What things can interfere with accuracy of fundal height?
    • maternal position
    • maternal height
    • 3rd trimester (fetal weight)
    • obese women
    • women with uterine fibroids
    • women with hydroamnios
  15. What causes the uterus to increase its capacity from 10 mL to 5.1 L?
    • Increase in cells (hypertrophy) in response to estrogen
    • Distention of the growing fetus
  16. How does the cervix keep bacteria from entering the uterus
    Secretes mucus that forms a plug at the opening of the endocervical canal
  17. What 3 reproductive organs does estrogen influence? How?
    • Cervix: mucus plug
    • Vagina: thicken mucus/relax connective tissue
    • Breasts: enlarge and increase number
  18. What is the increase of cardiac output in a pregnant woman? pulse?
    • 39-40%
    • 10-15 BPM
  19. What causes a decrease in blood pressure throughout the first and second trimester of pregnancy
    Pulmonary and Peripheral vascular resistance decreases by 40-50%
  20. How can postural hypertension develop during the third semester of pregnancy
    Uterus presses on pelvic and femoral vessels limiting blood return to the heart
  21. What can result in decreased blood flow to the right atrium and a decrease in blood pressure? How does this happen?
    • Vena Cava Syndrome
    • gravid uterus compresses vena cava
  22. How can Vena cava syndrome be prevented/treated
    lay the woman on her left side with a pillow under her right hip
  23. A pregnant woman presents to labor and delivery complaining of dizziness. You note that she seems pale and is diaphoretic. What is this an indication of?
    Vena cava syndrome
  24. What is the increase of blood volume for pregnant woman? RBC? Plasma?
    • 45%
    • 18-30%
    • 50%
  25. Why is there a decrease in HCT by 7% leading to physiologic anemia?
    Due to increased blood volume, RBC, and plasma volume, the blood becomes diluted
  26. What does the respiratory volume increase to? what is the reason for this increase?
    • 30-40%
    • Decreased airway resistance in response to progesterone
  27. Why does the intrathoracic volume remain unchanged even though the uterus presses up to the diaphragm
    The rib cage flares and the chest circumference increases
  28. What causes the waddling gait in pregnancy
    relaxation of pelvic joint
  29. What can cause diastasis recti separation of the abdominal muscles?
    uterus enlargment
  30. What causes low back pain in pregnancy
    physiological lordosis as a result of the weight of gravid uterus
  31. What causes N/V in the first trimester
    hCG increase
  32. What causes bloating, constipation, and gastic reflux in pregnancy
    Increased progesterone levels relax smooth muscles decreasing peristalsis
  33. What worsens GI symptoms in pregnancy
    pressure of gravid uterus on intestines
  34. What can cause hemorrhoids in pregnancy
    constipation and increased pressure on blood vessels in the rectum
  35. What causes increased urinary frequency in the first trimester
    gravid uterus presses on the bladder
  36. When is urinary urgency relieved in pregnancy and how is it relieved? When will it return?
    • Second trimester
    • The uterus moves into the abdominal cavity
    • Third trimester
  37. What causes glycosuria?
    GFR increases by 50% limiting the kidneys from absorbing all of the glucose
  38. What causes increased levels of pigmentation in the areola, nipples, vulva, etc...
    estrogen
  39. What is an increase in pigmentation on the forehead and around the yes (aggravated by sun exposure, common in women of color)
    cholasma
  40. What is darkly pigmented line that extends from umbilicus to pubic area
    Linea nigra
  41. What is reddish streaks on trunk and thighs? What color do they change to after delivery
    • Striae gravidarum
    • shiny gray-white
  42. What causes striae gravidarum
    Stretching of connective tissue due to increased adrenal steroid levels
  43. What is the recommended total weight gain for normal weight before pregnancy? First trimester? Subsequent trimesters?
    • 25-35 lbs
    • 3-5 lbs
    • 1 lb/week
  44. What causes water retention in pregnancy
    • increased sex hormones
    • decreased serum protein
  45. What hormone is secreted by trophoblast early in pregnancy?
    hCG
  46. What two hormones does hCG stimulate
    estrogen and progesterone
  47. What is another word for chorionic somatomammotropin
    Human placenta lectogen (hPL)
  48. What produces estrogen and progesterone for the first 7 weeks of pregnancy and later by the placenta
    corpus luteum
  49. What stimulates uterine development to support fetal growth and stimulates the ductal system of the breast for lactation
    estrogen
  50. Name 4 functions of progesterone
    • maintain endometrium
    • decrease uterine contractility
    • stimulate breast achini and lobules
    • relax smooth muscle causing heartburn
  51. What is Relaxin primarily made by
    corpus luteum
  52. What 3 things does relaxin do
    • decrease uterine contractility
    • helps soften cervix
    • long term effects on collagen
  53. What lipids found in the female reproductive system contribute to the decrease in placental vascular system and probably contribute to onset of labor
    prostaglandins
  54. How many extra calories does a pregnant woman need?
    300/day
  55. Describe the distribution of weight gain in pregnancy
    • fetus/placenta/amniotic fluid: 11 lbs
    • uterus: 2 lbs
    • Increased blood volume: 4 lbs
    • Breast tissue: 3 lbs
    • Maternal stores: 5-10 lbs
  56. What is the primary nursing diagnosis related to psychosocial changes in pregnancy
    Potential alteration of family processes
  57. What does TPAL stand for regarding para
    • T: # born >37 weeks
    • P: # born 20-37 weeks
    • A: # abortions (spontaneous or therapeutic) before 20 weeks
    • L: # children living
  58. Name 6 presumptive signs of pregnancy (subjective)
    • amenorrhea
    • n/v
    • fatigue
    • urinary frequency
    • breast changes
    • quickening (16-20 weeks)
  59. Name 7 probable signs of pregnancy (objective)
    • Hegar's sign
    • McDonald's sign
    • Chadwick's sign
    • Goodells sign
    • Abd enlargment
    • skin pigmentation changes
    • fetal outline
  60. What is softening of isthmus of uterus called
    Hegar's sign
  61. Name 3 diagnostic (definitive) signs of pregnancy
    • Fetal heart beat
    • Fetal movement felt by provider
    • Visualization of ultrasound
  62. How do you calculate estimated due date using Nagele's rule
    Subtract 3 months from LMP and add 7 days
  63. What method of estimating due date uses uterine size to indicate gestational age by measuring in CM the distance from the symphysis pubis to top of uterine fundus
    Mcdonald's sign
  64. When can a doppler advice be used for fetal heart tone/minute
    8 weeks
  65. What should the fetal heart rate normally be
    120-160
  66. How often should a woman be seen for prenatal visits?
    • 1/month until 28 weeks
    • 2/month 28-36 weeks
    • weekly until delivery
  67. What does a gush of fluid from the vagina indicate
    rupture of membranes
  68. What can vaginal bleeding indicate in pregnancy
    abruption or previa or bloody show
  69. What can abdominal pain indicate in pregnancy
    preterm labor or abruption
  70. When is alpha feto-protein level checked to screen for neural tube defect
    16-18 weeks
  71. When does mom do blood glucose challenge test
    24-28 weeks
  72. What does the US rank in infant mortality
    30th
  73. What is the number of deaths per 1000 live births in the first 28 days of life
    neonate mortality
  74. What is the number of deaths per 1000 live births in the first year of life
    infant mortality
  75. What is death from beginning of pregnancy through 6 weeks after delivery
    maternal mortality
  76. What is poverty level for a family of 4
    22,050
  77. What does FMLA allow for pregnant women for unpaid leave? What are the restrictions
    • 3 months
    • <50 employees at the job
    • Worked less than 1 year
    • Work <25 hrs/week
  78. What are fatty acids from fish and red meat important for
    • placental growth
    • fetal brain development
    • fetal visual function

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