Pregnancy MCN 1

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  1. Match CNS role:

    1. Gonadotropin releasing hormone
    2. Anterior Pituitary 
    3. Ovaries

    a. FSH and LH
    b. Gonadotropin releasing hormone
    c. Estrogen and Progesterone
    • 1. b
    • 2. a
    • 3. c
  2. This hormone is produced in the ovaries which stimulates and prepares the body for conception. 

    A. Gonadotropin
    B. Progesterone
    C. FSH and LH
    (this multiple choice question has been scrambled)
  3. This hormone is released by the pituitary gland that causes a new egg to mature and released from its ovarian follicle each month

    A. Gonadotropin
    B. Progesterone
    C. FSH and LH
    (this multiple choice question has been scrambled)
  4. As the egg migrates down the fallopian tube, this hormone is released to prepare the body for pregnancy causing the uterine lining to thicken. 

    A. Estrogen
    B. LH
    C. Progesterone
    (this multiple choice question has been scrambled)
  5. This reproductive hormone is produced bby the pituitary gland and stimulates the development of the maturing ovarian follicle, and controls ovum production in the female. 

    A. FSH
    B. Oestrogen
    C. LH
    (this multiple choice question has been scrambled)
  6. This reproductive hormone is produced by the pituitary gland and stimulates the ovaries to produce two other hormones to trigger ovulation. 

    A. Oestrogen
    B. LH
    C. FSH
    (this multiple choice question has been scrambled)
  7. This reproductive hormone pis produced by the ovaries (non preg) and by the placenta. It promotes the maturation and release of an ovum in every menstrual cyle

    A. Oestrogen
    B. FSH
    C. LH
    (this multiple choice question has been scrambled)
  8. This reproductive hormone is produced by the corpus luteum in the ovary. It prepares the endometrium for the reception and development of the fertilized ovum.

    A. Oestrogen
    B. LSH
    C. Progesterone
    (this multiple choice question has been scrambled)
  9. Fill in:

    __a__ stimulates the production of breast milk and is necessary for normal milk production during breastfeeding.

    __b__ is responsible for stimulation of milk ejection (milk letdown) and for stimulation of uterine smooth muscle contraction at birth.
    • a. Prolactin
    • b. Oxytocin
  10. This term refers to agents/factors that produce major/minor defects to a woman's pregnancy
  11. What does TORCH stand for when dealing with Teratogens?
    • Toxoplasmosis
    • Other (syphilis)
    • Rubella
    • Cytonegalovirus
    • Herpes
  12. In the placenta, there are finger-like projections called chorionic villi. What do they secrete that suggest a woman's pregnant?
  13. T or F: the Maternal side of the Placenta is the "red and fleshy side" or "dirty duncan"
  14. T or F: the Fetal side of the Placenta is the "red and fleshy" or "dirty duncan"
    False: it is the "shiny side" or "shiny schultz"
  15. What are some factors that prohibit effective nutrient transfer in the placenta?
    • Pre-eclampsia
    • smoking
    • Calcification
  16. This term is a condition during pregnancy characterized by HTN, sometimes with fluid retention and proteinuria
  17. What is the purpose of Wharton's Jelly?
    It protects the umbilical arteries and vein. Once exposed to cooler temperatures outside of the womb, it collapses the venous structures clamping them shut.
  18. What does the amniotic fluid do for the fetus? What could low fluid indicate?
    • Protection (shock absorber)
    • Temp. regulator
    • allows free movement
    • Prevents adherence of skin to amnion

    Low fluid: issues with GI, kidneys, nervous system
  19. What is the fluid range for amniotic fluid?
    500 - 1000mL
  20. In what weeks in the first trimester can the fetal heart tones be heard?
    9-12th weeks
  21. What is the HR range of the fetus?
  22. T or F: fetal movement can start from 16-24 weeks
    False: 16-18 weeks. Fetal movement MUST be felt at 20 weeks
  23. What diagnostic will be ordered if there is an abnormal sound in the fetal heart?
  24. What should the CM be with a mother 20 weeks pregnant?
    20 cm
  25. This endocrine hormone supports the growing uterus and breasts:

    A. progesterone
    B. HPL
    C. estrogen
    (this multiple choice question has been scrambled)
  26. This endocrine hormone supports the endometrium:

    A. HPL
    B. estrogen
    C. progesterone
    (this multiple choice question has been scrambled)
  27. What adrenal changes will you see during pregnancy? What will increase?
    Increase aldosterone for sodium reabsorption and increased cortisol
  28. How much will blood flow increase during pregnancy?
    How will blood volume and WBC increase?
    • an increase in 15-20ml/min
    • to 500-750ml/min
    • blood volume 50% above normal, WBC to 15k to 20k postpartum
  29. How much will cardiac output increase during pregnancy? How will this effect BP?
    • increase by 30-50%
    • Pulse increase 10-15/min
    • BP lowers
  30. T or F: BP is highest when sitting and lowest when on left side
  31. What can happen to BP if lying supine?
    Hypotension syndrome
  32. T or F: there will be a 20-30% increase in demand for O2 during pregnancy
  33. What causes glycouria during pregnancy?
    It is d/t high filtration and lactose production
  34. Does bladder capacity increase or decrease during pregnancy?
  35. What is recommended to take to prevent neural tube defect?
    Folic acid
  36. What s Linea nigra?
    dark line in the middle of the stomach
  37. What is chloasma?
    "mask of pregnancy"
  38. How will corticosteroid levels be affected during pregnancy?
    they will be suppressed to decrease possible rejection of fetus
  39. T or F: Na+ levels decreases in the body during pregnancy
    false: increases to maintain body fluid volumes
  40. T or F: Insulin production is decreased during pregnancy
  41. What happens to insulin absorption during the second trimester? What do you have to check?
    Mom becomes insulin resistant: check BG levels
  42. If BG levels are <140 or >180, what could this mean?
    Gestational diabetes
  43. What is adequate criteria for kick counts?
    10 kicks in 2 hours
  44. List danger signs to report
    • vaginal bleeding
    • leaking of fluid
    • Persistent h/a, blurred vision
    • foul smelling vaginal discharge
  45. This lab test is checked at 16-18 weeks to check for potential problems with the baby, including spina bifida:

    A. AFP
    B. H/H
    C. RhoGam
    (this multiple choice question has been scrambled)
  46. When do you want to check for H/H? 

    A. 24-28 weeks
    B. 24 weeks
    C. 16-18 weeks
    (this multiple choice question has been scrambled)
  47. When do you want to check for Blood glucose levels?

    A. 24 weeks
    B. 16-18 weeks
    C. 24-28 weeks
    (this multiple choice question has been scrambled)
  48. What is RhoGam used for?
    Used if the mother is Rh negative
  49. List how many times a mother should visit in each:

    a. 28 weeks
    b. 28-36 weeks
    c. Last month
    • a. once per month
    • b. every 2 weeks
    • c. Every week
  50. Fill in: The eyes of the fetus close at 9 weeks and reopen at ___ weeks after conception.
    26 weeks
  51. Fill in: Blood formation occurs primarily in the liver during the 9th week but shifts to the spleen by the end of the ___ week.
  52. T or F: the sex of the baby can be determined by the 24th week
    False: 12th week
  53. This term is a fatty, cheese-like secretion of the fetal sebaceous glands, which covers the skin to protect it from constant exposure to amniotic fluid.
    Vernix caseosa
  54. What is Lanugo and its function?
    It is a fine, downy hair that covers the fetal body to help the vernix (covers skin to protect from amniotic fluid) adhere to the skin.
  55. This type of fat helps the neonate maintain temperature stability after birth. Where can it be found?
    Brown fat: Back of neck, behind sternum, and around the kidneys.
  56. At what week will a neonate obtain: lanugo, vernix, and brown fat

    A. 13 weeks
    B. 21 weeks
    C. 25 weeks
    D. 17 weeks

    13-16 = quickening
    21-24 = Lungs produce surfactant, some gas exchange
    25-18 = eyes reopen, hair on head, blood formation from spleen to bone marrow
    (this multiple choice question has been scrambled)
  57. Which side of the placenta is smooth?

    a. Fetal side
    b. Maternal side
    a. Fetal side
  58. What is the purpose of the decidual layers?
    • Provides nourishment for the embryo
    • May protect mother from uncontrolled invasion of fetal placental tissue into uterine wall
  59. Exchange of substances between mother and fetus occurs within the ___ of the placenta

    A. decidua capsularis
    B. intervillous space
    C. decidua basalis
    (this multiple choice question has been scrambled)
  60. The ___ maternal antibodies are the primary ones transferred to the fetus by the placenta. 

    A. IgA
    B. IgG
    C. IgD
    D. IgB
    B. IgG may provide passive immunity against rubella or tetanus if the mom is immune
    (this multiple choice question has been scrambled)
  61. What is the corpus luteum and how does hCG affect it? Why does it regress after 20 weeks?
    It is a hormone secreting body that releases estrogen and progesterone for the first 6-8 weeks, which is due to the hCG.

    It will regress after 20 weeks as the placenta gradually takes over production of the estrogen and progesterone.
  62. This hormone decreases maternal insulin sensitivity and utilization of glucose. Why is this beneficial during pregnancy?
    Human Chorionic somatomammotropin (Human placental lactogen): It makes more glucose available for fetal growth
  63. This hormone causes enlargement of the woman's uterus, the breasts, and external genitalia. 

    It also enhances uterine activity, playing a role as labor begins.
  64. T or F: Progesterone causes the endometrium to change into the decidua, providing nourishment for the early conceptus.
  65. This hormone reduces uterine contractions and suppresses maternal reactions to fetal antigens to prevent spontaneous abortions.
  66. Fill in: an abnormally small quantity of fluid, less than __a__ %, is called __b__, and is associated with poor fetal lung development and malformations.
    • a. <50%
    • b. Oligohydramnios
  67. Match: Half of oxygenated venous blood goes bypasses the liver during early pregnancy through this first shunt and enters the vena cava. 

    A. ductus venosus
    B. ductus arteriosus
    C. foramen ovale

    Image Upload 1
    (this multiple choice question has been scrambled)
  68. Match: Most of the blood passes directly into the left atrium, through this second shunt, where it mixes with the small amount of blood returning form the lungs.

    A. ductus venosus
    B. ductus arteriosus
    C. foramen ovale
    (this multiple choice question has been scrambled)
  69. Match: This third shunt is where blood from the right ventricle joins oxygenated blood in the aorta.

    A. ductus arteriosus
    B. foramen ovale
    C. ductus venosus

    Image Upload 2
    (this multiple choice question has been scrambled)
  70. At ___ weeks, the fundus reaches midway between the symphysis pubis and umbilicus. 

    Then at ___ weeks, it is located at the umbilicus.
    • 16 weeks
    • 20 weeks
  71. This term occurs around 40 weeks, when the fetal head descends into the pelvic cavity and the uterus sinks to a lower level. 

    How will it help make the mom feel better?
    Lightening: it reduces pressure on the diaphragm and makes breathing easier.
  72. This term means irregular, usually mild contractions that become stronger in the last trimester, It may be confused with true or false labor.
    Braxton Hicks Contractions
  73. Fill in: Discoloration (bluid, purple color that extends to include the vagina and labia) is one of the earliest signs of pregnancy called __a__. It is from Estrogen which causes __b__ (congestion with blood of the cervix).
    • a. Chadwick's sign
    • b. Hyperemia
  74. How does estrogen and progesterone affect plasma volume levels?
    Plasma volume increases from 6-8 weeks by an increase of 40-60% (1200-1600mL). Estrogen and progesterone stimulate the renin - angiotensin - aldosterone system, which stimulate Na and water retention.
  75. Fill in: Generally, iron deficiency anemia occurs when the hemoglobin is less than __a__ g/dL or the hematocrit is less than __b__% in the first or third trimester.
    • a. 11g/dL
    • b. 33%
  76. How does supine hypotension occur?
    When the mom is supine, the weight of the gravid uterus can occlude the vena cava and aorta, which impedes return of blood and cardiac output.
  77. How much will leukocytes increase by during pregnancy?
    • 5,000-12,000 cell/mm to as high as 15,000 during pregnancy
    • Can increase up to 25-30,000 during labor.
  78. These 2 hormones play a role in decreasing airway resistance by relaxing smooth muscle in the respiratory tract.
    Progesterone and prostaglandins
  79. This hormone causes increased vascularity of the mucous membranes of the upper respiratory tract.
  80. This term means excessive salivation that can be unpleasant. It can occur from ingestion of starch, or decreased swallowing during n/v. 

    How can you offer some relief?
    Pytalism: small, frequent meals, gum chewing, and oral lozenges
  81. T or F: The mother during pregnancy will have an increased motility of the large intestines, which can lead to diarrhea.
    False: decreased motility which allows time for more water to be absorbed, leading to constipation.
  82. How does progesterone effect the  gallbladder?
    Gallbladder: becomes hypotonic and emptying time is prolonged, resulting in thicker bile, predisposing to gallstones, as well as itching.
  83. How is the liver affected during pregnancy?
    In the last trimester, the liver is pushed upward and backward by the enlarging uterus.

    Serum alkaline phosphatase rises 2-4x, and serum albumin and total protein fall.
  84. T or F: Nocturia is common during pregnancy
  85. T or F: Progesterone causes the kidneys and ureters to dilate
    True: ureters become elongated and more distensible. 

    Also, the ureters are compressed d/t the enlarging uterus, which causes stasis of urine, allowing time for bacterial build up.
  86. This line is a longitudinal mark of the midline of the abdomen, which can eventually darken. It occurs from increased pigmentation from elevated estrogen, progesterone, and melanocyte hormones.

    It can also cause brownish patches over the forehead, cheeks, and nose, called this...
    Linea nigra

    Melasma, chloasma, or the "mask of pregnancy
  87. During pregnancy, will FSH and LH increase or decrease?
    They will be suppressed, because they are not needed to stimulate ovulation during pregnancy.
  88. This hormone will stimulate milk-ejection, and also stimulate contractions of the uterus.
  89. Will progesterone levels increase or decrease after childbirth?
    Decrease: they will decline when the placenta is removed, and oxytocin will increase to keep the uterus contracted, preventing excessive bleeding. 

    (During pregnancy, progesterone will relax the smooth muscles of the uterus)
  90. Why does tissue sensitivity to insulin decline during pregnancy?
    During second half of pregnancy, tissue sensitivity of insulin decline because of HCS, prolactin, progesterone, estrogen, and cortisol all fluctuate. This causes the mother to use fat stores to meet energy demands, causing higher blood glucose levels, which then stimulate the pancreas to produce additional insulin. 

    Inadequate insulin production results in gestational diabetes.
  91. This hormone causes the corpus luteum to produce progesterone and estrogen until the placenta is sufficient enough to take over (at 10-12 weeks).
  92. List the major functions of progesterone (8)
    • 1. maintain endometrial layer for implantation of fertilized ovum
    • 2. Preventing spontaneous abortion by relaxing smooth muscle of uterus
    • 3. Prevent tissue rejection of fetus
    • 4. Stimulate development of lobes and lobules in breast for lactation
    • 5. Faciliate deposit of maternal fat stores, for energy reserve
    • 6. Smooth muscle relaxer
    • 7. Increase respiratory sensitivity to CO2, for ventilation
    • 8. Suppressing the immunologic response, prevecnting rejection of fetus.
  93. What is the purpose of hCS (Human Chorionic somatomammotropin)
    1. Increase the availability of glucose for the fetus. It is an insulin antagonist, reducing the sensitivity of maternal cells to insulin. This will increase free blood glucose.

    It also promotes mobilization and use of free fatty acids to provide energy for pregnant women.
  94. This hormone is produced by the corpus luteum, decidua, and placenta. Its purpose is to inhibit uterine activity, soften connective tissue in cervix, and lengthen pubic ligaments.
Card Set:
Pregnancy MCN 1
2018-01-19 02:46:13
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