Podcast
Questions and Answers
At what week of pregnancy can the fetal heart tones begin to be detected using a Doppler device?
At what week of pregnancy can the fetal heart tones begin to be detected using a Doppler device?
Which component of surfactant becomes the chief component by a ratio of 2:1 at approximately 35 weeks of pregnancy?
Which component of surfactant becomes the chief component by a ratio of 2:1 at approximately 35 weeks of pregnancy?
When does the heart rate of a fetus begin to show baseline variability of about 5 BPM?
When does the heart rate of a fetus begin to show baseline variability of about 5 BPM?
At what point during pregnancy do the alveoli and capillaries start to form?
At what point during pregnancy do the alveoli and capillaries start to form?
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During which weeks of intrauterine life does the nervous system begin to develop?
During which weeks of intrauterine life does the nervous system begin to develop?
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What is the recommended average weight gain during pregnancy?
What is the recommended average weight gain during pregnancy?
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What is the total caloric intake recommended for women during pregnancy?
What is the total caloric intake recommended for women during pregnancy?
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Which layer of the decidua is responsible for forming the maternal part of the placenta?
Which layer of the decidua is responsible for forming the maternal part of the placenta?
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How much protein do women need daily during pregnancy?
How much protein do women need daily during pregnancy?
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At what stage does the placenta take over from the corpus luteum?
At what stage does the placenta take over from the corpus luteum?
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What possible complications may arise if a condition is left untreated beyond the 18th week of gestation?
What possible complications may arise if a condition is left untreated beyond the 18th week of gestation?
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What is the Dietary Reference Intake (DRI) for calories for women of childbearing age?
What is the Dietary Reference Intake (DRI) for calories for women of childbearing age?
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What substance primarily constitutes the bulk of the umbilical cord?
What substance primarily constitutes the bulk of the umbilical cord?
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Which condition is characterized by an increased amount of amniotic fluid?
Which condition is characterized by an increased amount of amniotic fluid?
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What initiates the formation of the placenta as early as the 11th or 12th day after conception?
What initiates the formation of the placenta as early as the 11th or 12th day after conception?
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What is the primary function of the umbilical cord?
What is the primary function of the umbilical cord?
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Which structure develops into the chorionic membrane that surrounds the amniotic fluid?
Which structure develops into the chorionic membrane that surrounds the amniotic fluid?
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Which of the following embryonic structures is among the first systems to become functional in intrauterine life?
Which of the following embryonic structures is among the first systems to become functional in intrauterine life?
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Which structure in the male reproductive system produces the most seminal fluid?
Which structure in the male reproductive system produces the most seminal fluid?
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What is the primary function of the ovaries in the female reproductive system?
What is the primary function of the ovaries in the female reproductive system?
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During a tubal ligation, which part of the fallopian tube is typically cut or sealed?
During a tubal ligation, which part of the fallopian tube is typically cut or sealed?
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The vagina is primarily lined with which type of epithelium?
The vagina is primarily lined with which type of epithelium?
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What role do Döderlein’s bacillus play in the vagina?
What role do Döderlein’s bacillus play in the vagina?
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In males, which physiological change occurs during the excitement phase of the sexual response cycle?
In males, which physiological change occurs during the excitement phase of the sexual response cycle?
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Which of the following glands produces approximately 30% of seminal fluid?
Which of the following glands produces approximately 30% of seminal fluid?
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The cervix serves which primary function within the uterus?
The cervix serves which primary function within the uterus?
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What occurs to the vagina during the excitement phase of the sexual response cycle?
What occurs to the vagina during the excitement phase of the sexual response cycle?
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What is the primary role of the prostate gland in the male reproductive system?
What is the primary role of the prostate gland in the male reproductive system?
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What physiological change occurs as part of the body's preparation for labor?
What physiological change occurs as part of the body's preparation for labor?
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Which of the following best describes Braxton Hicks contractions?
Which of the following best describes Braxton Hicks contractions?
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What is the primary characteristic of the 'show' that indicates the onset of true labor?
What is the primary characteristic of the 'show' that indicates the onset of true labor?
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What is the safest way to monitor for the signs of labor according to the given content?
What is the safest way to monitor for the signs of labor according to the given content?
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What does the term 'ripened cervix' refer to in the context of labor?
What does the term 'ripened cervix' refer to in the context of labor?
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When is it appropriate for a pregnant individual to conserve energy according to the content?
When is it appropriate for a pregnant individual to conserve energy according to the content?
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What is the most reliable indicator that labor has commenced?
What is the most reliable indicator that labor has commenced?
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What might occur if a pregnant individual does not recognize her energy levels leading up to labor?
What might occur if a pregnant individual does not recognize her energy levels leading up to labor?
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What condition is characterized by the abnormal implantation of the placenta in the uterus?
What condition is characterized by the abnormal implantation of the placenta in the uterus?
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What is the most common site for an ectopic pregnancy?
What is the most common site for an ectopic pregnancy?
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Which of the following symptoms is commonly associated with the rupture of ectopic pregnancy?
Which of the following symptoms is commonly associated with the rupture of ectopic pregnancy?
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What treatment is typically recommended if an ectopic pregnancy has failed to rupture?
What treatment is typically recommended if an ectopic pregnancy has failed to rupture?
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What potential long-term risk may result from placental insulinase's effect on insulin during pregnancy?
What potential long-term risk may result from placental insulinase's effect on insulin during pregnancy?
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If an ectopic pregnancy ruptures late, what is a major concern to watch for?
If an ectopic pregnancy ruptures late, what is a major concern to watch for?
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What is the recommended action for an Rh(-) mother in the case of an ectopic pregnancy?
What is the recommended action for an Rh(-) mother in the case of an ectopic pregnancy?
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Which of the following describes a symptom that may fade after the completion of pregnancy due to placental insulinase?
Which of the following describes a symptom that may fade after the completion of pregnancy due to placental insulinase?
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Study Notes
Obstetric Nursing
- Topic: Anatomy and Physiology
- Subtopic: Male Reproductive System: External
- Scrotum
- Testes
- Seminiferous tubules
- Leydig's cells
- Penis
- Subtopic: Male Reproductive System: Internal
- Epididymis (20 ft)
- 5% semen production
- Vas Deferens
- Final maturation of sperm occurs
- Seminal Vesicles (30% semen production)
- Ejaculatory Ducts
- Prostate Gland (60% semen production)
- Bulbourethral (Cowper's) Glands
- Urethra
- Subtopic: Female Reproductive System: External
- Mons Veneris
- Labia Minora
- Labia Majora
- Other External Organs
- Hymen
- Vestibule
- Two Skene's glands
- Front of vaginal opening
- Bartholin's Glands
- Back part of vaginal opening
- Subtopic: Female Reproductive System: Ovaries
- Female gonad
- Produce, mature, and discharge ova (egg cells)
- Produce estrogen and progesterone
- Initiate and regulate menstrual cycles
- Subtopic: Female Reproductive System: Fallopian Tube
- Approximately 10 cm long
- Interstitial portion
- Isthmus
- Ampulla (fertilization usually occurs)
- Infundibulum (funnel shaped)
- Subtopic: Female Reproductive System: Uterus
- Receive ovum from fallopian tube
- Implantation and nourishment of fetus
- Expands during pregnancy
- Portion cut during C-section
- Cervix (lowest portion)
- Subtopic: Female Reproductive System: Vagina
- Lined with stratified squamous epithelium
- Similar to cervix covering
- Contains folds (rugae)
- Bulbocavernosus (at external opening)
- Acts as voluntary sphincter
- Mucus with rich glycogen content
- Lactobacillus (Döderlein's bacillus)
- Forms lactic acid
- Subtopic: Question
- On physical examination, Suzanne Matthews is found to have a cystocele
- A cystocele is the herniation of the bladder into the vaginal wall
Sexual Response Cycle
- Excitement (physical and psychological stimulation)
- Women: clitoris increases in size, vaginal walls lubricate, vagina widens in diameter and length, nipples become erect
- Men: penile erection, scrotal thickening and elevation of the testes
- Plateau (just before orgasm)
- Women: clitoris drawn forward and retracts, lower part of vagina congested (formation of orgasmic platform), increased nipple elevation
- Men: vasocongestion leads to penis distention, heart rate increases to 100-175 beats/minute, respiratory rate to approximately 40 respirations/minute
- Orgasm (discharge accumulated sexual tension)
- Women: vigorous contraction of pelvic area muscles, expulsion or dissipation of blood and fluid
- Men: muscle contractions surrounding seminal vessels, prostate project semen into the proximal urethra, propulsive ejaculatory contractions
Resolution
- 30-minute period for external and internal genital organs to return to an unaroused state
- Women: possible for additional orgasms immediately after
- Men: refractory period (further orgasm impossible)
Infertility/Subfertility
- Subfertility investigation usually limited to three assessments: semen analysis, ovulation monitoring, and tubal patency tests, and ultrasound
Management
- Therapeutic insemination (sperm deposition)
- In-vitro fertilization (IVF)
- Gamete intrafallopian transfer (GIFT)
Stages of Fetal Development
- Preembryonic (0-2 weeks, beginning w/ fertilization)
- Embryonic (3-8 weeks)
- Fetal (8 weeks-birth)
Fetal growth and development
- Three periods: preembryonic, embryonic, fetal
Fertilization
- Aka: conception
- Ovum
- Sperm
- Zygote
- Embroyo
- Fetus
- Conceptus
- Age of viability
Implantation
- Zygote moves towards the uterus body
- Mitotic cell division (cleavage) begins
- zygote consists of 16-50 cells
- Morula
Embryonic Structures: The Decision
- Corpus luteum continues to function
- Decidua is thickened endometrial lining
- Has three parts: basalis, capsularis, vera
Embryonic Structures: Chorionic Villi
- Develop by the 11th or 12th day
- Reach out from cells into uterine endometrium
- Begin formation of placenta
Embryonic Structures: The Placenta
- Blastocyst splits into embryo and placenta around 4 weeks
- Takes place of the corpus luteum around weeks 10-12
Embryonic Structures: Amniotic Membranes
- Smooth chorion develops into the chorionic membrane
- Forms sac with amniotic fluid
- Hydramnios: increased amniotic fluid
- Oligohydramnios: reduced amniotic fluid
- Slightly alkaline
Embryonic Structures: The Umbilical Cord
- Transports oxygen/nutrients to fetus and wastes to placenta
- Gelatinous mucopolysaccharide (Wharton's jelly)
- Consists of one vein and two arteries
Cardiovascular System
- First systems to become functional in intrauterine life
- Formation starts as early as the 16th day
- Heart beats by the 24th day
- Doppler audible by 10th-12th week
- Stethoscope audible by 16th week
Fetal Circulation
- Fetal heart beats 120-160 bpm
Respiratory System
- Alveoli and capillaries develop between weeks 24-28
- Surfactant (phospholipid substance) is produced in the alveolar cells around week 24
Nervous System
- Develops around weeks 3-4
- Neural plate (thickened ectoderm) becomes apparent in the third week
Neural Tube Defects
- Category of neurological disorders
- Includes: spina bifida, anencephaly, meningocele, myelomeningocele
- Caused by lack of folic acid and genetic factors
Determination of Estimated Birth Date
- EDD or EDC ranges from 38-42 weeks
- Naegel's Rule (LMP)
Fetal Movement
- Quickening (felt by mother) between weeks 18-20
- At least 10 times per day during weeks 28-38
Fetal Heart Rate/Tone
- Beats 120-160 bpm
- Rhythm strip testing assesses fetal heart rate
Nonstress Testing
- Measures fetal heart rate response to movement
- Monitor both fetal heart rate and uterine contractions
Contraction Stress Test
- Analyzes fetal heart rate during contractions
- Initiated with oxytocin or nipple stimulation
Ultrasonography
- Diagnosis of pregnancy, placenta, amniotic fluid, fetal sex, and position
- Maturity prediction
- Complication discovery
Amniocentesis
- Aspiration of amniotic fluid (scheduled between weeks 14-16)
- To reduce bladder size, and prevent inadvertent punctures
- Alpha-Fetoprotein = potential indication of anencephaly or myelomeningocele
- Rho(D) immune globulin administered if woman has Rh-negative blood
Pregnancy: Presumptive Signs
- Nausea, vomiting
- Amenorrhea
- Quickening
- Linea nigra
- Melasma
- Striae gravidarum
- Breast changes
Pregnancy: Probable Signs
- Chadwick's sign (violet vagina)
- Goodell's sign (softened cervix)
- Hegar's sign (softened lower uterine segment)
- Ballottement
- Braxton Hicks contractions
Pregnancy: Positive Signs
- Fetal heart tones (FHTs)
- Fetal movements felt by examiner
- Fetal visualization by ultrasound
Obstetric History
- Gravida (number of pregnancies)
- Para (number of pregnancies reaching viability)
- Term (full-term births)
- Preterm (preterm births)
- Abortion
- Living
- Multiple (multiple pregnancies)
Signs Indicating Complications of Pregnancy
- Vaginal bleeding
- Persistent vomiting
- Chills and fever
- Sudden escape of clear fluid from the vagina
- Pregnancy-Induced Hypertension (PIH)
- Increase or decrease in fetal movement
Health Promotion During Pregnancy
- Self-care needs
- Bathing (tub baths restricted)
- Dental care (routine oral hygiene)
- Perineal hygiene
- Clothing (comfortable and loose-fitting)
- Sexual activity
- Exercise
- Swimming
Discomforts of Early Pregnancy (First Trimester)
- Breast tenderness
- Palmar erythema
- Constipation
- Nausea, vomiting, pyrosis
- Muscle cramps
Discomforts of Early Pregnancy (First Trimester)
- Hypotension
- Varicosities
- Hemorrhoids
- Frequent urination (Kegel exercises)
- Pubococcygeal muscles
Discomforts of Middle to Late Pregnancy
- Backache (lumbar lordosis)
- Pelvic rocking/tilting
- Dyspnea (uterus pressure on diaphragm)
- Ankle edema
- Braxton Hicks contractions
Teratogenic Maternal Infections
- Toxoplasmosis, Rubella, Cytomegalovirus, Herpes Simplex Virus
Toxoplasmosis
- Protozoan infection acquired often through uncooked meat or handling cat feces
- Can damage CNS if transmitted through placenta
Rubella
- Viral infection potentially causing severe birth defects if contracted during pregnancy
- Immunization recommended before pregnancy
Cytomegalovirus
- Herpes virus family, leading to severe damage if mother infected
- Can cause neurologic problems, eye damage
Herpes Simplex Virus (Genital Herpes)
- Viral infection crossing the placenta causing first trimester complications like miscarriage or severe congenital abnormalities
- Treatment: Intravenous or oral antiviral medications
Syphilis
- Bacteria causing possible fetal complications if left untreated
Nutritional Health During Pregnancy
- Weight gain 11.2-15.9 kg (25-35 lb) recommended
- Adequate caloric intake, including 300 additional calories per day.
Protein Needs
- DRI increase to 71 g/day during pregnancy
Vitamin and Mineral Needs
- Increased fat-soluble and water-soluble vitamins and minerals crucial during pregnancy
- Important vitamins/minerals: Calcium, Phosphorus, Iodine, Iron, Zinc
Preparing a Family for Childbirth
- Tailor sitting
- Perineal abd abdominal exercises
- Squatting
- Kegel exercises
- Pelvic Rocking
- Swimming
Preparing for Labor
- Preliminary signs of labor (lightening, show, Braxton Hicks)
- True labor contractions
Signs of True Labor
- Show (Release of cervical plug)
- Contractions (30-70 secs, 5-10 mins apart)
- Rupture of membranes (sudden gush of amniotic fluid)
Components of Labor
- Passage
- Passenger
- Powers (uteral contractions)
- Psyche (psychological states)
Phases of the Puerperium
- Taking-In (2-3 days, reflection, passivity)
- Taking-Hold (Initiating action, interest for child)
- Letting-Go (Redefining new roles)
Pregnancy Complications
- Diabetes Mellitus
- Bleeding during Pregnancy, including threatened miscarriage, imminent/inevitable miscarriage, missed miscarriage, incomplete miscarriage, complete miscarriage, ectopic pregnancy, hydatidiform mole, premature cervical dilatation
Placenta Previa
- Condition of pregnancy in which the placenta implants abnormally in uterus
- Painless bleeding in 3rd trimester
Abruptio Placentae
- Premature separation of placenta from uterine wall during pregnancy
- Sharp, stabbing pain, heavy bleeding, DIC can occur
PIH (Pregnancy-Induced Hypertension)
- Vasospasm in small and large arteries during pregnancy
- Classic signs: hypertension, proteinuria, and edema.
- Classifications: gestational hypertension, preeclampsia, eclampsia
- Management: low-dose aspirin, bed rest, monitoring, nutritional support, and medications
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Description
Test your knowledge on key aspects of pregnancy and fetal development with this informative quiz. Questions cover topics such as fetal heart tones, surfactant components, and recommended weight gain during pregnancy. Perfect for students in obstetrics or individuals interested in maternal health.
