Summary NSG 307 Exam 1 Study Guide NSG 307 Care of the Childbearing Client | Already Graded A

NSG 307 Care of the Childbearing Client Exam 1 Study Guide Please use the PowerPoints to guide your textbook reading/study. This is not an all-inclusive Study Guide. You will need to do your book r eadings as well as review your PowerPoints. Community Health Concepts: Reproductive Health • Infant and maternal mortality rates as an indicator of health • Purpose of preconception counseling • Issues of pregnancy and infancy o Infant mortality o Preterm and low birth weight o Preconception health o Prenatal care o Prenatal substance abuse o Breast feeding • Reproductive health and nutrition • Primary, Secondary, and Tertiary Prevention measures o Primary: education, prevention; educating on prenatal vitamins, care, and diet o Secondary: screening; screening for glucose tolerance o Tertiary: preventing worsening of disease Ch 3 Female Reproductive System • External and internal structures o External ▪ Vulva, mons pubis, labia majora, labia minora, prepuce, clitoris, urethra, Skeen and Bartholin glands, perineum o Internal ▪ Vagina, uterine ligaments, uterus, fundus, uterine wall (endometrium, myometrium, perimetrium), cervix, squamocolumnar junction, uterine (fallopian tubes), ovaries • Menstrual Cycle (Hypothalamic-pituitary cycle, Ovarian cycle, & Endometrial cycle) o Hypothalamic-pituitary cycle ▪ Gonadotropin-releasing hormone (GnRH): is triggered by low levels of estrogen and progesterone ▪ Follicle-stimulating hormone (FSH): anterior pituitary stimulated by GnRH, stimulates development of ovarian Graafian follicle’s and their production of estrogen ▪ Luteinizing hormone (LH): anterior pituitary stimulated by GnRH, a marked surge and smaller peak of estrogen causes release of ovum o Ovarian cycle ▪ Graafian follicles (follicular phase) ovulation: oocyte matures ▪ Corpus luteum (luteal phase): (ranges 13-15 days) begins immediately after ovulation and ends up with the start of menstruation; peak functional activity 8 days after ovulation ▪ Estrogen and progesterone: increase allows fertilized ovum to be implanted ▪ What happens during ovulation o Endometrial cycle ▪ Menstrual phase: Shedding of the functional two thirds of the endometrium is initiated by vasocontraction ▪ Proliferative phase: rapid growth lasting from the fifth day to the time of ovulation • Completely restored in 4 days or slightly before bleeding ceases ▪ Secretory phase: day of ovulation to about 3 days before then next menstrual period • Large amounts of progesterone ▪ Ischemic phase: occurs 7-10 days after ovulation • Signs and Symptoms of ovulation o Spike in temperature o Changes in cervix and cervical mucus thin and clear o Localized abdominal pain (mittelschmerz) o Some spotting may occur Ch 6 Genetics • Prenatal tests, carrier screening tests, and predictive testing o Prenatal test ▪ Maternal serum screening • Blood test ▪ Fetal ultrasound or sonogram • Use to see fetus inside utero ▪ Invasive procedures • Chorionic villus sampling and amniocentesis o 2 different times you do amniocentesis. Know when and what you’re looking for. What do their results mean? o invasive definitive tests on fetal cells can be obtained through amniocentesis (during second trimester) and chorionic villus sampling (during 1st trimester) are offered by providers to test for fetal chromosomal abnormalities. o Looking for chromosomal abnormalities of the fetus o Carrier screening test ▪ Test parents to see if they carry the gene o Predictive testing ▪ Presymptomatic: has the gene and shows symptoms ▪ Predispositional: has the gene but does not show symptoms • Number of chromosomes and karyotyping o 46 chromosomes o Karyotype: pictorial analysis of the number, form, and size of the individual’s chromosomes • Autosomal dominant disorders and estimation of risk of occurrence o 50 % chance of passing the gene o Huntington disease, achondroplasia, neurofibromatosis, polycystic kidney disease • Autosomal recessive disorders and estimation of risk of occurrence o 25% chance of passing the gene o Cystic fibrosis, PKU, Tay-Sachs disease, sickle cell anemia, inborn errors of metabolism Ch 6 Conception and Fetal Development • Process of Conception (Fertilization) and implantation o Ovulation the ovum is released (estrogen levels increase to enhance cilia propel ovum down the fallopian tube) o Once the ovum gets to ampulla, fertilization occurs 3-4 days and the fertilized ovum comes to the uterus o 6-10 days after conception implantation occurs • Pregnancy duration including pre-embryonic, embryonic and fetal periods o Pre-embryonic: fertilization to 2 weeks o Embryonic: 2 weeks to 8 weeks o fetal • Functions of amniotic fluid o Maintain constant body temp o Serves as a source of oral fluid and repository for waste o Assist in maintenance of fluid and electrolyte homeostasis o Cushions fetus from trauma o Allows freedom of movement for musculoskeletal development o Barrier to infection and allows fetal lung development o Fluid keeps embryo from tangling with the membranes facilitating symmetric growth • Placental endocrine functions (know role during pregnancy) o hCG first hormone secreted and then gradually decline as placenta takes over o progesterone ▪ produced after corpus luteum stops functioning ▪ maintains endometrium ▪ decreases uterine contractility ▪ stimulates maternal metabolism o estrogen ▪ responsible for enlargement of uterine, breasts and breast glandular tissue ▪ role in increasing contractility ▪ stimulates uterine contractility o hCS ▪ hPL ▪ stimulates maternal metabolism ▪ increases resistance to insulin • Fetal maturation week by week o Know why amniotic fluid is important and what its made out of (in notebook) ▪ Formed by transudate of fetal plasma and later fetal urine (11wks) o 4 weeks ▪ Heart formed and beating, eyes and ear begin to form o 8 weeks ▪ Human form ▪ Every organ system and external structures present ▪ CNS remains vulnerable to teratogens ▪ Growth and refinement o 12 weeks ▪ Head dominate ▪ Fetal heart rate heard by electronic devices (ex: doppler) ▪ Gender apparent o 16 weeks ▪ Quickening in multigravida