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BSNC 5000 (MATERNITY) MODULE 1 EXAM QUESTIONS AND ANSWERS

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BSNC 5000 (MATERNITY) MODULE 1 EXAM QUESTIONS AND ANSWERS What hormone increases blood flow? - Answer-Estrogen How to measure blood flow? - Answer-Doppler ultrasound, fetal stethoscope What cervical changes occur during pregnancy? - Answer-The cervix is very responsive to hormonal changes of pregnancy. Cervix is firm, non-distensible, closed structure which changes to a highly elastic tissue that dilates and becomes almost indistinguishable during labor in preparation for birth. What is ballottement? - Answer-Changes related to the presence of the fetus. Passive movement of the unengaged fetus. What is prolactin? - Answer-Stimulates production of colostrum by end of the first trimester. In second trimester, hPL stimulates secretion of colostrum. Highest in the first 10 days after birth between 2-4am - in response to infant suckling to the breast. Why do mom's have slight cardiac hypertrophy? - Answer-Secondary to increased blood volume and cardiac output that occurs in pregnancy. Heart returns to normal size 6 months after pregnancy. Circulation and coagulation times during pregnancy. - Answer-Pregnancy is a hypercoaguable state - 5-6x increased risk for thromboembolic disease. Circulation time decreases slightly by week 32. Increase in clotting factors (VII, VIIIm IX, and X, and fibrinogen). Decrease in factors that inhibit coagulation. clot suppression/lysis is suppressed during pregnancy to protect against blood loss. Hematologic lab value changes during pregnancy. - Answer-hgb and hct decreases due to plasma increase. Increase in RBC. Respiratory system changes during pregnancy. - Answer-Maternal oxygen consumption increases during pregnancy by 20-40%. In advanced pregnancy, chest breathing replaces abdominal breathing, becomes less possible for the diaphragm to descend with inspiration. What changes occur to the URT? - Answer-The upper respiratory tract becomes more vascular in response to elevated levels of estrogen. Edema and hyperemia develop. What is the role of oxytocin? - Answer-stimulates uterine contractions and promotes birth, increased during breastfeeding due to suckling reflex, uterine involution (after pains). What can inhibit breast milk production? - Answer-Stress, fear, alcohol consumption, decreased oxytocin. Fluid and electrolyte imbalance. - Answer-Increase in total body water is linked to total blood volume. Increased water loss induces polydipsia. Glycosuria occurs at varying times. What is acroesthesia? - Answer-Numbness and tingling of hands caused by stoop-shouldered stance. What is hyperemesis gravidarum? - Answer-An electrolyte imbalance or ketonuria, characterized by persistent vomiting that leads to weight loss of greater than 5% or pre-pregnancy weight. Stages of adaptation during pregnancy. - Answer-Accepting the pregnancy. Identifying the role of the mother. Establishing relationship with unborn child. Establishing a relationship with the fetus. Preparing for birth. Sibling adaptation. When is the first trimester? - Answer-0-14 weeks. Fast growth and development. At highest risk for hazards. When is the second trimester? - Answer-15-27 weeks. Baby brain begins to develop. When is the third trimester? - Answer-28-40 weeks. Preparing to be born. Can safely arrive at 36 weeks. What is TORCH? What are the modes of transmission? - Answer-T- toxoplasmosis O - other: Syphilis, parovirus, B19, Hepatitis R- rubella C - cytomegalovirus (CMV) H - HSV Modes of transmission: Transplacental - transmission from the maternal circulation through the placenta to the fetal blood supply. Contact - with maternal body fluids during the birthing process (CMV, HSV, HepB) Breastmilk - in premature or small for gestational age babies (CMV) What are teratogens? - Answer-Environmental substances or exposures that result in functional or structural disability. Known human teratogens are drugs and chemicals, infections, exposure to radiation. Greatest effect from 15 to 60 days. Weeks 3 to 8 the fetus is at greatest risk for being affected by a teratogen. What is non-severe preeclampsia vs. severe preeclampsia? - Answer-Pre-eclampsia defined as BP 140/90 with proteinuria. Severe pre-eclampsia: BP 160/110 and proteinuria 3g/dL/day Can lead to HELLP syndrome id damage done to the liver. Pathophysiology of pre-eclampsia: Incomplete transformation of the spiral arteries - oxygen and nutrient supply do not match rate of fetal growth.

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BSNC 5000 (MATERNITY) MODULE
1 EXAM QUESTIONS AND
ANSWERS

What hormone increases blood flow? - Answer-Estrogen

How to measure blood flow? - Answer-Doppler ultrasound, fetal stethoscope

What cervical changes occur during pregnancy? - Answer-The cervix is very responsive
to hormonal changes of pregnancy. Cervix is firm, non-distensible, closed structure
which changes to a highly elastic tissue that dilates and becomes almost
indistinguishable during labor in preparation for birth.

What is ballottement? - Answer-Changes related to the presence of the fetus. Passive
movement of the unengaged fetus.

What is prolactin? - Answer-Stimulates production of colostrum by end of the first
trimester. In second trimester, hPL stimulates secretion of colostrum. Highest in the first
10 days after birth between 2-4am - in response to infant suckling to the breast.

Why do mom's have slight cardiac hypertrophy? - Answer-Secondary to increased
blood volume and cardiac output that occurs in pregnancy. Heart returns to normal size
6 months after pregnancy.

Circulation and coagulation times during pregnancy. - Answer-Pregnancy is a
hypercoaguable state - 5-6x increased risk for thromboembolic disease. Circulation time
decreases slightly by week 32.
Increase in clotting factors (VII, VIIIm IX, and X, and fibrinogen). Decrease in factors
that inhibit coagulation. clot suppression/lysis is suppressed during pregnancy to protect
against blood loss.

Hematologic lab value changes during pregnancy. - Answer-hgb and hct decreases due
to plasma increase. Increase in RBC.

Respiratory system changes during pregnancy. - Answer-Maternal oxygen consumption
increases during pregnancy by 20-40%. In advanced pregnancy, chest breathing
replaces abdominal breathing, becomes less possible for the diaphragm to descend
with inspiration.

What changes occur to the URT? - Answer-The upper respiratory tract becomes more
vascular in response to elevated levels of estrogen. Edema and hyperemia develop.

, What is the role of oxytocin? - Answer-stimulates uterine contractions and promotes
birth, increased during breastfeeding due to suckling reflex, uterine involution (after
pains).

What can inhibit breast milk production? - Answer-Stress, fear, alcohol consumption,
decreased oxytocin.

Fluid and electrolyte imbalance. - Answer-Increase in total body water is linked to total
blood volume. Increased water loss induces polydipsia. Glycosuria occurs at varying
times.

What is acroesthesia? - Answer-Numbness and tingling of hands caused by stoop-
shouldered stance.

What is hyperemesis gravidarum? - Answer-An electrolyte imbalance or ketonuria,
characterized by persistent vomiting that leads to weight loss of greater than 5% or pre-
pregnancy weight.

Stages of adaptation during pregnancy. - Answer-Accepting the pregnancy. Identifying
the role of the mother. Establishing relationship with unborn child. Establishing a
relationship with the fetus. Preparing for birth. Sibling adaptation.

When is the first trimester? - Answer-0-14 weeks. Fast growth and development. At
highest risk for hazards.

When is the second trimester? - Answer-15-27 weeks. Baby brain begins to develop.

When is the third trimester? - Answer-28-40 weeks. Preparing to be born. Can safely
arrive at 36 weeks.

What is TORCH? What are the modes of transmission? - Answer-T- toxoplasmosis
O - other: Syphilis, parovirus, B19, Hepatitis
R- rubella
C - cytomegalovirus (CMV)
H - HSV

Modes of transmission:
Transplacental - transmission from the maternal circulation through the placenta to the
fetal blood supply.

Contact - with maternal body fluids during the birthing process (CMV, HSV, HepB)

Breastmilk - in premature or small for gestational age babies (CMV)

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