OB NURS 306 Final Exam Study Guide | Complete to Score 100% (2023/2024)

OB NURS 306 Final Exam Study Guide | Complete to Score 100% (2023/2024) Chapter 3 Genetics, Conception, Fetal Development, and Reproductive Technology ! Genetics " study of heredity ! Genomics " addresses all genes and their interrelationships in order to identify their combined influence on growth and development of the organism o Providing better methods for preventing disease and abnormalities, diagnosing diseases, predicting health risks, personalizing treatment plans ! 30,000 genes in the human genome (organism’s complete set of DNA) ! 46 chromosomes; 22 homologous pairs of chromosomes and one pair of sex chromosomes ! genotype " person’s genetic makeup ! phenotype " how genes are outwardly expressed (eye color, hair color, height) ! recessive genetic disorders " sickle cell anemia, cystic fibrosis, thalassemia, Tay-Sachs disease ! carrier testing " identify individuals who carry one copy of a gene mutation that, when present in two copies causes a genetic disorder; used when there is a family history of genetic disorder ! preimplantation testing/preimplantation genetic diagnosis " used to detect genetic changes in embryos that are created using assisted reproductive techniques ! prenatal testing " early detection of genetic disorders ! risks for conceiving child with genetic disorder " maternal age older than 35, man/woman who has genetic disorder; family history of genetic disorder, history of previous pregnancy resulting in a genetic disorder or newborn abnormalities ! refer to support group whether they wish to terminate/continue with pregnancy ! sickle cell anemia o most common of African ancestry o sickle-cell hemoglobin forms rigid crystals that distort and disrupt RBCs; oxygen-carrying capacity of blood is diminished ! cystic fibrosis o most common genetic disease of European ancestry o production of thick mucus clogs in bronchial tree and pancreatic ducts o most severe effects are chronic respiratory infections and pulmonary failure ! Tay-Sach disease o Most common among Jewish ancestry o Degeneration of neurons and nervous system results in death by the 2 years old ! PKU o Lack of enzyme to metabolize the amino acid phenylalanine " leads to severe mental and physical retardation o Effects may be prevented by use of a diet at beginning of birth that limits phenylalanine ! Huntington’s Disease o Uncontrollable muscle contractions between 30-50 years followed by memory loss and personality o No treatment that can delay mental deterioration ! Hemophilia (X-linked) o Lack of factor 8 o Can be controlled with factor 8 from donated blood ! Duchenne’s Musclular Dystrophy o Replacement of muscle by adipose or scare tissue with progressive loss of muscle function; often fatal before age 20 due to involvement of cardiac muscle ! teratogens " any drugs, viruses, infections, or other exposures that can cause embryonic/fetal developmental abnormality ! degree or types of malformation vary on length of exposure, amount of exposure, and when it occurs during human development ! developing human is most vulnerable to effects of teratogens within first 8 weeks of gestation (organogenesis) " can cause gross structural defects ! exposure after 13 weeks may cause fetal growth restriction or reduction of organ size ! toxoplasma is a protozoan parasite found in cat feces and uncooked/rare beef and lamb o can cause fetal demise, mental retardation, blindness when fetus is exposed o avoid contact with cat feces and eating rare beef or lamb if pregnant or attempting pregnancy ! rubella " increased risk for heart defects, deafness and/or blindness, mental retardation, fetal demise ! cytomegalovirus " increased risk for hydrocephaly, microcephaly, cerebral calcification, mental retardation, hearing loss ! herpes varicella/chicken pox " increased risk for hypoplasia of hands and feet, blindness/cataracts, mental retardation ! syphilis " increased risk for skin, bone and/or teeth defects, fetal demise ! cocaine " increased risk for heart, limbs, face, GI/GU tract defects, cerebral infarctions, placental abnormalities Chapter 4 Physiological Aspects of Antepartum Care ! 2! ! G/P System o Gravida: # times a woman has been pregnancy including current pregnancy o Para: # of births after 20 weeks’ gestation whether live or stillbirths o Abortions are not accounted for in this system ! GTPAL o G: # times pregnancy o T: # of term infants born after 37 weeks o P: # of preterm infants between 20 and 37 weeks o A: # of abortions either spontaneous or induced before 20 weeks o L: # of living children ! Nulligravida: woman who has never been pregnant or given birth ! Primigravida: woman who is pregnant for the first time ! Multigravida: someone who is pregnant for at least the second time ! Prenatal period " entire time period during which a woman is pregnant through birth of baby ! Nurse places emphasis on health education and health promotion ! Family-centered maternity care is a model of obstetrical care based on a view of pregnancy and childbirth as a normal life event, a life transition that is not primarily medical but rather developmental ! Low-risk population should have approximately 14-16 prenatal visits per pregnancy ! First trimester o Woman learns frequency of follow-up visits and what to expect from pregnancy visits as pregnancy progresses during initial visit o Comprehensive health and risk assessment; currently pregnancy history; complete physical and pelvic examination; nutrition assessment; psychosocial assessment; assessment for intimate partner violence o Fetal heart tones are auscultated with US Doppler, initially by 10 and 12 weeks o At end of first trimester, fetus is 3 inches in length and weights 1-2 ounces, all organ systems are present o Assessment of uterine growth after 10-12 weeks is measured by height of fundus with centimeter measuring tape; zero point of tape is placed on the symphysis pubis and tape is extended to top of fundus; MEASUREMENT SHOULD EQUAL # OF WEEKS PREGNANT o Certain types of fish (king mackerel, shark, swordfish, tilefish) should be avoided due to high levels of methylmercury ! Second trimester o Chart review