BSNC 5000 OB Final Exam Questions
with Answers Graded A+
Health benefits of breastfeeding - Answer-- best nutrition for baby, all they need for first
6 months
- changes as baby grows, so it always provides the right nutrition
- easy to digest, supports babys growth, helps baby develop mentally and emotionally
- helps babys immune and digestive systems mature and work effectively
- may have lower rates of illnesses and diseases (sids, GI, ear, obesity, diabetes)
- helps bonding
- lowers maternal risk of disease like breast cancer, ovarian cancer, and diabetes
- always available, free, right temperature, cannot overfeed
3 stages of lactogenesis - Answer-I: begins around 16-18 weeks of pregnancy, brasts
are preparing for milk production by producing colostrum
II: begins with birth as progesterone levels drop after delivery of placenta, 2-3 days of
colostrum, mom's milk comes in around 3-5 days
III: breast milk continues to change in composition for 10 days when mature milk is
established
Colostrum - Answer-rich in antibodies, high in protein, low in fat, facilitates binding of
bilirubin, laxative action promotes passage of meconium, and important in the
establishment of healthy gut flora in the digestive tract
Foremilk vs hindmilk - Answer-foremilk - beginning of feed, contains lactose and protein,
low in calories
10-20 minutes later...
hindmilk - high in fat and calories, necessary for ensuring optimal growth and
contentment between feeds
first 24 hour of feeds - Answer-- first feed within 1-2 hours of birth
- minimum feeds: 5
- encourage mothers to recognize infant feeding cutes (crying is too late)
- average total feeding amount on day 1 = 6 mL
24-72 hours feeds - Answer-- minimum 8 times per 24 hours
- offer both breasts per feet to stimulate production, feed until baby satiated (20-50
mins)
,- unwrap infant before feed to keep them awake and alert
- monitor weight loss/gain after 24 hours
Weight loss concern - Answer-loss of greater than 7-10% in the first 4 days postpartum
for SVDs or 5 days for C/S indicates continued assessment needs for feeding
alternative feeding techniques - Answer-cup feeding, spoon/dropped/syringe, finger-
feeding
implications for breastmilk substitutes - Answer-- donor milk then formula
- infants that weight less than 1500g
- infants born less than 32 weeks GA
- infants who are unable to feed due to congenital malformations or illness
- infants at risk for hypoglycemia
- baby has jaundice, mothers milk hasnt come in yet
- if mother needs to pump and dump due to medications
- mom does not want to breastfeed
Causes of poor thermoregulation - Answer-- low brown fat means limited ability to
generate heat as needed
- low white fat deposition means limited insulating abilities
Non-shivering thermogenesis - Answer-heat loss --> cold stress to infant -->
thermoreceptors --> hypothalamus increase sympathetic activity -->
- thyroid stimulating hormone --> thermogenin --> brown adipose tissue
- norepinephrine --> vasoconstriction and brown adipose tissue
- brown adipose tissue --> norepinephrine --> monodeiodinase --> thermogenin -->
brown adipose tissue
brown fat genereates heat by mitochondria --> warms up baby
Cold stress - Answer-increased metabolic rate --> increased O2 consumption
vasoconstriction --> decreases blood flow to periphery, decreases uptake via lngs
HPV: babies are susceptible to hypoxic pulmonary vasoconstruction during first 3 weeks
of life
tissue hypoxia --> anaerobic respiration --> metabolic acidosis
Normal baby temp - Answer-36.5-37.4 axilla
Describe the psychosocial adaptation to pregnancy for mother, partner, sibling(s) and
other caregivers - Answer-Maternal/paternal adaptation: accepting the pregnancy →
, identifying with the mother/father role → reordering personal relationships →
establishing a relationship with the fetus → preparing for childbirth
Sibling adaptation: concerns about losing their place in the family hierarchy
Other caregivers: grandparents can act as a family historian, experienced caregivers
can act as resource persons who share knowledge, any caregivers can provide support
to strengthen the family system and widen the circle of nurturance
Describe the stages of a healthy pregnancy and normal growth and development. -
Answer-Ovum/pre-embryonic: conception until day 14
- Covers cellular replication, blastocyst formation, initial development of the embryonic
membranes, and establishment of the primary germ layer
Embryo: day 15 until 8 weeks after conception
- Most critical time in the development of the organ systems and the main external
features. Developing areas with rapid cell division are the most vulnerable areas to
malformation caused by environmental teratogens
Membranes, amniotic fluid, yolk sac, umbilical cord, placenta
Fetus: 9 weeks until pregnancy ends
- Refinement of structure until fetus reaches viability
Teratogens - Answer-Something that is going to affect the anatomical or the
physiological development of the embryo during the embryonic stage and/or the fetus
during the fetal stage
It can cause the termination of the pregnancy before it even happens (depends on type
of teratogen and severity of exposure, typically occurs during early days of pregnancy)
Examples: alcohol and tobacco products; environmental toxins, chemicals, radiation;
some prescription medications; maternal medical conditions; infections (TORCH)
Causes of developmental malformations - Answer-20-25%: genetic anomalies
5%: environmental factors (intrauterine infections, maternal metabolic disorders,
environmental chemicals, drugs, medications, radiation, etc.)
65-75%: multifactorial or unknown (ex. genetic + environmental)
When is exposure to teratogens most severe - Answer-week 5 (embryonic period,
weeks 3 to 8) as this is when all organ systems are being laid down
prior to embryonic period, there are no organ systems developing yet (just cellular
division), so there are no structural defects (however exposure can prevent implantation
to uterine wall)
List TORCH infections - Answer-Toxoplasmosis
with Answers Graded A+
Health benefits of breastfeeding - Answer-- best nutrition for baby, all they need for first
6 months
- changes as baby grows, so it always provides the right nutrition
- easy to digest, supports babys growth, helps baby develop mentally and emotionally
- helps babys immune and digestive systems mature and work effectively
- may have lower rates of illnesses and diseases (sids, GI, ear, obesity, diabetes)
- helps bonding
- lowers maternal risk of disease like breast cancer, ovarian cancer, and diabetes
- always available, free, right temperature, cannot overfeed
3 stages of lactogenesis - Answer-I: begins around 16-18 weeks of pregnancy, brasts
are preparing for milk production by producing colostrum
II: begins with birth as progesterone levels drop after delivery of placenta, 2-3 days of
colostrum, mom's milk comes in around 3-5 days
III: breast milk continues to change in composition for 10 days when mature milk is
established
Colostrum - Answer-rich in antibodies, high in protein, low in fat, facilitates binding of
bilirubin, laxative action promotes passage of meconium, and important in the
establishment of healthy gut flora in the digestive tract
Foremilk vs hindmilk - Answer-foremilk - beginning of feed, contains lactose and protein,
low in calories
10-20 minutes later...
hindmilk - high in fat and calories, necessary for ensuring optimal growth and
contentment between feeds
first 24 hour of feeds - Answer-- first feed within 1-2 hours of birth
- minimum feeds: 5
- encourage mothers to recognize infant feeding cutes (crying is too late)
- average total feeding amount on day 1 = 6 mL
24-72 hours feeds - Answer-- minimum 8 times per 24 hours
- offer both breasts per feet to stimulate production, feed until baby satiated (20-50
mins)
,- unwrap infant before feed to keep them awake and alert
- monitor weight loss/gain after 24 hours
Weight loss concern - Answer-loss of greater than 7-10% in the first 4 days postpartum
for SVDs or 5 days for C/S indicates continued assessment needs for feeding
alternative feeding techniques - Answer-cup feeding, spoon/dropped/syringe, finger-
feeding
implications for breastmilk substitutes - Answer-- donor milk then formula
- infants that weight less than 1500g
- infants born less than 32 weeks GA
- infants who are unable to feed due to congenital malformations or illness
- infants at risk for hypoglycemia
- baby has jaundice, mothers milk hasnt come in yet
- if mother needs to pump and dump due to medications
- mom does not want to breastfeed
Causes of poor thermoregulation - Answer-- low brown fat means limited ability to
generate heat as needed
- low white fat deposition means limited insulating abilities
Non-shivering thermogenesis - Answer-heat loss --> cold stress to infant -->
thermoreceptors --> hypothalamus increase sympathetic activity -->
- thyroid stimulating hormone --> thermogenin --> brown adipose tissue
- norepinephrine --> vasoconstriction and brown adipose tissue
- brown adipose tissue --> norepinephrine --> monodeiodinase --> thermogenin -->
brown adipose tissue
brown fat genereates heat by mitochondria --> warms up baby
Cold stress - Answer-increased metabolic rate --> increased O2 consumption
vasoconstriction --> decreases blood flow to periphery, decreases uptake via lngs
HPV: babies are susceptible to hypoxic pulmonary vasoconstruction during first 3 weeks
of life
tissue hypoxia --> anaerobic respiration --> metabolic acidosis
Normal baby temp - Answer-36.5-37.4 axilla
Describe the psychosocial adaptation to pregnancy for mother, partner, sibling(s) and
other caregivers - Answer-Maternal/paternal adaptation: accepting the pregnancy →
, identifying with the mother/father role → reordering personal relationships →
establishing a relationship with the fetus → preparing for childbirth
Sibling adaptation: concerns about losing their place in the family hierarchy
Other caregivers: grandparents can act as a family historian, experienced caregivers
can act as resource persons who share knowledge, any caregivers can provide support
to strengthen the family system and widen the circle of nurturance
Describe the stages of a healthy pregnancy and normal growth and development. -
Answer-Ovum/pre-embryonic: conception until day 14
- Covers cellular replication, blastocyst formation, initial development of the embryonic
membranes, and establishment of the primary germ layer
Embryo: day 15 until 8 weeks after conception
- Most critical time in the development of the organ systems and the main external
features. Developing areas with rapid cell division are the most vulnerable areas to
malformation caused by environmental teratogens
Membranes, amniotic fluid, yolk sac, umbilical cord, placenta
Fetus: 9 weeks until pregnancy ends
- Refinement of structure until fetus reaches viability
Teratogens - Answer-Something that is going to affect the anatomical or the
physiological development of the embryo during the embryonic stage and/or the fetus
during the fetal stage
It can cause the termination of the pregnancy before it even happens (depends on type
of teratogen and severity of exposure, typically occurs during early days of pregnancy)
Examples: alcohol and tobacco products; environmental toxins, chemicals, radiation;
some prescription medications; maternal medical conditions; infections (TORCH)
Causes of developmental malformations - Answer-20-25%: genetic anomalies
5%: environmental factors (intrauterine infections, maternal metabolic disorders,
environmental chemicals, drugs, medications, radiation, etc.)
65-75%: multifactorial or unknown (ex. genetic + environmental)
When is exposure to teratogens most severe - Answer-week 5 (embryonic period,
weeks 3 to 8) as this is when all organ systems are being laid down
prior to embryonic period, there are no organ systems developing yet (just cellular
division), so there are no structural defects (however exposure can prevent implantation
to uterine wall)
List TORCH infections - Answer-Toxoplasmosis
