NURS 131 Exam 2 Notes

jasmine's version from 2016-05-11 12:51

Section 1

Question Answer
2 Phases of the ovarian cycle Follicle and Luteal
Follicle Phase (days 1-14) Follicle matures and ovulation occurs
Luteal Phase (days 15-28) Begins when the ovum leaves the follicle, and the corpus luteum develops from the ruptured follicle
Four phases of menstrual cycle Menstrual, proliferation, secretory, and ischemic (if plantation does not occur)
Menstrual Occurs during the menstrual phase with shedding of some, but not all, endometrial cells
Proliferation The endometrial cells enlarge and become twisted under the influence of estrogen, and the endometrium thickens
Secretory Progesterone causes marked swelling and the amount of tissue glycogen increases. Vascularity of the entire uterus increases greatly, providing a nourishing bed for implantation
Ischemic (if implantation does not occur) Corpus luteum begins to degenerated Estrogen and progesterone levels fall. This phase is characterized by the escape of blood into the stromal cells of the endometrium/myometrium
Microbiome Full collection of microbes that naturally exist within the body; The microorganisms in a particular environment (including the body or a part of the body)
Alterations or disruptions in core microbiome associated with chronic illness Crohns disease; increased susceptibility to infection; allergy; Necrotising Enterocolitis (NEC) (vomiting green bile)
Necrotising Enterocolitis (NEC) An inflammation of the bowel (intestines) that may damage the bowel to a variable extent. It usually causes a temporary intolerance of milk feeds but at its worse the bowel may be so damaged that parts of it actually die. NEC may affect just a small part of the bowel or, on occasions, the whole bowel may be affected. It has a variable course ranging from feed intolerance and abdominal distension (swelling) to a sudden collapse of a baby who had previously been relatively well
Microbiome beneficial effect for the host Nutrient metabolism; Tissue development; Resistance to colonization with pathogens; Maintenance of intestinal homeostasis; Immunological activation and protection of GI integrity
Core microbiome established Soon after birth
Core microbiome of breastfeeding infant similar to Core microbiome of lactating mother
Components of breastmilk supporting establishment of microbiome Probiotics and prebiotics
Specific proteins in breast milk Lactoferrin, Secretory IgA, Lysozyme, Bifidus factor
Lactoferrin Inhibits the growth of iron-dependent bacteria in the GI tract; this inhibits certain organisms such as coliforms and yeast that require iron
Secretory IgA Works to protect the infant from viruses and bacteria, specifically those that the baby, mom, and family are exposed to; It also helps to protect against E. coli and possibly allergies; Other immunoglobulins, including IgG and IgM, in breast milk also help protect against bacterial and viral infections; Eating fish can help increase the amount of these proteins in breastmilk
Lysozyme An enzyme that protects the infant against E. coli and Salmonella; It also promotes the growth of healthy intestinal flora and has anti-inflammatory functions
Bifidus factor Supports the growth of lactobacillus; Lactobacillus is a beneficial bacteria that protects the baby against harmful bacteria by creating an acidic environment where it cannot survive

Section 2

Question Answer
First trimester weeks 1-12 weeks
Second trimester weeks 13-28 weeks
Third trimester weeks 29-40 weeks
The fetus is approximately what size at 9 weeks A quarter
The fetus is approximately what size at 12 weeks 3 inches
The fetus is approximately what size at 16 weeks 4 inches
The fetus is approximately what size at 20 weeks 6 inches and 9 ounces
The fetus is approximately what size at 24 weeks 8.5 inches and 1.5 lbs
The fetus is approximately what size at 28 weeks 10 inches and 2.7 lbs
The fetus is approximately what size at 32 weeks 11.5 inches and 4 lbs
The fetus is approximately what size at 38 weeks 14 inches and 6.8 lbs
CNS development approximately begins at what week? Week 3
Weeks 2 through 8 development Differentiation of cells; Especially sensitive to teratogens
Weeks 16 through 20 development Quicking is felt
Weeks 23 and 24 development Fetal viability (the ability of a thing [a living organism, an artificial system, an idea, etc.] to maintain itself or recover its potentialities)
Week 37 development Lung maturity
Statistical twin birth rate 33.9 per 1,000 live births
Statistical triplet or higher order birth rate 113.5 per 100,000 live births
How much does the placenta weigh at term? 2 lbs
Placenta metabolics Glycogen, cholesterol and fatty acids-Production for embryo and placenta
Placenta transfer process O2, nutrients, and antibodies to fetus, CO2 and waste products to mother
Placenta endocrine process Human chorionic gonadotropin (HCG), Human placental lactogen (HPL), Estrogen, Progesterone to maintain pregnancy

Section 3

Question Answer
Progesterone Influences the growth in size of alveoli and lobes; high levels of progesterone inhibit lactation before birth. Progesterone levels drop after birth; this triggers the onset of copious milk production
EstrogenStimulates the milk duct system to grow and differentiate. Like progesterone, high levels of estrogen also inhibit lactation. Estrogen levels also drop at delivery and remain low for the first several months of breastfeeding. Breastfeeding mothers should avoid estrogen-based birth control methods, as a spike in estrogen levels may reduce a mother's milk supply.
Prolactin Contributes to the increased growth and differentiation of the alveoli, and also influences differentiation of ductal structures. High levels of prolactin during pregnancy and breastfeeding also increase insulin resistance, increase growth factor levels (IGF-1) and modify lipid metabolism in preparation for breastfeeding. During lactation, prolactin is the main factor maintaining tight junctions of the ductal epithelium and regulating milk production through osmotic balance.
Human placental lactogen (HPL) From the second month of pregnancy, the placenta releases large amounts of HPL. This hormone is closely associated with prolactin and appears to be instrumental in breast, nipple, and areola growth before birth.
Follicle stimulating hormone (FSH), luteinizing hormone (LH), human chorionic gonadotropin (hCG) Through control of estrogen and progesterone production, and also, by extension, prolactin and growth hormone production, are essential.
Growth hormone (GH) Is structurally very similar to prolactin and independently contributes to its galactopoiesis (formation/production and secretion of milk by mammary glands)
Adrenocorticotropic hormone (ACTH) and glucocorticoids such as cortisol Have an important lactation inducing function in several animal species, including humans. Glucocorticoids play a complex regulating role in the maintenance of tight junctions.
Thyroid-stimulating hormone (TSH) and thyrotropin-releasing hormone (TRH) Are very important galactopoietic hormones, stimulating prolactin release from lactotrophs in a dose-dependent manner, whose levels are naturally increased during pregnancy
Oxytocin Contracts the smooth muscle of the uterus during and after birth, and during orgasm(s). After birth, oxytocin contracts the smooth muscle layer of band-like cells surrounding the alveoli to squeeze the newly produced milk into the duct system. Oxytocin is necessary for the milk ejection reflex, or let-down, in response to suckling, to occur

Section 4

Question Answer
Hypoglycemia Deficiency of glucose in the bloodstream
Polycythemia An abnormally increased concentration of hemoglobin in the blood, through either reduction of plasma volume or increase in red cell numbers. It may be a primary disease of unknown cause, or a secondary condition linked to respiratory or circulatory disorder or cancer
Galactosemia A rare genetic metabolic disorder that affects an individual's ability to metabolize the sugar galactose properly; Follows an autosomal recessive mode of inheritance that confers a deficiency in an enzyme responsible for adequate galactose degradation
Which one of the 3 major types, IgG, IgA, and IgM, of immunoglobulins primarily involved in immunity cross the placenta? IgG
Active acquired immunity When pregnant woman forms antibodies in response to illness or immunization
Passive acquired immunity When IgG antibodies are transferred from the pregnant woman to the fetus in utero
Fetus and antibodies Does not produce IgG antibodies
What is one reason preterm newborns (especially those born before 34 weeks of gestation) may be more susceptible to infection than term newborns? Maternal IgG is transferred primarily during the 3rd trimester
Vivo Within the living; Effects of various biological entities are tested on whole, living organisms
Vitro Within the glass; Partial or dead organism, or those tested within this