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NURP 531 Exam 3 Questions And Complete Answers
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NURP 531 Exam 3 Questions AndComplete Answers
What is the placenta made of? When is it considered mature? When is it considered
old/inviable? What should you do? - Answer - organ of pregnancy made from maternal
and fetal tissue that attaches to uterine wall on side of implantation and into the fetus via
umbilical cord
- mature at 34 weeks and anything over 42 weeks- must do UX to make sure placenta is
still viable and not creating calcium deposits
What are the functions of the placenta? - Answer - transport of nutrients, antibodies and
oxygen to fegus
- transfer of waste products/CO2 back from motherf from fetus
- gas exchange
- protective barrier
- produces and secretes hormones
- delivered around 30 minutes after baby is delivered by birth canal or removed with
c-section
T/F: one baby is born and umbicial cord is cut, then the placenta should be waited on to
fall; do not pull cord to speed up placental delivery as it can increase placental
fragments and retainment - Answer true
What are the seven hormones involved in pregnancy? When do these appear or rise?
What are each of their roles? - Answer 1) human placental lactogen
2) progesterone
3) estrogen
4) relaxin
5) oxytocin
6) human chorionic gonadotropin- rises throughout pregnancy and decreases when
HPL rises; created by placenta after implantation, supports C.L. in ovary, detected on
pregnancy test, can be detected earliest at 10 days after conception via blood test
7) prolactin- rises throughout pregnancy; main hormone needed for breast milk
,production
When is human placental lactogen (HPL) secreted? What are the 3 main functions? -
Answer - secreted by placenta by 2nd week of gestation and slowly increases
throughout pregnancy
1) metabolism regulation- breaks down fats
2) insulin resistance- decreases maternal glucose intake to increase fetal nutrient
availability
3) preparation of mammary glands for lactation
When is progesterone secreted? What are the main functions? - Answer - secreted by
C.L. and then placenta and increases throughout pregnancy
1) maintains myometrium- decreases smooth muscle contraction also increases blood
volume and perfusion to kidneys and placenta; relaxes smooth muscles and inhibits
production of prostaglandins/inhibits contractions
2) mediates immune system function
3) inhibits production of prostaglandins in the uterus- inhibits contractions
T/F: the withdrawal of progesterone at term, leads to uterine contractions and onset of
labor - Answer true- since prostaglandins would be released and contractions would
occur
- therefore you should draw progesterone early on and prescribe progesterone until
10-12 weeks when placenta can take over
When is estrogen secreted? What are the 3 types of estrogen in the female body? Which
estrogen type of prevalent during pregnancy? What are the main functions? - Answer -
estrogen rises throughout pregnancy
1) estradiol- prevalent during child bearing years
2) estrone- prevalent in menopause years
3) estriol- prevalent during pregnancy
*estriol is the estrogen involved in pregnancy
- promotes growth of uterus
- maintains uterine lining and increases uterine blood flow
- activates and regulates hormones
- helps fetal organ development
,- prepares breasts for lactation- stimulates milk duct development, but inhibits lactation
- involved in onset and timing of labor- increases myometrial sensitivity to oxytocin
during labor
When is relaxin secreted? What are the main functions? - Answer - rises throughout
pregnancy and decreases at end
- inhibits uterine contraction to prevent preterm labor
- increases blood vessels to increase blood volume and flow to placenta
- aids in implantation and placental growth
- later in pregnancy helps soften and widen pelvic ligaments and lengthens cervix during
birth
When is oxytocin secreted? What are the main functions? - Answer - rises sharply at
start of labor
- facilitates causes uterine contractions and increases production of prostaglandins-
increases uterine contractions and increases thinning and dilation of cervix
- helps prepare for breastfeeding- aids in release of milk during breast feeding
- facilitates bonding- feel good hormone
When is HCG secreted? When is the earliest you can detect it via blood? When is the
earliest to detect it via urine? What are the main functions? - Answer - HCG will peak at
12 weeks (3 months) via C.L. secretion and plataeu afterwards once HPL is released
from placenta (takes around 10-12 weeks to peak, but starts appearing around 2 weeks)
- detected via blood 10 days after conception
- detected via urine 14 days/2 weeks after conception
- increases progesterone production
- HCG levels rise steadily during first trimester then decline and level off
- levels generally double every 48-72 hours in early pregnancy (1st month)- causes N/V
especially in 1st trimester
If HCG is not doubling every 48-72 hours, what could be the problem? If HCG is higher
than doubling every 48-72 hours, what could be the problem? - Answer - not doubling-
loss of pregnancy?
- higher than doubling- multiple pregnancies
T/F: some people may still experience N/V after 1st trimester despite HCG decrease due
to increased sensitivity to HCG than others - Answer true
, Where does fertilization occur? Where does the embryo implant? What type of cell
division process occurs? When does organogenesis finish? When does the fetal period
begin? What factors impact fetal growth? - Answer - fertilization occurs in the fallopian
tube
- implantations occurs in the upper 1/3 of the uterus
- meiosis is the cell division that occurs- 23 from each parent; 46 chromosomes total
- organogenesis finishes by week 10- all organs should have begun to grow/develop by
week 10
- factors of growth- genetics, placental function, maternal condition and behaviors,
environment, maternal smoking or second hand smoke exposures
- fetal period begins at 10 weeks
T/F: we do not know cause of any fetal abnormalities or anything related to mother's
behaviors - Answer true
T/F: patients should check HCG 1 day after missed period - Answer true
What are presumptive signs of pregnancy? - Answer - subjective data, what the mom
tells us
- lease predictive and most subjective; cannot be assessed by provider
- dizziness, tenderness, fatigue and tiredness, increased sensitivity to smell, nausea,
mood swings, frequent urination, and missed period/amenorrhea
What are probably signs of pregnancy? - Answer - physiologic and anatomic changes
that can be noted on physical exam
- breast/skin changes
- enlargement of uterus
- Hegar's sign- softening of lower uterine segment
- Goodell's sign- softening of cervix
- Chadwick's sign- blue hue of cervix and vagina due to increased progesterone and
blood flow to area
- positive pregnancy test
What are the only 3 positive signs of pregnancy? - Answer - pregnancy visualized by
ultrasound
- audible fetal heart tones
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