BSNC 5000 module 1 OB Test Questions
with Correct Answers
What produces Human Placental Lactogen (HPL) - Answer-the placenta
What does human plancetal lactogen do - Answer-increases insulin resistance in
mother
What is the process of human placental lactogen - Answer-HPL leads to the breakdown
of maternal fat to provide fuel for mom and fetus (when mom's glucose levels decrease
between meals)
What are the maternal risk factors for gestational diabetes - Answer-- mother over
weight (obese)
- not physically active
- prediabetic prior to pregnancy or family member with type 2 diabetes
- GDM in previous pregnancy/prior baby weighing more than 4.1kg (9lbs)
- polycystic ovary syndrome (PCOS) increases risk by 40%
- race or ethnicity: black, hispanic, american, indian, and asian american
Maternal effects/complications of gestational diabetes - Answer-- hypertension
- pre-eclampsia
- increased risk of caesarian delivery
- increased risk of developing type 2 diabetes
What is the treatment for type 2 diabetes - Answer-- diet and exercise
- insulin
What are the effects of gestational diabetes on the fetus - Answer-- fetal
hyperinsulinemia = insulin's anabolic properties increase fetal tissue growth leading to
macrosomia
- excess fetal plasma glucose is converted to fat = increases fetal metabolic rate which
requires more oxygen
- tissue hypoxia increases the release of fetal catecholamines = norepinephrine causes
vasoconstrictions, may lead to hypertension
> risk of cardiac remodelling and/or hypertrophy of pulmonary trunk
> Higher risk of RDS (respiratory distress syndrome)
- hypoxia stimulates the release of erythropoietin from the fetal kidneys = increase
number of RBCs
- effects of an elevated hematocrit = vascular sludging and poor circulation
what are the effects of gestational diabetes on the newborn - Answer-- macrosomia
- postnatal hyperbilirubinemia = elevated hematocrit/polycythemia
- increased risk of hypercalcemia
,- increased risk of hyperglycemia
- increased risk of beta-cell dysfunction and insulin resistance
- increased risk of neonatal RDS
- increased risk of late preterm delivery, stillbirth and perinatal mortalility
what is macrosomia - Answer-growth beyond a specific threshold, regardless of
gestational age
what is uteroplacental circulation? - Answer-- uterine and ovarian arteries carry blood
supply to the spiral arteries
- spiral arteries elongate as the endometrium thickens to accommodate the implantation
of a blastocyst
- maternal blood flows from the spiral arteries into the intervillous space
- maternal veins drain the intervillous space
what should the volume of placental blood flow be - Answer-600-700ml/min
why is the hemoglobin level low in the first few weeks of pregnancy - Answer-- plasma
volume increases up to 1L
- rise in RBCs/blood volume but to lesser extent = placental lactogen stimulates
production of erythropoietin
- the dilutional gap causes physiological anemia
during maternal intravascular volume changes, the RAAS system is activated why is
this - Answer-- the RAAS system increases the plasma volume (diluting the RBCs = low
hemoglobin) from relesae of aldosterone (absorbing Na and H2O
what are the nornal maternal cardiovascular changes - Answer-- increasing volume,
causing increase preload = increased contractility
- decrease in vascular resistance reduces afterload which increases cardiac output by
50%, increasing the efficiency of the heart
what are the normal blood pressure changes in normal pregnancy - Answer--
progesterone relaxes smooth muscle in wall of blood vessels
- relaxin increases vasodilation to reduce peripheral resistance (plasma volume
increases)
> decreases the effective circulating volume
what are the maternal effects of vasodilation - Answer-- non-osmotic release of
vasopressin/ADH
-activation of the sympathetic nervous system and RAAS increase plasma volume for
adequate organ perfusion
what is the hypercoagulability state during pregnancy - Answer-- the increase in clotting
factors during pregnancy increases risk of thrombosis x2
, > platelet count decreases as pregnancy progresses (diulutional effects, sequestering
in the intervillious spaces of placenta)
- returns to normal 6-8 weeks postpartum
> risk of thrombosis increases x5.5 in postpartum period since platelets are no longer
sequestered by placenta
what is the normal maternal basal metabolic rate - Answer-- increases about 14% over
term of pregnancy
- causes an increase in oxygen consumption as pregnancy progresses to accommodate
increase in nutrition and energy use by mother and fetus
what is normal maternal pulmonary function - Answer-- increase in tidal volume from
450ml/min to 650ml/min
> expiratory reserve volume decreases
> lowers the oxygen reserve for mom
- mild dyspnea due to 4cm elevation of diaphragm
> hormones loosen ligaments to allow ribs to flare to compensate for decreasing lung
capacity
what is the normal maternal acid-base balance - Answer-- progesterone stimulates
respiratory centre = increased RR and decrease in pCO2
- chronic respiratory alkalosis with renal compensation = kidneys clear excess
bicarbonate buffer
what is the relevance of reproduction and sexual health in nursing practice? - Answer--
STDs can be transmitted to babies
- health and wellbeing education
- knowledge and access to contraceptives (can be limited)
what are the psychological and cultural factors to consider for sexual and reproductive
health - Answer-- cultural beliefs
- mental health
- relationship dynamics
- cultural norms
- traditions/rituals
- stress/addiction
what are the sociodemographic factors to consider for sexual and reproductive health -
Answer-- age and gender
- ethnicity
- marital status
- religion
- education
- income/socioeconomic status
- geography
with Correct Answers
What produces Human Placental Lactogen (HPL) - Answer-the placenta
What does human plancetal lactogen do - Answer-increases insulin resistance in
mother
What is the process of human placental lactogen - Answer-HPL leads to the breakdown
of maternal fat to provide fuel for mom and fetus (when mom's glucose levels decrease
between meals)
What are the maternal risk factors for gestational diabetes - Answer-- mother over
weight (obese)
- not physically active
- prediabetic prior to pregnancy or family member with type 2 diabetes
- GDM in previous pregnancy/prior baby weighing more than 4.1kg (9lbs)
- polycystic ovary syndrome (PCOS) increases risk by 40%
- race or ethnicity: black, hispanic, american, indian, and asian american
Maternal effects/complications of gestational diabetes - Answer-- hypertension
- pre-eclampsia
- increased risk of caesarian delivery
- increased risk of developing type 2 diabetes
What is the treatment for type 2 diabetes - Answer-- diet and exercise
- insulin
What are the effects of gestational diabetes on the fetus - Answer-- fetal
hyperinsulinemia = insulin's anabolic properties increase fetal tissue growth leading to
macrosomia
- excess fetal plasma glucose is converted to fat = increases fetal metabolic rate which
requires more oxygen
- tissue hypoxia increases the release of fetal catecholamines = norepinephrine causes
vasoconstrictions, may lead to hypertension
> risk of cardiac remodelling and/or hypertrophy of pulmonary trunk
> Higher risk of RDS (respiratory distress syndrome)
- hypoxia stimulates the release of erythropoietin from the fetal kidneys = increase
number of RBCs
- effects of an elevated hematocrit = vascular sludging and poor circulation
what are the effects of gestational diabetes on the newborn - Answer-- macrosomia
- postnatal hyperbilirubinemia = elevated hematocrit/polycythemia
- increased risk of hypercalcemia
,- increased risk of hyperglycemia
- increased risk of beta-cell dysfunction and insulin resistance
- increased risk of neonatal RDS
- increased risk of late preterm delivery, stillbirth and perinatal mortalility
what is macrosomia - Answer-growth beyond a specific threshold, regardless of
gestational age
what is uteroplacental circulation? - Answer-- uterine and ovarian arteries carry blood
supply to the spiral arteries
- spiral arteries elongate as the endometrium thickens to accommodate the implantation
of a blastocyst
- maternal blood flows from the spiral arteries into the intervillous space
- maternal veins drain the intervillous space
what should the volume of placental blood flow be - Answer-600-700ml/min
why is the hemoglobin level low in the first few weeks of pregnancy - Answer-- plasma
volume increases up to 1L
- rise in RBCs/blood volume but to lesser extent = placental lactogen stimulates
production of erythropoietin
- the dilutional gap causes physiological anemia
during maternal intravascular volume changes, the RAAS system is activated why is
this - Answer-- the RAAS system increases the plasma volume (diluting the RBCs = low
hemoglobin) from relesae of aldosterone (absorbing Na and H2O
what are the nornal maternal cardiovascular changes - Answer-- increasing volume,
causing increase preload = increased contractility
- decrease in vascular resistance reduces afterload which increases cardiac output by
50%, increasing the efficiency of the heart
what are the normal blood pressure changes in normal pregnancy - Answer--
progesterone relaxes smooth muscle in wall of blood vessels
- relaxin increases vasodilation to reduce peripheral resistance (plasma volume
increases)
> decreases the effective circulating volume
what are the maternal effects of vasodilation - Answer-- non-osmotic release of
vasopressin/ADH
-activation of the sympathetic nervous system and RAAS increase plasma volume for
adequate organ perfusion
what is the hypercoagulability state during pregnancy - Answer-- the increase in clotting
factors during pregnancy increases risk of thrombosis x2
, > platelet count decreases as pregnancy progresses (diulutional effects, sequestering
in the intervillious spaces of placenta)
- returns to normal 6-8 weeks postpartum
> risk of thrombosis increases x5.5 in postpartum period since platelets are no longer
sequestered by placenta
what is the normal maternal basal metabolic rate - Answer-- increases about 14% over
term of pregnancy
- causes an increase in oxygen consumption as pregnancy progresses to accommodate
increase in nutrition and energy use by mother and fetus
what is normal maternal pulmonary function - Answer-- increase in tidal volume from
450ml/min to 650ml/min
> expiratory reserve volume decreases
> lowers the oxygen reserve for mom
- mild dyspnea due to 4cm elevation of diaphragm
> hormones loosen ligaments to allow ribs to flare to compensate for decreasing lung
capacity
what is the normal maternal acid-base balance - Answer-- progesterone stimulates
respiratory centre = increased RR and decrease in pCO2
- chronic respiratory alkalosis with renal compensation = kidneys clear excess
bicarbonate buffer
what is the relevance of reproduction and sexual health in nursing practice? - Answer--
STDs can be transmitted to babies
- health and wellbeing education
- knowledge and access to contraceptives (can be limited)
what are the psychological and cultural factors to consider for sexual and reproductive
health - Answer-- cultural beliefs
- mental health
- relationship dynamics
- cultural norms
- traditions/rituals
- stress/addiction
what are the sociodemographic factors to consider for sexual and reproductive health -
Answer-- age and gender
- ethnicity
- marital status
- religion
- education
- income/socioeconomic status
- geography
