MCN LEC REVIEWER FINALS

 A pouching of the bladder into the anterior vaginal wall – CYSTOCELE

 A mucus plug, forms to seal out bacteria and help prevent infection in the fetus and membranes –
OPERCULUM
 Absence of sperm – ASPERMIA
 Undescended testes – CRYPTORCHIDISM
 During vasectomy, what part is pull forward, cut and tied? – VAS DEFERENS/DUCTUS
DEFERENS/SPERMATIC CORD
 A condition where prepuce can’t be contracted – PHIMOSIS
 The number of deaths during the perinatal time period (beginning when a fetus reaches 500 g, about
20 weeks pregnancy, and ending about 4 to 6 weeks after birth); the sum of the fetal and neonatal
rates – PERINATAL DEATH RATE
 The primary goal of both maternal and child health nursing – the promotion and maintenance of
optimal family health: SATA
o Provision of preconception healthcare
o Provision of nursing care of women throughout pregnancy, birth, and postpartum period
o Provision of nursing care of children from birth through adolescence
o Provision of nursing care to families in all setting
 SDG & MDG

 QSEN competencies – health promotion, health maintenance, health restoration, health

rehabilitation
o Teaching people the importance of rubella immunization before pregnancy; teaching
preteens with information about safer sex practices – HEALTH PROMOTION
o Encouraging patients to be partners in the prenatal care; teaching parents the importance of
safeguarding their homes by childproofing against poisoning – HEALTH MAINTENANCE
o Caring for a patient during a complicatin of pregnancy such as GDM – HEALTH RESTORATION
o Encouraging a patient with gestational trophoblastic disease to continue therapy – HEALTH
REHABILITATION
 Female hormones: FSH, LH, estrogen, progesterone
o FSH – active early; responsible for maturation of the ovum
o LH – active at midpoint; responsible for ovulation
o Progesterone –mammary gland maturation; increase in BBT; inhibits LH production
o Estrogen - regulate the growth, development, and physiology of the human reproductive
system; development of 2ary sexual characteristics; inhibits FSH production
 Ovulation day occurs at? 14 days before the beginning of the next menstrual cycle
 Spinnbarkeit test – tests for elasticity of vaginal discharge
 Phases of menstrual cycle
o Proliferative - after menstruation the endometrium is very thin (day 1 to 4); at day 5 to 14,
the endometrium begins to proliferate
o Secretory – the endometrium become corkscrew or twisted in appearance
o Ischemic – the endometrium starts to degenerate
o Menstrual – menses, menstrual flow
 Genetic counseling
o Provide concrete, accurate information
o Allow people to make informed choices about future production
o Offer support to people who are affected by genetic disorder
 Tay-Sachs disease – a detoriation of muscle and mental facilities; occurs most often in people of
Ashkenazi Jewish ancestry
 Duchenne muscular dystrophy – most common form of muscular dystrophy, is inherited as a sex-
linked recessive trait; therefore, it only occurs in male
 Stereotyping – expecting a person to act in a characteristic way without regard to their individual
traits
 Prejudice – a negative attitude toward members of a group
 Discrimination – treating of people differently based on their physical appearance or cultural traits
 Screening and diagnostic testing for babies
o Chorionic villi sampling – 10 to 12 weeks; biopsy of placenta
o Amniocentesis – 15 to 18 weeks; collection of amniotic fluid
o Percutaneous umbilical blood sampling – greater than 17 weeks; fetal umbilical blood
sampling
o Fetoscopy – second and third trimesters; small camera and instruments passed into the
amniotic sac to view and treat anomalies
 Organogenesis is completed at? 8th weeks
 During the early time of organogenesis, the growing structure is most vulnerable to invasion by
teratogens; it is most important for pregnant patients to minimize their exposure to teratogens
 The partner or the father experience physical symptoms such as nausea, vomiting, and backache to
the same degree or even more intensely than their partners during pregnancy. What syndrome?
COUVADE SYNDROME
 Which hormone causes endometrium to grow in thickness? ESTROGEN
 After fertilization, the endometrium is termed as? DECIDUA
 Chorionic villi – the trophoblastic layer of blastocyst matures rapidly and on the 11th to 12th day,
miniature villi or probing fingers called CHORIONIC VILLI reach out into the endometrium; outer
portion has 2 layers:
o Syncytiotrophoblast – outer layer; produce HCG
o Cytotrophoblast – inner layer; protection from infections; disappears at 20th to 24th week
 Ectoderm
o CNS & PNS
o Skin, hair, nails
o Sebaceous glands
o Sense organs
o Mucous membranes of anus, mouth, and nose
o Tooth enamel
o Mammary glands
 Mesoderm
 o Supporting structures (connective tissue, bones, cartilage, etc.)
o Dentin of the teeth
o Upper portion of the urinary system (kidneys and ureters)
o Reproductive system
o Heart
o Circulatory system
o Blood cells
o Lymph vessels
 Endoderm
o Lining of pericardial, pleural & peritoneal cavities
o Lining of the GI tract, respiratory tract, tonsils, parathyroid
o Thyroid, thymus gland
o Lower Urinary system (bladder and urethra)
 Presumptive signs of pregnancy
o Breast changes – enlarge and sore breast
o Nausea, vomiting
o Amenorrhea
o Frequent urination
o Fatigue
o Uterine enlargement
o Quickening – fluttering sensation felt by mother
o Linea nigra
o Melasma/ chloasma – mask of pregnancy
o Striae gravidarum – stretch mark
 Probable sign of pregnancy
o Serum laboratory test – test of blood serum
o Chadwick’s sign – bluish discoloration of vagina, cervix and perineum
o Goodell’s sign – softening of the cervix
o Ballottement – fetal rebound against examination
o Braxton Hicks contractions - painless and irregular
o Hegar’s sign – softening of lower uterine segment
 Positive signs
o Sonographic evidence of fetal outline
o Fetal heart audible – normal range: 120 to 160 bpm
o Fetal movement felt by examiner
 Home pregnancy test
o Check the expiration date of the kit
o Read the instruction
o A concentrated urine sample such as first urine in the morning tests best
o Read the results as the exact time the instructions dictate
o Early prenatal care is the best safeguard to ensure a successful pregnancy
 Fetal movement normal finding: 10 kicks per hour
 Assessment of fetal well-being and assesses the FHR for a normal baseline rate – RHYTHM STRIP
TESTING
 Screening test for syphilis – VDRL OR RPR
 Safe medication for syphilis in pregnant woman – IM benzathine penicillin (Bicillin L-A)
 5P’s of labor
o Passenger
 o Passageway
o Powers
o Psyche
o Position
 Theories of labor
o Prostaglandin theory
o Oxytocin theory
o Uterine stretch theory
o Placental degeneration theory
o Progesterone deprivation theory
 Transverse diameter of the outlet – TUBERO-ISCHIAL OR BI-ISCHIAL DIAMETER
 Four types of female pelvic shapes
o Gynecoid
o Android
o Anthropoid
o Platypelvic
 Ideal fetal position; fastest birth – ROA OR LOA POSITION
 Fetal engagement
o Engaged – at the level of ischial spines; 0 station
o Floating – above the ischial station; minus stations (-1 to -4)
o Plus stations – presenting part is below the ischial spines
o Crowning - +3 or +4; presenting part is at the perineum
 Powers of labor
o Primary power: uterine contractions
o Secondary power: maternal bearing down/pushing and intra-abdominal pressure
 Effacement – shortening & thinning of the cervical canal
o In primiparas- effacement occurs before dilatation
o In multiparas – dilatation occurs before effacement
 Dilatation – opening, widening, enlarging, increasing in diameter of the cervical os from 0 to 10 cm
 7 cardinal movements
o Engagement
o Descent – downward movement of biparietal diameter of the fetal head
o Flexion – the head bends forward onto the chest
o Internal rotation – brings the shoulder in the best position to enter the inlet
o Extension – occiput is born
o External rotation – almost after the head is born, the head rotates about 45* back
o Expulsion - once the shoulder is born, the rest of the body is born easily
 STAGES OF LABOR
o First stage – complete cervical dilatation and effacement
o Second stage/ expulsive stage – expulsion of the baby
o Third stage/ placental stage – expulsion of placenta
o Fourth stage – maternal recovery & bonding
 First stage of labor: 3 phases
o Latent phase – effacement begins; 0 to 3 cm dilatation; frequency: q5-30 min; duration: 20
to 40 secs; intensity: mild to moderate; monitor every 30 to 60 mins
o Active phase – 4 to 7 cm dilatation; frequency: 3 to 5 min; duration: 40 to 60 secs; intensity:
moderate; monitor every 15 to 30 mins
 o Transitional phase – fully dilated (10cm) and effaced (100%); frequency: 2 to 3 mins;
duration: 60 to 90 secs; monitor every 10 to 15 mins
 Reva Rubin 3 psychological phases of the adaption to motherhood:
 TAKING-IN PHASE
o 1st 2 to 3 days postpartum
o Passive and dependent
o Preoccupied with her own needs
o Wants to talk about her pregnancy, labor and birth
o Touches and explores her baby
o Nursing management: encourage her to talk about the birth to help her integrate it
into her life experience
 TAKING-HOLD PHASE
o 3rd day to 10th day
o Less dependent
o Take a strong interest in the care of her child and make her own decisions but still
feels insecure about her mothering skills
o Nursing management: give guidance and demonstrations on how to care a child
 LETTING-GO PHASE
o 10 days to 6 weeks
o Woman redefines her new role & motherhood functions are established
o Gives up her fantasized image of her child and accepts her child as a unique person
 Nipple stimulation leads to release of OXYTOCIN from the pituitary gland; this stimulates the release
of PROLACTIN which causes production of milk & the let-down reflex
 Teach mother to wash her breast with CLEAR TAP WATER ONLY (no soap, because that could be
drying and cause the nipples to crack); after washing, nipples should be dried well by patting with a
soft towel
MATERNAL DANGER SIGNS:

1. High or Low BP – systolic pressure >140 mmHg, diastolic pressure >90 mmHg or increase of 30
mmHg may be a sign of PIH. Sudden drop in BP may be the 1st sign of intrauterine bleeding
2. Abnormal pulse (PR= 70-80bpm)- >100 bpm may be a sign of hemorrhage
3. Inadequate or prolonged contractions – uterine exhaustion
4. Pathologic retraction rings – indentation across a woman’s abdomen where the upper and lower
segments join, may be a sign of extreme uterine stress and possible impending rupture
5. Abnormal Lower Abdominal Contour – with a full bladder, a round bulge on the lower abdomen may
appear.
 Danger sign for 2 reasons: bladder may be injured due to pressure; full bladder may prevent
fetal head descent
 Void every 2 hours during labor
6. Increasing Apprehension – O2 deprivation or internal hemorrhage

FETAL DANGER SIGNS

1. High or low FHR - >160 bpm (fetal tachycardia), < 110 bpm (fetal bradycardia), decelerations may be
a sign of fetal distress
2. Meconium staining
 Green color of AF due to loss of sphincter control may be due to fetal hypoxia
3. Hyperactivity – sign of hypoxia
4. Oxygen saturation (40% to 70%) – assessed by a catheter inserted next to the cheek (<40%) is low);
plus, acidosis (pH <7.2) suggests fetus is being compromised
 APGAR score of 8 means the NB is in good health
 APGAR score of 3 means the NB need resuscitative measure
 Normal developmental milestone of an 8 month baby: gross motor skill: sits securely without
support; language and social skill: has peak fear of strangers; plays: enjoys manipulation, rattles and
toys of different textures
 Moro reflex – NB abducts & extend arms & legs, fingers assume a “C” position; finally swinging the
arms into an embrace position & pull up the legs against the abdomen (adduction); it is strong for
the 1st 8 weeks & faded by the end of the 4th and 5th month
 Anterior fontanelles – found at the juncture of the frontal & parietal bones; diamond-shaped;
measures 2 to 3 cm in width and 3 to 4 in length ; closes at 12 to 18 months
 Posterior fontanelles – found at the junction of the parietal bones & the occipital bones; triangular-
shape; measures 1 cm in length ; closes at 2nd month

 Deciduous teeth starts to fall out at what age? 6 TO 7 years old

STAGES OF ERIKSON’S THEORY FREUD’S PIAGET’S THEORY OF KOHLBERG’S
GROWTH AND OF PSYCHOSOCIAL PSYCHOSEXUAL COGNITIVE THEORY OF
DEVELOPMENT DEVELOPMENT STAGE DEVELOPMENT MORAL
DEVELOPMENT
INFANT (0 to 18 Trust VS Mistrust Oral Sensorimotor stage Prereligious
months old) stage
TODDLER (18 Autonomy VS Shame Anal Preoperational Punishment-
months to 3 yrs & Doubt obedience
old) orientation
PRE-SCHOOL (3 Initiative VS Guilt Phallic Preoperational Preconventional
to 5 yrs old)
SCHOOL AGE (6 Industry VS Latent Concrete operational Conventional
to 12 yrs old) Inferiority
ADOLESCENT (13 Identity VS Role Genital Formal Operational Postconventional
to 20 yrs old) Confusion
YOUNG ADULT Intimacy VS Isolation
MIDDLE-AGED Generativity VS
ADULT Stagnation
OLDER ADULT Integrity VS Despair
 Primary cause of accidents/ injuries – motor vehicular accident; preventive measure: teach safety
with tricycles; look before crossing driveways; teach the child to always hold hands with an adult
before crossing a street
 Menarche – 1st menstruation 2 yrs after changes (9 ½ to 12 yrs)
 Karyotyping – a graphic representation of the chromosomes present
 IgG – most frequent occurring antibody in plasma; supplies passive immune protection
 Emotional responses to pregnancy: ambivalence (combination of pleasure and anxiety), grief,
narcissism, introversion vs extroversion, etc.
 Aspiration of blood form the umbilical vein, what test? Percutaneous umbilical blood sampling
(PUBS)/CORDOCENTESIS/FUNICENTESIS
 Indirect Coombs test – determination of whether Rh antibodies are present in an Rh-negative
mother; 28 weeks of pregnancy
 Brown fat, a special fat insulator deposits behind the kidneys, sternum & posterior neck. What
week? 20th weeks of gestational week
 At the end of 40th gestational week, what happens to the baby? SATA
o Fetus kicks actively causing discomfort
o Fetal hemoglobin begins conversion to adult hemoglobin
o Vernix caseosa is fully formed
 o Fingernails extend over fingertips
o Creases on foot soles cover at least 2/3 of surface
 Force supplied by the fundus of the uterus, causes cervical dilatation – uterine contractions
 True regarding effacement: shortening & thinning of the cervical canal; in primiparas, effacement
occurs before dilatation; in multiparas, dilatation occurs before effacement
 Dilatation – widening or enlargement of the cervical canal
 Mechanisms of labor: engagement, descent, flexion, internal rotation, extension, external rotation,
expulsion
 4 stages of labor
o 1st stage – complete cervical dilatation and effacement
o 2nd stage – delivery of the baby
o 3rd stage – delivery of the placenta
o 4th stage – maternal recovery
 Harlequin sign – due to immature circulation, a newborn lying oh his side appears red on the
dependent side of the body & pale on the upper side; the odd coloring fades immediately if the
infant’s position is changed or the baby kicks or cries
 Birth weight of an infant doubles at? 6 months and triples at? 12 months
 Skene’s gland and Bartholin glands helps to lubricate the external genetalia during coitus
 Ovulation period happens at what phase? SECRETORY PHASE
 At what age of gestation can you recommend the mother to play classical music for the fetus? 24
weeks

GENETIC DISORDERS
TRISOMY 13 OR PATAU SYNDROME extra chromosome 13
Trisomy 18 or Edward syndrome 3 copies of chromosome 18
Cri-du-chat syndrome missing portion of chromosome 5
Turner syndrome (gonadal dysgenesis) only one functional X chromosome
Klinefelter syndrome two X chromosomes and a Y chromosome
Fragile syndrome most common in males; one long arm of an X
chromosome is defective
Down syndrome/ Trisomy 21 most common chromosome abnormality;
