L3 Exam 1 Flashcards

A nurse is caring for a 1-day-old infant who has suspected Hirschsprung disease.

Which of the following should the nurse anticipate on assessment of this child?

(Select all that apply.)

) A. Nonbilious vomiting

) B. Bright red blood per rectum

) C. No passage of meconium

D. Increased hunger

E. Abdominal distention

2.

Hirschsprung disease (congenital aganglionic megacolon) is a congenital motor disorder of the intestine characterized by absence of neurons in sections of the colon. This is caused by the failure of nerve cells to migrate during fetal development, resulting in reduced gut motility and an inability to expel stool.

Hirschsprung disease is 3-4 times as common in male children. It is associated with a variety of syndromes caused by chromosomal abnormalities, including Downs syndrome. Hirschsprung disease is usually diagnosed in neonates. Infants will manifest failure to pass meconium by 48 hours of life, bilious vomiting, and abdominal distention. Initial symptoms can include a fever and other signs of enterocolitis and toxic megacolon. Children who have less severe variants may not be diagnosed until after the age of 3.

Trunk incurvature or Galant reflex emerges at ___ weeks and disappears at 9 months

a.38

b.20

c. 24

d. 28

Vital Concept:

Amniocentesis is performed to screen the fetus for Down syndrome (trisomy 21); trisomy 13; trisomy 18; fragile X syndrome, neural tube defects, and inherited metabolic disorders. Indications for amniocentesis include diagnosis of fetal chromosomal anomalies after other tests (ultrasound or biophysical markers) have identified a significant likelihood that the fetus will be affected with a chromosomal problem. Amniocentesis is used to detect fetal lung maturity and evaluate alloimmunization. Amniocentesis can also be used to obtain samples to rule out chorioamnionitis and to deliver intra-amniotic dye in cases in which premature rupture of membranes is suspected.

__________causes increased vascularity of the mucous membranes which can lead to vericose veins, nose bleeds, deepening of the voice,

the enlarging uterus lifts the diaphragm by ____ inches by the 3rd trimester. the thoracic circumference increases by __-_ inches

total lung capacity decreases by __-%

Some women experience ptyalism (excessive salivation) that is unpleasant and embarrassing. The cause of ptyalism appears to be stimulation of the salivary glands by the ingestion of ____

progesterone relaxes the smooth muscle to give emptying more time so the intestine tract can absorb water nutrients etc. can cause heartburn, constipation, gerd, hemmoroids, progesterone also causes functional changes of the liver and gallbladder, t/f?

Progesterone causes functional changes of the liver and gallbladder. The gallbladder becomes hypotonic and emptying time is prolonged, resulting in thicker bile and predisposing to the development of gallstones. Reduced gallbladder tone also leads to a tendency to retain bile salts, which can cause itching (pruritus) (Cunningham et al., 2018).
During the last trimester, the liver is pushed upward and backward by the enlarging uterus. Serum alkaline phosphatase rises to two to four times that of nonpregnant women, and levels of serum albumin and total protein fall

Hormonal influences, the increased blood volume, and changes in glomerular filtration rate (GFR) may play a significant role in urinary frequency

The flow of urine through the ureters is partially obstructed, particularly on the right side, causing the ureters and renal pelvis to dilate. The resulting stasis of urine allows additional time for bacteria to multiply and increases the risk of urinary tract infection during pregnancy.

glycosuria is common during pregnancy. t/f?

As a result of increased GFR, blood urea nitrogen and serum creatinine normally _______ (Blackburn, 2018).

of pigmentation include brownish patches, called melasma, _____, or the mask of pregnancy, over the forehead, cheeks, and nose. Melasma may also occur in women taking oral contraceptives. It increases with exposure to sunlight, but use of sunscreen may reduce the severity.

hair follicles return to the resting phase and hair loss begins 2-4 months postpartum. ___-___hair growth returns to normal.

the need for _____ increases especially in the third trimester due to the supply the fetus and maternal store nutrients

at 28-30 weeks the ________ separate creating a wide stance and waddling gate. the mother will lean back to help with the increased size of the uterus and this creates a progressive _____or curvature of the spine

During pregnancy, prolactin from the anterior pituitary increases to prepare the breasts to produce milk. FSH and LH are suppressed because they are not needed to stimulate ovulation during pregnancy. The posterior pituitary produces oxytocin, which stimulates the milk-ejection reflex after childbirth. Oxytocin also stimulates contractions of the uterus, but during pregnancy, this action is inhibited by progesterone, which relaxes smooth muscle fibers of the uterus. After childbirth, progesterone levels decline when the placenta is removed, and oxytocin keeps the uterus contracted, preventing excessive bleeding at the placental site.****

Hyperplasia and increased vascularity cause the thyroid gland to enlarge during pregnancy. Early in the first trimester, a rise in total serum thyroxine (T4) and thyroxine-binding globulin occurs. The level of serum free (unbound) T4 rises in early pregnancy and then returns to normal. Maternal thyroid hormones are important in the development of the fetal brain. The basal metabolic rate (BMR) increases up to 25% primarily because of the fetal metabolic activity