MCN REVIEWER

DEFINITION OF TERMS

CHAPTER 8 – Nursing Care of the Family Having Difficulty Conceiving a Child

Infertility - inability to conceive a child or sustain a pregnancy to birth.

Infertile Couple - one who has not become pregnant after at least one year of unprotected
coitus.
Subfertility - term used rather than “infertility” because it denotes that couple has a potential to
conceive.
Primary Subfertility - no previous conceptions.
Secondary Subfertility - previous pregnancies occurred; however, couple is not able to
presently conceive.
Sterility - is the inability to conceive because of a known condition, such as the absence of
uterus.
FSH (follicle stimulating hormone) - it acts on the ovaries to make the follicles and eggs grow.
In males, it acts on the testes to make sperm.
LH (luteinizing hormone) - a hormone secreted by the anterior pituitary gland
that stimulates ovulation in females and the synthesis of androgen in males
Anovulation – faulty or inadequate expulsion of ova
 Absence of ovulation or release of ova from the ovary
Varicocele – enlargement of a testicular vein
Hydrocele – a collection of fluid in the tunica vaginalis of the scrotum
Spermatogenesis – production of sperm cells
Sperm motility – the movement of sperm
Sperm Count – number of sperm in a single ejaculation.
Cryptorchidism – undescended testes
Varicocelectomy – removal of the varicocele
Erectile Dysfunction – inability to achieve an erection.

CHAPTER 20 – Nursing Care of a Family Experiencing a Pregnancy Complication from a

Preexisting or Newly Acquired Illness
HEMATOLOGIC DISORDERS AND PREGNANCY
 Iron-Deficiency Anemia - is the most common anemia of pregnancy, complicating as
many as 15% to 25% of all pregnancies.
 Folic Acid Deficiency Anemia - occurs most often in multiple pregnancies because of
the increased fetal demand.
 Sickle Cell Anemia - is a recessively inherited hemolytic anemia caused by an abnormal
amino acid in the beta chain of hemoglobin.
 Thalassemia - Thalassemias are a group of autosomal recessively inherited blood
disorders that lead to poor hemoglobin formation and severe anemia. Occurs most in
Mediterranean, African, and Asian population.
 Malaria - Malaria is a protozoan infection that is transmitted to people by Anopheles
mosquitoes.

 Artificial Valve Disease - artificial heart valves are used to replace heart valves that have
become damaged with age or by certain diseases or congenital abnormalities.
 Hypertensive Vascular Disease - an individual with chronic hypertensive disease enters
pregnancy with an elevated BP of 140/90 mm Hg or above.
 Venous Thromboembolic Disease - a condition that occurs when a blood clot forms in a
vein.
 deep vein thrombosis (DVT) - a serious condition where a blood clot forms in a deep
vein in the body, usually in the leg.

COAGULATION DISORDERS AND PREGNANCY

 Von Willebrand Disease (VWD) - is a coagulation disorder inherited as an autosomal

dominant trait and so does occurs in women.
 Hemophilia B (Christmas disease, factor IX deficiency) - is a sex-related disorder,
only males are affected by the disease.
 Idiopathic Thrombocytopenic Purpura (ITP) - which is a decreased number of
platelets, is not inherited, can occur at any time in life, and so occasionally occurs during
pregnancy.

RENAL AND URINARY DISORDERS AND PREGNANCY

 Urinary Tract Infection - is an infection in any part of the urinary system. The urinary
system includes the kidneys, ureters, bladder and urethra.
 Hyperactive Bladder - refers to a bladder that contracts more frequently than usual,
causing symptoms of frequency, urgency, and incontinence.
Fesoterodine - an antispasmodic drug
  Chronic Renal Disease - adapt poorly to a gestational increase in renal blood flow. This
may accelerate their decline in renal function and lead to a poor pregnancy outcome.
RESPIRATORY DISEASE AND PREGNANCY
 Acute Nasopharyngitis - It is more severe during pregnancy because estrogen
stimulation normally causes some degree of nasal congestion.
 Influenza - Is caused by a virus, the disease spreads in epidemic form and is
accompanied by high fever, extreme prostration, aching pains in the back and
extremities, and sore throat.
 COVID-19 - It is highly contagious novel coronavirus. It has the capacity to cause
respiratory and cardiovascular symptoms resulting in widespread death.
 Pneumonia - It is the bacterial or viral invasion of lung tissue by pathogens. Pneumonia
during pregnancy is associated with fetal growth restriction and preterm birth.
 Asthma - It is a disorder marked by reversible airflow obstruction, airway
hyperreactivity, and airway inflammation.
 Tuberculosis - is a serious infectious disease that mainly affects the lungs. With
tuberculosis, lung tissue is invaded by Mycobacterium tuberculosis, an acid-fast bacillus.
 COPD - COPD is constriction of the airway associated most often with long-term
cigarette smoking.
 Cystic Fibrosis - Cystic fibrosis is an inherited disease in which there is generalized
dysfunction of the exocrine glands.
RHEUMATIC DISORDERS AND PREGNANCY
 Rheumatoid Arthritis - is a disease of connective tissue marked by joint inflammation
and contractures.
 Systemic Lupus Erythematous - is a multisystem chronic disease of the connective
tissue that occurs most frequently in woman 20 to 40 years of age.
CARDIOVASCULAR DISORDER AND PREGNANCY
 Left-sided Heart Failure - 0ccurs in conditions such as mitral stenosis, mitral
insufficiency, and aortic coarctation.
 pulmonary edema - produces profound shortness of breath as it interferes with oxygen-
carbon dioxide exchange
 extremely high risk for spontaneous miscarriage, preterm labor, or even death.
 Right-Sided Heart Failure - occurs when the right ventricle is overwhelmed by the
amount of blood received by the right atrium from the vena cava.
 Eisenmenger syndrome
 Peripartum Heart Disease - An extremely rare condition peripartal cardiomyopathy is
a heart muscle weakness, the cause is unknown.
- Cardiomegaly refers to an enlarged heart seen on any imaging test, including a chest X-
ray.
GI DISORDERS AND PREGNANCY
 Appendicitis - inflammation of the appendix

 Gastroesophageal Reflux Disease (GERD) - refers to the reflux of acid stomach

secretions into the esophagus

 Cholecystitis (gallbladder inflammation) and Cholelithiasis (gallstone formation)

 Pancreatitis - inflammation of the pancreas

 Hepatitis - is a liver disease that occurs from the invasion of the hepatitis A, B, C, D, or
E viruses.
 Inflammatory Bowel Disease - Crohn disease (i.e., inflammation of the terminal ileus)
and ulcerative colitis (i.e., inflammation of the distal colon) occur most often in late
adolescents between ages 12 and 30 years
NEUROLOGIC DISORDERS AND PREGNANCY
 Seizure Disorder - Most seizures during pregnancy occur in women who already have
epilepsy. During pregnancy most women will continue their previous level of seizure
control, although 15-30% may experience an increase in seizures.

 Myasthenia Gravis - an autoimmune disorder characterized by the presence of an IgG

antibody against acetylcholine receptors in striated muscle.

- anticholinesterase drugs such as pyridostigmine or neostigmine and possibly prednisone

 Multiple Sclerosis - autoimmune disease that affects the myelin sheath of neurons in
the CNS. Cause inflammation and scarring of neuron and decrease in nerve signal
transmission.
MUSCOSKELETAL DISORDERS AND PREGNANCY
 Scoliosis – lateral curvature of the spine

ENDOCRINE DISORDERS AND PREGNANCY

 Thyroid Dysfunction - A woman with a preexisting thyroid illness may have difficulty
making this pregnancy transition.
 Hypothyroidism - “underproduction of the thyroid hormone”. Is a rare condition in late
adolescents and especially rare in pregnancy because women with symptoms of untreated
hypothyroidism are often anovulatory and unable to conceive.
  Hyperthyroidism - “overproduction of thyroid hormone” sometimes called Graves
disease, it is more seen in pregnancy than hypothyroidism.
 Diabetes Mellitus - is an endocrine disorder in which the pancreas cannot produce
adequate insulin to regulate body glucose levels. Most frequently seen medical
condition in pregnancy.
MENTAL ILLNESS AND PREGNANCY
 A woman with a psychiatric disorder is best cared for by a team approach, including
both a psychiatric care team and a prenatal care group, to ensure the stress of pregnancy
is not exacerbating the mental illness and that distorted perceptions or depression do not
complicate the pregnancy.
CANCER AND PREGNANCY
The malignancies most commonly seen with pregnancy are those that occur most frequently in
women during childbearing years such as ovarian cancer, uterine cancer, cervical cancer, breast
cancer, thyroid cancer, leukemia, melanoma, and Hodgkin lymphoma
As a rule, women can receive chemotherapy in the second and third trimesters without adverse
fetal effects. In contrast, radiation therapy, another modality that is a mainstay of cancer therapy,
puts the fetus at risk throughout pregnancy if the fetus is directly exposed.

CHAPTER 21 – Nursing Care of a Family Experiencing a Sudden Pregnancy

Complication

Hypovolemic Shock - Excessive blood loss results in hypovolemic shock; in an antepartum

patient, excessive blood loss diminishes uteroplacental blood flow and induces fetal distress.
Abortion – medical term for any interruption of a pregnancy before a fetus is viable but it is
better to speak of these early pregnancy losses as spontaneous miscarriages to avoid confusion.
Threatened Miscarriage - Symptoms of a threatened miscarriage begun as vaginal bleeding
initially only scant and usually bright red. A patient may notice slight cramping, but no cervical
dilation is present in vaginal examination.
Imminent (Inevitable) Miscarriage - Occur as, with cervical dilation, the loss of the products
of conception cannot be halted.
Complete Miscarriage - the entire products of conception (fetus, membranes, placenta) are
expelled spontaneously without any assistance. The bleeding usually within 2 hours and then
ceases within few days of the passage of the products of conception.
Missed Miscarriage - Referred to as early pregnancy failure, the fetus dies in utero but is not
expelled.
Recurrent Pregnancy Loss - patients who had three spontaneous miscarriages at the same
gestational age were called “habitual aborters”
Septic Abortion - An abortion complicated by infection.
Isoimmunization - A condition that happens when a pregnant woman's blood protein is
incompatible with the baby's, causing her immune system to react and destroy the baby's
blood cells.
Powerlessness or Anxiety - Sadness and grief over the loss or the feeling that a patient has lost
control of their life is to be expected
Ectopic Pregnancy - Is one in which implantation occurred outside the uterine cavity.
Abdominal Pregnancy - Abdominal pregnancy is a rare form of ectopic pregnancy in which the
pregnancy implants within the peritoneal cavity, exclusive of the fallopian tubes, ovaries, broad
ligament, and cervix.
Gestational Trophoblastic Disease (GTD) - is a group of rare diseases in which abnormal
trophoblast cells grow inside the uterus after conception. Hydatidiform mole (HM) is the most
common type of GTD.
Placenta Previa - A condition of pregnancy in which the placenta is implanted abnormally in
the lower part of the uterus, is the most common cause of painless bleeding in the third
trimester of pregnancy.
Chorioamnionitis - is an infection of the placenta and the amniotic fluid.
Couvelaire Uterus - also known as uteroplacental apoplexy or Couvelaire syndrome, is a rare
but non-fatal complication of severe form of placental abruption
Preterm Labor - occurs when regular contractions result in the opening of your cervix after
week 20 and before week 37 of pregnancy.
Gestational Hypertension - is a condition in which vasospasm occurs in both small and large
arteries during pregnancy, causing increased blood pressure.
Preeclampsia - Is a pregnancy related disease process evidenced by increased blood pressure
(hypertension) and proteinuria.
Eclampsia - is the most severe classification of pregnancy-related hypertensive disorders
- Eclampsia is when a person with preeclampsia develops seizures (convulsions)
during pregnancy.
Multiple Gestation - is considered a complication of pregnancy because a woman’s body must
adjust to the effects of more than one fetus.
Polyhydramnios - occurs when there is excess fluid of more than 2,000 ml or an amniotic fluid
index above 24 cm.
Oligohydramnios - refers to a pregnancy with less than the average amount of amniotic fluid.
Postterm Pregnancy - A term pregnancy is 38 to 42 weeks long. A pregnancy that exceeds
these limits is prolonged
Isoimmunization (RH incompatibility) – occurs when an Rh-negative mother (one negative for
a D antigen or one with a dd genotype) carries a fetus with an Rh-positive blood type (DD or Dd
genotype).
Intrauterine Transfusion - To restore fetal red blood cells, blood transfusion can be performed
on the fetus in utero.
Fetal Death - The mostly can causes of this include chromosomal abnormalities, congenital
malformation infections such as hepatitis B, immunologic causes, and complications of maternal
disease.

CHAPTER 23 – Nursing Care of a Family Experiencing a complication of Labor or Birth

Precipitate Labor - is extremely rapid labor and delivery. It is defined as expulsion of the fetus
within less than 3 h of commencement of regular contractions.
Induction of Labor - is the process of starting labor before it begins on its own.
Augmentation of Labor - the process of stimulating the uterus in order to increase the
frequency, duration or intensity of contractions after labor has already begun.
Uterine Rupture – a serious complication where uterus tears or breaks open. (common for
people who’ve had a previous C-section.)
Inversion of the Uterus – occurs when the uterine fundus collapses into the endometrial cavity,
turning the uterus partially or completely inside out.
Prolapse of the Umbilical Cord – occurs when the cord drops through the open cervix into the
vagina before the baby moves into the birth canal.
Macrosomia (Oversized Fetus) - a fetus who weighs more than 4,000 to 4,500 g 1358
(approximately 9 to 10 lb.)
Inlet Contraction - is narrowing of the anteroposterior diameter of the pelvis to less than 11
cm.
Outlet Contraction - is a narrowing of the transverse diameter, the distance between the
ischial tuberosities at the outlet, to less than 11 cm.
External Cephalic Version - is the turning of a fetus from a breech to a cephalic position
before birth. It may be done as early as 34 to 35 weeks, although the usual time is by 37 to 38
weeks of pregnancy.
ANOMALIES OF THE PLACENTA
Placenta Succenturiata - is a placenta that has one or more accessory lobes connected to the
main placenta by blood vessels.
Placenta Circumvallata - the fetal side of the placenta is covered to some extent with chorion.
Placenta Marginata - the fold of chorion reaches just to the edge of the placenta.
Battledore Placenta - the cord is inserted marginally rather than centrally.
Velamentous Insertion of the Cord - is a situation in which the cord, instead of entering the
placenta directly, separates into small vessels that reach the placenta by spreading across a fold
of amnion.
Vasa Previa - the umbilical vessels of a velamentous cord insertion cross the cervical opening
and therefore deliver before the fetus.
Placenta Accreta - is an unusually deep attachment of the placenta to the uterine
myometrium.

ANOMALIES OF THE CORD

Two-Vessel Cord - the absence of one of the umbilical arteries is associated with congenital
heart and kidney anomalies.
Unusual Cord Length - short umbilical cord can cause result in premature separation of the
placenta or an abnormal fetal lie.
- Long cord may be easily compromised because of its tendency to twist or knot.

CHAPTER 25 – Nursing of the High Risk Postpartal Client

Postpartum Hemorrhage - Defined as any blood loss from the uterus greater than 500 mL
within a 24- hour period.
Uterine Atony - Failure of the uterus to contract following delivery and is the most common
cause of postpartum hemorrhage.
- no contractions
Lacerations - tear after giving birth considered as normal consequence of childbearing,
however, large lacerations can cause complications.

TYPES OF LACERATIONS:
Cervical Lacerations - usually found on the sides of the cervix, near the branches of the
uterine artery.
Vaginal Lacerations - Vaginal lacerations are easier to locate and assess than cervical
lacerations because they are so much easier to view.
Perineal Lacerations - Lacerations of the perineum are more apt to occur when a woman is
placed in a lithotomy position for birth rather than a supine position because a lithotomy
position increases tension on the perineum.
CLASSIFICATION OF PERINEAL LACERATIONS:
First Degree – Vaginal mucous membrane and skin of the perineum to the fourchette.
Second Degree – Vagina, perineal skin, fascia, levator ani muscle, and perineal body.
Third Degree – Entire perineum, extending to reach the external sphincter of the rectum.
Fourth Degree - Entire perineum, rectal sphincter, and some of the mucous membrane of the
rectum.

Retained Placental Fragments - A delayed postpartum hemorrhage or prolonged

postpartum spotting, occurs when there is incomplete separation of the placenta and fragments
of placental tissue retained.
Disseminated Intravascular Coagulation (DIC) - is a deficiency in clotting ability caused by
vascular injury.
- Is usually associated with premature separation of the placenta, a missed early
miscarriage, or fetal death in utero.
Uterine Inversion - a prolapse of the fundus of the uterus through the cervix so that the
uterus turns inside out.
Subinvolution - the incomplete return of the uterus to its prepregnant size and shape. With
subinvolution, at a 4- or 6-week postpartal visit, the uterus is still enlarged and soft. Lochial
discharge usually is still present.
Perineal Hematomas - a collection of blood in the subcutaneous layer of tissue of the
perineum.
Puerperal Infection - Infection of the reproductive tract in the postpartal period.
Endometritis - is the infection of endometrium, the lining of the uterus.
Infection of the Perineum - If a woman has a suture line on her perineum from an episiotomy or
a laceration repair, a ready portal of entry exists for bacterial invasion.
Peritonitis - An infection at the peritoneal cavity that usually occurs as an extension of
endometritis.
Thrombophlebitis - is inflammation with the formation of blood clots.
- Classified as either superficial vein disease (SVD) or deep vein thrombosis
(DVT).
Femoral Thrombophlebitis - The femoral, saphenous, or popliteal veins are involved.
Although the inflammation site in thrombophlebitis is a vein, an accompanying arterial spasm
often occurs, diminishing arterial circulation to the leg as well.
Pelvic Thrombophlebitis - involves the ovarian, uterine, or hypogastric veins.
Pulmonary Embolus - is obstruction of the pulmonary artery by a blood clot; it usually occurs
as a complication of thrombophlebitis when a blood clot moves from a leg vein to the
pulmonary artery.
Mastitis - is an inflammation of breast tissue that sometimes involves an infection.

URINARY SYSTEM DISORDERS:

Urinary Retention – occurs when the bladder is unable to empty completely.
Urinary Tract Infection - person who is catheterized at the time of childbirth or during the
postpartum period is prone to the development of UTI.