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OB, Exam1
OB, Exam 1
Question | Answer |
---|---|
Encompasses complementary & alternative therapies in combination with conventional Western modalities of treatment. | Integrative Health Care |
Leading cause of pregnancy-related deaths in US. | Hemorrhage (also: blood clots, HTN, infection, stroke, amniotic fluid embolism, & heart muscle disease). |
2 or more emotionally involved people living in close proximity & having reciprocal obligations with a sense of commonness, caring, & commitment. | Family |
The emphasis in working with families is on: | Wellness & empowerment to achieve control over their lives. |
Theory as to how families react to stress. | Family Stress Theory |
Family Systems Theory is based on: | -Family system is part of larger suprasystem & composed of many subsystems. -Family is greater than sum of its individual members. -Change in one member affects all family members. -Family creates balance between change & stability. |
Theory that families move through stages. | Family Life Cycle Theory |
Theory that identifies family strengths & resources. | McGill Model of Nursing |
Theory that focuses on reducing culture & environmental barriers that interfere with access to health care. | Health Belief Model |
Theory which focuses on behavior & it's interaction with the environment. Contains Duvall's Developmental Theory. | Human Developmental Ecology |
Evolution of the family over time; predictable tasks & role expectations occur with each stage; family assessment looks at how well the family meets each task. | Duvall's Developmental Theory |
1st 3 stages of the 8 stages of Duvall's Developmental Theory: | Stage I: Marriage & an Independent Home (Joining of families) Stage II: Families with Infants Stage III: Families with preschoolers |
Theory which uses systems & other theories. Composed of 3 major categories: Structural, developmental, & functional. Each category branches further into subcategories | Calgary Family Assessment Model (CFAM) |
The process by which people retain some of their own culture while adopting the practices of the dominant society. | Acculturation |
Cultural group loses its identity & becomes part of the dominant culture. | Assimilation |
Rightness of one's own culture. | Ethnocentrism |
Applying standards of another culture, respecting other cultures. | Cultural relativism |
Sum of the beliefs & balues that are learned, shared, & transmitted from generation to generation by a particular group. | Culture |
Culture with strong influence of mother-in-law; male infant not circumcised. | Hispanic |
Culture which believes pregnancy is state of wellness, good baby thought to eat well. | African-American |
Culture which believes in hot & cold. | Asian |
Culture which believes in early prenatal care. | European |
Culture which believes in late prenatal care due to pregnancy being an natural state. | Native American |
Culture which is strongly male dominated. | Middle-Eastern |
What does CRASH stand for in culteral competence? | Culture, show Respect, Assess/Affirm differences, show Sensitivity/Self-awareness, do it all with Humanity |
Based on the principles of right and wrong behavior according to that individual's beliefs | Morals |
Looks at why we subscribe to a particular moral belief. There's a best course of action depending on the sitution, arises out of a set of moral principles, no solution seems completely satisfactory (dilema) | Ethics |
One is required to do or promote good for others. To do good. | Beneficence |
One must avoid risking or causing harm to others. Not to harm. | Nonmaleficence |
People have the right to self-determination, respect, privacy, and information for decision-making. Free will or agency. | Autonomy |
All People should be treated equally and fairly regardless of disease or social or economic status. Social distribution of benefits and burdens. | Justice |
Most common and fastest spreading STI. Difficult to diagnose, a bacteria, screen asymptomatic pregnant women, tx with azythromycin. | Chlamydia |
A bacteria STI, women often asymptomatic - may have menstrual irregularities & rectal complications, ts is antibiotic, spread by genital contact, risks are: age, african-american, early secual activity, multiple partners | Gonorrhea |
A bacteria STI, spread through sexual abraisions, can lead to mortality in the fetus/infant. screen pregnant woman's blood, fals positive. TX: penicillin &sexual abstinence during tx. | Syphilis |
Single most common serious infection to women, spread of MO's from vaginal & endocervix to upper genital tract, increased risk for ectopic pregnancy, inftility, chronic pelvic pain. | PID - Pelvic Inflammatory Disease |
STI that affects most people in the U.S. today, Most prevalent viral STI seen in ambulatory health care settings. | HPV - Human Papilloma Virus |
STI which presents with painful lesions, fever, chills, malaise, and severe dysuria. Adverse effects on mother and fetus and increased miscarriage rates during the 1st trimester, cervical cancer | HSV-2 |
Most threatining STI to the fetus and neonate, disease of the liver; often a silent infection and transmitted parenterally, perinatally, orally (rare), and intimate contact. Vaccination series, viral | Hepatitis B |
Most common blood-borne infection is US | Hepatitiis A |
Vaginal infection caused by MO's, associated with preterm labor and birth. Tx. Gardnerella and Mobiluncus. | Vaginitis |
Vaginal infection caused by yeast. Tx. Over the counter meds, fluganozole. | Candidiasis |
Common cause of vaginal infection, men should tell sexual partner if infected, Tx. Metronidazole 2 g orally in a single dose. | Trichomoniasis |
STI associated with poor pregnancy outcomes. Screening at 36-37 wks gestation. S&S in newborn: temp instability, poor feeding, irritability, letheragy. Risk factors:positive culture, preterm birht < 37 wks, Premature rupture of membranes > 18hrs, | Goup B Streptococci |
Breast self-exam is carried out during this phase of the menstrual cycle: | 5-7 days after menstruation stops |
Consists of the Endometrial cycle, Hypothalamic-pituitary cycle, and Ovarian cycle | Menstrual cycle |
Found in most organs of body; i.e. uterus, menstural blood, hormones made of oxygenated fatty acids involved in many reproductive functions. | Prostaglandins |
Transitionsal phase during which ovarian fxn & hormone production decline. | Climateric Phase |
Refers to the last menstrual period, cessation of menses for one yr., average age 51.4 yrs, range of age 35-60 yrs. | Menopause |
Menstrual event: Days 1-5 | Menstrual phase |
Menstrual event: to ovulation, estrogen impact causing endometrium to increase its thickness. | Proliferative phase |
Menstrual event: Mature egg released from ovary. | Ovulation |
Menstrual event: ovulation to day 28, progesterone influence causes endometrium to become fluid and blood rich, secretory bed to nourish embryo. | Secretory phase |
After ovum discharged, remaining empty follicle sac is called the corpus luteum, reaches peak in 8 days, coincides with normal implantation time if fertilization takes place. | Luteal Phase |
Hypothalamus secretes Gondadatropin Releasing Hormone. GnRH acts on pituitary -> Follicle Stimulating Hormone (FSH), Leutinizing Hormone (LH). | Hypothalamic-Pituitary Cycle |
Hormones the ovary secretes: | Estrogen: most active at beginning of cycle to mid cycle. Progesterone: most active from ovulation to end of cycle. |
Phases of the Ovarian cycle: | Follicular phase: day 5 to ovulation & development ovum. Ovulation: preceded by LH surge, and with prostaglandins causes rupture. Luteal phase: ovulation to menstruation approximately 14 days. |
Cell division | Mitosis & Meiosis |
Gametogensis | Spermatogenesis & Orogenesis |
Formation of a viable zygote by the union of the male sperm and female ovum; fertilization. | Conception |
Fertilization | Morula & Blastocyst |
Chorionic villi & Decidual basalis | Implantation |
Lenght until implantation: | 6-10 days (3-4 days in tubes + 2-3 days in uterus). |
The cell stages of the zygote: | 2 cell stage @ 1-1/2 days Morula stage @ 3 days (ball of cells) Blastocyst @ 4 days (58 cells, 2 cell layers) Trophoblast @ 14 days (fetal membranes & placenta, secrete enzymes to dissolve endometrium). |
Produced by trophoblast as early as day 1 of implantation, basis for pregnancy, causes corpus luteum to continue progesterone production for 10 wks until placenta takes over. | HCG (Human Chorionic Gonadotropin) |
3 Primary Germ Layers: | Ectoderm: skin, nails, nervous system, tooth enamel. Endoderm: auditory canal, endocrine glands, epithelial cells of respiratory tract & GI tract. Mesoderm: connective tissue, teeth, muscles, blood & vascular system. |
Stages of fetal development: | Ovum: until implantation is complete. Embryo: from 8 wks after ovulation, period of organogenesis. Fetus: from embryo until term or 40 wks. |
Fetal cardiac: | 1st system to develop, heart beating 3 wks after conception. Accessory structures: ductus venosus, ductus arteriosus, foramen ovale. |
Explain surfactants: | Produced 24 wks until birth, minimizes surface tension & keeps lungs inflated, Lecithin & Sphingomyelin, ratio is 1:1 & adequate by 32-35 wks, 2:1 ratio indicates lung maturity in normal pregnancy. |
Age fetus responds to tactile stimulation: | 8-1/2 wks |
Age fetus has generalized reflex responses to things such as pain: | 14 wks |
Age fetus does sucking & respiratory movements: | 20 wks |
Age the fetus has steady progression toward full term: | 28 wks |
Age fetal liver fxn begins: | 4 wks. |
Fetus is viabile at: | 24 wks. |
Critical time periods for: CNS, Heart, Arms-Legs-Eyes, Palate, Ext. Genitalia, Ears | CNS (3-6 wks), Heart (3-6 wks), Arms-Legs-Eyes (4-7 wks), Palate (7-8 wks), Ext. Genitalia (7-11 wks), Ears (4-10 wks) |
Define unifactorial genetic transmission: | A single gene controlling a trait, disorder, or defect. |
Types of unifactorial genetic transmission: | Autosomal dominant inheritance, Autosomal recessive disorder, Inborn errors of metabolism, X-linked dominant inheritance, X-linked recessive inheritance |
Define multifactorial genetic transmission: | Most common genetic malfunction. Combination of environmental & genetic factors: ie infections, radiation, drugs, chemicals, maternal condition. |
Examples of multifactorial genetic transmission: | Cleft lip & palate, anencephaly, neural tube defects, congenital heart disease, pyloric stenosis |
Nongenetic factors in birth defects: | Some congenital malformations caused by teratogens: drugs, chemicals, infections, exposure to radiation, and maternal conditions such as diabetes & PKU, maternal malnutrition. |
May occur in autosomes or sex chromosomes, may be an abnormality of number or structure. | Chromosomal Abnormalities |
Example of autosome abnormality of chromosome number: | Down syndrome |
A disease or disorder that can be passed from generation to generation. | Genetic disorder |
A disorder that is present at birth and can be caused by genetic factors, environmental factors, or both. | Congenital disorder |
Where do autosomal traits occur? | On any of the 22 pairs of autosomes. |
Where do sex-linked traits occur? | On any of the sex chromosomes (usually called x-linked) |
How are X-linked disorder expressed? | Varies with the sex of the person with the defective gene. If the mother is a carrier of the defective gene, it is expressed in the male offspring who has only 1 X-Chromosome. |
Explain autosomal dominant inheritance: | Will always be expressed, males & females are equally affected on autosome (not sex cells), affected individuals have an affected parent, 1/2 of kids of heterozygous affected parent will be affected & normal kids of affected parents will have normal kids |
Examples of autosomal dominant disorders: | Polydactyly & Huntington's chorea |
Explain autosomal recessive inheritance: | will always be homozygous for that trait. Trait does not appear in the heterozygous parents but they will pass the defective gene to their offspring. Males & females equally affected. Affected kids will have unaffected parents who heterozygous for trait. |
Examples of autosomal recessive disorders: | Cystic fibrosis, Phenylketonuria PKU ()missing enzyme to convert phenylalanine to tryosine = mental retardation), Sickle cell anemia, Tay Sachs (lacking enzyme for sphingolipid metabolism = brain & nerve deterioration & death by age 4) |
Expalin X-linked recessive disorders: | Affected individuals are usually male, have unaffected parents, female kids of affected males will be carriers, unaffected male kids of affected male can't transmit disorder. |
Examples of X-linked recessive disorders: | Hemophilia, Duchene muscular dystrophy. |
Examples of abnormality of chromosome number disorders: | Trisomy (Down Syndrom), monosomy, mosaicism. They are caused by paired chromosomes failing to separate during cell division (non-dysjunction). Trisomy & monosomy occur before fertilization; mosaicism occurs after fertilization. |
Explain multifactorial inheritance disorders: | combination of genetic & environmental factors. Gene pools of close relatives have 1/4 to 1/2 of the genes in common = greater likelihood that member will have harmful genes in common. |
Examples multifactorial inheritance disorders: | Cleft lip & palate, Congenital dislocated hip, Conginital heart defects, Neural tube defects, DM, HTN, Schizophrenia |
Nurse's role for genetic issues: | 1.) Identify families at risk for genetic issues. 2.) Aide families in coping w/potential genetic issues. 3.) Ensure the continuity of care (followed & assigned to appropriate physicians). |
Nutrient needs of pregnant woman (main): | 8-10 glasses H2O/day, IRON, Calcium, Vitamin B6, Vitamin D, Bitamin E, Folic Acid |
Define total weight gained in pregnancy: | 25-40lbs (27 avg) total, <1/2 total weight gain is from fetus, placenta, & amniotic fluid. Rest is from maternal reproductive tissues, fluid, blood, & stores. |
Pattern of weight gain during pregnancy per trimester: | 1st: 1 lb/month (2-4 lbs, related to ^ maternal tissues), 2nd: 1 lb/wk (10-15 lbs, largest maternal increase), 3rd: 1 lb/wk (8-10 lbs, largest fetal gain). |
Calorie needs in pregnancy: | Increase 300 cal/day |
Protien needs in pregnancy: | 60 gm/day for 2nd & 3rd trimester |
Total Iron needed in pregnancy: | 30 mg/day, begin with supplements by 12 wks gestation. additional of 60-120 mg/day for deficiencies, take with vitamen C. |
Anemai in pregnancy: | HCT (Hemocrit)<32% & Hgb (Hemoglobin)<11gm, Pica r/t low Fe (iron), Coffee, milk & tea bind to iron and prevent absorbtion |
Folic acid needs in pregnancy: | 600 mcg/day. Deficits in 1st 6wks associated w/spontaneous abortion & neural tube defects. |
Sources of Folic Acid: | Beans, Peanuts, Orange juice, Asparagus, Peas, Broccoli, Lettuce, Spinach. Difficult to get enough in diet. |
When else to increase folic acid: | Long term oral contraceptive use, anticonvulsant use. |
Explain Sickle Cell Anemia | Blacks & Mediterranean affected, complicated by iron & folic acid deficiency, causes vascular occlusion (pain & fever), brought on by hypoxia, infectin, edema, RBC destruction. Tx: give O2 during labor, maintain hydration, supplement folic acid. |
Calcium needs during pregnancy: | 1000 mg/day for adult, 1300/day for teen. Met if milk is consumed. |
Explain sodium in pregnancy: | Slight increased need, Estrogen causes some H2H retention, Diuretics not routinely used. |
Nutritional risk factors in pregnancy: | Vegans risk for vitamen B-12 defic. (prematurity), smoking (lbw & length & premature labor), alcohol (fetal alc. syndrom in baby w/> 5 oz daily intake, drugs (poorly nourished, infections, infant withdrawal), caffeine (lbw, muscle tone, activity at birth) |
Late pregnancy birthing classes which focuses on fear, pain, tension cycle. | Grantley-Dick Read |
Late pregnancy birthing classes which focuses on husband coached childbirth, deep breathing, relaxation, physical conditioning. | Bradley |
Late pregnancy birthing classes which focuses on Psychoprophylaxis (r/t the mind & to guard or prevent beforehand)& conditioned response. | Lamaze |
Late pregnancy birthing classes which focuses on water birth, environment quiet and dark. "Birth without violence". | LeBoyer |
Light fingertip massage of the abdomen. | Effleurage |
Name for the breath taken at the beginning & end of each contration. | Cleansing breath |
Tingling, feeling dizzy, and having fuzzy thinking are caused by this: | hyperventilation |
2nd stage breathing pattern. | Pushing |
Components of breathing techniques for labor: | Focusing, Cleansing breath, Relaxation, Effleurage |
Labor Transition characteristics: | Urge to push/have a BM, Sleepiness, Hot/Cold, GI problems, Very introspective, Bachache, Mood changes (panic), Loss of time perspective, Loss of modesty, Wants it to be over. |
Contraception method: FAMs (Fertility Awareness Methods) | Natural family planning (period abstinence), Calendar rhythem method, Standard days method, Basal body temperature method, Cervical mucus ovulation-detection method |
What is the Coitus interruptus method of contraception? | Withdrawal of penis before ejaculation. |
Types of contraception barrier methods: | Spermicides, Condoms, Vaginal sheath, Diaphragm, Cervical cap, Sponge. |