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39 Cards in this Set
- Front
- Back
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Define Infant mortality? What is the goal for HP? |
-The number of babies who die during the first year of life per 1,000 live births based on the birth cohort.
-HP Goal: 6/1000 live births |
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Why is infant mortality so important? |
-Critical indicator of health of the population
-Reflects overall state of maternal health and quality/accessibility of primary health care available to pregnant women and infants |
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What are the top 3 causes of death of infants among all races? |
1. Short Gestation and Low birth weight 2. Congenital Anomalies 3. SIDS |
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What are the top 3 causes of death among blacks? |
1. Short Gestation and Low birth weight 2. Congenital Anomalies 3. SIDS |
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What has the highest rate of infant mortality among races? Who has the lowest? |
Highest: African Americans Lowest: Hispanics |
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What is the name of the organization that met in 2011 to discuss how we solve the problem of infant mortality? What did they decide was the solution? |
- National Summit on Preconception Care
-Getting better care before you get pregnant |
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What were the recommendations made by the National Summit? |
-Improve preconception health -Vaccinations and supplementation (rubella, hep b, folic acid) -Chronic disease management (diabetes, hypothyroidism, HIV/AIDS) -Screening (STIS, depression- more at risk for ppd) -Lifestyle mods (smoking, drug/ETOH, obesity)
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What diet and exercise recommendations does the National summit give? |
- Diet: inc folic acid and iron, dec caffeine to 300mg
-Exercise: no extreme sports but still should participate in 30min of aerobic exercise/day |
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Explain how $ and culture are barriers to care. |
$: ability to par, access to providers, insurance coverage
Cultural: lack communication, race discrimination, religious beliefs, man make healthcare choices
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Explain how gender, age and substance use are barriers to care. |
Gender: provider gender, lesbians fear hostility, breach of confidentiality
Age: teens may not tell parents, ADA (advance maternal state)
Substance abuse and fear of law |
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Describe the process of conception. |
Egg is fertilized in fallopian tube by sperm -zygote
-Sperm: must be uniform in size, normally formed, high motility and secrete enzymes -Egg: basal body temp and fallopian tubes open without adhesions |
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Describe the process of implantation |
Zygote implants in the uterine lining (embryo and placenta develop
-Embryo: 15 days to 8 wks -Lots of progesterone secreted (can cause morning sickness -At 9 wks, becomes fetus till birth |
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Why is preconception care so important? |
The vital organs for function develop often before the mom knows she pregnant. |
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Compare congenital vs. genetic defects? |
Congenital: abnormality during development -ex: baby born with toes fused together
Genetic: abnormality during conception -ex: down syndrome |
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Describe the process of placental development. |
-Integration of embryonic and decidual cells - Formation of chorionic and amniotic membranes (amniotic fluid protects fetus) -Allows maternal-fetal blood and nutrient exchange -Placental fx dec may stimulate labor |
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Define: gravida, nulligravida, multigravida, term pregnancy, post term, preterm, viability. |
Gravida: pregnant woman Nulligravida: woman who's never been pregnant Multigravida: 2+ pregnancies Term pregnancy: from 38 wks -42 wks Post Term: pregnancy goes beyond 42wks PretermL at least 20 wks to 37 wks Viability: can live outside uterus; 22-25wks |
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What is the GTPAL System? |
(G)ravida- pregnant/# pregnancies including this one (T)erm- 38-42 wks (P)reterm- 20-27 wks (A)borions/miscarriages: elective v. spontaneous (L)iving children: currently |
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How are the 3 trimesters broken down? |
1st: week 1-13 2nd: week 14-26 3rd: week 27-40 |
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What is EDD, EDC, and LMP? |
EDD: estimated date of delivery EDC: estimated date of confinement -EDD and EDC the same
LMP: first day of last menstrual period |
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What is Naegele's Rule? |
Method for calculating due date: -Determine LMP -Subtract 3 months -Add 7 days -May need to change year |
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What are the types of pregnancy tests? |
Home: looks for hCG (human Chorionic Gonadotropin) in urine -87% effective -if negative, try again in 1 week
Serum test: diagnosis 6-11 days after conception
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What are the presumptive (subjective) signs of pregnancy? |
-Nausea/vomiting
-Change in breast sensations/size
-Inc urinary freq
-Missed menstrual period |
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What are the probable (objective) signs of pregnancy? |
-Enlargement of uterus -Hegar sign: softening of uterine isthmus -Chadwick sign: blue/cyanotic of cervix/upper vagina -Goodell sign: softening of the cervix -Piskacek sign: asymmetrical, softened enlargement of the uterine corner bc placental development -+ HCG in urine/blood |
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What are the positive signs of pregnancy? |
-Verification of pregnancy. -Detections of fetal heart tones by auscultation, ultrasonography, or Doppler -Measuring final height -Palpation of fetal body parts using Leoplands -Quickening -Radiological/ultrasonographic of fetal parts
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What is CRL? |
Crown Rump Length -used to determine due date -Why some pregnant women may have 2 due dates |
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How does an ultrasound work? When is it used? |
-High frequency sound waves bounce off fetal tissue to produce fetal image called a sonogram
-8-12 wks: confirmation, 18-22 wks: growth and anatomy |
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What happens at the initial prenatal visit? |
-History -Pap -Pelvis -Bloodwork -CCMS for C and S -Education |
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What is the schedule for prenatal visits? |
-Q4 wks up to 32wks -Q2 wks from 32-36 wks -Weekly from 36 to 40 wks -Twice/wk from 40-42 wks |
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What are the nutrition recommendations for pregnant women? |
-Inc 300cal/day -8-10 glasses of water -70g protein -inc fiber and roughage (constipation) -inc vitamins/minerals (iron 30mg, folic 400mcg) -fats/carbs for energy |
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What is the recommended weight gain for someone who has a normal, underweight, overweight, and obese BMI? How much should be gained in 1st trimester? 2nd&3rd? |
Normal: 25-35lbs Under: 28-40lbs Over: 15-25lbs Obese: 11-20lbs
1st: 305lbs 2nd&3rd: 1lb/wk |
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What are the risk factors for neural tube defects? |
-Higher in whites/hispanics -Hx spinal/neural tube defects -Diabetes Mellitus -Obesity -Folate deficiency** (folate a natural form of vitamin B-9) -Inc body temp -Anti-seizure meds |
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What are the fetus activity patterns in early pregnancy and later on in pregnancy? |
Early: spontaneous movements; reflexive Later: quickening @ 16-22 wks -Need to do "kick counts" after occurs to monitor fetal movement
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What are teratogens? |
An agent or factor that causes malformation of the embryo; cause either a functional or structural disability based on exposure.
-Can affect CNS (miscarriage, birth defects) -Risk factors: family hx, maternal age; need diagnostic tools |
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What is the TORCH screen? What does it stand for? |
Screen done prenatally to detect 5 teratogenic infections: (T)oxoplamosis (O)ther/hep B (R)ubella (no shot when pregnant) (C)ytomegalovirus (H)erpes simplex |
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What do you need to know with a mother who has herpes simples? |
-If she has an active lesion, cannot have a vaginal birth
-If no active lesions, vaginal birth is ok |
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What mothers get the RH shot? When is RH an issue? What can it cause in a fetus? |
-All who are (-); given at 28 wks -When mother is (-) and father is (+); mom could form antibodies against and cross placenta and destroy RH+ RBCs of fetus
*anemia, hyperbilirubinemia, death |
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When is a glucose test given during pregnancy? |
28 wks |
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What do you need to know about prescription medications for pregnant mothers? |
-NO ACCUTANE= teratogen
-Antibotics: most short term ok; tetracyclines cause teeth discoloration
-Anticonvulsants: barbiturates can cause newborn addiction; hydantoin also a problem |
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What peripheral vascular problems can occur during pregnancy? |
-Vena Cava Syndrome (can't lay on back)
-Orthostatic hypotension; bc 40% inc in blood volume |
