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206 Cards in this Set

  • Front
  • Back
How do nurses develop their skills?
By making clinical judgements & intervening appropiately, they process through 5 levels of competence.
5 levels of competence?
1. Novice
2. Advanced beginner
3. compentent
4. proficient
5. expert
The newborns & mothers self protection act of 1996 states what?
postpartum stay up to 48Hours after vaginal birth & 96Hours after c-section.
Early D/C increases the risk of being inadequately prepared to care for themselves and their newborn b/c?
early d/c limits time for client teaching.
why are home births not generally recommended?
in the event of a complication that threatens the well being of the mom or baby, a delay in emergency assistance may result.
when is the family more likely to accept and comply with the needed care?
when the nurse incorporates the family's cultural values into the care plan.
Roe vs Wade made what legal in the US?
Research w/ fetal tissue has advanced in the treatments of?
Alzheimers & DiGeorge Syndrome
Intrauterine fetal surgery is done when?
2nd trimester of pregnancy
Why is intrauterine fetal surgery done?
for therapy for anatomic lesions
what risk does one have with intrauterine fetal surgery?
If a woman decides to to have intrauterine fetal surgery, what is commited to?
c-section for this birth and subsquent births.
During therapeutic insemination, what testing must be done?
HIV testing
What do the use of ovulation-inducing meds do?
trigger the release of multiple eggs & increases the chance of multiples pregnancy.
What does cord blood contain?
regenerative stem cells
what are benefits of cord blood?
less invasive, no risk to mom or baby, works w/ less than perfect match, available more rapidly
What are descriptive & inferental statistics?
desc= describe/ summarize data.

infer= draw conclusion btwn. 2 or more variables.
what are family values?
system of attitude, idea, beleifs that bind a family in a common culture.
what is family power?
someone who can change behavior of other family members
Korean culture relies on who?
How is the father in cuban culture?
dominat, aggressive, critical to family decisions
family roles are based on?
Nucler family?
mom stay at home dad is the provider
Famiy development?
family cahnge over time
What must the nurse do to obtain accurate and concise famiy assesment?
establish a trusting relationship w/ the woman and her family
The nurse knoes data is best completed in a comfortable, private enviroment and free from interuptions. What communication skills must the nurse use?
Therapeutic communication skills- active listening, reflection, and sclience to encourage the woman/family to verbalize information.
What does basic info include?
Name, age, sex, cultural asociation, religous affiliations, support group, family structure, communication patterns
What data should nurse gather during personal history?
pregnancies, preg. losses, infant health concerns or deaths.
why must nurse complete comprehensive review of current health practices on health promotion behaviors?
to asses family's ability to prevent accidents and chronic health cinditions& obtain breif nutrition assesment to reduce risk of nut. related ilness.
What does a home visit enable nurse to do?
Observe the family directly in their own enviroment & personal space
What obversations should nurse include during home visit?
place for each to sleep, necessities for daily living,
enviromental hazzards that can be harmful, asses neighborhood for available resources.
what resources are important for the childberaing family to have?
safe place for baby to sleep,
clothes, blankets, age appropiate resources for other children
Ethnicity is?
social idenity that is associated w/ shared behaviors and paterns.
beleifs, values, attitudes accepte dby a population or individual.
process in which people adapt to new cultural norm
changes in cultural idenity to become part of a majority culture.
What is the traditional family structure in the US?
Nuclear family with extende fam living seperate.
A family's ________ may influence it's beliefs about and practices of childbearing, childrearing, importance of children, beleifs of pregnancy, health practices, and infant feeding behaviors
Many Muslims do not seek medical care b/c?
they believe in fatalism- the future is in the hands of god
Why may a greek woman refuse gyn. exams?
fear the exam will diminish their fertility.
Many Hispanics and Mexican-Americans feel having children is a sign of??
manliness, or machismo- a desired trait.
Who may not practice contraception b/c children are highly valued and the role of a woman is to bear children?
For a woman who views pregnancy as a natural occurence, what may not be a priority?
prenatal care
Establishing what kind of relationship enables the nurse to assist the family in meeting educational needs?
It is critical for the nurse to develop what type of understanding of their clients needs?
What is the beleif that one's culture is superior or only acceptable one?
Cultural, religious,& personal attitudes about menstruation are part of the menstrual experience and often reflect what toward women?
Negative attitudes
What is the average age of menarche?
the most critical factor in sucessful adaption to menarche is the preteen's or adolescent's what ?
level of preparedness
What basic info is needed for counsleing about menarche?
cycle length, amt of flow, lenght of meneses.
Norm cycle length?
21-35 days
Avg amount of flow?
25-60 ml
Avg. length of meneses?
2-8 days
The use of deoderized pads and tampons can cause the vagina what?
a rash on the vulva & tender mucous lining of the vagina.
Whe taking a sex hx, what approach should the nurse use to help the woman develop a comfort level before disclosing personal information?
start the interview w/ less intimate areas such as medical surgical hx and proceed the sex hx toward the end
Regarudless of the amt of blood flow, how often should a woman change her pad?
q 3-6 hours
A woman who supersaturates her maxipad every 1-2 for a couple of days should do what?
seek medical attention to decrease the risk of anemia.
What is the causative organism of TSS?
Staphylococcus aureus
To prevent TSS what should a woman do?
wash her hands before inserting a tampon
What may vaginal sprays cause?
itching, burning, vaginal discharge, rashes
What may douching cause?
when is douching contraindicated?
during pregnancy
short flow or dec. amt
abnormally long flow
no bleeding longer than 40 days
bleeding less than 22 days
excesive in amt and duration
norm amt. at irregular intrevals
excessive in amt and duration at irregular intrevals
Intermenstrual bleeding?
bleeding btwn cycles
What is primary amenorrhea?
menstruation has not been established by 16 yrs old
What is secondary amenorrhea?
whrn established menses longer than 3 months ceases.
Waht may cause amenorrhea?
Hypothalmic dysfunction
Pituitary dysfunction
ovarian failure
Anatomic abnormalaties
A serum prolacrin level is a screening test for?
pituitary function
what may an elevated FSH serum level indicate?
Ovarian failure
painful menstruation the day of or before onset of mensturation
Cx of primary dysmenorrhea?
high level of prostaglandins
what conditions most frequently cause secondary dysmenorrhea?
Endometrosis, PID, ovarian cysts, imperforate hymen.
Dysmenorrhea sometimes occurs in women who are also experiencing?
What are slef care measures for dysmenorrhea?
Vit. B, esp. B6, vit E, heat, daily exercise
The sympoms of PMS occur when?
btwn ovulation and onset of menses
Serotonin agents such as Prozac and Zoloft can be used to help alleviatesymptoms of what?
What may be effective in relieving symptoms of PMS?
1200mg calcium carbonate
what is menopause?
transition for a woman marking the end of her reproductive stagewhen estrogen levels are so low menstruation stops.
When does menopause occur?
45-52 yrs.
How long can perimenopause, the transition from normal ovulatory cycles to cessation of menses last?
2-8 yrs
What are symptoms of perimenopause?
PMS, hot flashes, irregular periods, insomnia, mood changes.
60% unplanned pregnancies for women over 40yrs is what?
ended by induced abortion
What is the most commonly used method of contraception in the US?
female sterilization
During menopause, lowered levels of testrone may be related to what?
decrased libido.
During menopause, atrophic changes occur in the ovaries, vagina, vulva, urethra & bladder & pelvis. What can help prevent this?
Kegel exercises and regular sexual activity.
What is vasomotor distrubances and how long and how often do they last?
hot flashes last 3-5 min and can occur 20-30 times a day.
Loss of protein from the skin along with sun damage and smoking causes?
Osteoprosis is most common in who?
middle aged women
Osteoprosis increases the risk of?
hip, forearm, and vertebrae fracture
When estrogen levels fall w/ menopause women are at risk for?
CHD, HTN, stroke
High Chlesterol, HTN, decreased estrogen levels and dec. folate can increase the risk of?
Alzheimers Disease
What are the only meds approved by the FDA to treat cognitive dysfunction for Alzheimers Disease?
Acetylcholinesterase inhibitors
Risks for Osteoprosis?
small frame, low wt, mid age woman, low ca+ intake, lack of wt. bearing exercise, early onset menopause
HRT can be helpful for?
decreasing symptoms of menopause
Only estrogen as HRT is for who?
women w/o uterus
What does progestrin do?
protect the endometrium
Women using HRT may experience?
Gallbladder disease, blood clots in legs and lungs
What test is useful for identifying women at risk for osteoprosis?
Bone Mineral Density test
Clients ofn Hrt should report what immediately?
HA, visual changes, signs of thrombophlebitis, or MI.
Why should women have their ht recorede every visit?
loss of ht indicates early sign vertebrae are being compressed b/c reduced bone mass.
women over the age 50 should have daily intake?
1200mg calcium
Estrogen may prevent?
Biphosphonates are calcium regulators that act by?
inhibiting bone resorption and increase bone mass.
SERM's - selective estrogn receptor modulators act by?
protect against osteoprosis, but does not stimulate breast or uterine tissue.
Salmon Calcitinin is?
Nasal Spray used in women 5yr post menopause to treat osteoprosis.
What is the number one killer in women?
Waht do wt. bearing exercises do?
inc. bone mass and potentiating the effect of estrogen on bone mass.
What are phytoestrogens?
plant sterols that have na estrogen like effect.
Pelvic floor or Kegel exercises do what?
matain vaginal musclae tone and inc blood circulation o the perineal area.
Phytoestrogens are found in?
carrots, soy, yams
What three things may help prevent osteoprosis?
adequate ca+intake, regular wt. bearing exercises, HRT
Common physiologic symptoms of menopause are?
Hot flashes, palpations, night sweats.
When does ovulation tend to occur?
14 (plus or minus 2) before the first day of the next menstrual cycle
How long are the sperm and ovum viable?
sperm- up tp 3 days
Ovum- 24 hours
Which method of the fertility awareness is the least reliable?
What is the BBT (basal bady temp)ovulation method?
requires woman to take her temp every morn. after waking.(can predict ovulation after 3-4 mts.) temp. drops just before ovulation, and rises and remains elevated several days after(safe days)
When using the cervical mucus sometimes called the ovulation method or the billings method, when does one know when she is ovulating?
the peak day of wetness and clear, strechable mucus os the day of ovulation.
What is the symptothermal method?
various assesments: cycle length, coitus, cervical mucous changes, inc. libido, abd. bloating, BBT.
What are situational contraceptives?
coitus interruptus(withdrawl), douching(ineffective), abstinence.
What should the woman using spermacides be aware of?
They destroy sperm and suppositories may take up to 30 min. to dissolve and they ar minimally effective when used alone.
What should the woman using a barrier method be alert of?
TSS s&s. (fever, sore throat, v/d, faintness, aches, weakness, rash.
Women whoh use vaginal barrier methods should avoid the use of what?
oil-based products such as mineral oil, baby oil, monistat or estrogen cream b/c they have a negative effect on latex.
KY jelly or Astroglide should be used to prevent what?
irritation and possiblecondom breakage
An STI increases the risk of what?
PID and resultant infertility
A female condom may be inserted up to how long before intercourse?
8 Hours
the use of a diaphgram reduces the incidence of?
gonorrhea,PID, and tubal infertility. This protection may be due in part of the use of a spermicide
how does the vaginal sponge work?
the sponge is moistened with water to activate the spermicide, iinserted in the vagina covering the cervix and should be left in place at least 6 hours after intercourse.
with placenemt of an IUD, the woman is instructed to do what?
check for the string once a week and after each menses.Amenorrhea may be a side effect of IUD use.
How long can the IUD be left in?
5-10 yrs. depending on the type.
How do hormonal contraceptives work?
By inhibiting the release of the ovum and maintaining thick cervical mucous inhibiting the penetration of sperm.
Ortho Evra is highly effective for what women?
those who weigh less than 198lbs.
What are long acting progestrin contraceptives?
Norplant, Depo-Provera, and the minipill.
What are the teo types of sterilization?
Vasectomy and tubal ligation.
The morning after pill, emergency postcoital contraception works how?
you take the pills within 72 hours of intercourse. Two pills as soon after intercourse as possible and the other two 12 hours later.
Mifepristone (Mifeprex) is used how?
to induce abortion during the first 7weeks of preg. It alters the endometrium by blocking progestrone. Two days after Mifeprex is taken, prostaglandin misoprostol induces contractions to expel the fetus.
How many chrosomes do humans have?
46- 23 pairs. 22 autosomes and 1 pair sex chrosomes.
Mitosis forms what cells?
body cells, organs
Meiosis is when what is formed?
ova and sperm.
how long is the ovum considered fertile?
12-24 hours
how long is the sperm capable of fertilizing the ovum?
24 hours
Where does fertilization occur?
in the ampulla (outter third) of the fallopian tube
Dizotic or Fraternal twins?
two separate ova & sperm
Identical or Monozygotic?
develop from single egg and sperm
The pt following a vasectomy knows he is infertile when?
affter 6-36 ejaculations to clear vas def. of sperm then sperm counts are done at 6mos and 12mos
when a baby has a nuchal cord, it means?
the umbilical cord is wrapped around the baby's neck
a pregnant woman (7wks) is exposed to chemicals at work. what is she worried about?
cleft palate
How does the fetus contribute to the volume of amniotic fluid?
by excreting urine into the fluid.
when listing to the uterine souffle, you place the doppler where?
just above the pubic symphis
the chances of having twins is what?
a genetic factor that results in elevated serum gonadatrophin levels leads to twinning
during the first trimester of pregnancy, she should avoid hot tubs b/c?
CNS defects
the placenta takes over the production of progestrone after?
10 weeks
Fetal development 38-40 weeks?
fingernails extend beyond the fingertips
The placenta is considered what type of organ during pregnancy?
Endocrine organ
How does blood exchange occur during pregnancy?
diffusion of blood through the placenta
What is the primary role of progestrin during pregnancy?
to maintain the preg, keeping from having spontaneous abortion
how much Amniotic fluid?
What is the purpouse of the amniotic fluid?
protect fetus, allow for growth and movement, control temp
The amniotic fluid contains?
Fat, billirubin, protein, albumin
What is the maternal part of the placenta?
The decidua bacalis
Preembryonic stage?
first two weeks
Embryonic stage?
3-8 weeks tissues differeniate int organs
Fetal stage?
9-40weeks organs mature, growth of the fetus.
What week is it considered a fetus?
9 wks
The umbilical cord contains?
2 arteries (deoxygenated)& 1 vein(oxygenated)
When is the embryo particularly vulnerable to tetragens?
the first 8 wks
What happens at 20 weeks?
the fetal heartbeat can be heard by the fetoscope and quickening felt.
When are all of the fetus' organ systems formed?
8-12 wks
The hormone human growth hormone can be detected at 4 wks. What does this do?
ensures more protein, glucose, and minerals are available for the fetus.
What is the purpose of the yolk sac?
forms RBC's the first 6wks until embryo's liver can take over and do it .
Wharton's jelly is what?
specialized connective tissue that prevents compression of the umbilical cord in utero.
the blood pressure reaches it's lowest point during?
second trimester
The soft blowing sound of blood pulsating through teh umbilical cord at the same rate as the fetal heart is known as the ?
funic souffle.
a soft blowing sound due to increased uterine vascularization and blood pulsating through the placenta at the same rate as the mother's heart rate is known as the?
uterine souffle
nausea & vomiting so early in pregnancy is due to?
increased level of hCG hormone
The nurse should understand edema during pregnancy is due to ?
increased levels of sex hormones contribute to fluid retention.
the mucous membranes are found to be blusih in color. This is?
Chadwick's sign
during assesment, what indicates the linea nigra during pregnancy?
darkening of the midline from the pubic area to the umbilicus.
What nursing intervention would be appropiate for the 32 wk preg. woman experincing dizziness in the supine position?
place the pt. on left side.
What is couvade syndrome?
the physical symptoms such as back ache, diff. sleeping, inc. appetite, depression, fatigue & headache experienced by the partner during pregnancy.
what are the early signs of pregnancy?
amenorrhea,NVP, fatigue, changes in breasts, urinary frequency.
the fundus of the uterus is palpable just above the pubis at 10-12wks. and at the umbilicus by how many wks?
20-22 wks.
Normal wt gain during preg?
norm wt= 23-25 lbs
over wt=15-25 lbs
under wt=25-35 lbs
What is the significance of iron during preg?
iron transfer takes place only in one direction toward the fetus, is necessary for hemeglobin formation, erythrocytes, blood volume and the need for increased tissue demands for mom and fetus.
How does pregnancy affect the GI system?
Heartburn(pyrosis), hyperemic gums, salavia may inc or dec, hemorrhoids, hypercholesterolemia, gallstones may form, Pruritus.
Why does the preg. woman become pron to develop postural hypotension?
b/c the blood flow is inc to the lower extremities.
What causes the waddling gait during pregnancy?
the sacroiliac, sacrococcygeal, and pubic joints relax during the later part of preg. as a result of hormonal changes.
Approx. 30g of Ca+ is retained in maternal bone for what?
fetal deposition late in pregnancy.
What is the effect of oxytocin?
promotes uterine contractility and stimulates milk ejection from the breasts.
human placental lactogen (hPL) is?
antagonist of insulin, decreases maternal metaboism of glucose in favor of fetal growth.
Estrogen during preg?
stimulates uterine development, develops the ductal sys. of breast for lactation.
why does gestational diabetes occur?
due to the inc. demand of insulin the islets of langerhans are stressed & deficiency may become apparent.
What does relaxin do?
inhibits uterine activity dec. strength of contraction, soften th ecervix, remodling collagen.
Vasopressin causes?
inc BP, antidiuretic effect.
What is the siginificance of the pituitary gland during preg?
it inc. in size and secertes FSH, LH, thyrotropin and adrenotropin, Prolactin, oxytocin and vasopressin.
Why soes the BMR inc 20-25%during preg?
increased Oxygen consumption is due primarily to fetal metabolic activity.
Goodell's sign is?
the softening of teh cervix.
An ease in flexing the body of the uterus against the cerviz is called?
McDonald's sign
Irregular softening and enlargement @ the site of implantation occurs about the 5th week is known as?
Barun von Fernwald's sign.
Piskacek's sign?
asymmetric tumor like enlarement
Fetal heart movement occurs about the 8th wk, but the doppler doesn't detect the fetal heartbeat until?
as early as 10-12wks.