Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
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?
|
Abortion
|
|
|
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?
|
Hemorrage
|
|
|
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?
|
grandfather
|
|
|
How is the father in cuban culture?
|
dominat, aggressive, critical to family decisions
|
|
|
family roles are based on?
|
expectations
|
|
|
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.
|
|
|
Culture?
|
beleifs, values, attitudes accepte dby a population or individual.
|
|
|
Accultration?
|
process in which people adapt to new cultural norm
|
|
|
Assimilation?
|
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
|
Culture
|
|
|
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?
|
Muslims
|
|
|
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?
|
trusting
|
|
|
It is critical for the nurse to develop what type of understanding of their clients needs?
|
holistic
|
|
|
What is the beleif that one's culture is superior or only acceptable one?
|
ethoncentrism
|
|
|
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?
|
12yrs
|
|
|
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?
|
Endometriosis
|
|
|
when is douching contraindicated?
|
during pregnancy
|
|
|
Hypomenorhea?
|
short flow or dec. amt
|
|
|
Hypermenorrhea?
|
abnormally long flow
|
|
|
Oligomenorrhea?
|
no bleeding longer than 40 days
|
|
|
polymenorrhea?
|
bleeding less than 22 days
|
|
|
Menorrhagia?
|
excesive in amt and duration
|
|
|
Metrorrhagia?
|
norm amt. at irregular intrevals
|
|
|
Menometrohhagia?
|
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
|
|
|
Dysmenorrhea?
|
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?
|
Menometrorrhagia
|
|
|
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?
|
PMDD
|
|
|
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?
|
wrinkling
|
|
|
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?
|
Osteoprosis
|
|
|
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?
|
CHD
|
|
|
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?
|
Calendar
|
|
|
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?
|
500-1000ml
|
|
|
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.
|
