Chapter 4 Health Promotion and Illness Prevention Flashcards
One purpose of preconception care is to:
a. Ensure that pregnancy complications do not occur.
b. Identify women who should not become pregnant.
c. Encourage healthy lifestyles for families desiring pregnancy.
d. Ensure that women know about prenatal care.
C. Preconception counseling guides couples in how to avoid unintended pregnancies, how to identify and manage risk factors in their lives and their environment, and how to identify healthy behaviors that promote the well-being of the woman and her potential fetus. Preconception care does not ensure that pregnancy complications will not occur. In many cases problems can be identified and treated and may not recur in subsequent pregnancies. In many instances counseling can allow behavior modification before damage is done, or a woman can make an informed decision about her willingness to accept potential hazards. If a woman is seeking preconception care, she likely is aware of prenatal care.
The nurse who provides preconception care understands that it:
a. Is designed for women who have never been pregnant.
b. Includes risk factor assessments for potential medical and psychologic problems but by law cannot consider finances or workplace conditions.
c. Avoids teaching about safe sex to avoid political controversy.
d. Could include interventions to reduce substance use and abuse.
D. If assessments indicate a drug problem, treatment can be suggested or arranged. Preconception care is designed for all women of childbearing potential. Risk factor assessment includes financial resources and environmental conditions at home and work. Health promotion can include teaching about safe sex.
Concerning the use and abuse of legal drugs or substances, nurses should be aware that:
a. Although cigarette smoking causes a number of health problems, it has little direct effect on maternity-related health.
b. Women ages 21 to 34 have the highest rates of specific alcohol-related problems.
c. Coffee is a stimulant that can interrupt body functions and has been related to birth defects.
d. Prescription psychotherapeutic drugs taken by the mother do not affect the fetus; otherwise they would not have been prescribed.
B. Although a very small percentage of childbearing women have alcohol-related problems, alcohol abuse during pregnancy has been associated with a number of negative outcomes. Cigarette smoking impairs fertility and is a cause of low birth weight. Caffeine consumption has not been related to birth defects. Psychotherapeutic drugs have some effect on the fetus, and that risk must be weighed against their benefit to the mother.
The use of methamphetamine (meth) has been described as the number one drug problem in America. To provide adequate nursing care to this client population the nurse must be cognizant that methamphetamine:
a. Is used only by those of a higher socioeconomic status because of the expense.
b. Uses amphetamine, a central nervous system stimulant, as the active ingredient.
c. Manifests a response similar to marijuana when smoked.
d. Decreases sexual activity when used among fertile women.
B. The use of meth procures a long-lasting high, manifested by hyperactivity, euphoria, increased vital signs, and potentially violent behavior. Meth is relatively cheap and is “hooking” more people across the socioeconomic spectrum. When smoked, the behavior of the client is similar to that resulting from use of cocaine, not similar to marijuana use. Meth results in users feeling hypersexual and uninhibited, leading to unsafe sexual practices.
What opiate causes euphoria, relaxation, drowsiness, and detachment from reality and has possible effects on the pregnancy, including preeclampsia, intrauterine growth restriction, and premature rupture of membranes?
a. Heroin
b. PCP
c. Alcohol
d. Cocaine
A. The opiates include opium, heroin, meperidine, morphine, codeine, and methadone. The signs and symptoms of heroin use are euphoria, relaxation, relief from pain, detachment from reality, impaired judgment, drowsiness, constricted pupils, nausea, constipation, slurred speech, and respiratory depression. Possible effects on pregnancy include preeclampsia, intrauterine growth restriction, miscarriage, premature rupture of membranes, infections, breech presentation, and preterm labor. Alcohol, PCP, and cocaine are not opiates
As a powerful central nervous system stimulant, which of these substances can lead to miscarriage, preterm labor, premature separation of the placenta, and stillbirth?
a. Heroin
b. PCP
c. Alcohol
d. Cocaine
D. Cocaine is a powerful central nervous system stimulant. Effects on pregnancy associated with cocaine use include abruptio placentae, preterm labor, precipitous birth, and stillbirth. Heroin is an opiate. Its use in pregnancy is associated with preeclampsia, intrauterine growth restriction, miscarriage, premature rupture of membranes, infections, breech presentation, and preterm labor. The most serious effect of alcohol use in pregnancy is fetal alcohol syndrome. The major concerns regarding PCP use in pregnant women are its association with polydrug abuse and the neurobehavioral effects on the neonate.
_____ use/abuse during pregnancy causes vasoconstriction and decreased placental perfusion, resulting in maternal and neonatal complications.
a. Alcohol
b. Tobacco
c. Caffeine
d. Chocolate
B. Smoking in pregnancy is known to cause a decrease in placental perfusion and is the cause of low birth weight. Prenatal alcohol exposure is the single greatest preventable cause of mental retardation. Alcohol use during pregnancy can cause high blood pressure, miscarriage, premature birth, stillbirth, and anemia. Caffeine may interfere with certain medications and make arrhythmias worse. Chocolate, particularly dark chocolate, contains caffeine.
Kegel exercises, or pelvic muscle exercises:
a. Were developed to control or reduce incontinent urine loss.
b. Are the best exercises for a pregnant woman because they are so pleasurable.
c. Help to manage stress.
d. Are ineffective without sufficient calcium in the diet.
A. Kegel exercises help control the urge to urinate. They ma be fun for some, but the most important matter is the control they provide over incontinence. Kegel exercises help manage urination, not stress. Calcium in the diet is important, but is not related to Kegel exercises.
During the past 20 years the prevalence of obesity has doubled in the United States, with 25% of women older than 20 years of age being obese. Body mass index is defined as the measure of an adult’s weight in relation to his or her height. This is currently the most accurate measure of weight. It is an important part of the health screening process because obesity is closely associated with:
a. The non-Hispanic Caucasian population.
b. A large number of chronic conditions.
c. Mostly acute illnesses.
d. Improved mental well-being.
B. Overweight and obesity are known risk factors for diabetes, heart disease, dyslipidemia, stroke, hypertension, arthritis, osteoporosis, and some types of cancer. In the United States the prevalence of obesity is highest among non-Hispanic black women, followed by Hispanic women, and non-Hispanic Caucasian women. Overweight and obesity are most frequently linked to chronic conditions. It is a myth that obesity if associated with improved mental well-being. In fact, obesity is associated with depression and increased stress.
The modern woman faces increasing levels of stress on a daily basis. As a result she is prone to a variety of increased complaints and illness. The nurse is most likely aware of the psychologic symptoms of stress such as anxiety and depression; however, a number of physiologic symptoms may also occur. To best assist her client in managing these symptoms the nurse is aware that stress may also result in:
a. Decreased heart rate and blood pressure.
b. Rapid digestion resulting in heartburn.
c. Decrease in hormone levels.
d. Flare-ups of arthritis and asthma.
D. Flare-ups of arthritis, asthma, frequent colds, infections, and cardiovascular problems may be the result of constant stress. Stress results in increased blood pressure and heart rate. Stress often causes slowed digestion and eating disorders. Stress often causes an increase in the level of both hormones and neurotransmitters, which may result in infertility or a weakened immune system.
The nurse’s best measure when evaluating the care of a woman in an abusive situation is based on the:
a. Woman’s decision to leave her partner.
b. Woman’s declaration of a safety plan.
c. Couple’s follow-through on a referral for counseling.
d. Woman’s gratitude to the nurse for the helpful information.
B. Safety is the most significant part of the intervention. This statement would be a positive step for the woman, but it is not the most significant part of the intervention. In addition, many women choose to return to the relationship. Couples counseling generally is not recommended. Initially individual counseling is more beneficial. Neither is a measure of success in the evaluation of the care plan of an abused woman. The woman may express her gratitude to the nurse in an effort to end the conversation. This does not indicate the woman’s readiness to leave the relationship or to make a plan for safety.
Intervention for the sexual abuse survivor often is not attempted by maternity and women’s health nurses because of the concern about increasing the woman’s distress and the lack of expertise in counseling. What initial intervention is appropriate and most important in facilitating the woman’s care?
a. Initiating a referral to an expert counselor
b. Setting limits on what the client discloses
c. Listening and encouraging therapeutic communication skills
d. Acknowledging the nurse’s discomfort to the client as an expression of empathy
C. The survivor needs support on many different levels, and a women’s health nurse may be the first person to whom she relates her story. Therapeutic communication skills and listening are initial interventions. Referring this client to a counselor is an appropriate measure but not the most important initial intervention. A client should be allowed to disclose any information she believes the need to discuss. As a nurse, you should provide a safe environment in which she can do so. Either verbal or nonverbal shock and horror reactions from the nurse are particularly devastating. Professional demeanor and professional empathy are essential.
Sexual assault is:
a. Limited to rape.
b. An act of force in which an unwanted and uncomfortable sexual act occurs.
c. A legal term for sexual violence.
d. An act of violence in which the partner is unknown.
B. Sexual assault encompasses a wide range of sexual victimization, including unwanted or uncomfortable touches, kisses, hugs, petting, intercourse, or other sexual acts. It includes, but is not limited to, rape. Sexual violence is a term for rape, not sexual assault, that includes a broader range of activities. A sexual act of violence, or rape, may be categorized as sexual assault. Statistically, the victim knows the assailant.
During a health history interview, a woman tells the nurse that her husband physically abuses her. The nurse’s first response should be to:
a. Advise the woman of mandatory state reporting laws pertaining to abuse and confidentiality.
b. Reassure the woman that the abuse is not her fault.
c. Give the woman referrals to local agencies and shelters where she can obtain help.
d. Formulate an escape plan for the woman that she can use the next time her husband abuses her.
A. Many states have mandatory reporting laws for health care providers. It is important to inform the client that you may need to report this. The nurse first should discuss the legal implications of this type of situation before responding in any other way.
With regard to violence against women, intimate partner violence (IPV) nurses should be aware that:
a. Relationship violence usually consists of a single episode that the couple can put behind them.
b. Violence often declines or ends with pregnancy.
c. Economic coercion is considered part of IPV.
d. Battered women generally are poorly educated and come from a deprived social background.
C. Economic coercion accompanies physical assault and psychologic attacks. IPV almost always follows an escalating pattern. It includes psychologic attacks and economic coercion. IPV often begins with and escalates during pregnancy. It includes psychologic attacks and economic coercion. Race, religion, social background, age, and education level are not significant factors in differentiating women at risk.
