prenatal Flashcards
(42 cards)
1
Q
un millenium goals (3)
A
- promote gender equality and empower women
- improve maternal health
- reduce child mortality
2
Q
maternal and child health: a global perspective (3)
A
- 350000 maternal deaths, 1.2 mill intrapartum related stillbirths, 3.1 neonatal deaths per year
- most in low-income countries are preventable
- top global goal is reducing child-birth associated mortality
3
Q
healthy people 2020 overarching goals
A
-achieve health equity, eliminate disparities, improve health of all groups
4
Q
HP 2020 maternal child health goal
A
-improve health and well-being of women, infants, children and families
5
Q
graph trends
A
- increase in pregnancy related deaths
- cardio probs is highest preg-related death of fetus
6
Q
health disparities
A
- racial and ethnic disparities in mortality and morbidity for mothers and children
- pre-term births are incr, black race is higher, males is higher
- infant deaths is down, black race has higher infant deaths
7
Q
maternal pre-pregnancy health risks (8)
A
- HTN and heart disease
- diabetes
- depression
- genetic syndromes
- sti,
- alch, nicotine, poly substance use
- inadequate nut
- unhealthy wt
8
Q
determinants of health: social (2) and physical (2) determinants of maternal health
A
- social: pre-preg behaviors and health status, environmental and social factors
- physical: affecting health directly, affecting ability to engage in healthy behaviors
9
Q
contemp issues and trends: integrative health care (4)
A
- encompasses complementary and alternative health care
- values pt input, beliefs, values, and desires
- focuses on the whole person, not just dz process
- allows for more pt autonomy in healthcare decisions
10
Q
contemp issues and trends: fertility and birth wt (6)
A
- low birth wt and pre-term birth
- infant mortality in us
- international trends in infant mortality
- maternal mortality trends
- incr in high risk preg
- high tech care
11
Q
probs with healthcare delivery system (4)
A
- structure of system: connection from inpt to outpt, see doctor before then completely different in hosp=disconnected
- reducing medical errors
- high cost of healthcare
- efforts to reduce health disparities
12
Q
nursing standards of practice (4)
A
- american nurses association (ANA)
- american college of nurse-midwives (ACNM)
- national association of neonatal nurses (NANN)
- association of women’s health ob and neonatal nurses (AWHONN), make guidelines
- joint commission: accrediting agency, ensure proper work, can “audit”
13
Q
standards of practice and legal issues (3)
A
- standard of care: level of practice that a reasonable nurse would provide, via policy, procedure, protocol
- risk management: systems of checks and balances to minimize the risk of injury. will step in to get involved and figure out how to reduce this risk
- sentinel events: joint commission, unexpected outcomes involving death or serious injury and produce protocol
14
Q
ethical issues in perinatal nursing (6)
A
- reproductive tech
- scarce resources
- older-age preg
- third-party payers
- induced ovulation and ivf
- hiv pos women seeking assisted reproduction
15
Q
research in perinatal nursing (3)
A
- ethical guidelines for nursing research: must protect rights of human subjects, ensure that subjects are fully informed and aware of rights
- analysis of risks and benefits to both mother and fetus
- ANA ethical guidelines in conduct, dissemination, and implementation of nursing research
16
Q
child-bearing beliefs and practices (5)
A
- communication. use of actual translators, joint commission will check to make sure in notes how comm was achieved
- use of interpreters
- personal space
- time orientation
- family roles
17
Q
developing cultural awareness (3)
A
- ability to think, feel, and act in ways that acknowledge respect and build on ethnic, sociocultural, and linguistic diversity
- act in ways that meet the needs of pt and are respectful of ways and traditions different from own
- integrating cultural awareness with nursing plan
18
Q
vulnerable popn in community (8)
A
- racial and ethnic minorities
- adolescent girls
- older women
- incarcerated women
- migrant women
- homeless women
- refugees and immigrants
- low literacy
19
Q
summary
A
- maternity nursing focuses on women, infants, and families during childbearing cycle
- nurses play an active role in shaping health care systems to be responsive to needs of contemporary women
- childbirth practices have changed to become focused on family with alternatives for care
- HP 2020 provides goals for maternal, infant, and child health
- ethical concerns have multiplied with increasing use of tech and scientific advances
- contemp american society recognizes and accepts a variety of family forms
20
Q
Pregnancy developmental periods
A
- assessment during 1-3rd trimester
- 1st: 1-13 wk
- 2nd: 14-27 wk
- 3rd: 28-40 wk
21
Q
focus on prenatal care
A
- great deal of attention placed on labor and delivery
- equally imp: events that occur during prenatal period
- prenatal care does not guarantee a normal neonate
- id of probs early to minimize or eliminate
22
Q
preg dx
A
- preg until proven otherwise
- most women who have been previously preg are correct 80% of time
- amenorrhea work-up even if she says she is not preg
23
Q
early dx of preg
A
- allows women wishing to continue preg to be counseled about potential insults to developing fetus
- option counseling: abortion is safest when performed before 12 wk
- ectopic preg: 95% fallopian tube (annula), lower abdominal pain may be ectopic
24
Q
GTPAL
A
Gravida: current pregnancy (count others)
Term births: number of term gestations delievering btn 37-42 wk
Preterm births: number of preterm preg ending >20 wk or viability but before completion of 37 wk
Abortion: number of preg ending before 20 wk or viability
Living children: number of children currently living
parity: live births
25
determining preg
- sophisticated preg tests at home or in health care facility
- probably s/ of preg
- positive s/ of preg
- earlier preg is dx the safer it is for mom and fetus
26
presumptive s/ -subjective (9)
- fatigue (12 wk)
- breast tenderness (3-4 wk)
- nausea and vomiting (6-12 wk)
- amenorrhea (4 wk)
- urinary freq (6-12 wk)
- hyperpigmentation of skin (16-20 wk)
- fetal movements (7-12 wk)
- uterine enlargement (7-12 wk)
- breast enlargement (6 wk)
27
probably s/ -objective (7)
- braxton hicks contractions: infrequent, irrecgular, may be like menstrual cramps, or no pain (16-28 wk)
- pos preg test (4-12 wk)
- breast enlargement (14 wk)
- ballottement: gloved hand inserted to push on cervix and feel baby bounce (16-28 wk)
- goodell's sn (5 wk): softening of cervix
- chadwick's sn (6-8 wk): bluish-purp coloration of vaginal mucosa and cervix
- hegar's sn (6-12 wk): softening of lower uterine segment or isthmus
28
pos s/ (3)
- ultrasound verification of embryo (4-6 wk)
- fetal movement felt by experienced clinician (20 wk)
- auscultation of fetal heart tones via doppler (10-12 wk) for full min
29
after preg is confirmed issues to be concerned with (4)
- ambivalence
- unintended preg
- unwanted preg (abortion)
- adoption
30
uterus changes (4)
- incr in size, wt, length, width, depth, vol, and overall capacity
- pear shape to ovoid, pos hegar's sn
- enhanced uterine contractility: braxton hicks
- ascent into abdomen after first 3 months
31
fundal ht measurement
: measure from fundus to pubic bone (mons pubis)
: length is number of weeks preg
: performed from after 20 -36 weeks
32
cervix (4) and vagina changes (4)
-cervix: softening goodells sn
:mucus plug formation
:incr vascularization (chadwick's sn)
:ripening about 4 wk before birth
-vagina: incr vascularity w/ thickening
:lengthening of vaginal vault
:secretions more acidic, white and thick=leukorrhea
33
ovaries (2) and breast change (3)
-ovaries: enlargement until 12-14th week of gestation
:cessation of ovulation
-breast: incr size and nodularity to prepare for lactation
:incr in nipple size becoming more erect and pigmented
:production of colostrum in third trimester: anti-body rich, yellow fluid that can be expressed after 12th week and after converts to mature milk after delivery
34
GI system changes (8)
```
-gums: hyperemic, swollen and friable
:ptyalism: excessive saliva
:dental probs, gingivitis
-decr peristalisis and smooth muscle relaxation
:slowed gastric emptying=heartburn
:prolonged gallbladder emptying
:nausea and vomiting
-constipation + incr venous pressure + pressure from uterus = hemorrhoids
-eat fiber, walking, hydration, colace
```
35
diaphragm/cervical cap (8)
- has to be put in prior to sex so timing is an issue and use spermicide
- need a normal cervix for it to be covered properly
- need prescription because fitted to your own cervix
- risk for UTI, STI
- woman inserts it so needs to be comfortable with their body
- Cervical cap: reusable, but not to be worn more than 48 hrs, silicone
- leave inside for 6 hours after sex
- diaphragm: not worn more than 24 hrs, latex
36
cervical ring (2)
- if pms sx arise, see if the body will adjust and if not switch up method
- thrombosis is a risk because it is estrogen based
37
depo provera (7)
- only progestin
- effective within 24 hrs
- once every 3 mo
- decrease bone mineral density
- breakthrough bleeding may occur
- common sx: HA, nausea
- treat these sx
38
IUD (4)
- placement is important to know that its in the correct place
- use one per mo
- risk for PID so check for lower abdominal pain
- two types, copper is toxic to sperm and other contains hormones
39
oral contraceptive (4)
- can be used while breastfeeding (not recommended)
- plan b can also be used during breastfeeding
- comes in mono, bi, triphasic contraceptives
- should use a back-up method for one full cycle
40
estrogen patch (3)
- used on the back, abdomen
- need to check platelets, for anemia, I/O, hyrdation when do lab work (risks for thrombosis)
- hematocrit, hemoglobin are too high then hypercoagulation, hypocoagulation
41
essure (3)
- given with no analgesia
- follow up to make sure it is working
- may still have some breakthrough bleeding
42
sponge (5)
- only in the body for 30 hrs
- no prescription
- not felt, no hormones
- 84% effective for nulliparious, and 68% for parious
- releases spermicide, polyurethane composed
