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OB, Exam1

OB, Exam 1

Encompasses complementary & alternative therapies in combination with conventional Western modalities of treatment. Integrative Health Care
Leading cause of pregnancy-related deaths in US. Hemorrhage (also: blood clots, HTN, infection, stroke, amniotic fluid embolism, & heart muscle disease).
2 or more emotionally involved people living in close proximity & having reciprocal obligations with a sense of commonness, caring, & commitment. Family
The emphasis in working with families is on: Wellness & empowerment to achieve control over their lives.
Theory as to how families react to stress. Family Stress Theory
Family Systems Theory is based on: -Family system is part of larger suprasystem & composed of many subsystems. -Family is greater than sum of its individual members. -Change in one member affects all family members. -Family creates balance between change & stability.
Theory that families move through stages. Family Life Cycle Theory
Theory that identifies family strengths & resources. McGill Model of Nursing
Theory that focuses on reducing culture & environmental barriers that interfere with access to health care. Health Belief Model
Theory which focuses on behavior & it's interaction with the environment. Contains Duvall's Developmental Theory. Human Developmental Ecology
Evolution of the family over time; predictable tasks & role expectations occur with each stage; family assessment looks at how well the family meets each task. Duvall's Developmental Theory
1st 3 stages of the 8 stages of Duvall's Developmental Theory: Stage I: Marriage & an Independent Home (Joining of families) Stage II: Families with Infants Stage III: Families with preschoolers
Theory which uses systems & other theories. Composed of 3 major categories: Structural, developmental, & functional. Each category branches further into subcategories Calgary Family Assessment Model (CFAM)
The process by which people retain some of their own culture while adopting the practices of the dominant society. Acculturation
Cultural group loses its identity & becomes part of the dominant culture. Assimilation
Rightness of one's own culture. Ethnocentrism
Applying standards of another culture, respecting other cultures. Cultural relativism
Sum of the beliefs & balues that are learned, shared, & transmitted from generation to generation by a particular group. Culture
Culture with strong influence of mother-in-law; male infant not circumcised. Hispanic
Culture which believes pregnancy is state of wellness, good baby thought to eat well. African-American
Culture which believes in hot & cold. Asian
Culture which believes in early prenatal care. European
Culture which believes in late prenatal care due to pregnancy being an natural state. Native American
Culture which is strongly male dominated. Middle-Eastern
What does CRASH stand for in culteral competence? Culture, show Respect, Assess/Affirm differences, show Sensitivity/Self-awareness, do it all with Humanity
Based on the principles of right and wrong behavior according to that individual's beliefs Morals
Looks at why we subscribe to a particular moral belief. There's a best course of action depending on the sitution, arises out of a set of moral principles, no solution seems completely satisfactory (dilema) Ethics
One is required to do or promote good for others. To do good. Beneficence
One must avoid risking or causing harm to others. Not to harm. Nonmaleficence
People have the right to self-determination, respect, privacy, and information for decision-making. Free will or agency. Autonomy
All People should be treated equally and fairly regardless of disease or social or economic status. Social distribution of benefits and burdens. Justice
Most common and fastest spreading STI. Difficult to diagnose, a bacteria, screen asymptomatic pregnant women, tx with azythromycin. Chlamydia
A bacteria STI, women often asymptomatic - may have menstrual irregularities & rectal complications, ts is antibiotic, spread by genital contact, risks are: age, african-american, early secual activity, multiple partners Gonorrhea
A bacteria STI, spread through sexual abraisions, can lead to mortality in the fetus/infant. screen pregnant woman's blood, fals positive. TX: penicillin &sexual abstinence during tx. Syphilis
Single most common serious infection to women, spread of MO's from vaginal & endocervix to upper genital tract, increased risk for ectopic pregnancy, inftility, chronic pelvic pain. PID - Pelvic Inflammatory Disease
STI that affects most people in the U.S. today, Most prevalent viral STI seen in ambulatory health care settings. HPV - Human Papilloma Virus
STI which presents with painful lesions, fever, chills, malaise, and severe dysuria. Adverse effects on mother and fetus and increased miscarriage rates during the 1st trimester, cervical cancer HSV-2
Most threatining STI to the fetus and neonate, disease of the liver; often a silent infection and transmitted parenterally, perinatally, orally (rare), and intimate contact. Vaccination series, viral Hepatitis B
Most common blood-borne infection is US Hepatitiis A
Vaginal infection caused by MO's, associated with preterm labor and birth. Tx. Gardnerella and Mobiluncus. Vaginitis
Vaginal infection caused by yeast. Tx. Over the counter meds, fluganozole. Candidiasis
Common cause of vaginal infection, men should tell sexual partner if infected, Tx. Metronidazole 2 g orally in a single dose. Trichomoniasis
STI associated with poor pregnancy outcomes. Screening at 36-37 wks gestation. S&S in newborn: temp instability, poor feeding, irritability, letheragy. Risk factors:positive culture, preterm birht < 37 wks, Premature rupture of membranes > 18hrs, Goup B Streptococci
Breast self-exam is carried out during this phase of the menstrual cycle: 5-7 days after menstruation stops
Consists of the Endometrial cycle, Hypothalamic-pituitary cycle, and Ovarian cycle Menstrual cycle
Found in most organs of body; i.e. uterus, menstural blood, hormones made of oxygenated fatty acids involved in many reproductive functions. Prostaglandins
Transitionsal phase during which ovarian fxn & hormone production decline. Climateric Phase
Refers to the last menstrual period, cessation of menses for one yr., average age 51.4 yrs, range of age 35-60 yrs. Menopause
Menstrual event: Days 1-5 Menstrual phase
Menstrual event: to ovulation, estrogen impact causing endometrium to increase its thickness. Proliferative phase
Menstrual event: Mature egg released from ovary. Ovulation
Menstrual event: ovulation to day 28, progesterone influence causes endometrium to become fluid and blood rich, secretory bed to nourish embryo. Secretory phase
After ovum discharged, remaining empty follicle sac is called the corpus luteum, reaches peak in 8 days, coincides with normal implantation time if fertilization takes place. Luteal Phase
Hypothalamus secretes Gondadatropin Releasing Hormone. GnRH acts on pituitary -> Follicle Stimulating Hormone (FSH), Leutinizing Hormone (LH). Hypothalamic-Pituitary Cycle
Hormones the ovary secretes: Estrogen: most active at beginning of cycle to mid cycle. Progesterone: most active from ovulation to end of cycle.
Phases of the Ovarian cycle: Follicular phase: day 5 to ovulation & development ovum. Ovulation: preceded by LH surge, and with prostaglandins causes rupture. Luteal phase: ovulation to menstruation approximately 14 days.
Cell division Mitosis & Meiosis
Gametogensis Spermatogenesis & Orogenesis
Formation of a viable zygote by the union of the male sperm and female ovum; fertilization. Conception
Fertilization Morula & Blastocyst
Chorionic villi & Decidual basalis Implantation
Lenght until implantation: 6-10 days (3-4 days in tubes + 2-3 days in uterus).
The cell stages of the zygote: 2 cell stage @ 1-1/2 days Morula stage @ 3 days (ball of cells) Blastocyst @ 4 days (58 cells, 2 cell layers) Trophoblast @ 14 days (fetal membranes & placenta, secrete enzymes to dissolve endometrium).
Produced by trophoblast as early as day 1 of implantation, basis for pregnancy, causes corpus luteum to continue progesterone production for 10 wks until placenta takes over. HCG (Human Chorionic Gonadotropin)
3 Primary Germ Layers: Ectoderm: skin, nails, nervous system, tooth enamel. Endoderm: auditory canal, endocrine glands, epithelial cells of respiratory tract & GI tract. Mesoderm: connective tissue, teeth, muscles, blood & vascular system.
Stages of fetal development: Ovum: until implantation is complete. Embryo: from 8 wks after ovulation, period of organogenesis. Fetus: from embryo until term or 40 wks.
Fetal cardiac: 1st system to develop, heart beating 3 wks after conception. Accessory structures: ductus venosus, ductus arteriosus, foramen ovale.
Explain surfactants: Produced 24 wks until birth, minimizes surface tension & keeps lungs inflated, Lecithin & Sphingomyelin, ratio is 1:1 & adequate by 32-35 wks, 2:1 ratio indicates lung maturity in normal pregnancy.
Age fetus responds to tactile stimulation: 8-1/2 wks
Age fetus has generalized reflex responses to things such as pain: 14 wks
Age fetus does sucking & respiratory movements: 20 wks
Age the fetus has steady progression toward full term: 28 wks
Age fetal liver fxn begins: 4 wks.
Fetus is viabile at: 24 wks.
Critical time periods for: CNS, Heart, Arms-Legs-Eyes, Palate, Ext. Genitalia, Ears CNS (3-6 wks), Heart (3-6 wks), Arms-Legs-Eyes (4-7 wks), Palate (7-8 wks), Ext. Genitalia (7-11 wks), Ears (4-10 wks)
Define unifactorial genetic transmission: A single gene controlling a trait, disorder, or defect.
Types of unifactorial genetic transmission: Autosomal dominant inheritance, Autosomal recessive disorder, Inborn errors of metabolism, X-linked dominant inheritance, X-linked recessive inheritance
Define multifactorial genetic transmission: Most common genetic malfunction. Combination of environmental & genetic factors: ie infections, radiation, drugs, chemicals, maternal condition.
Examples of multifactorial genetic transmission: Cleft lip & palate, anencephaly, neural tube defects, congenital heart disease, pyloric stenosis
Nongenetic factors in birth defects: Some congenital malformations caused by teratogens: drugs, chemicals, infections, exposure to radiation, and maternal conditions such as diabetes & PKU, maternal malnutrition.
May occur in autosomes or sex chromosomes, may be an abnormality of number or structure. Chromosomal Abnormalities
Example of autosome abnormality of chromosome number: Down syndrome
A disease or disorder that can be passed from generation to generation. Genetic disorder
A disorder that is present at birth and can be caused by genetic factors, environmental factors, or both. Congenital disorder
Where do autosomal traits occur? On any of the 22 pairs of autosomes.
Where do sex-linked traits occur? On any of the sex chromosomes (usually called x-linked)
How are X-linked disorder expressed? Varies with the sex of the person with the defective gene. If the mother is a carrier of the defective gene, it is expressed in the male offspring who has only 1 X-Chromosome.
Explain autosomal dominant inheritance: Will always be expressed, males & females are equally affected on autosome (not sex cells), affected individuals have an affected parent, 1/2 of kids of heterozygous affected parent will be affected & normal kids of affected parents will have normal kids
Examples of autosomal dominant disorders: Polydactyly & Huntington's chorea
Explain autosomal recessive inheritance: will always be homozygous for that trait. Trait does not appear in the heterozygous parents but they will pass the defective gene to their offspring. Males & females equally affected. Affected kids will have unaffected parents who heterozygous for trait.
Examples of autosomal recessive disorders: Cystic fibrosis, Phenylketonuria PKU ()missing enzyme to convert phenylalanine to tryosine = mental retardation), Sickle cell anemia, Tay Sachs (lacking enzyme for sphingolipid metabolism = brain & nerve deterioration & death by age 4)
Expalin X-linked recessive disorders: Affected individuals are usually male, have unaffected parents, female kids of affected males will be carriers, unaffected male kids of affected male can't transmit disorder.
Examples of X-linked recessive disorders: Hemophilia, Duchene muscular dystrophy.
Examples of abnormality of chromosome number disorders: Trisomy (Down Syndrom), monosomy, mosaicism. They are caused by paired chromosomes failing to separate during cell division (non-dysjunction). Trisomy & monosomy occur before fertilization; mosaicism occurs after fertilization.
Explain multifactorial inheritance disorders: combination of genetic & environmental factors. Gene pools of close relatives have 1/4 to 1/2 of the genes in common = greater likelihood that member will have harmful genes in common.
Examples multifactorial inheritance disorders: Cleft lip & palate, Congenital dislocated hip, Conginital heart defects, Neural tube defects, DM, HTN, Schizophrenia
Nurse's role for genetic issues: 1.) Identify families at risk for genetic issues. 2.) Aide families in coping w/potential genetic issues. 3.) Ensure the continuity of care (followed & assigned to appropriate physicians).
Nutrient needs of pregnant woman (main): 8-10 glasses H2O/day, IRON, Calcium, Vitamin B6, Vitamin D, Bitamin E, Folic Acid
Define total weight gained in pregnancy: 25-40lbs (27 avg) total, <1/2 total weight gain is from fetus, placenta, & amniotic fluid. Rest is from maternal reproductive tissues, fluid, blood, & stores.
Pattern of weight gain during pregnancy per trimester: 1st: 1 lb/month (2-4 lbs, related to ^ maternal tissues), 2nd: 1 lb/wk (10-15 lbs, largest maternal increase), 3rd: 1 lb/wk (8-10 lbs, largest fetal gain).
Calorie needs in pregnancy: Increase 300 cal/day
Protien needs in pregnancy: 60 gm/day for 2nd & 3rd trimester
Total Iron needed in pregnancy: 30 mg/day, begin with supplements by 12 wks gestation. additional of 60-120 mg/day for deficiencies, take with vitamen C.
Anemai in pregnancy: HCT (Hemocrit)<32% & Hgb (Hemoglobin)<11gm, Pica r/t low Fe (iron), Coffee, milk & tea bind to iron and prevent absorbtion
Folic acid needs in pregnancy: 600 mcg/day. Deficits in 1st 6wks associated w/spontaneous abortion & neural tube defects.
Sources of Folic Acid: Beans, Peanuts, Orange juice, Asparagus, Peas, Broccoli, Lettuce, Spinach. Difficult to get enough in diet.
When else to increase folic acid: Long term oral contraceptive use, anticonvulsant use.
Explain Sickle Cell Anemia Blacks & Mediterranean affected, complicated by iron & folic acid deficiency, causes vascular occlusion (pain & fever), brought on by hypoxia, infectin, edema, RBC destruction. Tx: give O2 during labor, maintain hydration, supplement folic acid.
Calcium needs during pregnancy: 1000 mg/day for adult, 1300/day for teen. Met if milk is consumed.
Explain sodium in pregnancy: Slight increased need, Estrogen causes some H2H retention, Diuretics not routinely used.
Nutritional risk factors in pregnancy: Vegans risk for vitamen B-12 defic. (prematurity), smoking (lbw & length & premature labor), alcohol (fetal alc. syndrom in baby w/> 5 oz daily intake, drugs (poorly nourished, infections, infant withdrawal), caffeine (lbw, muscle tone, activity at birth)
Late pregnancy birthing classes which focuses on fear, pain, tension cycle. Grantley-Dick Read
Late pregnancy birthing classes which focuses on husband coached childbirth, deep breathing, relaxation, physical conditioning. Bradley
Late pregnancy birthing classes which focuses on Psychoprophylaxis (r/t the mind & to guard or prevent beforehand)& conditioned response. Lamaze
Late pregnancy birthing classes which focuses on water birth, environment quiet and dark. "Birth without violence". LeBoyer
Light fingertip massage of the abdomen. Effleurage
Name for the breath taken at the beginning & end of each contration. Cleansing breath
Tingling, feeling dizzy, and having fuzzy thinking are caused by this: hyperventilation
2nd stage breathing pattern. Pushing
Components of breathing techniques for labor: Focusing, Cleansing breath, Relaxation, Effleurage
Labor Transition characteristics: Urge to push/have a BM, Sleepiness, Hot/Cold, GI problems, Very introspective, Bachache, Mood changes (panic), Loss of time perspective, Loss of modesty, Wants it to be over.
Contraception method: FAMs (Fertility Awareness Methods) Natural family planning (period abstinence), Calendar rhythem method, Standard days method, Basal body temperature method, Cervical mucus ovulation-detection method
What is the Coitus interruptus method of contraception? Withdrawal of penis before ejaculation.
Types of contraception barrier methods: Spermicides, Condoms, Vaginal sheath, Diaphragm, Cervical cap, Sponge.
Created by: imsuzanne