Ch. 1: Trends in Contemporary Childbirth:

What are the length of stays for both vaginal deliveries and cesarean births?

1) vaginal deliveries = 2 night stay

2) cesarean births = 4 night stay

Ch. 1: Trends in Contemporary Childbirth:

Majority of care is      in/out     of the hospital.

Out

Ch. 1: Trends in Contemporary Childbirth:

Contemporary childbirth is characterized by an emphasis on _________ 

Family and family-centered birth

Ch. 1: Trends in Contemporary Childbirth: 

The move from a low-tech form of childbirth to high-tech birthing is influenced by:

1) members of generation Y who grew up with technology

2) caregivers that practice defensive medicine to prevent legal issues

3) hospitals that believe this method is "easier" to manage more patients

Ch. 1: Trends in Contemporary Childbirth: 

What is a CNM?

CERTIFIED NURSE MIDWIFE

a registered nurse who is also prepared as a midwife

-educated in nursing and midwifery

-manages independently in low-risk pregnancies & normal newborns

Ch. 1: Trends in Contemporary Childbirth: 

What can nurses do to promote family-focused, low-tech childbirth?

1) advocate it w/in the community

2) make sure childbirth classes are available

3) increase personal labor support skills

4) accept doulas as part of the labor team

5) promote changes in birth environement where they work

6) participate in interdisciplinary committees to develop & implement standardized practices for care

Ch. 1: Self-Care Movement & Health Promotion Education:

What is self-care?

Taking responsibility for ones own health

Ch. 1: Self-Care Movement & Health Promotion Education:

How do healthcare providers foster self-care?

by focusing on health promotion education

Ch. 1: The Healthcare Environment:

_______ is the most prevalent form of insurance for people living in poverty, including pregnant women.

Medicaid

prevention

MANAGED CARE

1) it limits consumer choice = BAD quality of care

2) it should be fee-for-service model(allows consumers to choose and seek better quality care)

1) Health Insurance Portability and Accountability Act

2) protects health insurance coverage of employees & their family if they lose/change jobs; also addresses privacy & security of health info & requires national standards for electronic transmission of healthcare 

Ch. 1: Culturally Competent Care:

____% of all children <18 years old come from minority families

44%

1) Help-seeking behaviors (on slide)

2) Pregnancy & childbirth practices

3) Causes of diseases or illnesses

4) Death & dying

5) Caretaking and caregiving(on slide)

6) Childrearing practices 

graduate of an accredited program in nursing who passed the NCLEX and is an RN

they are GENERALISTS

Ch. 1: Professional Options in Maternal-Newborn Nursing Practice:

What is a CRN?

Certified Registered Nurse

-expert in a particular field of nursing b/c they took a national certification exam

Ch. 1: Professional Options in Maternal-Newborn Nursing Practice:

What is an NP?

-a professional nurse that received specialized education in either a Doctor of Nursing Practice or master's degree progrm

-focus on physical and psychosocial assessments

-make clinical judgments based on assessment data

-takes care of normal, low-risk patients only

Ch. 1: Professional Options in Maternal-Newborn Nursing Practice:

What is a CNS?

Clinical Nurse Specialist

-professional nurse w/ a MSN(master's degree) w/ additional specialized knowledge in a specific clinical area

-can take care of high-risk patients

Ch. 1: Professional Options in Maternal-Newborn Nursing Practice:

What is an APN?

Advanced Practice Nurse

-describes nurses by education and practice

-must have at least an MSN

Ch. 1: Professional Options in Maternal-Newborn Nursing Practice:

1) What are 4 examples of APNs?

2) Which of the 4 examples may not always be APNs?

1) NPs, CNMs, CNS, and CRNA

2) NPs and CNMs because they don't always have a master degree

Ch. 1: Professional Options in Maternal-Newborn Nursing Practice:

What is a nurse researcher?

-has an advanced doctoral degree (usually PhD)

-assumes leadership role

-usually in universities

Ch. 1: Professional Options in Maternal-Newborn Nursing Practice:

In _______, no single profession "owns the patient" because a multidisciplinary team is used.

Collaborative practice

Ch. 1: Professional Options in Maternal-Newborn Nursing Practice:

_______________ is an essential element of health care for uninsured and underinsured people.

Community based care

Ch. 1: Professional Options in Maternal-Newborn Nursing Practice:

Primary care focuses on ....

health promotion, illness prevention, and self-care

Ch. 1: Legal and Ethical Considerations:

1) What do sate nurse practice acts do?

2) Who is protected by nurse practice acts?

1) define legal scope of practice within which every nurse must function

2) the public

1) Maternal-fetal conflict

2) abortion

3) Fetal Rights

4) Fetal-stem cell research

5) Assisted reproductive technology

6) Cord blood banking

1) omitting or committing an act that a reasonably prducent person would not omit or commit under the same or similar circumstances

2) - there was a duty to provide care

    - the duty was breached

    - injury occurred

    - the breach of duty caused the injury

1) ANA - American Nurses Association

2) Council of Prenatal Nurses

3) AWHONN - Association of Women's Health, Obstetric and Neonatal Nurses

4) AORN - Association or Operating Room Nurses

5) NANN - National Association of Neonatal Nurses

Joint Commision/JCAHO

Commitment to professional & social responsibility

Accountability for personal & professional contributions

Respect for diversity of & among colleagues & clients

Integrity in exemplifying the highest standards in personal & professional behavior

Nursing excellence for quality outcomes in practice, education, research, advocacy and management

Generation of Knowledge to enhance the science & practice of nursing to improve the health of women & newborns

-establish minimum criteria for competent, proficient delivery of nursing care 

1) allows patients to make intelligent decisions regarding their own health care

2) - info given clearly at a level the pt can understand

    - must include risks & benefits, probability of    

      success, and significant treatment alternatives

    - explain consequences of refusing treatment

    - explain that refusing this tx does not withdraw

      all tx

1) adults that are legally determined as competent

2) parents of minors

3) minor parents of an infant/child patient

4) emancipated minors

5) adolescents between 16-18 y/o seeking birth control, mental health counseling, or substance abuse treatment

6) mature minors - 14-15 y/o that understand treatment risks (in some states)

-writing a living will or authorizing durable power of attorney for healthcare decisions on individual's behalf

Ch. 1: Special Ethical Situations in Maternity Care:

What is maternal-fetal conflict?

The idea that mom and fetus are two separate patients and that there are gray areas when determining whose rights come first in certain situations.

*Moms rights usually come first before viability, and then fetus's rights precede moms once viable.

Ch. 1: Special Ethical Situations in Maternity Care:

1) What is abortion?

2) Until when can abortions be performed?

3) What are special consideration allows abortions to be done after viability?

1) pregnancy that is terminated before 20 weeks or if fetus weighs <500g

2) Until the fetus becomes viable(can live independently of mom) which is usually 20 weeks

3) only when life or health of mom is threatened

Ch. 1: Special Ethical Situations in Maternity Care:

1) What is ART?

2) What is an example of ART?

1) Assisted Reproductive Technology; fertility treatment in which both egg and sperm are handled

2) IVF-ET - in vitro fertilization and embryonic transfer 

Ch. 1: Special Ethical Situations in Maternity Care:

What is TI?

Therapeutic insemination

-depositing sperm into woman from woman, husband, or donor

-legal problems arise when using donor sperm

Ch. 1: Special Ethical Situations in Maternity Care:

What is the difference between descriptive and inferential statistics?

Descriptive - describe set of data; report facts; can't make conclusions ; only ID trends & groups

Inferential - allow conclusions or inferences to be drawn about relationship between 2+ variables

# of live births / 1000 people

14.3 in 2007

# of infant deaths under 1 year of age / 1000 live births in a given population

-6.68 in 2006

1) # of infant deaths <28 days old / 1000 live births

2) # of infant deaths between 28 days & 1 year old / 1000 life deaths

3) neonatal deaths + fetal deaths / 1000 live births

4) death in utero at 20 weeks or more gestation

Congential malformations, deformations, and chromosomal abnormalities

1) prematurity

2) low-birth-weight

# of deaths from any cause related to or aggravated by pregnancy or its management during the pregnancy cycle(includes 42-day postpartum period) / 100,000 live births

13.3 in  2006

1) increased # of cesarean births

2) excessive bleeding

PANDIE

Pakistan

Afghanistan

Nigeria

Democratic Rep. of the Congo

India

Ethiopia

Ch. 1: What are Healthy People 2010 Maternal & Infant Health Goals?

1) reduce fetal & infant deaths

2) increase maternal prenatal care

3) reduce cesarean births

4) reduce low birth weight & very low birth weight

5) increase breastfeeding in moms

6) increase abstinence from alcohol, cigarettes, drugs in pregnant women

Ch. 1: Evidence Based Practice in Maternal-Child Nursing:

What are 3 basic competencies do nurses need that are related to evidence-based practice?

1) recognize which clinical practies are supported by sound evidence, which practices have conflicting findings, and which have no evidence

2) use data in their clinical work to evaluate outcomes of care

3) appraise & integrate scientific bases into practice

Ch. 1: Evidence Based Practice in Maternal-Child Nursing:

Evidence Based Practice increases ____________

patient quality of life(better outcomes)

Ch. 1: Evidence Based Practice in Maternal-Child Nursing:

What is evidenced-based practice?

nursing care in which all interventions are supported by current, valid research or other forms of evidence

-builds on actions needed to transform research findings into clinical practice

Ch. 2: Defining Family:

What is family? 

a group of two or more people(one of whom is the householder) related by birth, marriage, adoption and residing together

Ch. 2: Defining Family:

What are family values?

values that guide behavior and interactions w/in society & their own family units

Ch. 2: Defining Family:

1) What are family roles?

2) List some examples of family roles

1) homogeneous sets of behaviors that are normatively defined & expected of an occupant of a given social position

2) breadwinner, homemaker, nurturer, social planner, peace maker

Ch. 2: Defining Family:

What are some changes that can affect the contemporary family?

1) employment trends (ex. dual-earner households)

2) changes in marriage/divorce rates (single parent families and cohabitation)

3) economic trends (delayed childbearing or intentional childlessness)

4) increased role of grandparents

Ch. 2: Types of Families:

Traditional Nuclear Family 

-has husband provider, wife who stays at home, & kids

- NOT the most common type of family in US

Ch. 2: Types of Families:

Dual-Career/Dual-Earner Family

-both parents are working

-common in US

Ch. 2: Types of Families:

Childless or Childfree family

-couples w/ no children whether it's by choice or b/c of infertility

-this is increasing b/c of more opportunities for women in the workplace, delayed marriage, availability of contraceptives, and wider acceptance of women choosing not to be moms

Ch. 2: Types of Families:

Extended Families

a couple who shares household responsibilities, chores, & expenses w/ parents, siblings or other relatives

-multigenerational families (more common in non-US cultures)

Ch. 2: Types of Families:

Extended kin network family

- 2 nuclear families of primary or unmarried kin live in close proximity to each other

- specific form of extended family

Ch. 2: Types of Families:

Which type of family is most common in the Latino community?

Extended kin network family

Ch. 2: Types of Families:

Single Parent Family

-families headed by only 1 parent

-traditionally, head of the household is usually widowed, divorced, abandoned, or separated

-non-traditionally, head of household was never married

Ch. 2: Types of Families:

Stepparent Family

-include a biologic parent with kids a new spouse who may or may not have kids

-aka remarried families, reconstituted families, or blended families

Ch. 2: Types of Families:

Binuclear Family

post-divorced family in which biologic children are members of a 2 nuclear household

-BRADY BUNCH FAMILY

-involves coparenting & joint custody

Ch. 2: Types of Families:

Nonmarital Heterosexual Cohabitating Family

straight couple who may or may not have kids and live together but NOT married

-some prefer this for personal reasons

-can include never-married individuals, and divorced or widowed people

Ch. 2: Types of Families:

Gay and Lesbian Families

-two or more people who share a same-sex orientation lie together (with or without kids) as well as families consisting of a gay or lesbian single parent rearing of a child

Ch. 2: Types of Families:

What are the advantages and disadvantages to a nuclear-married or cohabitation family?

1) Advantages: small size=more affection/value placed on each member

2) Disadvantages: few members to share burden/offer support in crisis

Ch. 2: Types of Families:

What are the advantages and disadvantages to an extended family?

1) Advantages: many members to serve as resources and role models

2) Disadvantages: family resources can be stretched

Ch. 2: Types of Families:

What are the advantages and disadvantages to a blended/binuclear family?

1) Advantages: Increased security & resources and exposure to different ways of life

2) Disadvantages: childrearing problems, rivalry, challenging authority

Ch. 2: Contemporary Family Developmental Frameworks:

1) What does the Duvall Family Life Cycles  describe?

2) What type of family is it based on?

1) describes the developmental process that each family encounters

2) nuclear family

**the oldest child serves as marker for family's developmental stage(except for last 2 stages)

Ch. 2: Contemporary Family Developmental Frameworks:

What is stage I of Duvall's Family Life Cycle?

Married Couple

-blend individual needs, develop conflict-&-resolution approaches, focus on communication & intimacy patterns

Childbearing families with infants

-adjust to pregnancy and parenthood & changes in roles; maintain couple bond & intimacy

Families w/ preschool children

-understand normal growth & development; adjust to having more than one child in family; cope w/ lack of energy; maintain couple bond & intimacy

Families w/ school-age children

-work out authority & socialization roles w/ school; support children in outside interests; determine disciplinary actions & family rules

Families with adolescents

-allow adolescents establish their own identities and still be part of family; increase role of adolescents in family, cooking, repairs, and power base

Families launching young adults

-after member moves out, reallocate roles, space, power & communication; maintain parental couple intimacy & relationship

Middle-Aged Parents

-Refocus on marriage; ensure retirement security, maintain ties w/ kids

Aging Families

-adjust to retirement, grandparent roles, death of spouse & living alone

I. Married Couple

II. Childbearing families with infants

III. Families with preschool children

IV. Families with school-age children

V. Families with adolescents

VI. Families with young adults

VII. Middle-aged parents

VIII. Aging families

Ch. 2: Cultural Influences Affecting the Family: 

What is culture?

the beliefs, values, attitudes, and practices that are accepted by a population, a community, or an individual

*(on slide) a view of the world & traditions that a specific social group uses & transmits to the next generation

Ch. 2: Cultural Influences Affecting the Family:

Are you born with culture?

No you can only be learned.

Ch. 2: Cultural Influences Affecting the Family:

What is ethnicity?

social identity that is associated w/ shared behaviors & patterns such as language, dress, religion, & health behaviors

*(on slide) cultural group into which a person was born

Ch. 2: Cultural Influences Affecting the Family:

What is acculturation?

process by which people adapt to new cultural norm

-a step by step, gradual process

Ch. 2: Cultural Influences Affecting the Family:

What is assimilation?

when a group completely changes their cultural identify to become part of the majority culture

Ch. 2: Cultural Influences Affecting the Family:

Transcultural nursing is nursing care that is guided by _____________ & respects individual differences

cultural aspects

Ch. 2: Cultural Influences Affecting the Family:

What is cultural competency?

skills & knowledge necessary to appreciate, understand, & work with individuals from different cultures

Ch. 2: Cultural Influences Affecting the Family:

What is required of nurses who provide culturally competent care?

1) self-awareness

2) awareness & understanding of cultural differences

3) ability to adapt clinical practices 

Ch. 2: Cultural Influences Affecting the Family:

What is ethnocentrism?

the conviction that the values & beliefs of one's own cultural group are the best ones or the only acceptable ones

Ch. 2: Cultural Influences Affecting the Family:

What are some biologic differences among cultures?

1) genetic differences

2) physical differences (ex. mongolian spots)

3) disease patterns

Ch. 2: Cultural Influences Affecting the Family:

What culture group is at higher risk for hypertension, stroke, obesity, diabetes, & sickle cell anemia?

African Americans

Ch. 2: Cultural Influences Affecting the Family:

What culture group has a higher risk for thalassemia?

individuals of Mediterranean descent

Ch. 2: Cultural Influences Affecting the Family:

What culture group has higher rates for diabetes and lactose intolerance?

Hispanics

Ch. 2: Cultural Influences Affecting the Family:

What is communication?

method by which members of culture groups share information & preserve their beliefs, values, norms & practices

Ch. 2: Cultural Influences Affecting the Family:

List some aspects of communication other than language:

1) nonverbal communication

2) touch

3) space

4) time orientation (past, present, future)

5) use of clocks

Ch. 2: Impact of Religions & Spirituality:

What is religion?

institutionalized system that shares a common set of beliefs and practices

-also a belief in a transcendent power

Ch. 2: Impact of Religion & Spirituality:

What is spirituality?

concern w/ the spirit or the soul

Ch. 2: Beliefs During Pregnancy:

Which culture believes pregnant women should avoid doorways or steps?

Southeast Asia

Ch. 2: Beliefs During Pregnancy:

Which culture believes pregnant women should not lift arms above head?

Vietnamese

-they think it will increase risk of preterm birth

Ch. 2: Beliefs During Pregnancy:

Which culture believes pregnant women should not sit or lie down for long periods?

Vietnamese

-they think the baby can become too large

Ch. 2: Beliefs During Pregnancy:

Which cultures believes pregnant women should avoid drafts & bad air?

Southeast Asia and Mexican Americans(mal aire)

Ch. 2: Chinese Prenatal Care:

Do not use _________ on the bed because it can result in infant being born with a cleft palate or lip

sharp objects

Ch. 2: Chinese Prenatal Care:

Pregnancy is considered a      1)hot/cold      condition, so to balance,      2) hot/cold       foods must be consumed throughout pregnancy

1) hot

2) cold

Ch. 2: Chinese Prenatal Care:

Do not criticize others because ____________

your baby will act and look like the person you criticize

Ch. 2: Chinese Prenatal Care:

What fruit can cause miscarriages?

Pineapple

Ch. 2: Chinese Prenatal Care:

To determine sex of the baby: if belly is "pointed" its a 1)             and if it's "rounded" its a  2)          .

1) boy

2) girl

Ch. 2: Chinese Prenatal Care:

Traditionally, is the spouse present during delivery?

No

Ch. 2: Chinese Prenatal Care:

During labor, crying will attract ____________.

evil spirits

Ch. 2: Chinese Prenatal Care:

Rub _________ or ________ on baby's soft spot & belly to protect these areas.

ginger paste or tiger balm

Ch. 2: Chinese Postnatal Care:

What happens to the placenta?

keep it & bury it near birth place b/c it's required in order to be reborn after death

can also be used to make medicines 

Ch. 2: Family:

What are some roles that grandparents may have today?

1) witness: present for their grandkids

2) protector: cares for & ensures safety when needed

3) peacemaker: resolve conflicts

4) active participant: maintains involvement in family life

Ch. 2: Cultural Influences Affecting the Family:

Acculturation is frequently associated w/ _______

improved health status & health behaviors

Ch. 2: Family Assessment:

What tool can a nurse use to perform a comprehensive assessment of family functioning?

Friedman Family Assessment Tool

Ch. 3: Evolution of Complementary Therapies: 

1) What is CAM?

1) complementary and alternative medicine (CAM); group of diverse medical & healthcare systems, practice, & products that are not generally considered part of conventional medicine

Ch. 3: Evolution of Complementary and Alternative Therapies:

1) What is complementary therapy?

2) Examples

1) any procedure or product that is used together w/ conventional medical treatment

2) acupuncture, acupressure, massage therapy

1) used in place of conventional medicine

2) magnet therapy, herbal therapy, aroma therapy

Ch. 3: Evolution of Complementary and Alternative Therapies:

What are the two main differences between complementary and alternative therapies?

1) complementary therapies have scientific testing results to support its reliability and alternative therapies do not

2) complementary therapies may be accepted in the hospital setting, while alternative therapies may not

3) complementary therapies may be covered by health insurance plans, while alternative therapies may not be covered

Ch. 3: Benefits of CAM:

What are 5 benefits to CAM?

1) many emphasize promotion of wellness

2) high value of holistic healing

3) many are non-invasive

4) many have few side effects

5) may be more affordable than conventional tx

Ch. 3: Risks of CAM:

What are some risks/disadvantages of CAM?

1) lack of standardization & regulation

2) lack of research to substantiate effectiveness - particularly in children

3) inadequate training of some healers

4) financial risks of unproven methods

Ch. 3: Herbal therapy & Pregnancy:

A pregnant woman should _________ before taking any herbs(even teas)

1) consult physician 

** side effects tend to be higher in highly concentrated extracts, so avoid these

Ch. 3: Herbal therapy & Pregnancy:

A pregnant woman should avoid herbs that:

1) induce abortion or menstruation

2) stimulate the nervous system

3) stimulate the GI tract

Ch. 3: Types of Complementary & Alternative Therapies::

What are examples of complementary therapeutic systems?

1) homeopathy

2) naturopathy

3) traditional chinese medicine

4) ayurveda

Ch. 3: Types of Complementary & Alternative Therapies:

What is homeopathy?

1) using minute dilutions of substances that would produce effects similar to the symptoms of the disorder being treated

**uses like to cure like

Ch. 3: Types of Complementary & Alternative Therapies:

What is the central belief in naturopathy?

nature has healing power & body has ability to heal itself

also called natural medicine

Ch. 3: Types of Complementary & Alternative Therapies:

What is TCM?

traditional chinese medicine

-believes in balance of energy(chi)

-uses concept of yin & yang or hot & cold

Ch. 3: Types of Complementary & Alternative Therapies:

In the concept of yin & yang, yin is what kind of force?

female

cool

wet

close to earth

Ch. 3: Types of Complementary & Alternative Therapies:

In the concept of yin and yang, yang is described as what kind of force?

masculine

aggressive

dry

celestial

Ch. 3: Types of Complementary & Alternative Therapies:

What kinds of techniques are involved in traditional chinese medicine (TCM)?

acuptuncture

herbal therapy

nutrition

acupressure (chinese massage)

moxibustion - apply heat from small, burning herb

Qigong

T'ai chi

Ch. 3: Types of Complementary & Alternative Therapies:

What is ayurveda?

Hindu medicine; knowledge of how to live a vital, healthful life

-there are 5 elements: ether, wind, water, fire, earth

-elements take form of 3 doshas: vata, pitta, kapha

-believe that illness is lack of balance between doshas

Ch. 3: Types of Complementary & Alternative Therapies:

What are examples of mind-body therapies?

Biofeedback

Hypnosis

Meditation & prayer

Visualization 

Guided Imagery

Ch. 3: Types of Complementary & Alternative Therapies:

What is biofeedback?

helps individuals learn to control their physiologic responses based on concept that mind controls the body.

Ch. 3: Types of Complementary & Alternative Therapies:

What is the most commonly used complementary therapy?

Prayer specifically for health reasons

Ch. 1: Patient Rights:

Who is legally responsible for obtaining informed consent from a patient?

The health care provider performing the procedure or treatment, usually the physician

Ch. 3: Types of Complementary & Alternative Therapies:

T/F: hypnosis, if done correctly, can make people do something against their will.

False.

The patient has to really want to change for hypnosis to work.

Ch. 3: Types of Complementary & Alternative Therapies:

What is visualization?

person goes into a relaxed state & "visualizes" soothing or positive scenes (ex. beach)

-helps reduce stress

Ch. 3: Types of Complementary & Alternative Therapies:

What is guided imagery?

state of intense, focused concentration used to create compelling mental images; useful in imagining a desired effect (ex. weight loss)

Ch. 3: Types of Complementary & Alternative Therapies:

What are examples of manipulative & body-based therapies?

1) chiropractic therapy

2) massage therapy

3) reflexology

4) hydrotherapy

5) hatha yoga

6) regular physical exercise

Ch. 3: Types of Complementary & Alternative Therapies:

What is the 3rd largest independent health profession in the US?

Chiropractic surgery

Ch. 3: Types of Complementary & Alternative Therapies:

What is chiropractic therapy?

- based on spinal manipulation

- practitioners must earn a Doctor of Chiropractic (DC) degree

- believe diseases & illnesses were result of abnormal nerve transmissions caused by misalignment of spine (subluxation)

Ch. 3: Types of Complementary & Alternative Therapies:

Who develop chiropractic therapy?

Daniel David Palmer

Ch. 3: Types of Complementary & Alternative Therapies:

Massage therapy is manipulation of the 1)________ to reduce 2)____ & 3) _____, increase 4)________, diminish 5) _____, and promote a 6)___________

1) soft tissues

2) stress

3) tension

4) circulation

5) pain

6) sense of well being

Ch. 3: Types of Complementary & Alternative Therapies:

Infant massage has become popular in the US because it can help 1) ________ an infant & 2)____________.

1) soothe an infant

2) minimize crying

Ch. 3: Types of Complementary & Alternative Therapies:

What is reflexology?

form of massage that involves the application of pressure to designated points or reflexes on patient's feet, hands, or ears using the thumb and fingers

Ch. 3: Types of Complementary & Alternative Therapies:

Who mapped the specific reflex zones & spread the practice of reflexology?

Eunice Ingham

Ch. 3: Types of Complementary & Alternative Therapies:

What body part is most often manipulated in reflexology and why?

The feet

-many practitioners believe that certain parts of the feet correspond to certain organs or organ systems

Ch. 3: Types of Complementary & Alternative Therapies:

1) What is hydrotherapy?

2) Functions of hydrotherapy

1) makes use of hot or cold moisture in any form

2) - relaxes muscles

    - promotes rest and healing

    - decreases pain and cramps

    - reduces swelling and fever

    - improves well-being

    - cleanses wounds & burns

Ch. 3: Types of Complementary & Alternative Therapies:

What are the major types of hydrotherapy?

1) compresses - applied locally; alternate between hot & cold; improve circulation to reduce swelling

2) baths - can be local areas or full immersion; same functions as compresses but can also cleanse & promote comfort for pregnant women

3) sweat baths - open pores & induce sweating to eliminate toxins, drugs & salts

Ch. 3: Types of Complementary & Alternative Therapies:

What type of hydrotherapy should be avoided if pregnant and why?

Sweat baths because high heat has been associated w/ neural tube defects

Ch. 3: Types of Complementary & Alternative Therapies:

What is Hatha yoga?

physical branch of yoga that's used for wellness, illness prevention, and healing

Ch. 3: Types of Complementary & Alternative Therapies:

What are examples of nutritional & herbal therapies?

1) Dietary therapies

2) Use of supplements

3) Herbal therapies

Ch. 3: Types of Complementary & Alternative Therapies:

What is the most widely used form of supplement?

a multivitamin

Ch. 3: Types of Complementary & Alternative Therapies:

What are examples of sense therapies?

1) aromatherapy

2) color therapy

3) sound and music therapies

Ch. 3: Types of Complementary & Alternative Therapies:

1) What are essential oils?

2) What are essential oils used for in aromatherapy?

1) oils that are diluted in carrier oil  before applied to the skin; can also be inhaled or added to bath water

2) balances mood, alleviate stress, relieve pain, & improve sleep

Ch. 3: Types of Complementary & Alternative Therapies:

What is color therapy?

uses colors to help restore body to harmony 

Ch. 3: Types of Complementary & Alternative Therapies:

What is sound therapy?

exposing body to sound frequencies that allows body to restore itself

Ch. 3: Types of Complementary & Alternative Therapies:

What are examples of energy therapies?

1) acupressure

2) acupuncture

3) reiki

4) therapeutic touch

Ch. 3: Types of Complementary & Alternative Therapies:

What is acupressure?

pressure from fingers & thumbs to stimulate pressure points

Ch. 3: Types of Complementary & Alternative Therapies:

Acupressure wristbands can be used by pregnant women for _________

relieves nausea during early pregnancy

Ch. 3: Types of Complementary & Alternative Therapies:

What is acupuncture?

uses very fine stainless steel needles to stimulate specific points depending on pt's medical assessment & condition

Ch. 3: Types of Complementary & Alternative Therapies:

Which is a stronger therapy, acupressure or acupuncture?

acupuncture

Ch. 3: Types of Complementary & Alternative Therapies:

What therapy can improve pregnancy rates when given with embryo transfer in women undergoing IVF?

Acupuncture

Ch. 3: Incorporating complementary Therapies into Maternal-Newborn Nursing Care:

Before nurses can utilize CAM, they must first know...

does their state practice act address CAM and if so, is the specific treatment within their scope of practice

1) nausea & vomiting

2) labor stimulation

3) perineal discomfort

4) lactation disorders

5) postpartum depression

6) preterm labor

7) postpartum hemorrhage

8) labor analgesia

Ch. 10: Embryonic Development of Reproductive Structures & Processes:

 What is oogenesis?

production of oocytes, the female gamete, during fetal life

Ch. 3: Incorporating complementary Therapies into Maternal-Newborn Nursing Care:

To use CAMs, nurses must ensure that:

1) CAM is w/in scope of nursing practice

2) CAM does not infringe upon licensure of others

3) CAM is non-invasive

4) CAM is mainstreem

5) ex: acupressure wristbands for nausea, progressive relaxation, therapeutic touch, visualization, meditiation, prayer, guided imagery

Ch. 3: Incorporating complementary Therapies into Maternal-Newborn Nursing Care:

Are oocytes produced after birth?

No. A female is born with all her eggs

Ch. 3: Incorporating complementary Therapies into Maternal-Newborn Nursing Care:

What is spermatogenesis?

production of spermatozoa, the male gametes, by the testes

Ch. 3: Incorporating complementary Therapies into Maternal-Newborn Nursing Care:

When does spermatogenesis of mature sperm occur?

during puberty

Ch. 3: Incorporating complementary Therapies into Maternal-Newborn Nursing Care:

What period during gestation is considered the undifferentiated period?

The first 7 weeks

Ch. 3: Incorporating complementary Therapies into Maternal-Newborn Nursing Care:

What are the two pairs of genital ducts that develop during the undifferentiated period?

the mesonephric and paramesonephric ducts

Ch. 3: Incorporating complementary Therapies into Maternal-Newborn Nursing Care:

The fallopian tubes are formed from what embryologic structures?

Fused portions of paramesonephric ducts

Ch. 3: Incorporating complementary Therapies into Maternal-Newborn Nursing Care:

What embryological structures develop into the vagina?

- vaginal epithelium comes from endoderm

- vaginal musculature develops from uterovaginal primordium

- urethral & paraurethral glands comes from urethral outgrowths into mesenchyme

Ch. 3: Incorporating complementary Therapies into Maternal-Newborn Nursing Care:

What hormone stimulates the mesonephric ducts to develop into the male genital tract?

testosterone

Ch. 3: Incorporating complementary Therapies into Maternal-Newborn Nursing Care:

Genetic males & females have the same external genitals until week # ___ and then it differentiates by week # ____

1) 9

2) 12

Ch. 10: Puberty:

What is puberty?

developmental period between childhood & attainment of adult sexual characteristics & functioning

Ch. 10: Puberty:

Major physical changes in female:

1) broadening of hips

2) budding of breasts

3) appearance of pubic & axillary hair

4) onset of menstruation

Ch. 10: Puberty:

Major physical changes in the male:

1) linear growth spurts

2) increase size of external genitals

3) voice deepens

4) axillary & facial hair

5) nocturnal seminal emissions (wet dreams)

Ch. 10: Puberty:

What initiates puberty?

maturation of hypothalamic-pituitary-gonad complex(gonadostat) and input from CNS

Ch. 10: Puberty:

What is GnRH?

gonadotropin-releasing hormone

released by CNS --> anterior pituitary --> causes secretion of FSH & LH

Ch. 10: Puberty:

What are FSH & LH

gonadotropins that stimulate spermatogenesis & ova maturation

Ch. 10: Puberty:

What 2 kinds of hormones influence the development of secondary sex characteristics?

1) androgens (male sex hormones)

2) estrogens (female sex hormones)

Ch. 10: Female Reproductive System:

What are the external genitals of the female?

1) mons pubis

2) clitoris

3) labia majora

4) labia minora

5) urethral meatus & opening of paraurethral gland

6) vaginal vestibule

7) perineal body

Ch. 10: Puberty:

1) What causes menarche?

2) Age range for menarche

1) surge of estrogen

2) 9-15 y/o

10-17 y/o

secretion of clitoris that can sexually stimulate male

thin, elastic collar of tissue that surrounds vaginal opening

can break not just by intercourse, but by vigorous exercise, tampons, or menstruation

1) vagina

2) uterus

3) cervix

4) uterine ligaments

5) fallopian tubes 

6) ovaries

1) serve as passageway for sperm during coitus & for fetus during birth

2) provide passage for menstrual body flow from uterine endometrium to outside of body

3) to protect against trauma from sexual intercourse & infection of uterus, ovaries, & pelvis from pathogenic organisms

4-5

ovaries

1) produce, mature, & discharge ova

2) secrete estrogen & progesterone

3) initiate & regulate menstruation

Uterus

1) 2

- uterine corpus (includes uterine body)

- cervix (lower, cylindrical portion)

1) endometrium (innermost layer)

2) myometrium (middle/muscular)

3) perimetrium (serosal layer)

smooth, hollow tunnel for movement of ova to uterus

1) peritoneal (serous) layer

2) subserous layer - has blood & nerve supply

3) muscular layer - allows peristalsis in tube

4) mucosal layer - made of ciliated & nonciliated cells; has serous fluid to nourish ovum, cilia propel ovum

1) provide lubrication for vaginal canal

2) act as bacteriostatic agent

3) provide alkaline environment to shelter deposit sperm from acidic vaginal secretions

the linea terminalis

Progesterone

Inhibits uterine contractions & relaxes smooth muscle to cause vasodilation to allow pregnancy to be maintained

1) support & protect pelvic contents

2) form relatively fixed axis of birth passage

1) supports uterus during late months of pregnancy

2) directs fetus into true pelvis for birth

1) pelvic inlet: upper border

2) pelvic cavity: curved canal

3) pelvic outlet: lower border

1) gynecoid (50%)

2) android (20%)

3) anthropoid (25%)

4) platypelloid (5%)

Gynecoid

anthropoid

Android

Platypelloid

Gynecoid

fibrous tissues that suspend breasts & extend from deep fascia in chest outward to just under skin

1) provide nourishment & protective maternal antibodies to infants through lactation

1) estrogen - for growth of ductal epithelium

2) progesterone - for acinar & lobular development during luteal phase

3) prolactin - for milk production

4) oxytocin - milk ejection

1) anterior pituitary released prolactin to produce milk

2) posterior pituitary releases oxytocin for milk ejection

--> like supply & demand

Ch. 10: Female Reproductive System:

What composes the female reproductive system?

1) ovarian cycle (when ovulation occurs)

2) menstrual cycle (when menstruation occurs)

1) uterus increases in size & weight

2) myometrial contractility increases in uterus & fallopian tubes

3) increased uterine sensitivity to oxytocin

4) inhibits FSH production

5) stimulates LH production

mass of cells created after follicle ruptures & luteinization is accomplished

-secrete progesterone & small amounts of estrogen

Day 1-14

1) Graafian follicle appears & is under control of FSH & LH

2) mittelschmerz: midcycle pain

3) body temp increases after ovulation

Day 15-28

1) begins when ovum leaves follicle

2) if ovum is fertilized, it implants in endometrium & secretes hCG to maintain corpus luteum

3) if ovum isn't fertilized, corpus luteum degenerates & becomes corpus albicans causing an increased LH & FSH secretion (cycle begins again)

1) menstrual phase (day 1-6)

2) proliferative phase (day 7-14)

3) secretory phase (day 15-26)

4) ischemic phase (day 26-28)

1) low estrogen

2) cervical mucus is scant, viscous, & opaque

1) estrogen peaks at ovulation

2) cervical mucus at ovulation is clear, thin, watery, alkaline = more favorable to sperm

3) ferning pattern

4) has spinnbarkheit > 8cm (elasticity)

5) body temp drops then rises sharply at ovulation b/c of ovulation

1) estrogen drops

2) progesterone dominates

1) both estrogen & progesterone levels drop

2) corpus luteum degenerates if no fertiliztaion 

3) menstrual flow begins

1) FSH

2) LH

3) FSH

4) Estrogen

Ch. 10: Hormones & in the Luteal Phase:

-Corpus luteum produces 1) ____ & 2) _____

-Increased 3) _____& 4) ____ = decreased FSH & LH 

-No fertilization=corpus luteum degenerates= decreased estrogen & progesterone= 5)______ starts

1) estrogen

2) progesterone

3) estrogen

4) progesterone

5) menstruation

Ch. 10: Female Reproductive System:

An increase in FSH indicates _______

The beginning of a new menstrual cycle

Ch. 10: Female Reproductive System:

Ovulation occurs between what days (in a 28-day cycle)?

Ch. 10: Female Reproductive System: 

What does the corpus luteum replace?

Graafian follicle

Ch. 10: Male Reproductive System:

What is the primary reproductive functions of the male genitals?

1) produce & transport male sex cells (sperm) through & out of genital tract into female genital tract

Ch. 10: Male Reproductive System:

What are the male external genitals?

1) penis

2) scrotum

Ch. 10: Male Reproductive System:

What are the functions of the scrotum?

1) protects testes

2) regulates temp to be lower than body

Ch. 10: Male Reproductive System:

The penis serves what two body systems?

1) urinary

2) reproductive

Ch. 10: Male Reproductive System:

What are the internal genitals of the male reproductive system?

1) testes

2) epididymis

3) vas deferns & ejaculatory duct

4) Urethra

5) Accessory Glands

6) Semen

Ch. 10: Male Reproductive System:

What are the primary functions of the testes?

1) serve as site of spermatogenesis

2) produces testerone

Ch. 10: Male Reproductive System:

What are the main functions of the epididymis?

1) provides reservoir where spermatozoa can surive for long periods of time

2) sperm becomes mobile & fertile here

Ch. 10: Male Reproductive System:

What are the main functions of the vas deferens?

1) rapidly squeeze sperm from their storage site into urethra

Ch. 10: Male Reproductive System:

What are the accessory glands of the male reproductive system?

1) seminal vesicles - secrete fluid that creates favorable environment for sperm motility & metabolism

2) prostate gland - secretes fluid to protect sperm from acidic environment of vagina & male urethra

3) bulbourethral glands - secreted fluid becomes part of semen & lubricates penile urethra during sexual excitement

4) urethral gland - secretions add to #3

Ch. 10: Male Reproductive System:

How long can sperm live in the female genital tract?

Ch. 10: Male Reproductive System:

How long can sperm last male genital system?

1) 42 days

Ch. 10: Male Reproductive System:

How is testosterone secretion/action different from all female hormones?

Ch. 11: Cellular Differentiation: 

Is the epidermis made of ectoderm, mesoderm, or endoderm?

Ectoderm

Mesoderm

Endoderm

Ectoderm

Mesoderm

Endoderm

Ectoderm

Mesoderm

Endoderm

Ectoderm

Mesoderm

Endoderm

ectoderm

Mesoderm

endoderm

ectoderm

mesoderm

ectoderm

mesoderm

ectoderm

mesoderm

Ch. 11: Chromosomes:

1) What are chromosomes?

2) What are autosomes?

3) What are sex chromosomes?

1) threadlike bodies w/in nuclei of human cells

2) a type of chromosome; 22 pairs in both males & females

3) 1 pair: XX in females, XY in males

Ch. 11: Chromosomes:

1)What are heterozygous genes?

2)What are homozygous genes?

1) genes that are dissimilar

2) genes that are similar

Ch. 11: Cell Division:

What are the stages of mitosis?

1) Interphase

2) Prophase

3) Metaphase

4) Anaphase

5) Telophase

Interphase

-BEFORE CELL DIVISION

-DNA w/in chromosomes replicate (double amount of genes)

Prophase

MITOSIS BEGINS

spindles appear at poles of nucleus

centrosome forms at poles so spindles can attach from one centrosome to other side

NUCLEAR MEMBRANE DISAPPEARS

Metaphase

chromosomes line up at equator

Anaphase

2 chromatids of each chromosome separate & go to opposite ends of spindle to cluster near 2 poles

Telophase

OPPOSITE OF PROPHASE

-new nuclear membrane forms

-spindles disappear

-chromosomes w/in nucleus become threadlike

-furrow develops in cell cytoplasm & divides into 2 daughter cells

1) to produce reproductive cells

2) maintains constancy of chromosome # by reducing # from diploid to haploid for gametes

3) allows random assortment of maternal & paternal chromosomes between gametes

4) relocates segments of maternal & paternal chromosomes by crossing over to "shuffle" genes & make a new combination of genetic material

1) 23

2) 46

1) 1

2) 2

1) Products: meiosis produces reproductive cells (gametes) & mitosis produces cells for growth & tissue repair

2) cell division: meiosis has 2 divisions, mitosis has 1

3) # of daughter cells: mitosis makes 4 haploid, daughter cells & mitosis has 2 diploid, daughter cells 

1) process by which germ cells (gametes) are produced

2) oogenesis & spermatogenesis

meiosis begins in all oocytes before infant is born but stops before 1st division is complete & remains in this phase until puberty

1) 3 small polar bodies - eventually disintegrate

2) 1 ovum

-does NOT begin until puerty

-takes place w/in seminiferous tubules

4 haploid spermatids

-spermatids lose most of their cytoplasm later to become sperm (spermatozoa); also develop acrosome & flagella

1) Preparation

2) - ovum is released into fallopian tube

    - sperm is deposited into vagina

    - sperm must undergo capacitation & acrosomal    

       reaction

Ch. 11: Process of Fertilization:

How long are the sperm and ovum viable when they are first released?

1) sperm viable for 48-72h, (highly fertile in first 24h)

2) ovum viable for 24h

1) capacitation - plasma membrane is removed & membrane over acrosome is removed 

2) acrosomal reaction - acrosome release enzymes to break down corona radiata (membrane that surrounds zona pellicuda - the layer of cells closest to the membrane of the ovum)

1) block to polyspermy - zona pellucida changes so that no more sperm can enter

2) secondary oocyte completes 2nd meitotic division

3) nuclei of ovum & sperm swell & approach each other, then unite --> zygote

Ch. 11: Process of Fertilization:

What is the true moment of fertilization?

When the nuclei of the ovum and sperm unite

Sex of the zygote

1) 24-28h

2) 2-3 days

1)First 14 days, starting on day of conception

2) cell multiplication & cell differentiation 

Ch. 11: Pre-embryonic Stage:

What happens during cell multiplication?

1) zygote cleaves (mitotically divides) & creates blastomeres

2) enough blastomeres make a morula

3) morula enters uterus & develops a fluid filled cavity

4) inside cavity is blastocyst(solid cell mass)5

5) zona pellucida is replaced by trophoblast (becomes chorion)

Ch. 11: Pre-embryonic Stage:

What is the most frequent site of attachment for implantation?