Shared Flashcard Set

Details

OB Exam 1
Week 1-3
221
Nursing
Undergraduate 4
09/15/2013

Additional Nursing Flashcards

 


 

Cards

Term
Population in the USA consists of more men or women?
Definition
women (50.8%) compared to men (49.2%)
Term
Leading causes of women dying while giving birth in the 17th and 18th century?
Definition
Exhaustion, dehydration, infection, hemorrhage, or seizures
Term
Approximately __% of all children died before age 5, compared to the ___% infant mortality rate of today?
Definition
50% compared to 0.06%
Term
Certified nurse midwife
Definition
post-graduate training in the care of normal pregnancy and childbirth and is certified by the American College of Nurse Midwives (ACNM)
Term
Doula
Definition
a birth assistant who provides emotional, physical, and educational support to the woman and family during childbirth and the postpartum period
Term
Family-centered care
Definition
The delivery of safe, satisfying, high-quality health care that focuses on and adapts to the physical and psychosocial needs of the family
Term
Case management
Definition
A process of assessment, planning, application, coordination, follow-up, and evaluation of the options and services required to meet an individual's health needs through communication and available resources to promote quality cost-effective results
Term
Healthy People 2020 Major Concerns of the 21st Century
Definition
-Physical activity
-Overweight and obesity
-Tobacco use
-Substance abuse
-Responsible sexual behavior
-Mental health
-Injury and violence
-Environment quality
-Immunizations
-Access to health care
Term
Definition of health according to WHO
Definition
A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity
Term
Healthy People 2020- National Health Goals - Maternal, Infant, & Child
Definition
-Reduce the rate of fetal and infant deaths
-Reduce the rate of maternal mortality
-Reduce the 1-year mortality rate for infants with Down Syndrome
-Reduce maternal illness and complications due to pregnancy
-Reduce C-sections among low-risk women
-Reduce preterm births
Etc.....
Term
Mortality
Definition
Incidence or number of individuals who have died over a specific period (Presented as rates per 100,000)
Term
Neonatal mortality for infants <1 year, 28 days- <1 year, and <28 days are highest among what race?
Definition
African Americans (Blacks)
Term
Maternal mortality ratio
Definition
Annual number of female deaths from any cause related to or aggravated by pregnancy or its management during pregnancy and childbirth or within 42 days of termination of pregnancy
Term
In what race do the women suffer maternal mortality ratios far higher than those of other ethnic groups?
Definition
About 46/100,000 African Americans die due to childbirth
Term
What has drastically decreased the morbidity and mortality in the past several decades?
Definition
Increased emphasis on hygiene, good nutrition, exercise and prenatal care for all women.
Term
Leading cause of infant mortality rate in the USA?
Definition
Congenital abnormalities
Term
_______ mortality is a major but often overlooked problem?
Definition
Fetal
Term
Leading causes of pregnancy-related mortality?
Definition
Hemorrhage, infection, preeclampsia/ecclampsia, obstructed labor, and unsafe abortion
Term
What are some reasons as to why immigrant women do not receive good prenatal care?
Definition
Language and legal barriers
Term
Evidence based nursing practice
Definition
Use of research to establish a plan of care and to implement that care
Term
Fetal mortality rate?
Definition
The intrauterine death of a fetus at 20 weeks or more of gestation per 1,000 live births
Term
What factors contribute to fetal mortality rate?
Definition
Maternal factors- malnutrition, disease, or preterm cervical dilation
Fetal factors- chromosomal abnormalities or poor placental attachment
Term
Neonatal mortality rate
Definition
The number of infant deaths occurring during the first 28 days of life per 1,000 live births
Term
Infant mortality rate
Definition
The number of deaths occurring in the first 12 months of life
Term
At what week is a fetus considered viable? (Can be resuscitated and possibly live)
Definition
24 weeks.
Some hospitals as little as 22 weeks.
Term
What are the three levels for the number of weeks a hospital will deliver at?
Definition
Level I = Delivers all babies regardless of age
Level II = Only delivers 28-32 weeks and beyond, no NICU
Level III = Only due term, transfer everything else
Term
Which two races have consistently had higher infant mortality rates than other ethnic groups?
Definition
African American and American Indian/Alaska Native
Term
What has been shown to reduce rates of infection in infants and improve long-term health?
Definition
Breast-feeding
Term
The number one cause of death of women (regardless of racial or ethnic group)?
Definition
Cardiovascular Disease (CVD)
Term
Second leading cause of death of women?
Definition
Cancer.
Term
Risk factors for developing breast cancer?
Definition
Excess weight, not having children, oral contraceptive use, excessive alcohol consumption, a high-fat diet, and long-term use of hormone replacement therapy.
Term
Which weeks are the most vulnerable time during the pregnancy?
Definition
First 12 weeks.
Term
What is umbilical cord blood banking?
Definition
A vast source of primitive hematopoietic stem and progenitor cells available for clinical applicatoion
Term
Nurses responsibility in the informed consent process? (3)
Definition
-Ensuring form completed with signatures
-Serving as witness to signature process
-Determining client, family understanding of what they are signing through appropriate questions
Term
Nuclear Family
Definition
Husband, Wife, and Children living in same household (may include natural or adopted children)
Term
Binuclear family
Definition
Child who is a member of two families due to joint custody, parenting is considered a "joint venture"
Term
Single-parent family
Definition
One parent is responsible for care of children
Term
Commuter family
Definition
Adults in the family live and work apart for professional or financial reasons, often leaving the daily care of children to one parent
Term
Step-or blended family
Definition
Adults with children from previous marriages or from the new marriage
Term
Extended family
Definition
Nuclear family and grandparents, cousins, aunts, and uncles
Term
Same-sex family
Definition
Adults of the same sex living together with or without children
Term
Communal family
Definition
Group of people living together to raise children and manage household, unrelated by blood or marriage
Term
Foster family
Definition
A temporary family for children who are placed away from their parents to ensure their emotional and physical well-being
Term
Grandparents-as parent families
Definition
Grandparents raising their grandchildren due to the inability or absence of the parents
Term
Adolescent families
Definition
Young parents who are still mastering the developmental tasks of their childhood
Term
What does the abuse screening tool "RADAR" stand for?
Definition
R- Routinely screen every client for abuse
A- Affirm feelings and assess abuse.
D- Document your findings.
A- Assess for your client's safety.
R- Review options and make referrals.
Term
Enculturation
Definition
Involves acquiring knowledge and internalizing values.
Term
Cultural Competence
Definition
Ability to apply knowledge about a client's culture so that the health care provided can be adapted to meet her needs.
Term
What is the most important factor that limits care?
Definition
Financial barriers
Term
What is the leading reason for hospitalization in the USA?
Definition
Childbirth
Term
Can a nurse refuse to care for a client undergoing an abortion?
Definition
The ANA Code of Ethics for Nurses upholds that nurses have the right to refuse to care for a client undergoing an abortion if the nurse ethically opposes the procedure. *The nurse needs to make her values and beliefs known to her manager before a situation like this occurs
Term
Intrauterine therapy
Definition
A procedure that involves opening the uterus during pregnancy, performing a surgery, and replacing the fetus in the uterus.
Term
Maternal - fetal conflict
Definition
Fetal care becomes problematic when what is required to benefit one member of the dyad will cause unacceptable harm to the other
Term
Goal of stem cell research?
Definition
Relief of human suffering, which is ethically good!
Term
Benefits of stem cell research? (4)
Definition
-therapies for Parkinson's disease
-regenerating diseased body tissues
-repairing spinal cord injuries
-growing needed organs for transplant
Term
Family centered care
Definition
The collaborative partnership among the individual,family, and caregivers that exist to determine goals, share information, offer support, and formulate plans for health care
Term
Community
Definition
Specific group of people, often living in a defined georgraphic area, who share common interests, who interact with each other, and who function collectively within a defined social structure to address common concerns.
Term
Population
Definition
Group of individuals who share personal or environmental characteristics ex/ most commonly geographic location
Term
Community health nursing
Definition
Focuses on preventing illness and improving the health of populations and communities *They address the current and potential health needs of a population or community
Term
Epidemiology
Definition
the study of the causes, distribution, and control of disease in populations
Term
Community based nursing
Definition
Focuses on health promotion and primary health health care in community based settings *emphasis on primary care and outpatient treatment
Term
Community based nursing settings
Definition
Ambulatory care, home health care, occupational health, school health and hospice settings
Term
Primary Prevention
Definition
Preventing the disease or condition before it occurs through health promotion activities, environmental protection, and specific protection against disease or injury Ex/ Good hygiene, sanitation, immunizations, genetic counseling, smoking cessation
Term
Secondary Prevention
Definition
Early detection and treatment of adverse health conditions. This level is aimed at halting the disease, thus shortening its duration and severity to get the person back to a normal state of functioning. Ex/ Pregnancy testing, mammogram screening, cholesterol monitoring, blood pressure evaluations
Term
Tertiary Prevention
Definition
Designed to reduce or limit the progression of a permanent, irreversible disease or disability. Purpose is to restore individuals to their maximum potential. Ex/ Focus on minimizing and managing effects of a chronic illness such as Cerebrovascular disease
Term
Birthing center
Definition
Cross between a home birth setting and a hospital *In close proximity to a hospital in case of complications
Term
Advantages of birthing centers
Definition
Noninterventional approach to obstetric care, freedom to eat and move around during labor, ability to give birth in any position, and the right to have any number of family and friends attend the birth
Term
Disadvantages of birthing centers
Definition
Some centers have rigid screening criteria which may eliminate healthy mothers from using birth centers; many have rigid rules concerning transporting the mother to the hospital (ex/ prolonged labor, ruptured membranes), and many have no pediatrician on staff if the newborn has specials needs after birth
Term
Home birth
Definition
For women who want no medical interventions and a very family centered birth. Recommended for pregnant women who are considered to be a low risk for complications during labor and birth
Term
Home birth advantages
Definition
Least expensive, allows the woman to experience labor and delivery in privacy, comfort, and familiarity of home while surrounded by loved ones, permits the woman to maintain control over every aspect affect her labor (ex/ positions, attire), minimizes interference and unnecessary interventions- allowing labor to progress normally, promotes continuous one-on-one care by the midwife throughout the childbirth process, promotes the development of a trusting relationship with the nurse midwife
Term
Home birth disadvantages
Definition
Limited availability of pain meds and danger to the mother and baby if an emergency arises **A backup plan for a health care provider and nearby hospital on standby must be established should an emergency occur
Term
Complementary and Alternative Medicine (CAM)
Definition
Diverse practices, products, and health care systems that are not currently considered to be part of conventional medicine
Term
Complementary medicine
Definition
Used together with conventional medicine, such as using aromatherapy to reduce discomfort after surgery or to reduce pain during a procedure or during early labor
Term
Alternative medicine
Definition
Used in a natural diet to control nausea and vomiting or to treat cancer instead of undergoing surgery, chemotherapy, or radiation that has been recommended by a conventional doctor
Term
Integrative medicine
Definition
Combines mainstream medicine therapies and CAM therapies for which there is some scientific evidence of safety and effectiveness ex/ acupunture, yoga, meditation, homeopathy
Term
Multiple options for a client to seek assistance at a community-based setting: (3)
Definition
-School health
-Home health
-Hospice
Term
The uterine wall is composed of three layers:
Definition
1. endometrium - innermost layer
2. myometrium - muscular middle layer
3. perimetrium - outer serosal layer that covers the body of the uterus
Term
What is the uterus?
Definition
The site of menstruation, implantation of a fertilized ovum, development of the fetus during pregnancy, and labor
Term
Endometrium
Definition
mucosal layer that lines the uterine cavity in nonpregnant women
Term
Vagina
Definition
-Organ of copulation
-Birth canal

"Hollow tube with water balloon at the end"
Term
Uterus
Definition
-Implamentation and nutrition of fertilized ovum
-Expulsion of fetus during pregnancy
-Responsible for cyclic menstruation
Term
Fallopian Tubes
Definition
Allow for passage of ovum from the ovaries to the uterus
**Where fertilization occurs
Term
Ovaries
Definition
-Responsible for ovulation
-Produce estrogen, progesterone, androgen
Term
What portion of the fallopian tube serves as the most common place for fertilization?
Definition
Ampula
Term
Menstruation
Definition
The normal, predictable physiologic process whereby the inner lining of the uterus (endometrium) is expelled by the body. **Begins approximately 14 days after ovulation
Term
Menarche
Definition
The start of mensturation in females * ~12.8 years, with a range between 8-18. Genetics is the most important factor in determining the age at which menarche starts
Term
Cycle length?
Duration of flow?
Blood loss each cycle?
Definition
- 21-36 days
- 3-7 days
- 1-1.5 ounces blood loss for each cycle
Term
Ovarian Cycle
Definition
Series of event associated with a developing oocyte (ovum or egg) within the ovaries **Begins when the follicular cells (ovum and surrounding cells) swell and the maturation process starts
Term
Follicular Phase
Definition
Follicles in the ovary grow and form a mature egg.Starts on Day 1 of the menstrual cycle and continues until ovulation, approximately 10-14 days later
Term
Ovulation
Definition
A mature follicle ruptures in response to a surge of LH, releasing a mature oocyte (ovum). Usually occurs on day 14 in a 28-day cycle
Term
Luteal Phase
Definition
Begins at ovulation and lasts until the menstrual phase of the next cycle. It typically occurs in days 15 through 28 of a 28-day cycle
Term
Endometrial Cycle
Definition
Occurs in response to cyclic hormonal changes.
Term
Four phases of the endometrial cycle:
Definition
1. Proliferative Phase
2. Secretory Phase
3. Ischemic Phase
4. Menstrual Phase
Term
Proliferative Phase
Definition
Starts with the enlargement of the endometrial glands in response to increasing amounts of estrogen
Term
Secretory Phase
Definition
Begins at ovulation to about 3 days before the next menstrual period
Term
Ischemic Phase
Definition
If fertilization does not occur, the ischemic phase begins. Estrogen and Progestrone levels drop sharply during this phase as the corpus luteum starts to degenerate
Term
Menstrual Phase
Definition
Begins as the spiral arteries rupture secondary to ischemia, releasing blood into the uterus, and the sloughing of the endometrial lining begins
Term
Gonadotropin-Releasing Hormone (GnRH)
Definition
Secreted from the hypothalamus in a pulsatile manner through out the reproductive cycle. *Induces the release of FSH and LH to assist with ovulation
Term
Follicle-stimulating hormone (FSH)
Definition
Secreted by the anterior pituitary gland and is primarily responsible for the maturation of the ovarian follicle *Secretion is the highest and most important during the 1st week of the follicular phase of the reproduction cycle
Term
Luteinizing hormone (LH)
Definition
Secreted by the anterior pituitary gland and is required for both the final maturation of preovulatory follicles and luteinization of the ruptured follicle **Rises and stimulates the follicle to produce estrogen
Term
Estrogen
Definition
Secreted by the ovaries and is crucial for the development and maturation of the follicle *Predominant at the end of proliferative phase, directly preceding ovulation **Also causes the uterus to increase in size and weight bc of the increased gylcogen, amino acids, electrolytes, and water ***Secondary sex characteristics
Term
Progestrone
Definition
Secreted by the corpus luteum. Levels increase just before ovulation and peak 5-7 days after ovulation
Term
Prostaglandins
Definition
Primary mediators of the body's inflammatory processes and are essential for the normal physiologic function of the female reproductive systems
Term
4 Basic types of bony pelvis?
Definition
1. gynecoid - most conducive to vaginal birth
2. anthropoid
3. android - most common in men (narrow & boxy)
4. platy pelloid
Term
How many lobes is each mammary gland comprised of?
Definition
15-20 lobes divided into lobules (lobules are clusters of acini)
Term
What happens if someone has excessive amounts of FSH?
Definition
PCOS, Very hairy
Term
The nurse explained to her client that the ________ of the uterine corpus can fluctuate with changes of hormonal levels in the absence of pregnancy.
Definition
Endometrium
Term
The nurse describes the components of semen, stating that most of the volume of semen is provided by the seminal vesicles and the:
Definition
Prostate Gland
Term
What helps protect against vaginal infections?
Definition
the acidic environment
Term
During an examination of the client, the nurse will question the women concerning their LMP. This indicates:
Definition
The first day of their last menstrual period
Term
The nurse understands that the endometrium is prepped for egg implantation by the corpus luteum, which secretes:
Definition
Progesterone
Term
While describing the internal structures, the nurse will identify the neck of the uterus as the:
Definition
Cervix
Term
Premenstrual Syndrome (PMS)
Definition
A constellation of recurrent symptoms that occur during the luteal phase with the onset of menstruation cycle and resolve with the onset of menstruation
Term
Dysmenorrhea
Definition
Painful menstruation
Term
Primary Dysmenorrhea
Definition
Caused by increased prostaglandin production by the endometrium in an ovulatory cycle- Highest during the first 2 days of menses, when symptoms peak *Common ages effected 17-24, decreases after pregnancy
Term
Secondary Dysmenorrhea
Definition
-Acquired menstrual pain after age 25
-Diagnosis & treatment- removal of underlying pathology
Painful menstruation due to pelvic or uterine pathology *May be caused endometriosis (BIGGEST CAUSE), adenomyosis, fibroids, pelvic infection, an intrauterine device, cervical stenosis.
**Absence of menses for three cycles or 6 months in women who have previously menstruated (pregnancy, non-pregnant, pre-menopause)
Term
Medications/Treatments for Dysmenorrhea:
Definition
-NSAIDS
-Ibuprofen
-Naproxen
-Oral contraceptives- decrease prostaglandin synthesis
-Heat
-Massage
-Exercise- release of beta endorphins, suppress prostaglandins
Term
Maternal mortality
Definition
12.7/100,000 live births
Term
Neonatal mortality
Definition
4.19/100,000 live births
Term
Dysfunctional uterine bleeding (DUB)
Definition
Occurs most frequently in women at the beginning and end of their reproductive years. **Irregular, abnormal bleeding that occurs with no identifiable anatomic pathology
Term
Menorrhagia
Definition
Abnormally long, heavy periods
Term
Oligomenorrhea
Definition
Bleeding occurs at intervals of more than 35 days
Term
Metrorrhagia
Definition
Bleeding between periods
Term
Menometrorrhagian
Definition
Bleeding occurs at irregular intervals with heavy flow lasting more than 7 days
Term
Polymenorrhea
Definition
Too frequent periods
Term
Possible causes of DUB may include:
Definition
-Adenomyosis
-Pregnancy
-Hormonal imbalance
-Fibroid tumors
-Endometrial polyps or cancer
-Endometriosis
-Intrauterine system
Term
Treatment of DUB
Definition
Depends on the cause of the bleeding and the age of the client *Goal is to normalize the bleeding, correct the anemia, prevent or diagnose early cancer and restore quality of life
Term
Hypogonadotropic Amenorrhea
Definition
-Caused by pituitary lesions, inability to produce FSH and LG, sudden weight loss, eating disorders, strenuous exercise
-Problem in central hypothalmic-pituitary axis
-Results from hypothamic suppression **Common in athletes
Term
Treatment of DUB:
Definition
1. Estrogens - cause vasospasm of the uterine arteries to decrease bleeding
2. Progestins - used to stablize an estrogen-primed endometrium
3. Oral controceptives - regulate the cycle and suppress the endometrium
4. NSAIDs- inhibit prostaglandins in ovulatory menstrual cycles
5. Progestrone-releasing IUSs- Suppress endometrial growth
6. Androgens- Create a high androgen/low estrogen environment that inhibits endometrial growth
7. Iron salts- replenish iron stores lost during heavy bleeding
Term
Complications of DUB
Definition
infertility can result from lack of ovulation, severe anemia can result secondary to prolonged or heavy menses, and endometrial cancer can occur associated with prolonged buildup of the endometrial lining without menstrual bleeding
Term
Symptoms occuring in luteal phase of menstrual cycle:
Definition
Bloating, anxiety, breast tenderness, depression, fatigue, thirst, appetite changes
Term
Premenstrual dysphoric disorder (PMDD)
Definition
Severe variant of PMS
Term
PMS or PMDD Management
Definition
Requires a multidimensional approach because these conditions are not likely to have a single cause, they appear to affect multiple systems within a woman's body *Therefore requiring multiple treatments
Term
Treatment for PMS and PMDD
Definition
Vitamin supplements, diet changes, exercise, lifestyle changes, and medications
PMDD: antidepressants/anti-anxiety drugs, diet changes, exercise, lifestyle changes, and medications
Term
Symptoms of PMS can be categorized using the following: A.C.D.H.O.
Definition
A= anxiety: difficulty sleeping, tenseness, mood swings, and clumsiness
C= cravings: cravings for sweets, salty foods, chocolate
D= depression: feelings of low self-esteem, anger, easily upset
H=hydration: weight gain, abdominal bloating, breast tenderness
O= other: hot flashes or cold sweats, nausea, change in bowel habits, aches or pains, dysmenorrhea, acne breakout
Term
ACOG diagnostic criteria for PMS consist of having at least one of the following affective and somatic symptoms during the 5 days before menses in each of the 3 previous cycles:
Definition
Affective symptoms: depression, angry outbursts, irritability, anxiety
Somatic syptoms: breast tenderness, abdominal bloating, edema, headache
*Symptoms relieved from days 4-13 of menstrual cycle
Term
Endometriosis
Definition
Bits of functioning endometrial tissue are located outside of their normal site. This endometrial tissue is commonly found attached to the ovaries, fallopian tubes, the outer surface of the uterus, the bowels, the area between the vagina and the rectum, and the pelvic side wall **One of the most common gynecologic diseases, affecting more than 6 million women in the U.S.
Term
Factors that increase a woman's risk of developing endometriosis:
Definition
-Increased age
-Family hx of endometriosis in a first-degree relative
-Short menstrual cycle (less than 28 days)
-Long menstrual flow (more than 1 week)
-High dietary fat consumption
-Young age of menarche (younger than 12)
-Few (one or two) or no pregnancies
Term
Treatment options for Endometriosis
Definition
Surgical interventions: conservative or definitive
Medication therapy: NSAIDS, oral contraceptives, progestogens, antiestrogens, GnRH-a
Term
Infertility
Definition
Inability to conceive a child after 1 year of regular sexual intercourse unprotected by contraception
Term
Menopausal transition
Definition
Transition from a woman's reproductive phase of her life to her final menstrual period
Term
Perimenopause
Definition
Usually 2-8 years before cessation of menstruation *Ovaries begin to fail, producing irregular and missed periods and an occasional hot flash
Term
Menopausal transition effects on the body:
Definition
1. Brain - hot flashes, disturbed sleep, modd and memory problems
2. Cardiovascular - lower levels of high-density lipoprotein (HDL) and increased risk of cardiovascular disease
3.Skeletal - rapid loss of bone density that increases the risk of osteoporosis
4. Breasts - replacement of duct and glandular tissue
5. Geniourinary - vaginal dryness, stress incontinence, cystitis
6. Gastrointestinal - less absorption of calcium from food, increasing the risk for fractures
7. Integumentary- dry, thin skin and decreased collagen levels
8. Body shape - more abdominal fat, waist size that swells relative to hips
Term
Risks of Hormone Replacement therapy:
Definition
Risks of blood clots (biggest risk), heart attacks, strokes, and breast cancer, breast cancer, headaches, nausea, vomiting, bloating *In short, the overall health risks of HT exceeded the benefits
Term
Health risks of perimenopausal women:
Definition
-osteoporosis
-coronary heart disease
-estrogen has favorable effect on circulating lipids (cholesterol, heart disease increase after menopause)
Term
Alternative therapies for menopause:
Definition
-Nutrition
-Acupuncture
-Herbal supplements
-Vitamin supplements
Term
Dyspareunia
Definition
Difficult or painful intercourse
Term
Vaginal atrophy changes include:
Definition
thinning of the vaginal walls, an increase in pH, irritation, increased susceptibility to infection, dyspareunia, loss of lubrication with intercourse, vaginal dryness, and a decrease in sexual desire
Term
Factors to be considered when deciding to use Hormone Therapy:
Definition
-The risk/benefit ratio is highest in younger women who begin HT not long after menopause
-HT is approved for 2 indications: relief of vasomotor symptoms and prevention of osteoporosis
-Research suggests that HT may be beneficial for preventing diabetes, improving mood, or avoiding urinary tract problems
-Using HT long beyond menopause carries increased risks, which, for some women, may be outweighed by the benefits
Term
Apgar Scores
Definition
Used to quickly assess the health of a newborn immediately after birth

Appearance
Pulse
Grimace
Activity
Respiration
Term
Leopold's Maneuvers - First Maneuver: Fundal Grip
Definition
Determine the size, consistency, shape, and mobility of the form that is felt ex/fetal head is hard, firm,round, and moves independently
Term
Leopold's Maneuvers - Second Maneuver: Umbilical Grip
Definition
Attempts to determine the location of the fetal back
Term
Leopold's Maneuvers - Third Maneuver: Pawlick's Grip
Definition
Determine what fetal part is lying above the inlet
Term
Leopold's Maneuvers - Fourth Maneuver: Pelvic Grip
Definition
Attempt to locate the fetus' brow
Term
Lochia
Definition
Vaginal discharge during the puerperium (postpartum period) consisting of blood, tissue and mucous. Lochia last from 4-6 weeks
Term
Lochia Rubra
Definition
Red, distinctly blood tinged vaginal flow that follows birth and last 3-4 days. This is the first blood seen in the puerperium
Term
Lochia Serosa
Definition
Serous,pinkish brown, watery vaginal discharge that follows lochia rubra. Median duration is 22-27 days after childbirth
Term
Lochia Alba
Definition
Thin, yellowish to white, vaginal discharge that follows lochia serosa. Median duration is 10-14 days
Term
Estimated Blood Loss (EBL)
Definition
An estimate of total blood loss. If weighing blood loss, 1 gram = 1 milliliter (cc)
Term
Scant blood loss
Definition
Less than 1 inch (2.5 cm) stained on a peripad
Term
Small (light) Blood Loss
Definition
Less than 4 inches (10 cm) stain on a peripad
Term
Moderate blood loss
Definition
Less than 6 inches (15.2 cm) stain on a peripad
Term
Large (heavy) blood loss
Definition
Saturated peripad within 1 hour
Term
Intimate Partner Violence
Definition
is actual or threatened physical or sexual violenc or psychological/emotional abuse
Term
Cycle of violence
Definition
Comprises of 3 distinct phases:
1. Tension building phase
2. Acute battering phase
3. Honeymoon phase
Term
Individual risk factors for IPV in men
Definition
-Young age
-Heavy drinking
-Personality disorders
-Depression
-Low academic achievement
-Witnessing/experiencing violence as a child
-Low income
Term
Relationship risk factors for IPV in men
Definition
-Marital (martial) conflict
-Economic distress
-Dysfunctional family
-Marital instability
-Male dominance in family
-Cohabitation
-Having outside sexual partners
Term
Community risk factors for IPV in men
Definition
-Weak sanctions against IPV
-Poverty
-Low social capital
Term
Societal risk factors for intimate partner violence in men
Definition
-Traditional gender norms
-Social norms supportive of violence
Term
What are the 4 types of abuse?
Definition
1. Emotional
2. Physical
3. Financial
4. Sexual
Term
Emotional abuse
Definition
-Promising, swearing, or threatening to hit the victim
-Forcing the victim to perform degrading or humiliating acts
-Threatening to harm children, pets, or close friends
-Destroying valued possessions
-Controlling victim's every move
Term
Physical abuse
Definition
-Hitting or grabbing the victim so hard that it leaves marks
-Throwing things are victim
-Slapping, spitting at, biting, burning, pushing, choking, or shoving victim
-Kicking or punching the victim, or slamming her against things
-Attacking the victim with a knife, gun, rope, or electrical cord
-Cording access to health care for injury
Term
Financial abuse
Definition
-Preventing the woman from getting a job
-Sabotaging a current job
-Controlling how all money is spent
-Failing to contribte financially
Term
Sexual abuse
Definition
-Forcing the woman to have vaginal, oral, or anal intercourse
-Biting the victim's breasts or genitals
-Shoving objects into victim's vagina
-Forcing the woman to do something sexual that she finds degrading or humiliating
-Forcing the victim to perform sexual acts on other people or animals
Term
Battered woman syndrome
Definition
Woman has experienced deliberate and repeated physical or sexual assault by an intimate partner, feels terrified, helpless, and alone, and reacts to any expression of anger or threat by avoidance and withdrawal behavior.
Term
Factors leading to battering during pregnancy
Definition
-Inability of couple to cope with stressors of pregnancy
-Young age at time of pregnancy
-Having less than high school diploma for both partners
-Unemployment for either or both in partnership
-Violence in family of origin
-Cohabitation and single marital status
-Sexual proprietariness on the part of male partner
-Heavy drinking by partner
-Resentment toward the interference of the growing fetus and change in the woman's shape
-Doubts about paternity or fidelity of expectant mother
-Perception that baby will be a competitor
-Outside attention the pregnancy brings to the woman
-Unwanted pregnancy
-The woman's new interest in herself and her unborn baby
-Financial burden r/t expense of pregnancy
-Stress of role transition to fatherhood
Term
Signs of abuse during pregnancy
Definition
-Poor attendance at prenatal visits
-Unrealistic fears
-Weight fluctuations
-Difficulty with pelvic exams
-Noncompliance with treatment
Term
SAVE model
Definition
-Screen all of your clients for violence
-Ask direct questions in a nonjudgemental way
-Validate the client
-Evaluate, educate, and refer this client
Term
What is the first way to detect abuse?
Definition
Routine screening
Term
How do you establish trust and rapport during IPV assessment?
Definition
-Communication support through a nonjudgemental attitude and telling the woman the no one deserves to be abused
Term
What are should you do during an IPV assessment and screening?
Definition
-Screen for abuse during every health care visit
-Isolate client immediately from family
-Ask direct or indirect questions about abuse
-Assess immediate safety
-Document and report your findings
Term
What are some risk factors for abuse-related murders?
Definition
-Increased frequency or severity of abuse
-Presence of firearms
-Sexual abuse
-Substance abuse
-Generally violent behavior outside of the home
-Control issues
-Physical abuse during pregnancy
-Suicide threats or attempts
-Child abuse
Term
Possible signs of abuse during an assessment?
Definition
-Injuries: bruises, scars from blunt trauma, or weapon wounds on face, head and neck
-Injury sequelae: headaches, hearing loss, joint pain, sinus infections, teeth marks, clumps of hair missing, dental trauma, pelvic pain, breast or genital injuries
-Reported history of injury that is not consistent with the actual presenting problem
-Mental heath problems: depression, anxiety, substance abuse, eating disorders, suicidal ideation or suicide attempts, anger toward health provider, PTSD
-Frequent tranquilizer or sedative use
-Bruises to upper arm, neck and face, abdomen, or breasts
-Comments about emotional or physical abuse of "a friend"
-Sexually transmitted infections or pelvic inflammatory disease
-Frequent health care visits for chronic, stress-related disorders such as chest pain, headaches, back or pelvic pain, insomnia, injuries, anxiety, and gastrointestinal disturbances
-Partner's behavior at health care visit: appears overly solicitous or overprotective, is unwilling to leave her alone with the health care provider, answers questions for her, and attempts to control the situation.
Term
Sexual abuse
Definition
Occurs when a woman is forced to have sexual contact of any kind without her consent
Term
Incest
Definition
Any type of sexual exploitation among blood relatives or surrogate relatives before the victim reaches 18 years of age
Term
Rape
Definition
An expression of violence, not a sexual act. It is a legal rather than a medical term and denotes penile penetration fo the vagina, mouth, or rectum of the female or mae without consent.
Term
Statutory rape
Definition
Sexual activity between an adult and a person under the age of 18 and is considered to have occurred even if the underage person was willing.
Term
Acquaintance rape
Definition
Someone is forced to have sex by a person he or she knows.
Term
Date rape
Definition
An assault that occurs within a dating relationship or marriage without consent of one of the participants. It is a form of acquaintance rape and is common on college campuses.
Term
PTSD
Definition
A significant portion of women who are raped experience PTSD. Symptoms usually begin within 3 months but occasionally may only emerge years later.
Term
Female genital cutting (FGC)
Definition
-A procedure involving any injury of th external female genitalia for cultural or nontherapeutic reasons.
-Performed to decrease a woman's sexual desires and to ensure her chastity until marriage and receipt of a dowry
-Complications vary. Frequently performed w/o anesthesia under nonsterile conditions. Complications include: infertility, dysmennorrhea, dyspareunia, sexual dysfunction, infection, hemorrhage after procedure, vaginal stenosis, chronic vaginitis, pelvic inflammatory disease, chronic UTI, incontinence, genital fistulas, recurrent abscesses, transmission of HIV or hepatitis during procedure, severe pain and shock after procedure, difficulty walking or using stairs due to severe scarring, urinary retention, inability to experience orgasm, and difficulty in giving birth.
-Psychological effects range from eating disorders, insomnia, depression, PTSD, and negative effects on women's self-esteem and identity
Term
Human trafficking
Definition
The enslavement of immigrants for profit in America.
-Victims are primarily women and children who lack education, employment, and economic opportunities in their own countries.
-Traffickers promise victims employment as nannies, maids, dancers, factory workers, sales clerks, or models in the U.S.
-Traffickers transport the victims from the countries to unfamiliar destinations away from their support systems
-Once they are here, traffickers coerce them, using rape, torture, starvation, imprisonment, threats or physical force, into prostitution, pornography, the sex trade, forced labor, or involuntary servitude.
Term
Sexual Assault Nurse Coordinator (SANE)
Definition
Has specialized training in examining these patients and recognizing, collecting, and preserving evidence.
Term
Phases of response to traumatic event
Definition
-Acute phase: Disorganization
-Outward adjustment phase: Denial
-Reorganization
-Integration and Recovery
Term
Chlamydia
Definition
-Caused by chlamydia trachomatis
-Most common STI in American women
-Often no symptoms; can have dysuria and/or vaginal discharge
-If left untreated can cause PID/Infertility
-Sexually active 15-19 y.o. have highest rate
-Cultures done in beginning of pregnancy and at end if risk factors present
-Tx with antibiotics-TOC should be done in pregnancy or if non-compliance suspected with treatment
Term
Gonorrhea
Definition
-2nd most prevalent STI in U.S.
-Similar to chlamydia in age prevalence
-1/3 of cases asymptomatic
-Pain, menstrual irregularities predominant presenting symptom. May have some discharge.
-In pregnancy can cause PROM, preterm delivery, chorioamnionitis, neonatal sepsis, IUGR, opthalmia neonatorum, post partum maternal infection
-Cultures done: should test for co-infection
-Treatment with antibiotics-responds rapidly
Term
Syphillis
Definition
-Transmission occurs through skin breaks: in addition to sexual transmission, can also be through oral contact as well
-Transplacental transmission may occur-risk r/t amount of spirochetes in the blood stream
-Manifested in stages and may lead to systemic disease and death if untreated
-Has Primary lesion that occurs 1 to 6 weeks after infection; Secondary symptoms occur within 2-6 mos. after lesion, and is characterized by rash on palms and soles. May develop multiple condylomas. Will enter latent phase if left untreated.
-Tertiary symptoms develop in about 1/3 of women with latent infection. Will eventually progress to multi-system involvement and complications.
-Tested by blood test and microscopic examination of lesion; can get false-negative if early in disease process
-Tx is penicilin
Term
HSV II
Definition
-Responsible for genital herpes
-20% of U.S. woman infected
-Can be transmitted if pt. is asymptomatic
-Primary infection is most painful and uncomfortable: generalized symptoms over whole body
-Primary infection in first trimester associated with increased risk for miscarriage
-Dx made through inspecition and history-confirmed with culture
-No cure, but anti-viral meds can control symptoms and limit outbreaks
-Outbreak in pregnancy at time of delivery needs delivery by C-Section
Term
Trichomoniasis
Definition
-Contracted by vaginal intercourse with infected partner; may be picked up from direct genital contact with damp or moist objects
-Dx by microscopic evaluation of vaginal secretions or culture
-May be asymptomatic; can have dysuria, urinary frequency, vaginal discharge, dyspareunia, irritation or itching of area
-Treated with Metronidazole
Term
Genital warts (HPV)
Definition
-Most common viral STIs in U.S.
-Could lead to cancers of cervix, vulva, vagina, anus, or penis
-No cure; caused by Human papilomavirus
-Transmitted by vaginal, anal, or oral sex with infected partner
-Dx by visual inspection or abnormal pap
-Symptoms include wart-like lesions that are soft, moist, or flesh-colored and appear on the vulva and surrounding vagina and anus.
Term
Pelvic inflammatory disease
Definition
-Infection involving pelvic structures such as fallopian tubes, uterus, ovaries and peritoneum
-Cause by ascending, untreated infections-chlamydia and gonorrhea common culprits
-Can sometimes be difficult to dx and tx due to vague, non-specific symptoms (abd. pain, fever, n/v, irregular bleeding
-Can cause problems with fertility, miscarriage, ectopic pregnancy
-Treat source of infection with antibiotics, pain meds
Term
What are the vaccine preventable STIs?
Definition
-Hep A
-Hep B
-HPV
Term
Hepatitis infections
Definition
-A & B can be sexually transmitted
-A is usually self-limiting and does not become chronic. B can result in serious or permanent liver damage
-Vaccine available for A & B
-Should minimize things that wil cause further liver damage
-Mothers who are positive will need to have infants vaccinated and also receive the immune globulin to avoid transmission
Term
Hep C
Definition
-Not sexually transmitted; transmitted through Injection drug-use or blood transfusion before 1992
-Prevalence in pregnant women is 1%
-Perinatal transmission is rare except in women who are immunocompromised
Term
HIV
Definition
-Virus that attacks immune system and makes patient unable to fight off infections
-Usually accompanied by flu-like response
-Testing during pregnancy should be done with routine prenatal labs-repeat as needed for high-risk pt.
-Early treatment can decrease transmission risk to fetus to 1-2%
-Combination antiretroviral drugs work best-major side effect is bone marrow suppression; periodic counts should be checked for WBC, platelets and Hct.
-C-section delivery recommended to avoid perinatal transmission
-Invasive procedures to fetus should be avoided
-Infant should be treated with oral antiretroviral medications for 6 weeks post delivery
-Breastfeeding should be avoided
Term
Nursing strategies to prevent the spread of STIs
Definition
-Provide basic information about STI transmission
-OUtline safer sexual behaviors for ppl at risk
-Refer clients to appropriate community resources to reduce risk
-Screen asymptomatic persons with STIs
-Identify barriers to STI testing and remove them
-Offer pre-exposure immunizations for vaccine-preventable STIs
-Respond honestly about testing results and options available
-Counsel and treat sexual partners of persons with STIs
-Educate school administrators, parents, and teens about STIs
-Support youth development activities to reduce sexual risk-taking
-Promote the use of barrier-methods to prevent the spread of STIs
-Assist clients to gain skills in negotiating safer sex.
-Discuss reducing the number of sexual partners to reduce risk.
Term
The nurse is helping the client understand the possible diagnosis of endometriosis. The nurse realizes that this diagnosis is definitively confirmed by:
Definition
Pelvic laparoscopy
Term
The nurse is assessing a couple who have come to the health care facility because they have been unable to conceive a child. When assessing the woman, which factor would the nurse identify as increasing the woman's risk for infertility?
Definition
Endometriosis
Term
A nurse is evaluating the client to determine the possible cause of her dysmenorrhea. The nurse is aware that the most common etiology for secondary dysmenorrhea is due to:
Definition
Endometriosis
Term
Premenstrual syndrome (PMS) affects millions of women during their reproductive years. As a nurse you realize that approximately ______ of the women in the United States report disabling, incapacitating symptoms.
Definition
10%
Term
A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection?
Definition
Gonorrhea
Term
When describing the methods of transmission for herpes simplex virus to a group of college students, which method would be least likely?
Definition
Sharing contaminated needles
Term
The nurse is preparing to administer medication therapy to a woman diagnosed with syphilis. The nurse would expect to administer:
Definition
Penicillin G
Term
The nurse recognizes that one of the most common causes of vaginal discharge is:
Definition
Candidiasis
Term
The nurse emphasizes the importance of regular Pap smears and routine physical examinations due to the fact that _______ of women are asymptomatic when infected with chlamydia.
Definition
70%
Term
Primary amenorrhea
Definition
1. Absence of menses by age 14, with absence of growth and development of secondary sexual characteristics
2. Absence of menses by age 16, with normal development of secondary sexual characteristics
Term
Secondary Amenorrhea
Definition
The absence of menses for three cycles or 6 months in women who have previously menstruated regularly
Term
Common lab tests to determine cause of amenorrhea:
Definition
-karotype
-ultrasound to detect ovarian cysts
-hCG
-Thyroid function
-Prolactin level
-FSH
-LH
Term
Endometriosis affected between ___-____% of women of reproduction age
Definition
6-10%
Term
Menstrual Disorder Vocabulary
Definition
Meno = menstrual related
metro = time
oligo = few
a = without, none, or lack of
rhagia = excess or abnormal
dys = not or pain
rhea = flow
Term
Syphilis is curable true or false?
Definition
True - it a complex,curable bacterial infection
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