08/26/2015 Chapters 1 and 2 Flashcards
What’s a short overview of obstetrics?
Colonial: difficult/dangerous childbirth
1700s: home births with midwives, no men attended
1800s: shift from midwives to doctors
1900s: births move into hospitals, nurseries created
1950/70s: starts natural childbirth movement/less interventions
90s/current:home births and midwives return
what’s the C-section rate?
1 out of 3 women, trend is away from C-sections
What’s family-centered care (example given)
- care thought of within context of family unit
ex: if mom has 1 and 2 yo and is taking antidepressants, might not be a candidate to breastfeed
what is the advantage of breast feeding?
gives baby boost to immune system by passive immunity (antibodies transferred through breast milk)
what are the three main points of a good family-centered care plan?
1) cost-effective
2) quality-oriented
3) outcome focused
What are the basic principles of family-centered care?
a) childbirth: a normal, healthy event
b) BUT childbirth does affect families tremendously
c) take away point: the health of each individual member affects the family health and the family health affects the health of each individual member
d) family makes decisions about own care
what is case-managed care? (example provided)
an interdisciplinary approach, usually more complex patients
ex: woman delivered vaginally and pubis bone separated during childbirth and the pubis bone has to come back together on its own; woman had to have PT, OT, childcare for baby at home, transportation
- all of these had to be coordinated
4 overarching goals of healthy people 2020 for women’s health
1) prevent disability, disease, and preventable death
2) create gender equality
3) promote environments that are conducive to good health
4) create healthcare that supports every stage of life development
what is the maternal, fetal, neonatal, and infant death rates
maternal: number of deaths of any cause during pregnancy/100,000 live births
fetal: number of fetal deaths (>20 weeks gestation) in 1,000 live births
maternal facotrs: substance abuse,
fetal factors:
neonatal: any infant death in first 28 days of live/1,000 deaths
infant: number of deaths in first 12 months of life/1,000 live births
(note: so infant mortality rate includes the neonatal mortality rate, BUT the neonatal mortality rate doesn’t include the full scope of the infant mortality rate)
how many woman die from pregnancy-related deaths per day?
1600/day
why does the US have a high rate of maternal death rates?
- lots of healthcare tourists come to the US, many of which are sick (true? not sure)
- many other factors
- US has high racial disparity in death rates
what are the leading causes of maternal death?
1) hemorrhage
2) infection
3) HTN disorders
4) obstructed labor
5) unsafe AB
what are leading factors in causing maternal deaths?
less than 20, over 35 years of age, lack of prenatal care, low education, unmarried status, non-Caucasian race
Infant mortality is “______________;” US infant mortality rate =
the indicator of the health of a nation
about 6.17 in 2014 (ok these number need more research #sketchydata)
where’s the infant mortality rate the highest in the US?
southeast
info we already know
- need more prevention
- women lack insurance
- we ignore reproductive health, mental , health violence against women
- no one wants to research women’s health
what’s one of the biggest health issues for women and why?
- cardiovascular disease, because they have atypical symptoms and is therefore harder to diagnose #1 cause of death in women
what’s number one cancer that kills women?
1) lung
(second is breast, risk factors: family hx, early age menstural irregularities, excess weight, no children, BC use, excessive alcohol, high-fat diet, long-term hormone use)
where is breast cancer the highest?
in women of North America
what are the 8 different family structures?
1) nuclear family: male/female partners and children (natural or adopted)
2) extended: members include grandparents, aunts, uncles, or other blood relatives
3) cohabitating-parent families: children live with two unmarried biologic or adoptive two parents (more common with latinos)
4) single-parent famlies: unmarried or single b/c of death, separation, desertion, divorce (increasing numbers
5) homosexual famlies
6) setp-blended family: result of remarriage
7) no-parent families: grandparents or aunts/uncles caring for children, foster care (seeing more and more with higher rates of drug use)
8) bi-nuclear family (child member of 2 families usually due to joint custody)
relation of violence against women during pregnancy?
- usually an increase in incidence once a woman becomes pregnant (often a result of partner’s panic)
what is nurse’s role with a patient experiencing violence?
- not your role to directly save the patient, instead empower the patient and help her get out of the situation
what is the radar screening tool?
- screens for domestic violence and abuse R: routinely screen every client A: affirm feelings and assess abuse D: document your findings A: assess R:
what are nutrition problems for pregnant moms
- iron deficiency: can cause anemia
- an excess would be obesity
what’s an important vitamin for pregnant women?
- folic acid
what’s the most significant barrier to healthcare?
- finances
the two types of stem cells
1) multipotent: can turn into anything
2) pluripotent: already somewhat specialized umbilical cord cells, adult bone marrow cells
what does the controversy of stemm cells focus on?
- the origin of the cells, big controversy is with embryonic stem cells
what is umbilical cord blood banking
- vast source of primitive hamtopoietic stem and progenitor cells, use syringe to draw them out of umbilical cord after childbirth
- you can also donate cord blood to public banks allowing anyone to access it that could need it/doesn’t have money otherwise
what’s the number one cause of maternal death?
hemorrhage (during childbirth)
so there’s a lot of info about how to care for the patient that’s pretty common sense
main takeaway point is to empower and not be biased, like duh
what is the most common alternative for maternity health?
prayer
what is difference between complementary, alternative, and integrative medicine?
- used together with convential medicine (aromatherpay, massage, acupuncture, vitamins, herbs)
- alternative: used in place of conventional medicine
- integrative: combines conventional western medicine with complementary treatments based on scientific evidence
what is WIC?
women, infant, and children
- offers health services for these groups and is federally funded
what is a birthing center/its advantages?
- home-like setting: creates a more relaxed environment, not as many rules to follow; can have unlimited number of people in room
- close to hospital if complications
- “normalcy” of birth
- usually discharged within 24 hours of birth
- less rules, have more say
- ** have strict criterias for who can give birth there -> only want low-risk patients
disadvantages: may not have a physician at the birthing center, bad for emergencies
why would you opt for an at-home birth?
- LOW cost
- in your environment, get to set all the rules
disadvantages: emergencies, no pain meds available
3 factors to make sure are present for effective communication
1) trust-building
2) be respectful (provide modesty when possible)
3) show empathy
techniques to facilitate learning when teaching new mothers
1) slow down and repeat
2) make more like a conversation
3) chunk info and teach in bits
4) prioritize info: teach the main survival skills first
5) use visual aids and pictures
6) get patient to demonstrate teachings
