405 4 Flashcards
Kids with defects are more likely to
be abused because of the added stress
Physical neglect definition
withholding or failing to provide
Between ages 6 and 16
you MUST go to school or be home schooled
Phys neglect compared to Phys abuse
neglect is slightly less bad
Signs of emotional abuse
- Child is a bully or bullied
- Withdrawn
- Conduct disorder
- Learning disability
Failure to thrive
Not growing enough enough
Failure to thrive is sometimes caused by
not feeding enough
Munchausen
mother pretends child is sick or purposely makes him sick
When do you report suspected abuse?
immediately
Do you need proof to report abuse?
Not really, just reasonable cause
Social Hold
There’s no phys reason, but you hold them for other reasons
The role of a nurse in a court case
Nurse usually doesn’t go to court, but the documentation does
You could be liable if
you fail to report abuse
Fetal Alcohol Syndrome has __ and ___ components
phys and mental
Fetal Alcohol Syndrome baby has small head but not
microcephaly
Fetal Alcohol Syndrome baby size
SGA
Fetal Alcohol Syndrome baby might have messed up ___ reflex
moro reflex
Fetal Alcohol Syndrome baby might not get a perfect APGAR score because
they have diminished moro reflex
Fetal Alcohol Syndrome baby eating consideration
They are poor feeders
Might need an NG tube
Fetal Alcohol Syndrome emotional consideration
they cry a lot so they need a lot of attention
Fetal Alcohol Syndrome baby might need medication for
antiseizure
Fetal Alcohol Syndrome: start assessing for cognitive problems at
early toddler period
Fetal Alcohol Syndrome need what kind of interdisciplinary help
OT and PT
Fetal Alcohol Syndrome: a good way to stimulate cognition is
play
Fetal Alcohol Syndrome: a condition that often goes along with it
ADHD
Teen pregnancies have a higher rate of
pre terms
Teen pregnancy: they might be bad about
getting prenatal care
2nd stage of Grief
Anger
3rd stage of Grief
Bargaining
Grief: early verse late miscarriage
either way it’s still a loss
Grief and loss: you need to give the parents enough
time
How might a 9, 10, or 15 year old express themselves
drawing
writing
Visiting rules for a dying patients
might be more lenient with the rules
A helpful strategy for explaining death to pre schoolers
pictures/objects
The approach for dealing with grieving family
use a combination of giving them space and being supportive
Dying process: Encourage ___ __ ___ for as long as possible
connections with friends
Difference between beating and spanking
beating leaves marks (phys or emotional)
Gestational DM baby size
could be LGA
Could also be SGA because of vasoconstriction
Macrosomia
LGA
Women who are DM or Gestationally DM often need
C section because the baby is LGA
Which ethnicities have the most Gestational DM
all non-white
Bethamethasone
drug that makes the fetus’ lungs mature faster
Gestational DM tx
try diet and exercise
If that doesn’t work try insulin or oral med
Treatment for Gest DM woman after she delivers
Standard care except that they need blood sugar testing
It’s possible mom could get type 2 DM
If you’ve had Gest DM, the chances of getting it again
are high
Gest DM: Newborn care
They will be hypOglycemic
Give them oral glucose by bottle
Gest DM: babies are born preterm, watch out for
respiratory distress
HypOglycemia is more effected by
food amount than exercise level
HTN in pregnancy: need to find out the mother’s
baseline
HTN in pregnancy: assess for
vision changes and headache
Worse BP than in pregnancy HTN
preclampsia
Preclampsia patients need rest to prevent
seizures
clonus
muscular spasm involving repeated, often rhythmic, contractions.
Preclampsia: assess for ____ and ____ to help detect seizures
clonus and hyper-reflexes
Preclampsia positioning
lay on left side to promote circulation to fetus
A muscle relaxant that can prevent seizures and prevent early labor
magnesium sulfate
magnesium sulfate
A muscle relaxant that can prevent seizures and prevent early labor
Tocolytics
one use is to prevent early labor
CCB
too much could cause a problem with labor bc the muscles are blocked from contracting
Spontaneous abortion; ask the patient
if she has any of the tissue that passed
Ectopic pregnancy: ask the patient
what the discharge looked like and was there an odor
Ectopic pregnancy: do 2 tests
blood test
sonogram
Ectopic pregnancy: administer
methotrexate to kill the pregnancy
Ectopic pregnancy signs
pelvic pain
maybe pain when urinating
Hydatidiform mole: test
sonogram
Hydatidiform mole: sign
bleeding
Hydatidiform mole: procedure
D and C
Hydatidiform mole: administer
methotrexate
Infertility definition
inability to conceive after one year of active unprotected intercourse
a mental cause of infertility
stress
Sexual Abstinance effectiveness rate
anywhere from 10 to 100%
Calendar method
Subtract 18 from shortest and 10 from longest
Natural Method: Monitor Temperature –
low prior to ovulation
Natural Method effectiveness
80%
Spermacides: Use with condom or diaphragm
may interfere with integrity of latex/rubber
Spermacides alone: effectiveness
50%
Pill/patch contraceptions
High BP, CVD, smoking, DM
Mifepristone and Mistopristol
Abortion Pills
when is the Abortion Pill taken
Early Pregnancy – 63 days or 9 weeks
97% effective
Mifepristone: how does it work
Blocks progesterone and encourages endometrial sloughing
Mistopristol: how does it work
empties the uterus of conception (cramping and bleeding)
Mistopristol, side effects
cramping and bleeding
Mistopristol, how long does it take to work
30 min to 5 hours
is a Vasectomy permanent
usually it is
Vasectomy: Residual sperm remains in vas deferens for
4 - 6 wks
is a Tubal ligation permanent
Yes
HPV: prevent it by administering
vaccine
HPV: Early screening should be done using
PAP test
Pre-menstrual Syndrome: recommended activity level
rest, exercise in moderation
Pre-menstrual Syndrome: medication
antidepressants
Pre-menstrual Syndrome: diet
High Carb
low salt,
caffiene,
vitamin B, E, Ca, Mg
Pre-menstrual Syndrome: Nurses’ Role
listen,
take complaints seriously,
make referrals prn
Magnesium foods
Green vegetables
Legumes & nuts
Whole grains
Magnesium functions
muscle and nerve function,
keeps heart rhythm steady,
supports a healthy immune system,
keeps bones strong
Vitamin B foods
liver,
eggs,
spinach,
avocados
Vitamin E foods
Fish
Nuts
Vitamin B and E function
supports immune system
Endometriosis definition
presence of endometrial tissue outside the uterus (young adults)
Endometriosis Etiology:
unknown, but it is R/t delayed pregnancy
Endometriosis Risk factors
obesity,
DM-II,
High BP
Endometriosis Pathology
tissue overgrowth during luteal phase of menstrual cycle.
Tissue adhesion to reproductive organs,
inflammation of tissue
Endometriosis Clinical Findings
genitourinary pain, infertility
Endometriosis Dx testing
sonogram
Endometriosis tx medications:
oral contraceptives,
testosterone
GnRH to decrease ovulation
Endometriosis side effects of tx medications:
infertility, artificial menopause
Endometriosis tx when it involves cancerous cells
Hysterectomy
Uterine Fibroids/Leiomyomas definition
benign tumors of uterus
Uterine Fibroids/Leiomyomas Etiology
unknown, but r/t estrogen levels
Uterine Fibroids/Leiomyomas: how do they change over time?
increase in size during childbearing years, atrophy during menopause
Uterine Fibroids/Leiomyomas Clinical Findings:
- discomfort on surrounding tissue/organs with increased size
- excessive menstrual bleeding
Uterine Fibroids/Leiomyomas Dx test:
sonogram
Uterine Fibroids/Leiomyomas complications
anemia, hemorrhage
Uterine Artery Embolization definition
Insertion of a catheter into the common femoral artery to access the arteries to the uterus.
Uterine Artery Embolization is used to treat
Fibroids
Uterine Artery Embolization: after the catheter is in place,
arteries are then filled (or ‘embolized’) with polyvinyl alcohol particles or tris-acryl gelatin that stop the blood supply to the fibroid(s) causing shrinkage of fibroids
Uterine Artery Embolization: post procedure
Higher incidence of pre-term births and C –sections
Uterine Fibroids: dietary prevention
lots of dairy
Uterine Fibroids: hormone tx
GnRH
Uterine Fibroids: surgical tx
Myomectomy – tumor removal
Hysterectomy – partial or total
Partial Hysterectomy
uterus only
total Hysterectomy
uterus, ovaries and fallopian tubes
Pre-menopause is characterized by
irregular menstrual cycle
Peri-menopause includes these time periods
pre-menopause and menopause plus 1 year
Post-menopause
cessation of menses
Therapeutic menopause
artificial menopause as a result of oopharectomy
Menopause cause
decline in production of estrogen, progesterone
A couple clinical findings of menopause
Smaller breast tissue
Bone loss
Menopause risks
increased risk for infection, heart disease, fractures
Menopause vitamin tx
D and Ca
Menopause: preventive testing
bone density testing
Menopause exercise
weight bearing and non weight bearing
Kegel
Menopause: yearly implications
Gyn appointment (PAP test and HPV test)
Menopause: monthly implications
SBE
