Block 11 - part 2 Flashcards

1
Q

Puerperium

A

Postnatal period of about 6-8 weeks where mother’s reproductive organs return to their non-pregnant condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

main aims of antenatal care

A

monitor progress of pregnancy to optimise maternal and foetal health, develop partnership between mother and health preofessional, exchange info that promotes choice, recognise deviations from the norm and refer, increase understanding of public health issues, provide opportunities to prepare for birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

6 key documents which influence antenatal care provisions

A

MBRRACE-UK (mothers and babies - reducing risk through audits and confidential enquiries across the UK),
NICE antenatal care guidelines 2008, mod 2014,
EB practise,
Local policy/guidelines,
Midwifery 2020,
National maternity review ‘better births’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

7 key themes of national maternity review ‘better births’

A

Personalised care, continuity of carer, safer care, better postnatal and perinatal mental health care, multi-professional working, working across boundaries, a fairer payment system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Tests done at antenatal visit

A

Physical examination, bloods, psychosocial and emotional support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

antenatal physical examination

A

weight, BP, urinalysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

antenatal bloods

A

FBC, antibodies, ABO and Rh, HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

antenatal psychosocial assessment

A

general wellbeing, work, financial, anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

7 risk factors for adverse outcomes in pregnancy

A

chronic/acute disease, proteinuria, significant increase in BP, significant oedema, large/small uterus for gestational age, malpresentation, infection, sociological factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

4 different forms of pregnancy loss

A

spontaneous miscarriage,
ectopic pregnancy,
termination of pregnancy,
stillbirth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

miscarriage

A

loss of pregnancy before 24 completed weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

MBRRACE report (2014)

A

looked at standards of care and mortality and morbidity rates, 2/3 mothers dies from medicla and mental health problems, 1/3 from direct causes. 3/4 women who died had known mentla health problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

common causes of death in postnatal period

A

infection, haemorrhage, thrombosis, hypertensive disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

physical health/wellbeing disorders a woman might experience postnatally (9)

A

perineal care, urinary retention, dyspareunia, headache, fatigue, backache, constipation, haemorrhoids, breast/nipples

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mental health problems experienced in the post natal period

A

50-80% - the blues
10-15% - postnatal depression
0.2% - puerperal psychosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The blues

A

Very weepy over small things, time-limited, recovers very quickly, if continues then worry about postnatal depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

postnatal depression

A

tiredness, worthlesness, low mood

18
Q

puerperal psychosis

A

severe episodes of mental illness that begins uddenly, mania, depression, confusion, hallucinations, delusions

19
Q

main outcome of Peel committee report (1970)

A

Sufficient facilities should be made available for 100% of childbearing women to give birth in hospital

20
Q

risks associated with caesarean section

A

general anaesthesia - Mendelsohn’s syndrome, paralytic ileus.
surgical technique - radical abdominal surgery, risk to other internal organs from surgical trauma.
childbearing risks for further births

21
Q

medical model of birth

A

birth seen as a dangerous journey, only normal in retrospect, therefore assume the worse. Low threshold for intervention

22
Q

social model of birth

A

birth seen as a normal physiological process, whcih women are uniquely designed to achieve

23
Q

cultural issues during pregnancy

A

unintended pregnancy - delay in seeking prenatal care, higher levels of stress/depression.
Pregnancy may not fit with mothers plans.
Social disapproval for pregancny out of wedlock and teenagers.

24
Q

Outcome of midwives’ act (1902)

A

established normality in childbearing as the midwife’s role - refer to doctors as soon as abnormality occurs. Ensures equal access to midwives and doctors for childbearing women of all socioeconomic standing

25
benefits of institutionalised childbirth (5)
standardisation of care, access to good facilities to support childbirth, availability of populations for childbearing women for healthcare training, faster access to emergency care, access of effective obstetric anaesthesia
26
risks of insitutionalised childbirth (5)
medicaisation, depersonalisation of birth, lack of privacy, inflexibility in labour and birth practices, limitation of resources
27
role of doctors in welfare
must consider safety and welfare of children and young people, regardless of if you routinely see them as patients. identifying signs of abuse or neglect early and taking action quicly. knowing what to do if you are concerned that a child is at risk or or suffering abuse or neglect. act on any concerns
28
indications of a successful breastfeed - baby
audibile and visible swallowing, sustained rhythmic suck, relaxed arms and head, moist mouth, regular soaked nappies
29
indications of a successful breastfeed - mother
breast softening, no compression of nipples at end of fees, relaxed/sleepy
30
problems that may occur with breastfeeding (6)
nipple pain, engorgement, mastitis, inverted nipple, ankylossia, sleepy baby
31
'quality' in relation to health care
the extent to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge
32
why is there a heavy emphasis on quality management in healthcare
quality management produces improved quality, reduced costs, increased productivity, increased market share
33
three deficiencies in medical practice internationally which make consumer protection necessary
medicine has weak evidence base, large variations in clinical practice, failure to measure success outcomes in healthcare
34
data available to improve patient safety
hospital episode statistics, patient reported outcome measurements, reference cost data
35
summary hospital level mortality indicator
ratio between actual number of patients who die within 30 days of discharge, compared with the number that would be expected to die on the basis of average
36
3 key consumer protection agencies
Care quality commission (CQC), NHS improvement (formerly monitor), National institute for health and clinical excellenece (NICE)
37
role of CQC in consumer protection
regualtes 'quality' and financial performance of all health and social care providers, public and private, provides regulatory framework, licenses all providers of health and social care
38
NHS improvement role in consumer protection
ensures financial obligations are met in terms of balancing income and expenditure
39
NICE role in consumer protection
set standards for treatment
40
Who enforced NICE guidlines?
royal colleges, GMC, professional audit
41
how can consumer protection be improved (5)
appraisal by peers, revalidation by GMC, compulsory medical audits, GP/consultant contracts transparency and accountability
42
clinical governance
framework through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care.