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Community Health Nursing II > CHN across the lifespan > Flashcards

CHN across the lifespan Flashcards

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1
Q

Who are the clients of a CHN?

A

individuals, families, and communities

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2
Q

What ensures retained excellent care throughout a changing healthcare delivery system?

A

continuity & collaborative care

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3
Q

community-based programs that aim to improve people’s well-being and self-actualization by helping them engage in actions that help them reach their full health potential

A

health promotion programs

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4
Q

most vulnerable members of the community

A

mothers and children

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5
Q

important markers of country’s present health status

A

health of mothers and children

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6
Q

According to 2003 FHSIS report, what are the leading causes of maternal and infant mortality?

A

> maternal mortality = difficulties connected to pregnancy

> infant mortality - other perinatal disorders & pneumonia

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7
Q

DOH program that aims to reduce perinatal, infant, and young child (0-4) morbidity and mortality by sustaining optimal maternal health and ensuring physical, emotional, and cognitive well-being of the child

A

Maternal and young Child Health (MCH program)

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8
Q

DOH program that aspires to create a vision of healthy, empowered Filipino moms who are capable of making their own decisions and contributing to our country’s socioeconomic progress by increasing mother’s well-being through a holistic strategy (preventive, promotive, curative, and rehabilitative care)

A

Safe Motherhood Initiative program

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9
Q

women capable of becoming mothers (fertile age)

A

15-49

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10
Q

essential healthcare services for mother & child

A

antenatal care & emergency obstetric care

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11
Q

normal prenatal check ups include

A

> an antenatal visit during 1st, 2nd, & 3rd trimester

> visit every 2 weeks after 8th month of pregnancy

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12
Q

care required for high-risk pregnancies and difficulties during delivery and postpartum

A

emergency obstetric care

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13
Q

instrument utilized to improve prenatal, natal, and postnatal care for women, as well as family planning; analyzes health of the at-risk woman

A

Home-Based Mother’s Record (HBMR)

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14
Q

most important physiologic changes during pregnancy with nutritional implications

A
  1. increased BMR
  2. tendency to retain water
  3. decreased gastric acidity and intestinal motility (early trimesters = digestion & absorption impairment; last trimester = constipation)
  4. production of simple glycosuria
  5. hormonal changes
  6. positive nitrogen balance
  7. increase in plasma volume & corr. decrease in hemoglobin concentration
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15
Q

pregnant mother’s food intake should account for

A
  1. increased BMR
  2. increasing fetus’ nutritional needs
  3. dev’t of reproductive tissues
  4. nutrition reserves to compensate for losses following delivery
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16
Q

normal weight gain during pregnancy & distribution of weight

A

normal weight gain = 20-25 lbs
> 7 - 7 1/2 lbs - infant at birth
> 3 - 3 1/2 lbs - uterus, placenta, and membrane
> 2 lb - amniotic fluids
> 1 - 1 1/2 lbs - mammary glands & tissues
> remaining lbs - increased blood vol & maternal fluids

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17
Q

to avoid constipation

A

increase fiber & water intake

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18
Q

closely managed during pregnancy to keep weight growth under control

A

caloric intake

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19
Q

supplementation for strict vegans or as prescribed

A

iron, zinc, folate, & b12

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20
Q

limited to 2 cups

A

regular coffee

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21
Q

can cause fetal alcohol syndrome and should be avoided

A

alcohol

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22
Q

dietary guidelines for women in first trimester experiencing nausea and vomiting

A 
> dry crackers before rising
> small frequent meals
> liquids between meals
> hard candies for relief
> no oily or fried food
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23
Q

iron supplementation

A

> 1 tablet/day for at least 180 days (6 mos)

> 2 tablets/day if starting at 2nd-3rd trimester

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24
Q

folic acid supplementation

A

800 mg

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25
Q

vitamin a supplementation

A

> 1 tablet/capsule of 10000 IU twice a week from 4th month to birth
not for mothers taking prenatal vitamins w/ vitamin a or micronutrient tablets

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26
Q

iodine supplementation for mothers in goiter-prone locations

A

1 iodized oil capsul containing 206 mg iodine once a year

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27
Q

supplementation for mothers in malaria-prone areas

A

150 mg Choroquinone twice a week throughout the course of pregnancy

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28
Q

significant nutrient-related risk factors for pregnant teens

A

> low pregnancy weight gain
low or excessive pre-pregnancy weight for height
low gynecological age (age of conception - age of menarche)
unhealthy lifestyle
history of eating disorders
presence of anemia, toxemia, & other chronic diseases

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29
Q

caloric intake of pregnant teen

A

must account for anabolic demands of pregnancy & fetus and developmental demands as a growing teen; surpasses caloric needs of mature adult pregnancy

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30
Q

normal weight gain of pregnant teen

A

14-15 kg or 30 lbs at a pace of 500 g/week

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31
Q

How to prevent Tetanus neonatorum?

A
  1. tetanus toxoid vaccination

2. proper/good hygiene

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32
Q

TT1 dose timing & period of protection

A

as early as possible during 1st pregnancy

none

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33
Q

TT2 dose timing & period of protection

A

4 weeks after TT1 during the same pregnancy

3 years

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34
Q

TT3 dose timing & period of protection

A

6 months after TT2 or during subsequent pregnancy

5 years

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35
Q

TT4 dose timing & period of protection

A

1 year after TT3 or during subsequent pregnancy

10 years

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36
Q

TT5 dose timing & period of protection

A

1 year after TT4 or during subsequent pregnancy

All child-bearing years

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37
Q

Maximum TT doses during a lifetime

A

5 doses

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38
Q

months of immunity conveyed to newborn by immunized mother

A

5 months

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39
Q

dental care of pregnant woman

A

> regular brushing of teeth with fluoride toothpaste and dental flossing
dental visit for treatment at 2nd trimester
invasive procedures postponed until after baby is born

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40
Q

When is the puerperium stage, the most critical stage for the mother because of unstable vital signs?

A

1-2 hours after delivery

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41
Q

Puerperium nursing responsibilities

A

PFV BBN RIPP BFE

  1. Perineal care
  2. feel the Fundus
  3. Vital signs (BP, PR, RR)
  4. observe flow of Blood from vagina during uterine massage.
  5. keep Bladder empty.
  6. offer Nourishing liquids or foods as tolerated.
  7. encourage Rest and sleep.
  8. prevent Infection by hand washing technique
  9. encourage mother to practice Personal hygiene
  10. teach mother to wash Perineum with concoction of herbs (e.g. bayabas)
  11. discuss the importance of Breastfeeding, care of the newborn and immunization
  12. motivate to practice Family planning
  13. issue an ECCD card for the mother to fill-out
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42
Q

frequency of checking the fundus

A

every 15 minutes for 1 hour

then every 30 minutes for the next hours

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43
Q

for the first 12 hrs after birth the fundus should be

A

firm, at the midline, and above the umbilicus

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44
Q

NI if uterus is not contracted

A

massage to prevent bleeding

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45
Q

NI if bleeding is present

A

place mother in trendelenburg position

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46
Q

BP and PR may be slightly above normal due to labor, but will normalize in how many hours?

A

1 hour

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47
Q

the 30-50% increase in fetal cardiac volume during pregnancy will be reabsorbed in how long?

A

5 minutes after delivery

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48
Q

How much bleeding is normal postpartum?

A

moderate amount; pad completely saturated by 30 minutes

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49
Q

signs of full bladder postpartum

A

fundus at right mid-line, clots expressed, & dark-red bleeding

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50
Q

a record of important services that a child should get from birth to 6 years

A

early child care development (ECCD) card

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51
Q

originally yellow, now printed as white; a chart for monitoring appropriate weight for child as he/she ages

A

growth monitoring chart

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52
Q

BUBBLESHE stands for

A 
> Breast
> Uterus
> Bowel
> Bladder
> Lochia
> Episiotomy
> Skin
> Homan's sign
> Emotional status
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53
Q

what is the homan’s sign

A

thrombophlebitis, edema, or tenderness of legs

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54
Q

progression of uterus down its original location

A

1 fingerbreadth below the umbilicus each day

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55
Q

How can the mother prioritize her health during postpartum?

A

eating well (for her own nutritional needs and for milk production) & returning to normal physical activities as soon as she is able

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56
Q

Immediate Newborn Care

A

SACS CCV KKI

  1. Suctioning to clear the airways.
  2. APGAR scoring 1 minute and 5 minutes after birth
  3. Crede’s prophylaxis or eye treatment
  4. Skin care
  5. Cord dressing
  6. Complete physical assessment
  7. Vital Signs
  8. Keep warm & dry
  9. vitamin K injection
  10. proper Identification
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57
Q

what is checked during 1 minute APGAR score

A

cardio-respiratory and nervous system functioning

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58
Q

what is checked during 5 minute APGAR score

A

newborn’s adjustment to new environment

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59
Q

RATIONALE for crede’s prophylaxis

A

to prevent opthalmia neonatorum or gonorrheal conjuctivitis

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60
Q

medicine used in crede’s prophylaxis

A

Terramycin opthalmic ointment placed 1 cm from innter to outer canthus of the NB’s eyes

61
Q

RATIONALE for strict asepsis during cord dressing

A

avoid tetanus neonatorum

62
Q

What are checked and monitored during cord dressing?

A

> completeness of vessels (1 vein, 2 arteries)
presence of omphalocele or umbilical hernia
presence of omphalangia (for 24 hrs)

63
Q

what is omphalocele

A

congenital protrusion of abdominal viscera into weakened portion of the navel

64
Q

what is omphalangia

A

bleeding of cord

65
Q

normal weight at birth

A

3-3.4 kg

66
Q

weight doubles at ____ and triples at ____

A

6 months; 1 year

67
Q

average height at birth

A

50 cm

68
Q

normal head circumference at birth

A

23-35 cm

69
Q

normal abdomen and chest circumference at birth

A

31-33 cm

70
Q

best route for checking newborn’s temp

A

axilla

71
Q

risks of checking anal temp

A

> mucosal perforation & peritonitis
tissue injury
inaccurate results

72
Q

What is vitamin K for?

A

promote blood clotting

73
Q

best IM site for vitamin K injection

A

vastus lateralis or mid-antero-lateral aspect of thigh

74
Q

best identification for NB

A

footprints

75
Q

identification band should contain

A

mother’s name, date & time of birth, sex

76
Q

simple procedure to check for congenital metabolic disorders that can cause mental retardation or death if untreated

A

Newborn Screening (NBS)

77
Q

method used in NBS

A

heel-prick method

78
Q

When is NBS done?

A

at least 24 hrs after birth until 72 hours (1-3 days); repeated again after 2 weeks

79
Q

what should be avoided while expressing breastmilk?

A

pinching (instead press towards chest wall)

80
Q

washing containers for breastmilk should be done with ____ and rinsing should be done with ____

A

hot soapy water; hot clear water

81
Q

how to warm stored breastmilk?

A

place in bowl with hot water

82
Q

what to do when fat globules separate from milk

A

shake to recombine fat with the rest of the liquid

83
Q

breastfeeding positions

A

> cradle hold
side-lying position
football hold

84
Q

how should a mother’s hand be positioned when holding her breast?

A

C-hold/C-position

85
Q

how often should a nursing newborn be burped?

A

after each breast and at the end of each feeding

86
Q

are both breasts used during feedings? how?

A

yes. first breast for 10 minutes, then transfer to the other breast for 6 minutes. at the next feeding, start with the breast you ended the last feeding with.

87
Q

how often should a newborn be nursed?

A

shortly after birth, every 2-3 hrs

88
Q

what do sore nipples and prolonged feedings indicate?

A

baby not latching on breast properly

89
Q

which is normal during first week of breastfeeding, soreness or tenderness?

A

tenderness

90
Q

until when should an infant be breastfed?

A

2 years old

91
Q

how much milk does a nursing woman produce each day on average?

A

750-1000 mL

92
Q

nutritional requirements for lactation

A

> 300-400 additional kcal per day
1 glass of liquids at each infant meal time
750-1000 mL additional fluid intake each day
additional protein, vitamins, and minerals (esp calcium)
avoid coffee & alcohol
medications may imply that breastfeeding is contraindicated or newborn will have to be monitored for adverse effects

93
Q

age marked by fastest rate of growth and dev’t; triple weight; increased height by 50%

A

first year of life

94
Q

caloric requirements

A

> 0-6 mos = 108 kcal/kg/day

> 6-12 mos = 98 kcal/kg/day

95
Q

milk should provide how much of the infant’s caloric reqs? and what would provide the remaining calories?

A

2/3; additional carbs & later supplementary meals

96
Q

protein reqs

A

> 0-6 mos = 2.2 g/kg/day

> 6-12 mos = 1.6 g/kg/day

97
Q

Fat provides necessary fatty acids and accounts for at least 1-2% of total caloric demands. Where are they sourced from?

A

human or whole cow’s milk

98
Q

most variable nutrition need due to changes in infant’s activities and ambient temp.

A

fluids

99
Q

where is niacin and choline generated from?

A

tryptophan and methionine, respectively

100
Q

how much fluids needed

A

4.5-5 oz/kg/day

101
Q

which vitamin needs to be supplemented, while the rest is adequately sourced from milk?

A

vitamin a

102
Q

which mineral store is depleted after 3 months and needs to be supplemented?

A

iron

103
Q

What indicates a sufficient nutrition supply?

A 
appropriate weight and height gain
> 5-8 oz weight gain per week -slows to-> 4 oz/week
> doubled weight @ end of 5 months
> tripled weight @ end of 12 months
> +10 inches or 50% of height @ end of 12 months
> firm, well-formed muscles
> moderate subQ fat
> happy disposition
> normal dental and motor dev't
104
Q

until when should NBs be exclusively breastfed?

A

4-6 months

105
Q

when can NBs be introduced supplemental feedings?

A

6 months

106
Q

guidelines for supplemental feedings

A

> introduce one kind of food at a time
always start with small amounts, in a more dilute form and with smooth texture; gradually, texture will be coarser
when baby’s teeth erupts, finely chopped fruits, veggies, meat, toast, and teething crackers are suitable
whole eggs delayed until 10-11 mos

107
Q

short-term measure of DOH to improve children’s nutritional status

A

micronutrient supplementation

108
Q

long-term measure of DOH to improve children’s nutritional status

A

> Araw ng Sangkap Pinoy Food Fortification
Sangkap Pinoy Seal Program
Garantisadong Pambata program

109
Q

set of tools for promoting and maintaining excellent health and growth in children under the age of five

A

Growth Monitoring and Promotion

110
Q

begins in the mother’s womb and continues throughout life; achievement & maintenance of excellent health status

A

Growth Promotion

111
Q

nutritional check-up done on a regular basis

A

Growth Monitoring

112
Q

weighing children under 12 months should be done how frequently?

A

once a month

113
Q

weighing children from 1-5 years old should be done how frequently?

A

every three months

114
Q

where will the growth measurements be recorded?

A

growth monitoring chart of ECCD

115
Q

the process of identifying clinical characteristics linked to malnutrition in order to identify people who are at risk and arrange suitable nutrition therapy

A

nutritional screening

116
Q

nutritional anthropometric measurement indicators

A
  1. weight for age
  2. Waterlow classification of malnutrition (height for age & weight for height)
  3. Mid-upper arm circumference (MUA)
117
Q

A child’s actual weight is compared with an ideal weight for his age.

A

weight for age

118
Q

76-90% below ideal weight for age

A

1st degree or mildly underweight

119
Q

61-75% below ideal weight for age

A

2nd degree or moderately underweight

120
Q

below 60%

A

3rd degree or severely underweight

121
Q

child’s weight falls below ideal for age

A

underweight

122
Q

What measurements fall under Waterlow classification of malnutrition?

A

> height for age

> weight for height

123
Q

A child’s actual height is compared with an ideal height for his age

A

height for age

124
Q

child’s height falls below ideal for age

A

stunted

125
Q

what does a stunted child indicate

A

chronic malnutrition or malnutrition that has not been corrected and has been occurring for a long time

126
Q

A child’s weight is compared with an ideal weight for his height

A

weight for height

127
Q

child’s weight falls below ideal for height

A

wasted

128
Q

what does a wasted child indicate

A

current or recent malnutrition

129
Q

if child’s MUA falls below ideal

A

undernourished

130
Q

pediatric immunizable diseases

A 
> hepatitis B
> pertussis / whooping cough
> tetanus
> diphtheria
> measles
PH TMD
131
Q

before his/her first birthday, a completely immunized infant has had…

A 
> 1 dose of BCG (for TB)
> 3 doses of Hep B
> DPT (Diphtheria, Pertussis, Tetanus)
> OPV (Oral Polio Vaccine)
> 1 dose AMV (Anti-Measles Vaccine
(ABB DO)
      3
132
Q

vaccines included in expanded program in immunization (EPI)

A 
> BCG birth dose
> Hepatitis B birth dose
> Oral Poliovirus Vaccine
> Pentavalent Vaccine
> Measles Containing Vaccines (Antimeasles Vaccine, Measles, Mumps, Rubella) 
> Tetanus Toxoid
> Pneumococcal Conjugate Vaccine 13
133
Q

it is safe and immunologically effective to administer all EPI vaccines ________

A

on the same day at different sites

134
Q

When is the measles vaccine administered? Should it be postponed if another vaccine is scheduled at the same date?

A

as soon as the child is 9 months old; no

135
Q

Should the vaccine schedule be restarted if the interval between doses exceeded the recommended interval by months or years?

A

no

136
Q

If the child is sick, can they still be vaccinated?

A

Moderate fever, malnutrition, mild respiratory infection, cough, diarrhea, and vomiting are not contraindications to vaccination.

Generally, one should be immunized unless the child is so sick that he needs to be hospitalized. Then the hospital needs to decide on when to immunize the child.

137
Q

contraindications to immunizations

A

> BCG vaccine on child with AIDS

> DPT2 or DPT3 on child who had convulsions or shock within 3 days of previous dose

138
Q

When do you need to repeat a BCG vaccination?

A

no scar formed after 1st injection

139
Q

monitor the developmental tasks of newborns, children, and adolescents through screening instruments, a comprehensive history, physical evaluation, and/or directed observation

A

developmental screening

140
Q

tool used to assess the overall developmental status of children aged birth to six years; formerly known as the Denver Developmental Screening Tool

A

DENVER II

141
Q

What are included in DENVER II?

A

Personal-social, fine, motor-adaptive activities; language; and gross motor abilities

142
Q

primary cause of mortality in children over the age of 1

A

accidental injuries

143
Q

protecting children includes

A

> promoting health
providing safe surroundings
providing medical care access
protecting from child abuse and violence

144
Q

nutritional assessment tool used in the case management of sick children who come to the health center for help.

A

Integrated Management of Childhood Illnesses (IMCI) chart

145
Q

six childhood ailments created in the IMCI

A 
> malnutrition
> malaria
> measles
> pneumonia
> diarrhea 
> dengue hemorrhagic fever
3MP2D
146
Q

antiseptic dye used to treat infections on infant

A

gentian violet

147
Q

fast breathing in infant less than 2 mos

A

60 brpm or

148
Q

fast breathing in 2- 12 mos

A

50 brpm or

149
Q

fast breathing in 12 mos-5 yrs

A

40 brpm or

Community Health Nursing II (1 decks)

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