Final exam Flashcards
What are the 4 curable infections
What are 4 viral uncurable infections
Curable: syphilis, gonorrhea, chlamydia, trich
Uncurable: hepatitis B, herpes, HIV, HPV
Infections characterized by vaginal discharge
Vulvovaginal candidiasis
Trich
BV
Infections characterized by cervicitis
Chlamydia
Gonorrhea
Infections characterized by genital ulcers
Herpes
Syphilis
Vaccine preventable STIs
Hep A and B
Vaginitis
generic term that means inflammation and infection of vagina
P-LI-SS-IT model
P - permission
Ll - limited information - information given to women about STI
SS- specific suggestions - attempt to change behavior
IT - intensive therpay -
Risk factors for vaginal candidiasis
Preg
Oral contrceptives
DM
Use of broad spect antibiotics
obesity
steorid and immunosuppress
HIV
tight clothes
douching / trauma to vag mucosa
How to diagnosis VC
Wet smear which reveals filamentous hyphae and spores characteristic of a fungus when viewed under microscope
Where can the trich organism live
wet damp surfaces, poorly cleaned hot tubs and drains
Symptoms of Trich
Women
Men
Women - Vulvar itching, malodorus foamy discharge
Men - asymptomatic carrier
What are risks with Trich in a pregnant person
Preterm, postpartum endometritis
How is trich viewed under microscope
Ovoid, single cell protozoan parasite making a jerky swaying motion
What are tests for trich
-OSOM trich rapid test
-Immunochromatocgraphic capillary flow dipstick technology
-Nucleic acid probe test
WHat are the risks for having BV during preg
preterm, pROM, chorioamnionitis, postpartum endometritis and PID
Cervicitis
Catchall term that implies presence of inflammation or infection of cervix
Used to describe everything from symptomless erosions to inflammed cervix that bleeds and produces discharge
What is the most commonly reported bacterial STI in US
CHlamydia
MOst common risk factors assoc with chlamydia
Age less than 25, change in sexual partner or multiple partners, poor socioeconomic condition, prostitution, nonwhite race, single status, lack of condom
People with chlamydia usually get
Men?
Women?
Med - irethritis
WOmen - cervicitis, acute urethral syndrome, salpingitis, ectopic preg, PID, infertility
What is the bacterium that causes chlamydia
intracellular parasite that cannot produce its own energy and depends on host for survival.
Newborns delivered to mothers with chlamydia can get
Ophthalmia neonaturm
Treatment for chlamydia
Doxycycline 100mg PO 2x a day for 7 day s
OR
Azithromycin 1g PO single dose
Ceftrazone with doxy or azitr is prescribed
Risk factors for chlamydia
Adolescent
Multiple sex partner
new partner
without condoms
oral contraceptives
being preg
history of sti
Symptoms of chlamydia
Mucopurulent vag discharge
Urethritis
bartholinitis
endometritis
salpingiti
dysfunction uterine bleeding
What is 2nd most commonly reported infection in uS
Gonorrhea
What is gonorrhea under microscope
aerobic gram negative intracellura diplococcus that infects mucosal surfaces. The site of infection is columnar epitehlium of endocervix
What is the risk in pregnancy for a person with gonorrhea
Chorioamnionitis, preterm, PROM, postpartum endometritis
When a newborn comes in contact with gonorrhea what can they get
Ophthalmia neonatorum
Can lead to blindness, joint infection or life threatening blood infection
Preg women with gonorrhea should not be treated with
Quinolones or tetrcyclines
Symptoms of gonorrhea
ABnormal vag discharge
dysuria
cervicitis
enlarged lymph
abnormal vag bleeding
bartholin abscess
PID
Neonatal conjunctivitis
Mild sore throat
rectal infection
perihepatitis
What happens if gonorrhea goes untreated
Can enter bloodstream and produce disseminated gonococcal infection.
Severe form can invade joints, heart, brain and liver
Symptoms of a primary infection with HSV
painful vesicular lesions, mucopurulent discharge, superinfection with candida, fever chills, malaise, dysuria, headache genital irritation, inguinal tenderness and lymphadenopathy
Symptoms of recurrent infection with HSV
Tingling, itching pain, unilateral genital lesions, more rapid resolution than primary
What is syphilis under microscope
Spirochete that rapidly penetrates mucous membrane and within hours enters lymphatic system and blood stream to produce systemic infection long before appearance of primary lesions
What are consequences of maternal infection with syphilis
spontaneous abortion, low birth weight, FGR, premature, still birth, multisystem failure, structural bone damage, mental retardation
What are complications of PID
ectopic preg, pelvic abscess, subinfertility, chronic ab pain, depression
Risk factors for PID
young adult
non white
multiple sex partners
early onset of sex
history of PID or STI
alcohol or drug use
partner w/ untreated urethritis
cig smoke
douching
prostitution
Symptoms of PID
Abnormal cervical or vag mucopurulent discharge
temp above 101
elevated erythrocyte sedimentation rate
elevated C-reactive protein level
prolonged menstrual bleed
dysmenorrhea
dysuria
painful sex
nausea
vomit
How to diagnose PID
endometrial biopsy, transvag ultrasound, laparoscopic exam
Hep C
not sexually transmitted / injection drugs
Infects humans only and targets liver cells
Zika
Transmitted by sex, perinatal, and blood transfusion
Assoc with microcephaly, calcifications, motor abnormalities, hearing loss, neurologic impairment, IUGR, still birth
No vaccine
Syphilis stages of infection
Primary
secondary
latency
tertiary
PRIMARY - painless ulcer at site of bacterial entry (disappear w/in 1 -6 wks)
SECONDARY - 2-6mo after exposure, flu like symptoms and maculopapular rash at trunk, palms and soles. Alopecia and adenopathy also fever, pharyngitis, weight loss adn fatique
can last 2 years
LATENCY - absence of symptoms. Can last 20 years
TERTIARY - life threatening heart disease, neurologic disease slowly destorys heart, eyes, brain, CNS and skin
Candidiasis
Maternal effects
Fetal effects
Maternal effects - resistent to treatment, localized itching and discharege
Fetal effect- Thrush
Trich
Maternal effects
Fetal effects
Maternal effects - PROM and preterm
Fetal effects- premature
BV
Maternal effects
Fetal effects
Maternal effects - spontaneous abortion, PROM, chorioamnionitis, postpartum endometritis, preterm
Fetal effects- neonatal sepsis
Chlamydia
Maternal effects
Fetal effects
Maternal effects - postpartum endometritis, PROM, preterm
Fetal effects - neonatal conjunctivitis, pneumonia, low birth weight, PROM and preterm
Gonorrhea
Maternal effects
Fetal effects
Maternal effects - Chorioamnionitis, preterm, PROM, FGR, postpartum sepsis
Fetal effects- Ophthalmia neonatorum can lead to blindness adn sepsis including arthritis and meningitis
Genital herpes
Maternal effects
Fetal effects
Maternal effects - Spontaneous abortion, intrauterine infection, preterm, PROM, FGR
Fetal effects- Birth anomalies, transplacental infection, skin or mouth sores, intellectual disability, premature, low birth weight, blindness, death
Syphilis
Maternal effects
Fetal effects
Maternal effects - Spontanous abortion, preterm, still birth
Fetal effects- fetal or infant death, congenital syphillis leads to multisystem organ failure, structural damage, can lead to blindness, hearing loss and mental retardation
HPV
Maternal effects
Fetal effects
Maternal effects - Dystocia if large lesions
Fetal effects- no known
Hep B
Maternal effects
Fetal effects
Maternal effects- Preterm
Fetal effects- can become chronic carrier which may lead to liver cancer or cirrhosis
HIV
Maternal effects
Fetal effects
Maternal effects - Fatique, nausea, weight loss
Fetal effects - transmission can occur transplacentally, during childbirth or breast milk
In the 1700’s
Who attended births?
How did woman feel about childbirth?
Men did not attend births, female midwives attended births at home
Women felt fear of death
In the 1800’s
Shift from midwives to —
What fever was occuring
C-section
WHat was developed in 1895 to assess pelvic size
MIdwives to doctors
Puerperal (childbed) fever / stretoccoi
Boston 1894 1st c-section
Xray
In the 1900’s
How many women gave birth in hospitals?
What was first performed to assess fetal growth?
50-75% of women gave birth in hosptials
amniocentesis was performed in 1966
In 2000’s
how many women undergo surgical birth?
US ranks — in maternal deaths and – in infant deaths in the world?
1 in 3 women undergo surgical birth
48th in maternal deaths and 55th in infant deaths
CNM Certified nurse midwife
Postgraduate training in the care of normal pregnancy and delivery. Certified by American College of Nurse Midwives
Doula
Nonmedical birth companion who provides continuous emotional, physical, and educational support to the woman and family during childbirth and postpartum period.
Who is the father of peds
Abraham Jacobi 1870
When did these start
Nursing in public schools
Professional course on ped nursing
Nurse practitioner role
Maternal-child standards
1902 - Nursing in public schools
1900 - Professional course on ped nursing
1960 -Nurse practitioner role
1980 -Maternal-child standards
Mortality
Incidence or number of people who have died over a specific period.
rates per 100,000 calculated from a sample of death certificates
Maternal Mortality ratio
the annual number of deaths form any cause related to or aggravated by pregnancy and its managment during pregnancy and childbirth or within 42 days of termination of pregnancy per 100,00 live births for a year
Fetal Mortality rate
spontaneous intrauterine death of fetus at any time prior to bith per 1000 live births
Neonatal mortality rate
number of infant deaths occuring in first 28 days of life per 1000 live births
deaths occuring in 1st month account for 2/3rd
Infant mortality rate
Number of deaths occuring in first 12 months of life
younger than 1 year per 1000 live births
What is the main cause of early infant death in US
prematurity, low birth weight, congenital and choromosomal anomalies, SIDS, RDS, unintentional injuries, bacterial sepsis, Necrotizing enterocolitis
Childhood mortality rate
number of deaths per 100,000 population in children 1-14
Morbidity
measure of prevalence of specific illness in a population at a specific time.
Rates per 1000 population
Clinical manifestions of heart attack in women
nausea, dizziness, irregular heart beat, unusual fatique, sleep disturbance, sweating, indigestion, anxiety, neck, jaw, arm or shoulder pain, SOB, pain or discomfort in 1 or both arms, weakness.
Family structure
people who interact with eachother on a regular recurring basis in socially sanctioned ways
Friedmans structual functional theory
Social system of family
-Love and belonging
-teaching how to function
-Reproductive role
-Economic function
-health care function
Duvall develop theory
Developmental stages
Marriage
Childbearing
Preschool children
school-aged children
adolescents
young adults
middle aged parents
family in later years
Von Bertalanffy: General system theory
to define how families interact with eachother to ensure survival, and growth
Not the sum of its parts but as a whole and unity
Family stess theory
The way family responds to stress and copes
Resiliency model of family stress and family adjustment and adaptation
addresses the ways families adapt to stress and rebound
Nuclear family
husband wife and children living in same household
can include adopted
Binuclear family
Child who is member of two familys who are joint parenting
Communter family
adults living and working apart for professional and financial reasons
Extended family
Nuclear family with grandparents, cousins, aunts etc
Communal family
groups of people living together to raise children and manage household
Genetics
Hereditary
Genetics - study of heredity and its varations
Hereditary- process of transmitting genetic characteristics from parent to offspring
African Americans beliefs that affect childrens health
Strong extended family relationship; Matriarchial
Food symbol of health and wealth
Folk healing and home remedies
Strong church
Asain Americans beliefs that affect childrens health
Strong loyality to family; patriarchal
Members care for eachother
ARAB Americans beliefs that affect childrens health
Women suborinate to men, young subordinate to old
MOdesty and cleanilness
Disease and illness is will of allah
Good health = eating healthy and fasting
Indian Americans beliefs that affect childrens health
Family and tribe
food to celebrate
perfer herbal medicines and healing ceremonies
Hispanic Americans beliefs that affect childrens health
Father source of strength, wisdom, mother is caretaker and decision maker for health
food for celebrations
folk medicine and prayer, herbal tea and poulticies for illness
Religons affecting childrens health
BUDDHISM
Illness from karmic cause
Illness as opportunity to develop the soul
ultimate goal to achive nirvana
Chanting at bedside after death
-No restrictions for medciatons, vaccines, or therapeutic intervention
Organ donation acceptable, cremation common
Religons affecting childrens health
CHRISTAN SCIENCE
Disease viewed as error of human mind / healing through prayer
General opposition to human interventions
Usually do not use blood products, transplants, biopsies or exams
Religons affecting childrens health
HINDU
Illness due to sins commited in previous life
acceptance of most medical care
Meat consumption forbidden
washing body by family after death and certain restrictions on who touches body
Religons affecting childrens health
ISLAM
God cures but will accept treatment
Prayers at dawn, noon, afternoon, sunset and nightfall
Pork and alcohol forbidden
Fasting required at ramadam except preg moms, elderly or ill
Specific burial rituals (washing, wrapping, prayers burial)
Religons affecting childrens health
JUDAISM
Illness for specific reason (violating dietary restrictions)
No treatments/procedures on sabbath
Ingestion of blood prohibited
Kosher diet
Cant eat pork, fowl, no mixing of milk in dishes with meat, no shellfish
Fasting during yom kippur
Washing after death
Religons affecting childrens health
MORMON
Diving health via laying of hands
Herbal folk remedies
Caffeine, alcohol and tobacco prohibited. Fasting 1X a month for 24 hrs a day
Cremation discourages
Religons affecting childrens health
ROMAN CATHOLIC
Eucharist as the food of healing
Fasting and no meat on ash wed and good fri
What is primary prevention
health promotion and diease prevention
preventing before it occurs
*nutrition, hygiene, sanitation, immunizations, genetic counseling,
What is seconadry prevention
early detection and treatment of adverse health conditions
Aimed at halting the disease and getting person back to normal
Preg testing, blood pressure, cholesterol, breast exam, mammogram, pap smears
What is Teriary prevention
reduce or limit the progression of permanent irreversible disease or disability
*minimizing effects of CVD, STIs etc
The nursing process
Assessment
Analysis
Planning and expected outcomes
IMplementation
Evaluation
Epidemiology
Study of causes, distrubtion and control of disease in populations
What is ambulatory care
Doctor offices
HMOs
Day surgery centers
Urgent care
Family planning clinics
Birth centers
Mobile mammogram
What is home health care and services
High risk preg
Maternal/child
Skilled nursing
Hospice care
Health dept services
Family planning clinics
STI infection program
Immunization clinics
Substance abuse programs
Jails/prisions
Long term care
Skilled nursing facilities
Nursing homes
Hospice
assisted living
Other community based settings
Parish nursing homes
Summer camps
CHildbirth ed classes
Scholl health programs
Occupational health programs
