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M&S 2 > Maternal and Child Health > Flashcards

Maternal and Child Health Flashcards

1
Q

What is Maternal, Newborn, and Child Health? (MNCH)

A

refers to integrated continuum of care that delivers basic services to mothers, infants and children at critical points (within first 5 years of life) with the goal of ensuring health and survival

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2
Q

What are the indicators of MNCH?

A

Maternal Mortality Rate
Infant Mortality Rate
Neonatal Mortality
Under Five Mortality Rate

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3
Q

What are the 5 things included in MNCH?

A
  1. Improved Prenatal care
  2. Skilled practitioners during birth
  3. Access to emergency obstetrics and newborn care
  4. Postnatal visits
  5. Adequate nutrition and education
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4
Q

7.6 million children under the age of _____ die each year world wide?

A

five

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5
Q

Over _____ of all child deaths are die to malnutrition.

A

1/3

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6
Q

More than _______ neonates die every year in their first month of life, _____ occur in the first week of life.

A

3 million

75%

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7
Q

What is the maternal mortality rate in the industrialized world compared with the developing countries?

A

Industrialized: 1 in 8,000

Developing: 1 in 76

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8
Q

What is the definition of maternal death?

A

The death of a woman while pregnant or nothing 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

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9
Q

From 1987 to 2011 did pregnancy-related mortality rate increase or decrease.

A

Increased from 7.2/100,000 (1987) to 17.8/100,000 (2009/2011)

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10
Q

What are the common causes of maternal mortality?

A

Severe bleeding (hemorrhage)
infections
Eclampsia
Unsafe abortion

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11
Q

Compare the maternal mortality rate between black and white women.

A

White: 12.5
Black: 42.8
(per 100,000 live births)

Women of other races = 17.3

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12
Q

What is the infant mortality rate?

A

The death of a child less than one year of age per 1000 live births

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13
Q

What is the gestation age-specific infant mortality rate?

A

Number of infant deaths for a specific gestational age group (for example, 24-27 weeks of gestation), divided by the number of live births for the same gestational age group x 1,000.

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14
Q

What is Preterm birth?

A

Birth before 37 completed weeks of gestation

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15
Q

What is early neonatal death?

A

Death of a live born infant under age 7 days

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16
Q

What is early neonatal mortality rate?

A

Number of infant deaths under age 7 day per 1,000 live births

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17
Q

Between 2006 and 2012, total, early, and late fetal mortality rates were generally flat in the US.

A

Just know this

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18
Q

What is childhood mortality rate?

A

Defined as the death of a child before the child’s 5th birthday

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19
Q

Infant, Neonatal, and postneonatal mortality decreased from 1940 to 2000. Infant mortality is the higher and post neonatal is the lowest.

A

just know this

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20
Q

What is reproductive health?

A

Consist of methods and techniques and services that contribute to reproductive health and well being.

important for maternal health

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21
Q

What are the services that are involved in reproductive health?

A

Comprehensive family planning for men and women
Pre and post abortion care for complications
Management of reproductive health related problems of adolescents
Prevention and management of sexually transmitted infections (STIs)
Prevention and management of HIV/AIDS
Management of Infertility

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22
Q

What are oral contraceptives

A 
Usually Estrogen/Progesterone 
Taken Daily (35 and older use low progesterone)
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23
Q

What are the side effects, safe comorbidities, advantage, and contraindications of oral contraceptives

A

Side Effects
Nausea, HA, Increase BP, Breast Tenderness, Bloating, weight gain

Safe Comorbidities
Depression, Endometrial Ca, Endometriosis, HA w/o Aura, HIV/AIDS, Seizures, Thyroid Disorder

Advantages
Dysmenorrhea, menorrhagia, irregular menses, Acne , Hirsutism or polycyctic ovarian syndrome

Contraindication
Cautious >35 smoking, VTE, Stroke, MI, HTN, DM complicated, Current Breast Ca, Migraines with aura, Cirrhosis, active hepatitis

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24
Q

What is NuvaRing?

A

A flexible ring that is placed vaginally for 3 weeks, must be places at least 7 days in a row

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25
Q

What are the Side effects, safe comorbidities, Advantages, and Contraindication for NuvaRing?

A

Side Effects
Vaginal discomfort, increased vaginal discharge

Safe Comorbidities
Depression, Endometrial Ca, Endometriosis, HA w/o Aura, HIV/AIDS, Seizures, Thyroid Disorder

Advantages
Obese, compliance

Contraindication
Cautious >35 smoking, VTE, Stroke, MI, HTN, DM complicated, Current Breast Ca, Migraines with aura, Cirrhosis, active hepatitis

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26
Q

What is one important thing that one must know when using a Transdermal patch?

A

DO NOT PLACE ON BREAST

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27
Q

What are the Side effects, safe comorbidities, Advantages, and Contraindication for the Transdermal patch?

A

Side Effects
Breast discomfort, skin irritation

Safe Comorbidities
Depression, Endometrial Ca, Endometriosis, HA w/o Aura, HIV/AIDS, Seizures, Thyroid Disorder

Advantages
Dysmenorrhea, menorrhagia, irregular menses, Acne , Hirsutism or polycyctic ovarian syndrome

Contraindication
Cautious >35 smoking, VTE, Stroke, MI, HTN, DM complicated, Current Breast Ca, Migraines with aura, Cirrhosis, active hepatitis

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28
Q

How often is the Depo Provera administered?

A

Administered every (q) 3 months

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29
Q

What are the Side effects, safe comorbidities, Advantages, and Contraindication for Depo Provera?

A

Side Effects
Weight gain, decrease bone mineral density

Safe Comorbidities
Seizures, STD, Smoking, Thyroid Disorder, Uterine Fibroids, valvular heart disease, superficial thrombophlebitis , HTN, HA w/aura, DM, Endometriosis, PID, Ovarian Ca, Ovarian cyst

Advantages:
Unable to take estrogen, compliance, dysmenorrhea

Contraindications
Current Breast Ca, Cautious with liver disease, current DVT, Rheumatoid Arthritis

30
Q

How long does the Implant/Nexplanon last?

A

Last up to 3 year. Placed in arm during a minor office procedure

31
Q

What are the Side effects, safe comorbidities, Advantages, and Contraindication for Implanon/Nexplanon?

A

Side Effects
Irregular bleeding or spotting

Safe Comorbidities
Seizures, STD, Smoking, Thyroid Disorder, Uterine Fibroids, valvular heart disease, superficial thrombophlebitis , HTN, HA w/aura, DM, Endometriosis, PID, Ovarian ca, ovarian cyst, Rheumatoid Arthritis, SLE

Advantages
Compliance, long term affect

Contraindications
Current Breast ca, Cautious with liver disease, current DVT

32
Q

What are the two type of IUD?

A

Paraguard- 10 yr copper

Mirena- 5 year Progesterone

33
Q

What are the Safe comorbidities, side effects, and contraindications for Paraguard?

A

Stroke, Breast CA current and h/o, DM, HTN, HA, MI, Liver disease, Smoking, Thyroid disorder, valvular heart disease, varicose veins, current DVT h/o DVT

Side Effect: Heavy periods

Contraindications: Ovarian Ca, Uterine fibroids with distortion of cavity, Cervical Ca awaiting treatment

34
Q

What are the Safe comorbidities, side effects, and contraindications for Mirena?

A

DM, HTN, valvular disease, Thyroid Smoking, ovarian cyst

Side Effect: Spotting

Contraindications: Ovarian Ca, Uterine fibroids with distortion of cavity, Cervical Ca awaiting treatment

35
Q

What is involved in Natural planing/Rhythm method?

A

Abstinence or barrier method on most fertile days

Must keep track of menstrual cycle so can predict “fertile days” {5 days before and 3 days after ovulation}

Involves checking cervical mucus and daily body temperature

36
Q

What are the most effective contraceptives?

A

Implant, Intrauterine Device (IUD), or Sterilization

37
Q

What are the least effective contraceptives?

A

Spermicide and fertility-awareness base methods

38
Q

What is a key components of MNCH?

A

ensuring that all women receive prenatal care to be safe and healthy throughout pregnancy and childbirth

39
Q

What is prenatal care?

A

Preventive care with the goal of providing regular check up that allow physicians/midwives to that and prevent potential health problems throughout the course of the pregnancy while promoting healthy lifestyles that benefit mother and child

40
Q

Between you 16th and 30th week of pregnancy how often should you be visiting a physician?

A

Every 4 weeks

41
Q

When do you begin visiting the physician every 2 weeks?

A

From week 30 to birth

42
Q

When is the postpartum visit?

A

at 6 weeks

43
Q

What are essential topics that should be discussed during pregnancy?

A 
Vitamin Supplementation 
Safety/IPV 
Nutrition 
Dental Care 
Substance Abuse
44
Q

Inadequate prenatal care is associated with?

A

Neonatal mortality

45
Q

What are the common problems in normal pregnancy?

A 
Vomitting 
Heartburn 
constipation 
hemmorhoids 
varicose veins 
vaginal discharge
46
Q

When a women is pregnant what is she at risk for?

A

Pregnancy induced HTN

Gestational Diabetes Mellitus

47
Q

What percent of maternal deaths occur after delivery?

A

50%

This is why the mothers condition should be assessed after delivery for general condition and postpartum complications
Also a crucial time to assess newborn

48
Q

What are essential topics that should be discussed postpartum?

A

Anemia
Nutrition
Depression

49
Q

Which organizations recommend exclusive breast feeding for the first 6 moths of life?

A

AAP, AAFP, and WHO

Should begin within 1 hour of birth. And should be fully established before discharge from the hospital.

50
Q

What are ways to promote breast feeding?

A

Rooming Mother and Baby together

Making Lactation Consultations Available

51
Q

What is the optimal source of nutrition for a newborn?

A

Breastfeeding

52
Q

What 4 things have an impact on breastfeeding?

A

Activities
Attitudes
Procedures during the delivery
Postpartum Period

53
Q

When should a newborn screening be completed?

A

On the 48-72 hour of life but it can be done after 34 hours of life.

It aims to identify any infants who are affected by certain genetic/metabolic/infectious conditions.

54
Q

What conditions are screened during a newborn screening?

A
  • Phenylketonuria
  • Congenital hypothyroidism
  • Galactosemia
  • Glucose 6 phosphate dehydrogenase deficiency (G6PD)
  • Congenital Adrenal Hyperplasia (CAH)
55
Q

Hearing and Vision are typically checked when?

A

At the newborn screening

56
Q

What is the purpose of family planning counseling?

A

To inform patients on the various methods of contraception and family planning

57
Q

What are the key factors that are involved in Newborn care?

A
  • History from parents
  • Parental guidance: sleeping, feeding, behavior, safety, health, parenting
  • Growth and Development (milestones)
  • Physical exam
  • Other health screenings (vision, fluoride,
    lead)
  • Immunizations
58
Q

What issues do you expect to see during the 2-4th week of life? What safety issues must be discussed?

A

Issues:
Sleep (position), feeding, crying, response, growth
Safety:
car seats, exposure to smoking, shaking baby

59
Q

What issues do you expect to see during the 2nd month of life? What safety issues must be discussed?

A

Issues:
sleep (position), feeding, growth
Safety:
burns, sun exposure, smoking, car seats, shaking baby

60
Q

What issues do you expect to see during the 4th month of life? What safety issues must be discussed?

A

Issues:
introducing food, sleep, talking to baby
Safety:
falling, car seats

61
Q

Key Development points

A 
1 mo:
Looks at face
Responds to voice
Moves extremities equally
Lifts head
2 mo:
Vocalizes
Smiles
Follows to midline
Responds to sounds
62
Q

4 mo Milestones

A 
4 mo:
Holds head at 90º
Laughs
Follows past midline
No persistent fist clenching*
63
Q

6 mo milestone

A 
6 mo
No head lag
Bears weight on legs
Rolls over
Turns toward voice
Transfers hand to hand
64
Q

9 mo milestone

A 
9 mo:
Sits without support
Stands holding on
Cruises
Imitates speech
Thumb finger grasp
Dada, Mama
Peek a boo
65
Q

1 yr milestone

A 
1 yr:
Stands alone
Walks with help
Specific Dada Mama
Responds to “no”
Pincer grasp
Waves “bye-bye”
Bangs 2 blocks together
66
Q

18 mo milestone

A 
18 mo
Walks backward
2 body parts
Drinks from cup
Imitates household chores
Uses 20 words
Scribbles
Stacks 2 blocks
Understands simple commands
67
Q

2 yr milestone

A 
2 yr
Kicks ball
Takes off clothes
2 words together
Knows 50 words
Understands 2-part command
Uses own name
Stacks 4 blocks
6 body parts
68
Q

3 yr milestone

A 
3 yr
Washes hands
Draws vertical line
Understands “tired, hungry”
Throws ball
Pedal tricycle
Asks “Why?”
69
Q

4 yr Milestone

A 
4 yr
Dresses self
Plays games (tag)
Says what to do when tired, hungry, cold
First and last name
Up and down stairs alternating feet
Balances each foot 2 sec
Draws a circle
70
Q

Parental Guidance

A 
6 mo
Issues:	
food
Safety:	
child-proofing house, poisons, walkers, car seats
9 mo
Issues: 
table food, using cup, teeth
Safety:	
drowning, burns, car seats
12 mo
Issues:	
weaning, brushing teeth, lead screening, playing with baby
Safety:	
child-proofing house, choking, car seats
71
Q

Vision

A

Visual acuity should be checked yearly at age 3 (SOR: C)
Refer for:
- Visual acuity < 20/50 age 3, < 20/30 age 5
Asymmetry at any age
- Strabismus > 3-6 mo
- Any abnormal red reflex
- Amblyopia due to strabismus is the leading cause of monocular vision loss in children

72
Q

Dental

A

Tooth eruption:
12 mo: 4 teeth
(then one tooth a month until 20 teeth at 28 months)
Teething:
Does not cause fever, diarrhea, or other infections
Treat with acetaminophen, teething ring

M&S 2 (15 decks)

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