Maternity/Infant Health (Exam One) Flashcards
1
Q
The organization AWHONN focuses on what aspects of nursing?
A
- Neonatal nursing
- Obstetrics nursing
- Women’s health
2
Q
Why is health literacy a problem in the United States?
A
- Many diverse population
- Differences in cultures and beliefs about healthcare
3
Q
A low birth weight baby weighs less than what?
A
Less than 2500 grams
4
Q
Babies of this race are most at risk of having a low birth weight?
A
Non-hispanic black babies
5
Q
When are low birth weight babies most at risk, or most likely, to die?
A
Within the first year of life
6
Q
How can babies being born at a low birth weight be prevented?
A
- Access to prenatal care
- Access to community resources
7
Q
Besides low birth weight, what factors influence infant mortality?
A
- Sudden Infant Death Syndrome (SIDS)
- Maternal medical conditions
- Bacterial sepsis
- Respiratory distress syndrome
8
Q
What amount of women in the United States are obese?
A
One-third of women
9
Q
What are the associated complications of obesity?
A
- Hypertension
- Diabetes
10
Q
Hypertension and diabetes associated with obesity can lead to what other complications?
A
- Infertility
- Congenital anomalies of the infant
- Miscarriage
- Fetal death
11
Q
There has been an _____ in international infant mortality rates
A
Increase
12
Q
What are the top three factors contributing to maternal mortality trends?
A
- Hypertension
- Hemorrhage
- Infection
13
Q
Who can provide prenatal care?
A
- OBGYN
- Certified nurse-midwives
14
Q
What is a lay midwife? In what setting is a lay midwife most common?
A
- Unlicensed or uncertified midwife
- Home birth setting
15
Q
Women are typically ____ during childbearing.
A
Healthy
16
Q
List ways to decrease risk factors that could result in a poor pregnancy outcome.
A
- Nutrition
- No smoking or secondhand smoke exposure
- No alcohol
- Violence prevention
- Support system
17
Q
Why is there no safe limit of alcohol during pregnancy?
A
Everyone metabolizes alcohol differently
18
Q
What question should the nurse ask the patient in private to help promote violence prevention?
A
“Do you feel safe at home?”
19
Q
What are international concerns that also occur in the United States?
A
- Female genital mutilation
- Human trafficking
20
Q
What is female genital mutilation?
A
- All or part of the female genitalia is removed
- Can cause complications during childbirth
21
Q
How many women in the United States have experienced female genital mutilation?
A
Over 500,000
22
Q
Human trafficking victims may experience what?
A
- Hard labor
- Sexual work
- Organ donation
23
Q
What is the leading cause of death in women?
A
Heart disease
24
Q
The risk of violence _____ during pregnancy.
A
Increases
25
What is standard of care?
Level of practice that a reasonably prudent nurse would provide in the same or similar situation
26
A nurse who is unsure how to perform a skill within her scope of practice should do what?
Look at the policy and procedure manual
27
Define risk management.
- System of checks and balances
| - Make sure the nurse is doing everything they can to decrease the risk of injury to a patient
28
What is a sentinel event?
-Unanticipated event that results in the death or serious psychological or physiological harm of a patient
29
What is outcomes oriented practice?
Compares outcomes with clinical practice standards
30
A nurse should recognize that the most significant barrier for access to care is the pregnant woman's what?
Inability to pay
31
Family planning prenatal care continues until the baby is how old?
One year old
32
Who does a nuclear family consists of?
- Husband
- Wife
- Biological or adopted children
33
Are nuclear families increasing or declining in society?
Declining
34
What does an extended (multigenerational) family provide?
Social, emotional, and financial support for one another
35
Who does an extended (multigenerational) family consist of?
- Aunts
- Uncles
- Cousins
- Grandparents
36
Who does a married blended family consist of?
- Husband
- Wife
- Children from prior relationships
37
A single-parent family is considered to be what?
- Non-traditional
| - More socially vulnerable
38
A single-parent family can affect what?
- Health status
- School achievement
- Promote high-risk behaviors
39
What two factors play the most powerful role in the actions of individuals and families?
- Beliefs
| - Values
40
Regarding assessment, the nurse will focus on what with a low-risk family?
Promoting healthy behaviors during pregnancy and delivery
41
Regarding assessment, the nurse will focus on what with a high-risk family?
Focus on additional illnesses (i.e. drug or alcohol abuse)
42
What is subculture?
A culture within a culture
43
What is acculturation
A person retains some of their own culture but adopts practices of the dominant society.
44
What is assimilation?
- Loss of cultural identity
| - Completely becoming a part of the dominant culture
45
What is ethnocentrism?
- When one believes that their beliefs and values are the best
- They are the only right way
46
Women make up what percent of the population?
51%
47
Why might a racial or ethnic minority be considered a vulnerable population?
Language barriers
48
Why might adolescent girls be considered a vulnerable population?
- Lack of societal experience
| - More likely to participate in high-risk behaviors (i.e. unprotected sex)
49
Why might older women be considered a vulnerable population?
More at risk for chronic illnesses
50
Why might incarcerated women be considered a vulnerable population?
- More at risk for communicable diseases (i.e. STD's)
| - More likely to participate in high-risk behaviors
51
Why might women in rural areas be considered a vulnerable population?
Limited access to care
52
Homeless women are considered a vulnerable population because they are more at risk for what?
- Infectious diseases
- Lack of prenatal care
- Anemia
- Substance abuse
- Chronic diseases
53
List examples of primary level prevention.
- Immunizations
- Carseats
- Exercise
- Nutrition
54
List examples of secondary level prevention.
- Target a specific population
- Screenings (i.e. mammograms, pap smears)
- Contraceptives
55
List examples of tertiary level prevention.
Preventing further deterioration (i.e. rehab)
56
The structures of the female reproductive system develop and grow in response to which hormones?
- Estrogen
| - Progesterone
57
Age or decline in hormones can cause the female reproductive structures to do what?
- Atrophy
| - Become less effective
58
What is the uterus responsible for?
- Receiving, implanting, and retaining a fertilized egg
- Menstruation
- Housing the fetus
- Expulsion of the fetus during a vaginal birth
59
Where is the female egg fertilized by the sperm?
Fallopian tube
60
What is the endometrium? What happens to the endometrium during menstruation?
- Vascular lining of the uterus
| - Layers of the endometrium are shed during menstruation
61
What dilates or stretches during a vaginal birth?
Cervix
62
What is produced by the ovaries?
Ova (eggs)
63
What are the ovaries responsible for?
- Ovulation
| - Hormone production
64
The vagina is a passageway for what?
- Menstrual flow
| - Childbirth
65
Mammary glands are made up of what?
Lobules
66
Dimpling to the breast tissue may indicate what?
Malignancy (i.e. breast cancer)
67
Nodules or masses within the breast are always considered what?
Cancerous
68
Growth of the breasts is stimulated by what?
Estrogen
69
What are the functions of the breasts?
- Lactation
| - Sexual arousal
70
Anatomically, where are the mammary glands found?
Between the second and the sixth rib
71
What is menarche? What is the average age for menarche?
- First menstrual period
| - 13 years old
72
What is puberty?
Transition between childhood and sexual maturity
73
What is the purpose of the menstrual cycle?
Prepares the uterus for pregnancy
74
How long does bleeding last during a menstrual period? What is the amount of blood lost during a menstrual period?
- Five days
| - 50 mL
75
What is the average length of the menstrual cycle? What factors influence the menstrual cycle?
- 28 days
| - Physical, emotional and environmental factors
76
What are prostaglandins (PGs)? Where are prostaglandins (PGs) produced?
- Oxygenated fatty acids (i.e. hormones)
| - Produced in uterus
77
What do prostaglandins (PGs) play a key role in?
- Moderate hormonal activity
| - Ovulation
78
What is climacteric menopause?
Transition phase between ovarian function and the decrease in hormone production
79
What is menopause? When can menopause occur?
- Last menstrual period
- Noted after one full year of no bleeding
- Can occur between 35 and 60 years of age
- Average age of menopause is 51.4
80
What happens in the four years prior to menopause?
- Decrease in ovarian function
- Decrease in the amount of ova released
- Decrease in shedding of the uterus
81
What are the two main female hormones?
- Estrogen
| - Progesterone
82
How are gender issues a barrier in healthcare?
- Females may only want to see female providers
| - Males may only want to see male providers
83
The average age for a female to first engage in sexual intercourse is what?
17 years old
84
Women who become pregnant over the age of thirty-five are at an increased risk for what?
- Congenital anomalies (i.e. down syndrome)
| - Genetic anomalies
85
How much folic acid should a childbearing woman intake per day?
400 mcg
86
Specifically related to gynecology and obstetrics, what medical conditions are considered risk factors to a woman's health?
- Infertility
- Miscarriage
- Pre-term labor
- Ovarian cysts
- Sexually transmitted diseases (STDs)
87
List lifestyle risk factors that have have a negative impact on the mother or on the fetus.
- Unprotected sex
- Female genital mutilation
- Human trafficking
- Domestic violence
- Environmental or work place hazards
88
How does the nurse know who to screen for anxiety and depression?
You don't! Screen everyone!
89
Substance abuse is considered what?
Anything from caffeine to cocaine
90
Before performing any type of invasive procedure or exam, such as a pelvic exam, the nurse should obtain what?
Consent
91
What position is the woman placed in when receiving a pelvic exam?
Lithotomy position
92
What screening, or exam, is used for cervical cancer?
Pap smear
93
Specimens can be collected to test for what specific infections?
- Candida
- Bacterial vaginitis
- Group B Strep
- Gonorrhea
- Chlamydia
- HSV (Herpes)
94
When obtaining a reproductive health history from a woman, the nurse should always do what?
Explain the purpose for the questions asked and how the information will be used
95
What is amenorrhea?
Absence of menstrual flow
96
Amenorrhea is noted if
- Menarche and secondary sexual characteristics are not present by age 13
- Absence of mensis by age 15 with normal growth and development
- Absence of mensis within 5 years of breast development
97
Secondary amenorrhea occurs when what?
A woman experiences menstruation and then menstruation ceases for 6+ months
98
What lab value is assess to determine pregnancy?
HCG
99
In the female athlete triade the nurse will assess for what?
- Osteoporosis
- Amenorrhea
- Insufficient nutrition
100
What is dysmenorrhea?
Pain during or shortly before menstruation
101
Severe dysmenorrhea can be associated with what?
- Early menarche
- Nulliparous
- Lack of physical exercise
102
What occurs during primary dysmenorrhea?
Excessive release of prostaglandins
103
When prostaglandins are released, they cause what?
Arterioles within the uterus to spasm
104
What are the treatments options for primary dysmenorrhea?
- Apply heat to abdomen
- Exercise
- Relaxation techniques
- Low sodium, low fat diet
- Vitamin E supplements
105
What drug provides optimal relief for primary dysmenorrhea?
NSAIDS
106
What is secondary dysmenorrhea?
Menstrual pain acquired later in life (after 25 years old)
107
What are the signs and symptoms of secondary dysmenorrhea?
- Bloating
- Pelvic fullness
- Pain in the legs or lower back
108
What are the causes of secondary dysmenorrhea?
- Pelvic pathology (i.e. endometriosis)
| - Fibroid development in pelvic cavity
109
What symptoms will be seen in premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD)?
Cyclic symptoms
110
List the cyclic signs and symptoms of premenstrual syndrome (PMS).
- Fluid retention
- Pelvic fullness
- Breast tenderness
- Weight gain
- Depression
- Irritability
- Cravings
- Headache
- Fatigue
111
What are the treatment or management options for premenstrual syndrome (PMS)?
- Healthy diet
- Exercise
- Relaxation
- Quit smoking
- Encourage supplements
112
What supplements may be beneficial in relieving symptoms of premenstrual syndrome (PMS)?
- Calcium
- B6
- D3
113
What is endometriosis?
- Presence and growth of endometrial tissue outside of the uterus
- Can occur anywhere in the body
114
List the signs and symptoms of endometriosis?
NOTE: Need to know these!
- Dysmenorrhea
- Painful intercourse that can progress overtime
- Abnormal uterine bleeding
- Infertility
115
What are the management options for endometriosis?
- NSAIDS
- Medications that suppress estrogen
- Birth control
- Surgery
116
Why is a women with endometriosis prescribed birth control? How long is it usually prescribed?
- Decrease adhesions
- Reduce pain
- 6 to 12 months
117
What is the definitive cure for endometriosis?
Abdominal hysterectomy (complete removal of uterus)
118
What are the physiological characteristics of menopause?
- Anovulation
- Menstrual cycle lengthens
- Ovulation occurs less frequently
- Progesterone is not produced
- Elevated FSH
119
List the physical changes associated with menopause.
- Lighter or heavier bleeding
- Vaginal atrophy
- Decrease in libido
- Vaginal dryness
- Incontinence
- Vasomotor instability (hot flash)
- Changes in mood or behavior
120
What are the health risks of perimenopausal women?
- Osteoporosis
| - Coronary artery disease
121
Why are perimenopausal women at an increased risk for developing osteoporosis?
- Decreased levels of estrogen
| - Estrogen is responsible for converting Vitamin D to calcitonin
122
Hormonal therapy increases a woman's chance of developing what?
- Breast cancer
| - Increases risk for developing breast cancer up to 5 years after stopping hormonal therapy
123
What are the signs and symptoms of hormonal therapy?
- Headache
- N/V
- Brown spots on skin
- Depression
124
What medications are used in menopausal hormonal therapy?
- Estrogen
- Estrogen and Progesterone Combo
- SSRI
- Gabapentin
- Clonidine
125
What supplements have been found effective as alternative therapies for menopausal symptoms?
- Soy
| - Vitamin E
126
What nursing management should be provided to a menopausal woman?
- Sexual counseling
- Well balanced diet
- Exercise
- Medication education
- Encourage support groups
127
What is micromastia?
-Underdevelopment of breast tissue
128
What is macromastia?
- Large, heavy breasts
| - Women often complain of back and shoulder pain
129
What are developmental anomalies of the breast?
- Noticeable change in size of breasts
- Breasts are asymmetrical
- Can cause difficulty breastfeeding
130
What are the two initial evaluation goals in relation to the pathophysiology of benign breast disease?
1) Distinguish between benign and malignant
| 2) Assess the risk of breast cancer
131
What is the most common benign problem of the breast?
Fibrocystic changes
132
Fibrocystic changes are related to an imbalance of what?
Estrogen and progesterone
133
What are the clinical manifestations of cystic masses?
- Lumpiness with or without pain
| - Pain may be noticed around time of menstrual cycle
134
Breast pain related to fibrocystic changes is most common around what time?
- One week before menstruation or one week after menstruation
- Most common in younger women
135
List characteristics of fibrocystic masses of the breast.
- Moveable
- Soft
- Well differentiated
136
Breast pain is also known as what?
Mastalgia
137
Breast pain is _____ in breast cancer.
Uncommon
138
What are the risk factors for developing cellulitis of the breast?
- Obesity
- Macromastia
- Previous surgeries to or around breast
- Radiation
- Smoking
- Diabetes
- Nipple piercings
139
What percentage of breast lumps are discovered by the patient?
90%
140
When is the breast self exam (BSE) best performed?
- 5 to 7 days after menstrual period every month
| - Perform in same pattern every time
141
Clinical breast exams ,performed by a healthcare provider, should begin in a woman's _____. Routine mammograms should be conducted every year after a woman turns _____.
- Twenties
| - Forty
142
What are the three most important nursing actions related to benign breast conditions?
1) Discuss intervals for breast screening
2) Provide written education
3) Therapeutic communication
143
What are the risk factors for developing breast cancer?
- Early menarche
- Family history
- Non-hispanic white
- Nulliparous
144
The presence of BRCA 1 and BRCA 2 genetic mutations tells a woman what?
She has an 85% chance of developing breast cancer
145
If BRCA1 and BRCA2 genetic mutations are present, but the woman exhibits no signs or symptoms of breast cancer development, the physician will recommend she do what?
-Have biannual breast exams with imaging
146
Chemoprevention be given when what two factors are present?
- Genetic mutations are present
| - Extensive family history is present
147
___ in ___ women will develop a breast malignancy.
1 in 8
148
What is the survival rate for breast cancer or breast malignancy?
83% for ten years after diagnosis
149
Nipple carcinoma is often connected with what disease?
Paget's disease
150
Inflammatory breast cancer is often _____.
Misdiagnosed
151
Inflammatory breast cancer is often mistaken for what conditions?
- Mastitis
| - Cellulitis
152
Inflammatory breast can usually presents as a stage ____. It is _____ _____.
- Two
| - Very aggressive
153
The most common type of breast cancer is what?
Invasive Ductal Carcinoma
154
The rate of breast cancer growth depends on the effects of what?
- Estrogen
| - Progesterone
155
What are the four common places that breast cancer will spread to?
- Bones
- Lungs
- Brain
- Liver
156
What is the gold standard for diagnosing breast cancer?
- Mammogram
| - Not 100%
157
What is a lumpectomy?
Removal of tumor and small margin of healthy tissue that surrounds it
158
What is a mastectomy? When is this option utilized
- Removal of breast including nipple and areola
- Most invasive
- Utilized when other treatment therapies have not worked or the patient has a very large/multiple tumors
159
When would a prophylactic mastectomy be done?
- Patient presents with genetic mutations
| - Patient has strong family history of breast cancer
160
Radiation is considered what? It is often performed in addition to what surgeries?
- Most conservative approach
- Lumpectomy
- Mastectomy
161
Radiation can cause what?
- Fatigue
- Heaviness to the breast
- Irritation
162
Women taking the oral anti-estrogen medication Tamoxifen will follow these specific guidelines:
- Annual pap smear
- Annual eye exam
- Liver function tests every six months
- Bone density screening every three years
163
What are the adverse affects of Tamoxifen?
- Weight gain
- Hot flashes
- Higher risk for developing deep vein thrombosis
164
What is the most common type of therapy for tumors? How is it administered?
- Chemotherapy
| - IV, SubQ, PO
165
The nurse should not perform these actions on the side of the body where a mastectomy has been performed?
- Take blood pressure
- Insert an IV
- Draw blood
166
Women under the age of 40 who develop breast cancer are at an increased risk for what?
Recurrence later in life
167
When assessing for breast cancer, the nurse always wants to assess for?
- Unilateral changes
| - Changes that only affect one breast
