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Midterm Flashcards

1
Q

Adverse socio-economic conditions

A

Discusssion

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2
Q

Age less than 17 over 40

A

Discussion

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3
Q

Cigarette and/or cannabis use

A

Discussion

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4
Q

Grand multipara (5 or more births)

A

Discussion

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5
Q

History of substance abuse

A

Discussion

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6
Q

History of infant over 4500 g

A

Discussion

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7
Q

History of 1 late miscarriage (after 14 weeks) or one pre term birth

A

Discussion

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8
Q

History of one small for gestational age infant

A

Discussion

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9
Q

Less than 12 mo from last delivery to present date

A

Discussion

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10
Q

Poor nutrition

A

Discussion

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11
Q

Previous antepartum hemorrhage

A

Discussion

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12
Q

Previous postpartum hemorrhage

A

Discussion

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13
Q

One documented previous low-segment cesarian section

A

Discussion

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14
Q

History of hypertensive disorders of pregnancy

A

Discussion

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15
Q

Known uterine malformations or fibroids

A

Discussion

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16
Q

History of trauma or sexual abuse

A

Discussion

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17
Q

Current medical conditions that may affect pregnancy or are exacerbated due to pregnancy, family history of genetic disorders, hereditary disease or significant congenital anomalies

A

Consultation

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18
Q

Pre existing (chronic) hypertension

A

Consultation

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19
Q

History of cervical cerclage

A

Consultation

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20
Q

History of 3 or more first trimester spontaneous abortions

A

Consultation`

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21
Q

History of one or more second trimester spontaneous abortions

A

Consultation

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22
Q

History of more than one preterm or one preterm birth less than 34 weeks

A

Consultation

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23
Q

History of significant medical illness

A

Consultation

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24
Q

Previous myomectomy, hysterotomy or cesarean section other than one documented previous low-segment cesarean section

A

Consulatation

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25
Q

Previous neonatal mortality or stillbirth

A

Consultation

26
Q

Age less than 14 yo

A

Consultation

27
Q

History of postpartum hemorrhage requiring transfusion

A

Consultation

28
Q

Current medical condition(s) that may adversely affect or are exacerbated by pregnancy that require specialized medical care (common examples include cardiac disease, renal disease, pre-existing insulin-treated diabetes mellitus)

29
Q

No prenatal care before 28 weeks gestation

A

Discussion

30
Q

14 social determinants of health

A

1) Education (2) Income and Income distribution (3) Unemployment and Job security (4) employment and working conditions (5) early childhood development (6) food insecurity (7) social exclusion (8) social safety networks (9) health services (10) aboriginal status (11) race (12) gender (13) disability (14) housing

31
Q

BMI

A

weight (kg) / height (m) ^2 normal 18.5-24.9

32
Q

Naegle’s Rul

A

-3 mo + 7 days, subtract >28, add <28

33
Q

Components of a soap note

A

Name:
Demographics: Age (gender) GTPAL at _ gestation, in for ____

Subjective : what client says
Objective: what you see
Assessment: Urgent: most pressing first, non urgent: most likely to least likely
Plan: what we need to do next. Include plan for next meeting

34
Q

Setting for Health History

A

4 Cs

Courtesy: Introduce, Acknowledge, confidentiality, professionalism

Comfort: Sit, eye level, calm, open expression, calm pace, quiet, private, good temp.

Connection: eye contact, listen, language, open ended questions, flexible, know form, nothing b/w you

Confirmation: verbal cues, body language, summarize, ANYTHING ELSE YOU WANT TO TELL ME?

35
Q

Determinants of Health breakdown

A

Clinical care - 10 %, Social and economic factors 40%

36
Q

Symptoms of pregnancy

A

Presumptive – experience ie. Tires, sore breasts (client’s words)
Probable – enlarged uterus, Hegals sign, urine test (midwive’s assesment)
Positive – FHR, BHCG, US with FH activity (tests)

37
Q

Why do we do a history?

A

(1) Identify medical risk factors (2) Guide care planning for care and consults (3) Learn what we need to know to provide care/build a relationship

38
Q

What’s on ANR Part 1?

A

1) Demographics
2) Allergies and medication
3) EDD and contraceptives
4) OBST history
5) Present pregnancy
6) Family history
7) Medical history
8) Physcosocial
9) Substances

39
Q

(1) Demographics section?

A

Name, family doc, DOB, Age at EDD, preferred name pronouns, Language, Ethnicity, Indigenous Identity, Highest level of education, Parter’s name, Age, occupation, ethnicity, bio donor?

40
Q

(3) EDD and contraception section?

A

Contraceptives (last used), pregnancy planned, LMP, EDD by LMP, Dating US GA and EDD

41
Q

(2) Allergies and Medication section?

A

Allergies, Medication - including supplements and herbs, TI folic acid, pre-conception folic acid, Beliefs/practices

42
Q

(4) Obstetrical history section?

A

GTPAL
(Term being 37 weeks on)
(Abortus being 20 weeks less)

Record all births - Date, Place of birth, GA, duration of labour, Mode of birth, Perinatal complication/comments, Sex, Birth weight, Breastfed, Child’s present health

43
Q

(5) Present pregnancy

A

ART, Bleeding, Nausea, Travel (self/partner), infection/rash/fever, Other

44
Q

(6) Family history

A

Anaesthetic complications, Hypertension, Thromboembolic, Hiabetes, Mental Health, SUD, Inherited conditions, Other

45
Q

(7) Medical History

A

Surgery, Anesthetic complications, Neurological, Respiratory, CV, Abdominal/GI, Gynaecological, Hematology, Endocrine, Mental health, Infectious disease, Immunizations, Other

46
Q

(8) Lifestyle/Social

A

Diet/nutrition, exercise, financial, housing/food security, transportation, safety, gender based violence, relationship/support

47
Q

(9) Substance Use

A

Alcohol (drinks per week), 4 or more drinks at a time, Quit alchohol when ?, Tobacco, cigarettes [er day, 2nd hand smoke, quit cigarettes?, Cannabis, Other drugs

48
Q

How to set up for a PE?

A

1) Hand hygiene and PPE (2) Consent before and during (3) Setting comfortable including language (4) Clothing, drape (5) Check equipment

49
Q

How to set up for a PE?

A

1) Hand hygiene and PPE (2) Consent before and during (3) Setting comfortable including language (4) Clothing, drape (5) Check equipment

50
Q

Lateral? Medial? Distal? Proximal?

A

Lateral away from midline, Medial toward the midline, Distal down toward bottom, Proximal up toward top.

51
Q

What are the vital signs?

A

Oxygen saturation, temperature, heart rate, respiration rate, blood pressure

52
Q

Why Vital signs?

A

Helps determine need for immediate intervention, urgent reassessment, transfer of care (Blood pressure and respiration rate at all meetings)

53
Q

When vital signs?

A

Antenatal and postpartum visits, labour assessments, birth, in emergencies repeat frequently

54
Q

Tell about temperature?

A

Normal range 36-37.5, 38 is fever. Reasons: dehydration, infection, exercise, stress thyroid disorder.

55
Q

Tell about oxygen saturation?

A

Should ne 95-100 SPO2 AKA O2Sat, Pulse Oxymeter, SAT monitor

56
Q

Where to take heart rate? Normal range?

A

Radial - in wrist below thumb (EASIEST), Bracheal - in antecubital foss (inside dip of elbow), Carotid- in neck, femoral - where leg and groin meet, Pedal - on top of foot. Normal range 60-89 ,could be 100 in labour.

57
Q

Tell about respiration rate?

A

Before counting make sure they can talk and breath. Take when not aware for 30-60 seconds, One count cycle full breath in and out. May be elevated dehydtration, anxiety, hypovolemia, infection, asthma 12-16 breaths per minute

58
Q

What is systolic and diastolic and normal range?

A

Systolic (TOP) - pressure in the arteries when the hear beats and pushes blood out into the body normal 90-140

Diastolic (BOTTOM) the pressure in teh artiers when the hear rests between beats normal 60-90

Hypertenstion can result from stress, smoking, salt intake.

Worry over 140/90

59
Q

How to take blood pressure?

A

Appropriate size cuff, automatic or manual
Equipment: Stethescope and sphygmomanometer
Position, sitting, standing, lying down
Which arm: no hx blood clots etc
One step: pump until you do not hear pulse then increase 20
Two step: Feel for pulse then increase 20

Extend arm, supported and relaxed
Palpate brachial artery
Place arrow/ marker 2-5cm above the artery and close velcro
Fit: slide two fingers under, should not be too loose or too tight, or may get inaccurate BP
Make sure you can see sphygmomanometer

Place stethoscope over brachial artery
Close the valve on the pump and inflate until you do not hear the brachial artery anymore
Let it drop slowly
Listen for first sound – systolic
Listen for when the sound stops – diastolic

60
Q

What are some practical steps around trauma informed care?

A
  1. Realizes the widespread impact of trauma and
    understands potential paths for recovery;
  2. Recognizes the signs and symptoms of trauma
    in clients, families, staff, and others;
  3. Responds by fully integrating knowledge
    about trauma into policies, procedures, and
    practices; and
  4. Seeks to actively resist retraumatization.

6 principles:

  1. Safety
  2. Trustworthiness and transparency
  3. Peer support
  4. Collaboration and mutuality
  5. Empowerment, voice, and choice
  6. Cultural, historical, and gender issues

Midterm 2 (11 decks)

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