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Nursing Theory II > MIDTERM > Flashcards

MIDTERM Flashcards

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1
Q

Naegele’s Rule

A

calculating expected delivery date: day of last period - 3 months + 7 days

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2
Q

Presumptive signs of pregnancy

A

signs and symptoms that may resemble pregnancy but are actually something else. Ex. nausea, vomiting, fatigue, frequent urination & breast tenderness

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3
Q

Probable signs of pregnancy

A

signs that indicate pregnancy the majority of the time. Ex. Positive pregnancy test, an enlarged abdomen

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4
Q

Positive signs of pregnancy

A

demonstration of separate fetal heart, fetal movements felt by examiner, or visualization of fetus via ultrasound

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5
Q

Stages of fetal development (3)

A 
Pre-embryotic period/Intrauterine development (first 14 days)
Embryonic stage (day 15 - week 8)
Fetal stage (week 9 - 38 to 40 weeks
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6
Q

Postpartum maternal psycho-social changes (Expected)

A

Rubins Restorative/Adaptive Phases:
Taking-in Phase - mother needs sleep, fluids & food 24h-3days
Taking-hold Phase - mother starts to take care of herself & becomes more involved with the infant
Letting-go Phase - things may not be how they expected, begin to establish a life that includes the baby

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7
Q

Postpartum maternal psycho-social changes (Unexpected)

A

Postpartum depression - can last for months. feelings of sadness, resentment & despair
postpartum psychosis - rare and severe form of depression. Includes delusional thinking and hallucinations.

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8
Q

Social Isolation

A

caused by loss of work role, relocation, reduced mobility or independence, withdrawal due to ageism.
Interventions - peer helping/visiting outreach model

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9
Q

Respiratory Physiological changes

A

increased chest wall rigidity & increased risk of respiratory infection

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10
Q

Cardiovascular Physiological changes

A

blood vessel walls thicken
increased pulmonary vascular tension
increased systolic blood pressure

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11
Q

Gastrointestinal Physiological changes

A

periodontal disease

decreased esophageal peristalsis and small intestinal motility

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12
Q

Delerium

A

a usually brief state of excitement and mental confusion often accompanied by hallucinations

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13
Q

Dementia

A

a slowly progressive decline in mental abilities (memory, thinking, judgement) often accompanied by personality changes

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14
Q

Depression

A

pessimistic sense of inadequacy and a despondent lack of activity

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15
Q

CFAM

A 
3 major categories of family life
Structural dimension
Developmental dimension
Functional dimension
Each category contains several subcategories
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16
Q

First Trimester 0-13 weeks

A
  • most crucial to babys developement
  • body structure and organ systems develop
  • symtoms: nausea, vomiting, breast tenderness, frequent urination
17
Q

Second Trimester 14-26 weeks

A
  • many unpleasant symptoms disappear

* may experience back pain, abdominal pain, leg cramps, constipation and heart burn

18
Q

Third Trimester 27-40 weeks

A
  • shortness of breath, hemorrhoids, urinary incontinence, varicose veins & sleeping problems
  • many symptoms arise in the size of your uterus - expands from approximately 2ounces to 2.5lbs at birth
19
Q

Attributes of healthy family

A

communcation, honesty,fun, commitment, appreciation, togetherness, coping with stress, wellness, positive attitude, resilience

20
Q

Health Risks for Young to Middle Adult

A

Lifestyle
• Poor food choices, smoking, stress, substance abuse, inactivity increase risk of illness

Family History
• Increased risk of developing disease (genetics, cardiovascular, renal, endocrine, diabetes

Accidental Death & Injury
• Leading causes of death in young adult- MVA physical assault, suicide
• Predisposing factors- poverty, breakdown of family relations, child abuse, neglect, access to firearms
• Environmental risk factors- social determinants of health
• Assess behaviour patterns, history, education, social support system
Substance Abuse
• Contributes to mortality & morbidity directly or indirectly
• Regular heavy drinking (5 OR MORE)
• Drug dependence- can lead to accidental or intentional OD
Routine Screening
• Clients should perform monthly skin, breast, or male genital self-examinations.

21
Q

Health Concerns Middle Adult

A
  • Stress and Stress reduction
  • Levels of wellness
  • Obesity
  • Forming positive health habits
  • Anxiety
  • Depression
22
Q

Structural Dimension

A
  • Genogram- diagram of family constellations; provides you a picture.
  • Ecomap-diagram of the family’s contact with others outside the immediate family
23
Q

Developmental Dimensions

A

o The development assessment is divided into 3 components
• Stages
• Tasks
• Attachments

6 stages of family life cycle (based on traditional)
• Between families Unattached Young Adults
• The Joining Of Families Through Marriage
• Families with Young Children
• Families with Adolescents
• Launching Children & Moving On
• Families in Later Life

24
Q

Functional Dimensions

A 
o	Expressive functioning-10 categories
•	Emotional communication
•	Verbal communication
•	Non-verbal communication
•	Circular communication
•	Problem solving
•	Roles
•	Influence
•	Beliefs
•	Alliance & coalitions
25
Q

Newborn (first month)

Physical Changes

A
  • Average newborn weighs 3400g, 50cm long, and 35cm head circumference
  • Up to 10% of birth weight is lost in the first few days, primarily because of fluid loss by respiration, urination, defecation, and low fluid intake
  • Birth weight is usually regained by the second week
  • Heart rate: 120-160 beats/minute
  • Respirations: 30-60 breaths/minute
  • Temperature 36-37.5C
  • BP: 85/54
  • Lanugo on the skin of back is present, cyanosis of the hands and feet for 24hours & a soft, protuberant abdomen
  • Skin colour varies depending on genetic heritage, and changes as the child ages
26
Q

Infant (1 month – 1 year)
Developmental Milestones
Birth to 4 Months

A
  • Involuntary reflexes such as crawling, startle
  • Infant may roll over
  • Eye-hand coordination improves & the involuntary grasp reflex increases
27
Q

Infant (1 month – 1 year)
Developmental Milestones
5 to 7 Months

A
  • Rolls over
  • Sits momentarily
  • Grasp & manipulates small objects
  • Picks up dropped object
  • Well-developed eye-hand coordination
  • Can focus on & locate very small objects
  • Tendency to put objects in mouth
  • Can push up on hands & knees
  • Crawls backwards
28
Q

Infant (1 month – 1 year)
Developmental Milestones
8 to 12 months

A
  • Crawls & creeps
  • Stands, holding on to furniture
  • Stands alone
  • Cruises around furniture
  • Walks
  • Climbs
  • Pulls on objects
  • Throws objects
  • Can pick up small objects & has pincer grasp
  • Explores objects by putting in mouth
  • Dislikes being restrained
  • Explores away from parents
  • Understanding of simple commands & phrases increase
29
Q

Infant (1 month – 1 year)

Neurofuction (Cognitive Development)

A
  • Learns by experiencing and manipulating the environment
  • Developing motor skills and increasing mobility expand and infant’s environment, and, with developing visual and auditory skills, enhance cognitive development
  • Piaget named the first stage of cognitive development that extends until the infant’s 3rd birthday – Sensorimotor Period
30
Q

Preschoolers (3 - 6 years)

Play

A
  • Become more social, shift from parallel to associative play
  • Children playing together engage in similar activities
  • Preschoolers demonstrate awareness of social context
  • Sex role identification is strengthening & children most often assume roles of their own sex
  • Frequently repeat or mimic social experiences (significant in hospitalized children)
  • Provides a healthy outlet for frustration especially when a child has been subjected to painful or restrictive experiences against their will
  • Imaginary play (child’s memory of things they have seen and heard) involving other children occupies about 1/3 of a 5-year-old child’s time
  • Pretending allows children to understand others’ point of view, develop skills in solving social problems and become more creative
  • Imaginary playmates are a sign of creativity and healthy development
31
Q

Preschoolers (3 - 6 years)

Language

A
  • Vocabulary increase rapidly
  • By age 5 kids know more than 2100 words and construct sentences with 5-6 words
  • Language is more social, and questions expand to “why” and “how come”
  • Phonetically similar words may cause confusion (ex. Dye and die)
32
Q 
School Age (6 - 12 years)
Physical Development
A
  • Slower than at anytime but continues steadily (may vary depending on the child)
  • School aged children appears slimmer than preschoolers as a result of changes in fat distribution
  • Growth accelerates at different times for different children
  • Many children double their height during these middle childhood years
  • Boys are slightly taller and heavier than girls during these early school years
  • About 2 years before puberty, children experience a rapid acceleration in skeletal growth
  • Girls generally reach puberty first
  • Puberty occurs between the ages of 9 and 13 years in girls, and 11 and 14 years in boys
  • Cardiovascular functioning is refined and stabilized
  • Heart rate: 75-100 beats/minute
  • BP normalizes to approx.: 110/65
  • Respiratory rate stabilizes 20-30 breaths/minute. Lung growth is minimal and respirations become slower, deeper and more regular
  • Heart has generally reached its adult size, 6 times the size at birth
  • Large muscle coordination improves and strength doubles (more graceful)
  • Playing (running, jumping, throwing balls, catching, balancing, etc…) results in refinement of neuromuscular function and skills
  • Fine motor skills are improved and as control is gained over fingers and wrists children become proficient in a wide range of activities
  • Most 6 year olds can hold a pencil adeptly and print letters and words. By age 12, they can make detailed drawings and write sentences in script
  • Improve refine motor skills by playing computer games, painting, drawing, making models
  • Allow child to participate in care as much as possible. They have developed their own way of caring for themselves
  • Steady skeletal growth in the trunk and extremities occur. Dental growth is prominent during school years. First permanent tooth can erupt at 6. Begins with 6 year molars, and follow same order as primary teeth. By 12 years primary teeth have been shed &majority of permanent teeth have erupted.
  • Small and long bone ossification is present but incomplete
  • Body appearance and posture changes due to skeletal growth. Earlier stoop-shouldered, slight lordosis and prominent abdomen changes to a more erect posture. Girls over 12should be evaluated for scoliosis
  • Eye shape alters because of skeletal growth, this improves visual acuity
33
Q 
School Age (6 - 12 years)
Physical Development
A
  • Slower than at anytime but continues steadily (may vary depending on the child)
  • School aged children appears slimmer than preschoolers as a result of changes in fat distribution
  • Growth accelerates at different times for different children
  • Many children double their height during these middle childhood years
  • Boys are slightly taller and heavier than girls during these early school years
  • About 2 years before puberty, children experience a rapid acceleration in skeletal growth
  • Girls generally reach puberty first
  • Puberty occurs between the ages of 9 and 13 years in girls, and 11 and 14 years in boys
  • Cardiovascular functioning is refined and stabilized
  • Heart rate: 75-100 beats/minute
  • BP normalizes to approx.: 110/65
  • Respiratory rate stabilizes 20-30 breaths/minute. Lung growth is minimal and respirations become slower, deeper and more regular
  • Heart has generally reached its adult size, 6 times the size at birth
  • Large muscle coordination improves and strength doubles (more graceful)
  • Playing (running, jumping, throwing balls, catching, balancing, etc…) results in refinement of neuromuscular function and skills
  • Fine motor skills are improved and as control is gained over fingers and wrists children become proficient in a wide range of activities
  • Most 6 year olds can hold a pencil adeptly and print letters and words. By age 12, they can make detailed drawings and write sentences in script
  • Improve refine motor skills by playing computer games, painting, drawing, making models
  • Allow child to participate in care as much as possible. They have developed their own way of caring for themselves
  • Steady skeletal growth in the trunk and extremities occur. Dental growth is prominent during school years. First permanent tooth can erupt at 6. Begins with 6 year molars, and follow same order as primary teeth. By 12 years primary teeth have been shed &majority of permanent teeth have erupted.
  • Small and long bone ossification is present but incomplete
  • Body appearance and posture changes due to skeletal growth. Earlier stoop-shouldered, slight lordosis and prominent abdomen changes to a more erect posture. Girls over 12should be evaluated for scoliosis
  • Eye shape alters because of skeletal growth, this improves visual acuity
34
Q 
School Age (6 - 12 years)
Physical Development
A
  • Slower than at anytime but continues steadily (may vary depending on the child)
  • School aged children appears slimmer than preschoolers as a result of changes in fat distribution
  • Growth accelerates at different times for different children
  • Many children double their height during these middle childhood years
  • Boys are slightly taller and heavier than girls during these early school years
  • About 2 years before puberty, children experience a rapid acceleration in skeletal growth
  • Girls generally reach puberty first
  • Puberty occurs between the ages of 9 and 13 years in girls, and 11 and 14 years in boys
  • Cardiovascular functioning is refined and stabilized
  • Heart rate: 75-100 beats/minute
  • BP normalizes to approx.: 110/65
  • Respiratory rate stabilizes 20-30 breaths/minute. Lung growth is minimal and respirations become slower, deeper and more regular
  • Heart has generally reached its adult size, 6 times the size at birth
  • Large muscle coordination improves and strength doubles (more graceful)
  • Playing (running, jumping, throwing balls, catching, balancing, etc…) results in refinement of neuromuscular function and skills
  • Fine motor skills are improved and as control is gained over fingers and wrists children become proficient in a wide range of activities
  • Most 6 year olds can hold a pencil adeptly and print letters and words. By age 12, they can make detailed drawings and write sentences in script
  • Improve refine motor skills by playing computer games, painting, drawing, making models
  • Allow child to participate in care as much as possible. They have developed their own way of caring for themselves
  • Steady skeletal growth in the trunk and extremities occur. Dental growth is prominent during school years. First permanent tooth can erupt at 6. Begins with 6 year molars, and follow same order as primary teeth. By 12 years primary teeth have been shed &majority of permanent teeth have erupted.
  • Small and long bone ossification is present but incomplete
  • Body appearance and posture changes due to skeletal growth. Earlier stoop-shouldered, slight lordosis and prominent abdomen changes to a more erect posture. Girls over 12should be evaluated for scoliosis
  • Eye shape alters because of skeletal growth, this improves visual acuity
35
Q

Adolescent (12 - 19 years)

Suicide Risk

A

HISTORY – Previous attempts? Attempts by family or friends? Child maltreatment? Past psychiatric hospitalization? Death of parent when child was young?
INDIVIDUAL FACTORS – hopelessness; marked, persistent depression; alcohol or drug abuse; impulsiveness; difficulty tolerating frustration; feelings of self hatred, excessive guilt, or humiliation; thinking disorder; physical problem or problems with body image; gender identity concerns; being gay or lesbian in unsupportive environment; seeing self as totally helpless, a victim of fate; and needing to do things perfectly.
FAMILY FACTORS – Difficult home situation, hostile parents, overt rejection by one or both parents, divorce or separation of parents, recent or impending move, family break up or loss of parent, stress of unrealistically high parental expectations, parental indifference with very low expectations.
SOCIAL & ENVIRONMENT FACTORS – firearms in the home; incarceration; lack of effective social support system; isolation; suicide of someone known; few social, vocational, or educational opportunities.

36
Q

Adolescent (12 - 19 years)

Health Risks

A

Injuries – self inflicted injuries, motor vehicle accidents & poisoning are the leading causes of death in adolescents
Suicide – increased cause of death between adolescents between 15-19
Substance Abuse – those who have dysfunctional families are more at risk
Eating Disorders – number of eating disorders is on the rise in adolescents, particularly girls
Obesity & Physical Inactivity – becoming serious public health concerns. Rates of overweight have doubled and obesity tripled since the 1990s.
Sexual Experimentation – Sexually Transmitted Infections (STI), increasing in adolescents & Pregnancy

Nursing Theory II (1 decks)

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