Module 0 Foundations Study Guide/Practice Questions Flashcards
When discussing risks with a patient, what is the recommended order of presenting risks and benefits?
Note: you should present absolute risk NOT relative risk
What are the 5 essential steps in shared decision making using the SHARE acronym?
S: Seek your patient’s participation
H: Help your patient explore and compare treatment options
A: Assess your patient’s values and preferences
R: Reach a decision with your patient
E: Evaluate your patient’s decision
How does the nurse-midwife utilize shared decision making when: Equipoise is present?
Present the evidence concisely and explain the amount and quality of the research. Explain the risks and benefits of options and let pt decide.
How does the nurse-midwife utilize shared decision making when: Strong evidence supports the use of an intervention?
When the evidence supports an intervention, you should recommend that option and against the other(s).
What does it mean when the nurse-midwife consults with the physician?
Consultation is the process whereby a CNM maintains primary management responsibility for the woman’s care and seeks the advice or opinion of a physician or another member of the health care team.
What does it mean when the nurse-midwife collaborates with the physician?
Collaboration is whereby the CNM and physician jointly manage the care of a woman or newborn who has become obstetrically complicated. The scope of the collaboration may encompass the physical care of the client, including the delivery by the CNM according to a mutually agreed-upon plan of care. When the physician must assume a dominant role in the care of the client due to the increased risk status, the CNM may continue to participate in the physical care, counseling, guidance, teaching, and support. Effective communication between CNM and physician is essential for ongoing collaborative management.
What does it mean when the nurse-midwife refers to the physician?
Referral is the process by which the CNM directs the client to a physician or another health care professional for management of a particular problem or aspect of the client’s care (ACNM, 1992).
What are the components of a SOAP note and the type of information that is included in each component?
S: Subjective (History)- Demographics, Chief complaint, HPI (OLDCARTS), active medical problems/PMH, current pregnancy info and pregnancy hx, allergies, medication, family Hx, social Hx
O: Objective (Physical Exam)- General appearance, Assessment, Labs available now
A: Assessment (Diagnosis)
P: Plan-Rx, Tx, Dx, Education, F/U, referrals
What are the components of SBAR communication? What type of information is included in each component?
S: Situation
B: Background
A: Assessment
R: Recommendation
An intrauterine fetal demise (IUFD) is unexpectedly discovered during a 40 week visit. The woman is in shock and asks to go home and consider her options. The nurse-midwife advises her:
80-90% of women will go into labor within 1-2 weeks of fetal death.
During the 6 weeks postpartum exam, a G2P2002 scores 12 on the Edinburgh Postnatal Depression Scale. She is adamant that she wants to avoid using any medication while breastfeeding. The nurse-midwife offers self-help measures for combating postpartum depression including
eating three meals/day
avoiding major life changes, i.e. moving
opening window shades during the day
ensuring an adequate sleep schedule
exercising with daily walks
participating in a support group
On Postpartum day 4 a G1P1 calls with concerns that she has been feeling overwhelmed at times with sporadic unprovoked outbursts of crying. The nurse-midwife gathers additional information by asking (select all that apply)
” How often are you eating?”
“What is your activity and sleep pattern?”
“Do you have any history of depression?”
“Do you have any feelings of wanting to hurt yourself or your baby?”
Nine months postpartum a G4P3013 complains of fatigue, sleeping all the time, and a loss of interest or pleasure in doing activities she use to enjoy. She feels like she has lost herself. She denies any thoughts of harming herself or baby. An appropriate assessment (A) and management plan (P) include
A: Postpartum depression vs. thyroid disorder; P: order thyroid stimulating hormone (TSH), discuss antidepressants and psychotherapy options.
The nurse-midwife should initially assess women for postpartum mood disorders during what type of office visit
antepartum visits.
At 12 months postpartum a young mother explains that she is worried about her son’s development since at the height of her depression she felt so overwhelmed that she merely went through the daily motions of caring for him and rarely actually interacted with him. Research on postpartum depression’s effect on infant and child development reveal
slower cognitive development.
