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BALANTAD | MATERNAL CHILD HEALTH NURSING 2 > MODULE 4: Pregestational Problems > Flashcards

MODULE 4: Pregestational Problems Flashcards

STD & STI & SUBSTANCE ABUSE

1
Q

Each year the new cases of STD’s estimates to about

A

9 million

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2
Q

Each year the new cases of STD’S occurs on ages

A

15-24

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3
Q

Highest STD rates occurs in what age group in the country

A

Sexually active youth

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4
Q

Pregnant women with STD’s are at greater risk of what

A

miscarriage and premature delivery

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5
Q

In some cases of pregnant women with STD’s, they can also transmit the infection to which individuals

A

Babies

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6
Q

HIV cases per day in year 2008

A

1

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7
Q

HIV cases per day in 2010

A

4

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8
Q

HIV cases per day in 2012

A

9

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9
Q

HIV cases per day in 2014

A

17

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10
Q

HIV cases per day in June 2016

A

26

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11
Q

Risk Factors of STD’s

A

a. lower socio-economic status
b. lower educational level
c. sexual activity with multiple partner
d. unsafe sexual intercourse

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12
Q

Sexually Transmitted Infections

A

a. Candidiasis
b. Trichomoniasis
c. Bacterial Vaginosis

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13
Q

Affects the skin, skin of the vagina, the penis, and the mouth

A

Candidiasis

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14
Q

A yeast infection and a thrush

A

Candidiasis

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15
Q

An STD’s that can also infect the bloodstream or internal organs such as liver and skin

A

Candidiasis

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16
Q

Where does Candida albicans thrive

A

Glycogen (high in estrogen = high in glycogen levels)

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17
Q

Oral contraceptives

A

alters vagina making glycogen rich

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18
Q

Destroys normal flora

A

Cephalosporin

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19
Q

Vaginal discharge of candidiasis

A

Cream cheese

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20
Q

Etiologic Agent of Candidiasis

A

Candida albicans

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21
Q

Candidiasis can cause

A

a. newborn candidiasis
b. oral thrush (white patches on tongue)

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22
Q

Risk factors of candidiasis

A

a. Pregnancy
b. Oral contraceptives
c. Antibiotic therapy
d. Immunosuppression
e. Diabetes mellitus

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23
Q

Assessment for Candidiasis

A

a. Reddened vulva
b. Pruritus
c. White patches on the vaginal wall
d. Thick cream-cheese like vaginal e. discharges
e. Pain during coitus
f. Painful urination

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24
Q

Screening and Diagnosis

A

a. complete history taking
b. physical exam
c. KOH wet smear
d. checking of vaginal pH

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25
Q

Checking of vaginal PH

A

bluish discoloration in nitrazine paper

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26
Q

Oral contamination of candidiasis can lead to

A

Oral thrush (small patches on tongue)

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27
Q

Medications used for Candidiasis

A

a. Application of an over-the-counter antifungal cream (Monistat) for 7 days
b. Oral Fluconazole

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28
Q

Symptoms of Candidiasis

A

a. thick yellow vaginal discharge
b. pruritus

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29
Q

What organism is Candida albicans

A

Fungus

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30
Q

Management of Candidiasis

A

a. Sitz bath
b. Not wearing under pants

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31
Q

How is Sitz Bath being done

A

a. Add 1.2 to 1 tablespoon (5mL to 15 mL) of baking soda or 1 to 2 teaspoons (5mL to 10mL) of salt to the water in the plastic sitz bath
b. Swirl the water until the baking soda or salt dissolves
c. Carefully sit down in the plastic sitz bath and soak your bottom area for 10 to 15 minutes

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32
Q

A common cause of this STD’s is vaginal infection and discharge

A

Trichomoniasis

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33
Q

Trichomoniasis

A

a. Incubation period 4 - 20 days
b. Common cause is vaginal infection and discharge
c. Inflammation of the vulva and vagina
d. Irritation and itching in vaginal area
e. Profuse greenish-yellow discharge with foul odor

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34
Q

Assessment: Trichomoniasis

A

a. Vaginal irritation
b. Frothy (mabula) white or grayish-green vaginal discharge
c. Reddened upper vagina
d. Pruritus

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35
Q

Medical Management of Trichomoniasis

A

a. discuss the importance of partner treatment
b. discuss the sexual transmission of this disease
c. Metronidazole (anti-fungal) - given on second trimester onwards

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36
Q

Trichomoniasis characteristics

A

a. Inflammation of the vulva and vagina
b. Irritation and itching in vaginal area
c. Profuse greenish - yellow discharge with foul odor
d. Frosty white or grayish - green vaginal discharge

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37
Q

Etiologic Agent of Trichomoniasis

A

Trichomonas Vaginalis

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38
Q

Effects of Trichomoniasis to fetus / pregnancy

A

a. Preterm labor
b. Premature Rupture of Membranes (PROM)
c. Post-cesarean infection
d. Medical Management: Metronidazole (anti-fungal)

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39
Q

A common vaginal infection that happens when some normal bacteria that lives in the vagina overgrows

A

Bacterial Vaginosis

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40
Q

Absence of lactobacilli

A

Bacterial Vaginalis

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41
Q

Common vaginal infection that happens when some normal bacteria that lives in the vagina overgrows

A

Bacterial Vaginalis

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42
Q

Nitrogen-containing compounds produced by bacterial metabolism with strong odors

A

Vaginal amines

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43
Q

Etiologic agent of Bacterial Vaginalis

A

Gardnerella Vaginalis

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44
Q

Bacterial vaginalis effect on vagina

A

Acidity of vagina increases (alkalotic)

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45
Q

Screening and Diagnosis

A

a. complete history taking
b. Report fishy odor & increase vaginal discharge
c. normal saline smear

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46
Q

Normal Saline Smear

A

a. 10% Potassium Hydroxide
b. Only seen through microscope
c. Check Vaginal secretions for pH and amine odor

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47
Q

Signs and symptoms of bacterial vaginalis

A

a. gray and has a “fishy” or “musty” odor vaginal discharge
b. pruritus

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48
Q

Bacterial Vaginalis has been related with what conditions and complications of pregnancy

A

Gynecologic

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49
Q

Effects to fetus / gynecologic conditions and complications of pregnancy due to bacterial vaginalis

A

a. Pelvic inflammatory disease (PID)
b. Post hysterectomy vaginal cuff cellulitis
c. Endometritis
d. Amniotic fluid infection
e. Preterm delivery, preterm labor
f. Premature rupture of the membranes (PROM)
g. Spontaneous abortion

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50
Q

Medical Management of Bacterial Vaginalis: topical

A

a. metronidazole (flagyl) - 0.75 percent vaginal gel
b. clindamycin - 2 percent vaginal cream

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51
Q

Medical Management of Bacterial Vaginalis: Cream

A

a. Metronidazole - 500 mg orally twice daily (5 day therapy)
b. clindamycin 300 mg orally twice daily (5 day therapy)

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52
Q

Benefits of medical management at twice daily

A

a. At twice-daily, 5-day therapy of vaginal metronidazole had a reported cure rate of 75–81 percent, while treatment with clindamycin cream was reported to resolve 82–96 percent of cases of BV

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53
Q

Considered medication that is safe in pregnancy

A

There is no evidence that metronidazole is teratogenic or mutagenic

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54
Q

Assessment : Chlamydia

A

a. heavy, grayish-white discharge
b. pruritus
c. common complications; cervicitis, urethritis, vaginitis, PID

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55
Q

Etiologic agent of the STI Chlamydia

A

a. Chlamydia Vaginalis
b. Chlamydia trachomitis

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56
Q

In Asia, rates among pregnant women tend to be much higher for up to

A

a. Up to 17% in India
b. Up to 26% in rural Papua New Guinea

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57
Q

Screening and Diagnosis

A

a. Complete history taking
b. Physical exam with symptoms
c. Cervical culture during 1st prenatal visit, if positive, repeat at 36 weeks

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58
Q

Cervical culture during 1st prenatal visit, if positive, repeat at 36 weeks

A

a. Use sample urine if cervical swab is unavailable
b. To prevent conjunctivitis and pneumonia

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59
Q

Signs and Symptoms of Chlamydia

A

a. heavy, gray - white discharge
b. common clinical manifestations include; cervicitis, urethritis, vaginitis, pelvic inflammatory disease

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60
Q

Risks of Chlamydia

A

a. Studies have shown that infants born through an infected birth canal have a 60-70% risk of acquiring the infection
b. In approximately 25.50% of exposed infants, conjunctivitis will develop; In 10-20% of the infants, pneumonia will develop
c. In pregnant women, Chlamydia infections can lead to ectopic pregnancy, preterm premature rupture of membranes (PPROM), and premature delivery

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61
Q

Medical Management of Chlamydia

A

a. Tetracycline & Doxycyline (non-pregnant state)
b. amoxicillin or erythromycin (pregnant) orally single dose
c. azithromycin (pregnant) 1 g orally

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62
Q

Doxycycline

A

a. teratogenic
b. mostly used in non-pregnant women

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63
Q

Effects : Chlamydia

A

a. Ectopic pregnancy
b. Preterm birth
c. Premature Rupture of Membranes (PROM)
d. Amniotic fluid infection
e. Premature delivery

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64
Q

A sexually transmitted infection characterized by progressive stages that can lead to serious complications

A

Syphilis

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65
Q

Etiologic agent of Syphylis

A

treponema pallidum

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66
Q

Syphilis

A

a. Etiologic Agent: Treponema pallidum
b. Incubation Period: 10 - 90 days
c. Early Pregnancy - intact cytotrophoblast layer of the chorionic villi
d. 16th to 18th week

67
Q

Research on Syphilis

A

a. Studies of pregnant women in Africa have revealed rates of 17.4% in Cameroon, 8.4% in South Africa, 6.7% in Central African Republic and 2.5% in Burkina Faso
b. In the Western Pacific, there are relatively high cases in the South Pacific (8%), 4% in Cambodia and 3.5% in Papua New Guinea

68
Q

Signs and symptoms of Shyphilis

A

a. Primary stage
b. Secondary stage
c. Latent stage
d. Tertiary stage

69
Q

Primary stage of Syphilis

A

small, hard based chancre or sore

70
Q

Secondary stage of Syphilis

A

a. skin rashes
b. loss of patches of hair
c. malaise
d. fever

71
Q

Latent stage

A

asymptomatic for a few years to several decades, positive VDRL test

72
Q

Tertiary stage

A

a. gumma formation (rubbery mass of tissue)
b. affect major organs (heart, nervous system)

73
Q

Diagnostic Procedure for Syphilis

A

a. Patients suffering from syphilis produce antibodies that react with cardiolipin antigen (present in beef meat) in a slide flocculation test, which are read using a microscope

74
Q

Screening and Diagnosis of Syphilis

A

a. VDRL test
b. Repeated test when close to term (8th month pregnancy) - if exposure is concern
c. infant born to a mother with syphilis

75
Q

Infant born to a mother with syphilis

A

positive for 3 months even though disease is treated during pregnancy

76
Q

Effects of Syphilis to Fetus

A

a. Spontaneous abortion
b. Still born infant
c. Premature labor
d. Congenital syphilis (enlarged liver & spleen, skin lesion, rashes, pneumonia, hepatitis)
e. Hira, S. K. (1988) found out that pregnancy outcomes of the 81 seropositives before intervention showed 11 abortions, 12 preterm deliveries, 9 low birth weight babies, 11 stillbirths, and 4 congenital syphilis (58% of syphilitic pregnancies).

77
Q

Medical Management for Syphilis

A

a. Benzathine penicillin G (pregnancy)
b. Procaine penicillin, intramuscular, 750 mg daily for 10 days
c. Erythromycin 500 mg four times a day should be given for 14 days (allergy to PenG)
d. Azithromycin 500 mg should be given daily for 10 days (allergy to PenG)

78
Q

Jarish - Herxcheimer reaction

A

a. It is causes due to sudden destruction of spirochetes
b. May last about 24 hours

79
Q

Signs and symptoms of Jarish - Herxcheimer reaction

A

a. hypotension
b. fever
c. tachycardia
d. muscle aches

80
Q

Congenital Anomalies

A

a. Extreme rhinitis (sniffles)
b. Syphilitic rash (face, soles of the feet, palm of hands)
c. Hutchinson’s teeth
d. Interstitial keratitis

81
Q

Assessment: Syphilis

A

a. History Taking for Multiple partners, unprotected intercourse and drug related risks

82
Q

Nursing Interventions: Syphilis

A

a. Facilitate Learning
b. Provide Social and Emotional Support
c. Promote Self care

83
Q

Promote Self care

A

Emphasize that douching is contraindicated unless prescribed

84
Q

A sexually transmitted disease affecting the mucous membranes of the genitals, rectum, and throat, and potentially leading to severe complications if untreated.

85
Q

Can be concurrent with chlamydia

86
Q

Research on Gonorrhea

A

a. In the Western Pacific in the 1990s, the highest prevalence rates (3% or greater) were in Cambodia and Papua New Guinea
b. Other areas such as China, Vietnam and the Philippines had rates of 1% or less

87
Q

What is the Etiologic agent of Gonorrhea

A

Neiserria Gonorrhoeae

88
Q

Mode of transmission of Neiserria Gonorrhea

A

a. Genital to genital
b. Anal to genital
c. Oral to genital
d. Vagina to rectum

89
Q

Assessment of Gonorrhea

A

a. Yellowish to greenish vaginal discharge
b. Inflamed Bartholin’s glands
c. Painful Bartholin’s glands (painful during palpation)

90
Q

Screening and Diagnosis

A

a. Urine culture
b. Vaginal culture
c. Urethral culture (especially in males)
d. Anal culture
e. Oral culture (newborn baby born to gonorrhea mother)

91
Q

Effects of Gonorrhea to fetus / pregnancy

A

a. Severe eye infection (fetus)
b. Blindness
c. Endocervicitis
d. Intrauterine growth restriction
e. Premature Rupture of Membrane (PROM)
f. Preterm birth
g. Maternal postpartum sepsis

92
Q

Medical Management of Gonorrhea

A

a. Oral cefixime (Suprax)- 400 mg PO once
b. Ceftriaxone (Rocephin)- 125-250 mg IM once
c. common side effects - nausea and vomiting

93
Q

Most recent drug suggestion

A

Azithromycin

94
Q

Common side effects of Oral Cefixime and Ceftriaxone

A

Nausea and Vomiting

95
Q

Etiologic Agent of Herpes Genitals

A

a. Herpesvirus hominis type 2
b. Herpes simplex virus 2 (HSV-2)

96
Q

Mode of transmission of herpes genitals

A

shin to skin contact / direct contact

97
Q

Shin to skin contact / direct contact

A

a. Break in the skin or mucous membrane
b. Incubation period of 3-14 days

98
Q

Assessment: Herpes Genitals: Primary Stage (week 1)

A

a. Pinpoint vesicles (lesion) from the external genitalia
b. Flu like symptoms (increased temperature
c. Profuse vaginal discharge
d. Intense pain on contact with clothing or acidic urine

99
Q

Screening and Diagnosis

A

a. Appearance of the lesions
b. Pap smear
c. Vesicle culture
d. ELISA

100
Q

Medical Management: Herpes Genitals

A

a. Acyclovir (Zovirax) - antiviral that inhibits replication of herpetic viruses

b. Topical imiquimod (Aldara) - vesicular lesions of pt

c. Foscarnet (Foscavir) - prescribed for resistant lesions

d. Valacyclovir (valtrex) - used as a preventive measure to help limit the disease spread

e. Sitz bath (TID)

f. Use of condoms

g. Annual Pap Tests

101
Q

Effects: Herpes Genitals

A

a. Transmitted across the placenta
b. Transmitted to the newborn at birth (primary/secondary active lesions in the vagina)
c. Congenital herpes - severe systemic infection (fatal)
d. CS Birth is scheduled (active lesions)
Vaginal Birth (no lesions)

102
Q

Has no cure

A

Herpes Genitals

103
Q

A virus that attacks the immune system, specifically CD4 cells, weakening the body’s ability to fight infections

104
Q

HIV

A

a. can lead to aids, but not all cases

105
Q

Most advanced stage of HIV infection, characterized by severe immune suppression and increased susceptibility to opportunistic infections and certain cancers

106
Q

Characteristics of HIV / AIDS

A

a. AIDS is increasing more rapidly among women, as it is now the fourth leading cause of death among women aged 25- 44
b. For women in their reproductive years (15–44), HIV/AIDS is the leading cause of death and disease worldwide, while unsafe sex is the main risk factor in developing countries

107
Q

Etiologic agent of HIVf transmission

A

Human retrovirus

108
Q

Mode of transmission of HIV

A

a. intimate sexual contact
b. Parenteral exposure to blood, body fluids and blood-containing products
c. Perinatal transmission

109
Q

Stages of HIV Infection

A

a. Initial Invasion
b. Seroconversion
c. Asymptomatic period
d. Symptomatic period

110
Q

Initial Invasion

A

a. flu-like symptoms
b. Mononucleosis-like or influenza-like symptoms

111
Q

Seroconversion

A

a. converts from having no HIV antibodies in her blood serum to having HIV antibodies
b. usually happens 6 weeks - 1 year after exposure

112
Q

Asymptomatic period

A

weight loss and fatigue (3-11 years old)

113
Q

Symptomatic period

A

a. opportunistic infections occur like oral and vaginal candidiasis, kaposi sarcoma, herpes complex, pneumocystis carnii
b. These opportunistic infections are the ones that causes death to HIV patients (especially pneumonia)

114
Q

Diagnostic Procedure for HIV

A

a. ELISA (Enzyme-Linked Immunosorbent Assay)
b. Western blot analysis (for confirmation)
c. Possible Diagnosis: Risk for infection related to dysfunctional immune system

115
Q

Nursing Management for HIV

A

a. aseptic technique - hand washing and gloves; reverse isolation
b. administration of medications as prescribed
c. provide health education
d. Goal: Maintain CD4 cell count >500 cells/mm3
e. cesarean delivery

116
Q

Maintain CD4 cell count >500 cells/mm3

A

a. Administer oral zidovudine along with ritonavir (Norvir) or indinavir (Crixivan)
b. If PCP develops, a woman is treated with TMP-SMZ (Bactrim, Septra), pentamidine (Pentam) is the DOC in nonpregnant women
c. Platelet transfusion if close to birth

117
Q

Administration of medications as prescribed

A

acyclovir; antiretroviral therapy

118
Q

Provide health education on

A

a. breastfeeding
b. protected sexual activity

119
Q

Nursing Management for STD

A

a. assessment
b. diagnosis
c. interventions

120
Q

Assessment

A

a. history taking

121
Q

What to include in history taking

A

a. multiple partners
b. unprotected sexual intercourse

122
Q

Diagnosis

A

knowledge deficit

123
Q

Interventions

A

a. discuss the causes of STD: multiple partners
b. teach about proper hygiene: perineal washing
c. provide care with a non-judgmental attitude

124
Q

Etiologic agent of Papilloma Infection (HPV infection)

A

human papilomavirus

125
Q

Genital warts

A

a. External vulva
b. Vagina
c. Cervix
d. anus

126
Q

Assessment : Papilloma Infection

A

a. Profuse vaginal discharge
b. Itching
c. Dyspareunia
d. Post-coital bleeding
e. Bumps on vulva
f. Cauliflower like

127
Q

Screening and Diagnosis : Papilloma Infection

A

a. Physical exam
b. Pap Smear
c. Histological evaluation biopsy of specimen (most definite)

128
Q

Histological evaluation biopsy of specimen (most definite)

A

Tutusukin yung wart and kukunin yung tissue as specimen

129
Q

Medical Management: Papilloma Infection

A

a. Removal of warts
b. Administer vaccine (Gardasil)
c. Keep the area clean and dry
d. Wear cotton underwear and loose-fitting clothes that decrease friction and irritation

130
Q

Removal of warts

A

a. Application of podophyllin (Podofin) - small lesions
b. TCA/BCA applied to lesions weekly for pregnant women
c. Laser therapy, cryocautery, knife excision - large lesions

131
Q

Administer vaccine (Gardasil)

A

a. Recommended for teenage girls (9 - 14 years old) in 3 doses
b. Reduces incidence of HPV and cervical cancer

132
Q

Pregnancy and HPV

A

a. Increase of HPV lesions
b. Ulcerated and Infected lesions
c. Foul vulvar odor

133
Q

Classifications of Substance Abuse

A

a. alcohol
b. cocaine and crack
c. marijuana
d. MDMA (Ecstasy)
e. Heroin
f. Methadone

134
Q

Characteristic on Alcohol abuse

A

a. Woman may experience withdrawal seizures in the intrapartal period as early as 12-48 hours after she stops drinking
b. Delirium tremens may occur in the postpartum period
c. newborn may suffer a withdrawal syndrome

135
Q

Effects of Alcohol on mother

A

a. Malnutrition - folic acid and thiamine deficiency
b. bone marrow suppression
c. Increased incidence of infections
d. Liver diseases

136
Q

Effects of Alcohol on Fetus

A

a. Fetal Alcohol Syndrome (FAS)
b. Physical and mental abnormalities
c. Intoxicate the infant
d. Inhibit the maternal letdown reflexetal
e. Fetal mental retardation
f. Fetal growth restrictions

137
Q

Nursing intervention for abuse of alcohol

A

a. sedation to decrease irritability and tremors
b. seizure precautions
c. intravenous fluid therapy for hydration
d. preparation for an addicted newborn
e. breastfeeding is contraindicated

138
Q

Sedation to decrease irritability and tremors

A

Take caution on fetal depression

139
Q

Breastfeeding is contraindicated

A

Alcohol is excreted in the breastmilk

140
Q

Alcohol abuse of mother can lead to physical abnormalities

A

a. small head
b. undeveloped pinna (outer ear)
c. short nose
d. missing groove above lip
e. pointed, small chin
f. small eye openings
g. flat face
h. thin lips

141
Q

Characteristics of Cocaine abuse

A

a. Placental vasoconstriction decreases blood flow to the fetus
b. Feeling of euphoria and excitement
c. Usually followed by irritability, depression, pessimism, fatigue, and addiction
d. Cocaine metabolites may be present in the urine of the pregnant woman for 4-7 days after use
e. Cocaine crosses into breast milk

142
Q

How does cocaine abuse lead to placental vasoconstriction

A

stimulates sympathetic nervous system

143
Q

What happens after placental vasoconstriction occur due to cocaine abuse

A

a. reduced blood flow to the fetus
b. decrease oxygen and nutrient supply to fetus
c. fetal growth restriction
d. low birth weight
e. development issues
f. increased risk of placental abruption
g. preterm birth
h. placental complications

144
Q

Take caution on pregnant women with;

A

a. extreme irritability
b. vomiting
c. diarrhea
d. dilated pupils
e. apnea

145
Q

Signs and symptoms of cocaine abuse

A

a. mood swings
b. appetite changes

146
Q

Withdrawal symptoms on cocaine includes;

A

a. depression
b. irritability
c. nausea
d. lack of motivation
e. psychomotor changes

147
Q

Effects of cocaine on pregnant women

A

a. seizures
b. hallucinations
c. pulmonary edema
d. cerebral hemorrhage
e. respiratory failure
f. heart problems
g. spontaneous abortion
h. abruption placentae
i. preterm birth
j. stillbirth

148
Q

Effects of cocaine on fetus

A

a. IUGR (intrauterine growth restriction)
b. small head circumference
c. cerebral infarction
d. altered brain development
e. shorter body length
f. malformation of the genitourinary tract
g. APGAR score (low/poor)

149
Q

Effects of cocaine on newborn

A

a. exposed in utero may have neurobehavioral disturbances
b. irritability
c. exaggerated startle reflex
d. labile emotions
e. sudden infant death syndrome

150
Q

It is a CNS depressant narcotic

151
Q

What Heroin Abuse do

A

alters perception and produces euphoria

152
Q

An addictive drug that is administered IV

153
Q

Abuse of Heroin on pregnant women would lead to

A

a. increased incidence of poor nutrition
b. iron deficiency anemia
c. pre-eclampsia

154
Q

Abuse of Heroin on fetus would lead to

A

a. increase risk for IUGR)
b. meconium aspiration
c. hypoxia

155
Q

Abuse of Heroin on newborn would lead to

A

a. restlessness
b. shrill
c. high-pitched cry
d. irritability
e. fist sucking
f. vomiting
g. seizures

156
Q

When does withdrawal symptoms typically occur when withdrawing from heroin

A

appear within72 hours

157
Q

Characteristics of Methadone drug

A

a. most commonly used therapy for women dependent on opioids
b. blocks withdrawal symptoms
c. reduces or eliminates the craving for narcotics
d. it crosses the placenta
e. prenatal exposure

158
Q

What will happen when pregnant women withdraws from methadone

A

Newborn may experience withdrawal symptoms that are often severe and longer lasting

159
Q

Abuse of methadone would lead to

A

Prenatal exposure

160
Q

Prenatal exposure

A

a. reduced head circumference
b. lower birth weight

161
Q

Nursing Diagnosis for Methadone

A

a. Imbalanced nutrition: less than body requirement related to inadequate food intake secondary to substance abuse
b. Risk infection related to use of inadequately clean syringes and needles secondary to IV drug use
c. Risk for ineffective health maintenance related to a lack of information about the impact of substance abuse on the fetus

162
Q

Planning and Implementation on Methadone Abuse

A

a. prevention on substance abuse during pregnancy
b. provide information about the relationship between substance abuse and existing health problems
c. preparation for labor and birth should be part of prenatal planning
d. preferred methods of pain relief

163
Q

Preferred methods of pain relief

A

a. psychoprophylaxis and regional blocks (epidurals)
b. local anesthetics (pudendal block, local infiltration)

164
Q

Evaluation on Methadone abuse

A

a. the women is able to describe the impact of her substance abuse on herself and her unborn child
b. the women gives birth to a healthy infant
c. the woman accepts a referral to social services for follow - up care after discharge

BALANTAD | MATERNAL CHILD HEALTH NURSING 2 (15 decks)

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