Module 6: Chelsea Flashcards
1
Q
What are some drugs associated with substance use (3)?
A
- alcohol
- amphetamines: Ritalin
- barbiturates: Seconal, Nembutal, Amytal, Tuinal
- benzodiazepines: Xanax, Valium, Ativan, Halcion
- cocaine
- opioids: morphine, codeine, methadone, heroin
** All drugs, whether prescribed or illicit, can have potential to cause harm to maternal and/or fetal/neonatal health.
2
Q
What are affects on the developing fetus with substance use (3)?
A
- act directly on the fetus (a teratogen): birth defects
- alter function of the placenta: intrauterine growth restriction, microcephaly
- cause muscles of the uterus to contract: spontaneous abortion, or premature delivery
3
Q
What are affects of substance use on newborn after birth (3)?
A
- withdrawal symptoms
- respiratory distress
- infections (HIV, hepatitis)
- postnatal growth delay
- feeding difficulties
- long-term cognitive delays that may not manifest until school age
4
Q
What is neonatal abstinence syndrome (NAS)?
A
- a group of drug withdrawal symptoms that occur in a newborn who was exposed to opioid drugs during pregnancy
- specific to opioids, but withdrawal can also occur after in-utero exposure to non-opioid agents such as benzodiazepines, selective serotonin reuptake inhibitors (SSRIs), and nicotine
5
Q
What adverse outcomes does opioid (illicit or prescription) have on pregnancy/infant (3)?
A
- prematurity,
- low birth weight, and
- neurobehavioural abnormalities
6
Q
When can withdrawal symptoms appear for infants? how long does it last?
A
- can appear shortly after birth and up to 2 weeks of age
- last for up to 4–6 months
7
Q
What are the 12 social determinants of health as per Government of Canada?
A
- Income and social status *
- Employment and working conditions
- Education and literacy *
- Childhood experiences
- Physical environments
- Social supports and coping skills *
- Healthy behaviours
- Access to health services
- Biology and genetic endowment
- Gender *
- Culture
- Race/racism
8
Q
How does income and socioeconomic status affect perinatal and neonatal care?
A
- A person’s level of income shapes the basic conditions in which they live, such as safe housing, the availability of healthy food, and access to education.
- infants born to families of a lower socioeconomic position are at an increased risk for small for gestational age, preterm birth, and perinatal death
9
Q
How does education affect perinatal and neonatal care?
A
- Women with lower education levels are more vulnerable to adverse birth outcomes, such as preterm birth, small for gestational age, stillbirth, and infant mortality.
- This may be through lack of knowledge about antenatal care, nutrition and infant care, prevalence of risky behaviours, and health care utilization
10
Q
How does lack social support have on perinatal care for mom?
A
- Lack of social support can lead to poor mental and physical health, increased risk of depression, and pregnancy complication
11
Q
How does food security and housing affect perinatal and neonatal care?
A
- Lower-income or poorer people tend to replace healthy fresh food with processed, high-fat, sugary foods.
- Purchasing and consumption of unhealthy diets, in particular, eating fewer fruits and vegetables, is strongly patterned by socioeconomic status
12
Q
How does indigenous health affect perinatal and neonatal care?
A
- Indigenous people experience higher unemployment rates, lower education, more food insecurity, and a disproportionate burden of illness and early death compared to non-indigenous people.
- these disadvantages challenge indigenous women during pregnancy, a time when they are most vulnerable, which translates into disproportionate burden of ill health (gestational diabetes, obesity, post-partum depression, and stress-related behaviours) for indigenous women compared to non-indigenous women
13
Q
How does gender affect perinatal and neonatal care?
A
- Gender equality refers to equal rights, responsibilities, and opportunities of women and men and girls and boys
- Women are also less likely to be employed full-time and are less likely to be eligible for employment benefits.
- Furthermore, the higher percentages of women living in poverty than men and the persistence of violence, sexual assault, and sexual harassment against women all contribute to gender inequality and increase women’s risk for health issues and substance use problems
14
Q
What is a key aspect of providing trauma-informed care?
A
- to create an environment where these families do not experience further traumatization or re-traumatization and where they can make decisions about their care in a safe, supportive environment.
- we care for both the mother and the infant: meeting the women’s needs should be the focal point of the overall plan of care.
- “When we care for the mother, we care for the baby”
15
Q
What is trauma?
A
- The response that happens when an individual experiences an event, series of events, or set of circumstances (such as death of a significant parent or child, experiencing a significant injury or illness, neglect, abuse, witnessing violence or war) as physically or emotionally harmful or threatening.
- Depending on the person’s developmental stage, social supports, and resources, this event can have long-lasting effects on physical, social, emotional, or spiritual well-being
**Trauma is strongly correlated with substance use and mental health issues.
16
Q
What are 2 trauma strongly correlated with?
A
- substance use and
- mental health issues.
17
Q
What are the 5 types of trauma?
A
- single incident trauma: unexpected and overwhelming event, such as an accident, a natural disaster, a single episode of abuse or assault, sudden loss, or witnessing violence
- complex or repetitive trauma: Ongoing abuse, domestic violence, war, ongoing betrayal, often involving being trapped emotionally and/or physically
- developmental trauma: Exposure to early ongoing or repetitive trauma (as infants, children, and youth) involving neglect, abandonment, physical abuse or assault, sexual abuse or assault, emotional abuse, witnessing violence or death, and/or coercion or betrayal
- intergenerational trauma: the impact of a traumatic experience, not only on one generation, but on subsequent generations after the event.
- historical trauma: Cumulative emotional and psychological wounding over the lifespan and across generations emanating from massive group trauma. These collective traumas are inflicted by a subjugating (ex. slavery)
18
Q
What is trauma-informed practice?
A
- Trauma-informed care recognizes the impact of trauma and provides care to address these complex challenges.
Trauma-informed practice includes:
- trauma awareness,
- offering choice, collaboration and connection,
- offering safety and trustworthiness, and
- incorporating strength-based and skill building in our care.
19
Q
What are 4 factors of trauma and violence-informed care?
A
- acknowledging the effects of historical and structural conditions
- seeking client input about safe and inclusive strategies
- encouraging client empowerment in relation to treatment options and adoption of harm reduction strategies
- implementing policies and processes that allow for flexibility and encourage shared decision-making
20
Q
What is harm reduction model?
A
- a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use.
- Harm reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs
21
Q
What does harm reduction model takes into account?
A
- the impact of poverty, class, racism, trauma, and social inequalities on a person’s vulnerability to, and capacity for, dealing with substance use.
22
Q
What does adopting harm reduction view means?
A
- accepting that licit and illicit drugs are part of our world and that we should work to minimize the effects rather than condemn or ignore them
- understanding that drug use is complex and multi-faceted
- measuring the success of policies by quality of life and well-being, rather than cessation of all drug use
- calling for non-judgmental, non-coercive services for people who use drugs
- recognizing that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination, and other social inequalities affect both people’s vulnerability to and capacity for effectively dealing with drug-related harm
- not attempting to minimize or ignore the real and tragic harm associated with illicit drug use
23
Q
What are some examples of harm reduction programs (2)?
A
- heroin maintenance programs
- opioid replacement therapy
- safe injection sites
- needle exchange programs
- safer sex programs
- home naloxone kits
24
Q
What are programs in BC provide services for women who use substances during pregnancy via a women-centred (2)?
A
- sheway, vancouver bc
- maxxine wright community health centre, surrey bc
- FIR square, BCW hospital
- herway home, victoria
25
Q
What is opioid agonist treatment (OAT)?
A
- is a safe and effective medication-based treatment for people who are dependent on opioid drugs.
- It helps people living with opioid addiction improve their day-to-day functioning, stabilize, manage withdrawal, and work toward recovery.
- It can lower the risk of drug-related harm (harm reduction program) and
- assist people to stay in treatment and be active participants in their care and health outcomes
