Nursing 1 test flashcards
What is a nuclear family?
child lives with biological family
What is an extended family?
couples share household and childrearing responsibilities with parents, siblings and others
Acculturation
modifying one’s culture to fit within the new or dominant culture ex: Japanese people dressing up in western clothing still keeps it’s cultural values)
-able to keep their original culture to some degree
Assimilation
adopting and incorporating traits of the new culture within one’s practice. Forget one’s original culture and adopt a new culture completely
Who believes in curandero and what is it?
Mexican americans holistic healer Uses herbs Laying of the hands Massaging the afflicted area Wearing amulates Cleansing body Candle with a prayer Calling the spirits
Who believes in espiritistas and what are they?
Puerto Rican
a healer who communicates with spirits for the physical and emotional development of the client
Who believes in shamans?
Native Americans
Which two cultures has a large family size?
Amish and Appalachians
What culture where the child’s character is considered a reflection of the family’s influences?
Arab
Which culture lavishes resources on their children and where males are valued more than females?
Chinese American
Which culture does not encourage their children to leave the home?
Mexican American
Which culture allows children to make decisions about their care?
Navajo Indian
What are the 2 parts in the menstrual cycle?
uterine cycle and ovarian cycle
What are the 4 phases in the uterine cycle?
menstrual, proliferation, secreting and ischemic
What occurs in the menstrual phase? What days does it occur?
estrogen gets low and endometrial area shed
-day 1 to 6
What is the proliferation phase? What days does it occur?
endometrial gland is:
- enlarged because of an increase in estrogen
- endometrial tissue increases and blood vessels are prominent
- cervical mucosa thins and become alkaline
What is secreting phase and what days does it occur?
o Stage 3: Secreting Phase day 15 to 26
The endometrium and estrogenic influence undergo cellular growth
Progesterone warps the growth into folds
The glandular epithelial cells fill in the cellular debris
The glands secrete small amounts of fluid to prepare to fertilize the ovum
The vascularity of the uterus increases greatly to provide nourishment
If implantation occurs (sperm enters) the endothelium under the influence of progesterone thickens
What is ischemic phase and what days does it occur?
Both estrogen and progesterone levels drop. Spiral arteries undergo vasoconstriction. Endometrium becomes pale, blood vessels rupture. Blood escapes into uterine stromal cells, gets ready to be shed.
o **If fertilization occurs, menstrual phase (day 27-28) begins
What phases occur in the ovarian cycle and what occurs during that time?
Follicle Phase: day 1-14 (Corresponds with the menstrual and proliferation phase)
• Primordial follicle matures under influence of FSH and LH up to the time of ovulation
Luteal Phase: day 15 to 28 (corresponds with the secretory phase)
• Ovum leaves follicle; corpus luteum develops under LH influence and produces high level of progesterone and low levels of estrogen
How long are you considered an embryo?
From day 15th to approximately 8 weeks after conception
How long are you considered a fetus?
9th weeek till full term
What happens in the fetal stage at 9-12 weeks?
o C-R (crown to rump) is 5 cm (end of 9 wks.)
o At 12 weeks, 8cm
o Fetus can move fingers and create a tiny fist
o Eyelids close
o Kidneys begin to produce urine
o RBC made mostly by liver
o Heart rate can be examined (120-160 bpm)
o Sucking reflexes observed
What happens in the fetal stage at 13 to 16 weeks
o C to R is 9 cm
o Active movement is present
o Fetus exercises arms and legs by stretching
o Sweat glands develop
o Sucking motion observed when swallowing the amniotic fluid
o Skeletal ossification is clearly identified
o Meconium made (stool/ poop)
o Liver and pancreas begin to work
o 16 weeks: baby’s sex can be seen
What happens in the fetal stage at 20wks?
o C to R is 19 cm
o Fine hair begins to develop
o Nipples appear
o Mother feels fetal movement known as quickening
o Fetal heart audible through a fetoscope
What happens in the fetal stage at 24wks
o 23 cm for C to R
o Long head of hair, eyelashes and eyebrows formed
o Fetus has a hand grip
o Fingerprints and footprints are formed
o Alveoli beginning to form
o Vernix caseosa (protective cheese like fatty substance secreted by the sebaceous gland) covers entire fetal body
Used to lubricate skin to prevent it from becoming dry
What happens in the fetal stage at 25-28 wks
o Brain develops rapidly o Eyelids open and close o Nails have formed o If male, testes begin to descend o Lungs able to provide gas exchange o C to R is 27 cm o Nervous system is complete enough to regulations of body function
What happens at 29-32 weeks
o Pupillary light reflex is present o C to R is 31cm o Bones fully developed o Fetus begins to store iron, calcium and phosphorous o Nails reach the end of the fingertips
What happens at 35-36 weeks
o Pupillary light reflex is present o C to R is 31cm o Bones fully developed o Fetus begins to store iron, calcium and phosphorous o Nails reach the end of the fingertips
What happens at 38-40 weeks
o Body plump with good skin turgor
o The head is generally pointed downwards as well as flexed
o After 5 months, patterns in feeding, sleeping, and activity become established
What is another term for increase salivation?
ptyalism
WHat test can detect down syndrome in babies?
Alpha Fetoprotein
WHen should you perform an amniocentesis and what is it?
15-20 weeks because there is plenty during this time
used to assess fetal maturity
What test is used to see if amniotic fluid is leaking?
Fern Test; instruct patient to cough to see if there is a leakage in teh uterus
What test is used to determine if there will need to perform a preterm birth?
FIbronectin Test
What does a negative nonstress test mean?
baby’;s well being is normal; nonstress test tests the fuinction of the placenta
What does a positive nonstress test mean?
accelerations are less than 15bpm; nonstress test tests the fuinction of the placenta
What is a contraction stress test
uterus is stimulated with pitocin to assess contraction;
tests ability to tolerate labor
What is a negative contraction stress test?
normal and there is no late decelerations
What is a positive contraction stress test?
abnormal and it means there is a late deceleration
What is VEAL CHOP
V-Variable E-Early A-Accelerations L-Late C-Cord Compression H-Head Compression O-Okay P-Placental Insufficiency
What happens to the mother in the first trimester?
o Fatigue o Tender breasts o Food cravings o N/V o Mood swings o Frequent urination
What happens to the mother in the second trimester?
o Swelling of legs/ cramping o Aching of lower back o Hemorrhoids and varicose veins o Heart burn o constipation
What happens to the mother in the third trimester?
o Stretch marks o Leaky beasts o Irregular contractions (Braxton-hicks) o Vivid dreams o Dyspnea o Nose bleeds
How much weight does the mother gain in each trimester?
-On a trimester basis in a woman with normal pre-pregnancy weight: First trimester: 1-4.5 pounds. Second trimester: 1-2 pounds per week. Third trimester: 1-2 pounds per week
What is GTPAL
- G gravidity= number of pregnancies
- T term births= the number born longer than 37 weeks gestation
- P preterm births= the number of births after 20 weeks and less than 37 weeks gestation whether living or stillborn
- A abortion or miscarriage before 20 weeks
- L living children
WHat is nagele’s rule?
- First day of last menstrual period: September 12, 2014
- Subtract 3 months: June 12 3014
- Add 7 days: June 19, 2014
- Add one year: June 19, 2015 (estimated delivery)
What are positive signs of pregnancy?
- Fetal heart rate
- Active fetal movements palpable by examiner
- Outline of fetus via radiography or ultrasonography
What is probable signs of pregnancy?
Goodell sign Chadwick sign Hegar sign Mcdonald sign Enlargement of the abdomen Braxton hicks contractions Uterine souffle Changes in pigmentation of skin. Ballottement Pregnancy test
What are presumptive signs of preganncy?
N/V Amenorrhea Breast tenderness Fatigue Urinary frequency Quickening
What is the first stage of labor?
latent (0-3), active(4-7), transitional (8-10 which is full dilation)
What is the second stage of labor?
pushing stage
mechanism of labor
o Mechanisms of labor are used (engagement, descent, flexion, internal rotation, extension, restitution, external rotation, expulsion
WHat is the third stage of labor?
Placental stage: delivering the placenta
What is the 4th stage of labor?
- Maternal Homeostatic Stabilization
What is 1st degreee perineal laceration?
tear of the perineal skin and the vaginal epithelium
What is 2nd degree perineal laceration?
laceration involves the perineal skin, vaginal mucus membrane, underlying fascia, and muscles of the perineal body; it may extend upward on one or both sides of the vagina
What is 3rd degree perineal laceration?
laceration extends through the perineal skin, vaginal mucus membranes, and perineal body and involves the anal sphincter; it may extend up the anterior wall of rectum
What is 4th degreee perineal laceration?
laceration is the same as third degree but extends through the rectal mucosa to the lumen of the rectum, it may be called a third degree laceration with a rectal wall extension
WHat does REEDA stand for and what is it used for
episiomtomy assessment: • R- redness • E- edema • E-ecchymosis (bruise) • D- discharge • A- approximation
What does BUBBLEHEAD stand for?
- B-breasts
- U-uterus
- B-bladder
- B-bowels
- L-Lochia
- E-Episiotomy
- H-Homan’s sign
- E-Emotional status
- D-Diastasis Recti (abdomen ripped)
What is lochia rubra?
- Dark red
- Occurs for the first 2-3 days and contains epithelial cells, erythrocytes, leukocytes, shreds of decidua, and occasionally fetal meconium, lanugo, and vernix caseosa
- Small clots ( no larger than a nickel) are common
What is lochia serosa?
- Pinkish color
- Day 3 until day 10
- Composed of serous exudate, shreds of degenerating decidua, erythrocytes, leukocytes, cervical mucus, and numerous microorganisms
What is lochia alba
- Creamy or yellowish discharge
- 1-2weeks
- Composed of leukocytes, decidual cells, epithelial cells, fat, cervical mucus, cholesterol crystals, and bacteria.
How would you inhibit breastmilk from appearing? (5)
o Woman begins wearing a supportive bra 6 hours after birth
o Bra is worn continuously until lactation is suppressed (about 5 to 7 days) and is removed only for showers
o Ice packs should be applied on the arm pits 20 minutes four times a day
o Avoid stimulation of her breasts by her baby, herself, breast pumps or sexual partner until the feeling of fullness is gone (5 to 7 days)
o Avoid heat on the nipples and make sure to let shower flow over back instead of breasts
What is convection?
Losing heat caused by cooler air currents
What is radiation?
Loss of heat because of the transfer of heat to a cooler surface not in direct contact with the neonate
What is evaporation?
Loss of heat caused by water turning into vapor
What is conduction?
Loss of heat to a cooler surface that is in direct contact with the neonate
