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STATE EXAM PREP > part 3 > Flashcards

part 3 Flashcards

1
Q

Changes to genital organs with pregnancy?

A

Bluish purpleish discolouration of labia, vagina and cervix (chadwicks sign)
Cervical softening with mucous plug (goodells sign)
Abdominal enlargement
Breast enlargement and vascular engorgment
Colostrum secretion

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2
Q

When would abdominal enlargement occur during pregnancy?

A

Around the 12th week

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3
Q

When would you expect colostrum secretion in pregnancy?

A

Around the 16th week

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4
Q

How to diagnose a pregnancy?

A

Raised human chorionic gonadrotropin (hCG) 7-10 days (blood) and 3rd week (urine) after contraception
Steadily increases to maximum levels between the 8-11th week (pee stick/bloods)

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5
Q

What does an ultrasound see in pregnancy?

A

Uterine enlargement
Gestational sac
Foetal pulse
Foetal lie, presentation, position, size, number, death

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6
Q

When would a pregnant patient have a foetal electrocardiography?

A

12th week

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7
Q

How many bpm is a foetal heart?

A

120-160

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8
Q

What is a teratogen?

A

an agent or factor that causes malformation of an embryo. Can cause birth defects or death

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9
Q

List 4 examples of teratogens?

A

Infectious disease like rubella
STI’s like syphilis
Drugs like diet pills
Environmental toxins like mercury

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10
Q

What are the 2 main hormones in pregnancy and what do they do?

A

Oestrogen: develops female sexual characteristics, maintains a healthy pregnancy, produced by the ovaries and placenta.
Progesterone: relaxes smooth muscles, causes uterine lining to thicken. Produced in the placenta

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11
Q

What are the 4 P’s in labour?

A

Powers: contractions and duration of labour
Passage: size of pelvis, type of pelvis, ability of cervix to dilate
Passenger: foetus, foetal head size, attitude, lie, positions, presentation
Psyche: preparations, people, professionals, environment

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12
Q

What duration of labour is typical for a primigravida?

A

12-20 hours

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13
Q

What duration of labour is typical for a multigravida?

A

6-12 hours

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14
Q

What is involution?

A

Uterus reduction to pre-pregnancy state.

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15
Q

What is lochia?

A

Vaginal discharge after delivery composed of endometrial tissue blood and lymph

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16
Q

What are 5 pieces of advice to give a pregnant woman?

A 
Stay smoke free
Zero alcohol
Folic scid and iodine intake
Avoid listeria (food poisoning)
Get blood and syndrome tests
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17
Q

When should a pregnant woman take folic acid?

A

Ideally once a day for 3 months prior to pregnancy and for the first 3 months of pregnancy

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18
Q

When should a pregnant woman take iodine?

A

One tablet per day throughout pregnancy

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19
Q

What are the blood tests needed through out pregnancy? (8)

A 
Blood group or rhesus factor
Haemoglobin or iron
Antibodies
Immunity to rubella
Hep B
Syphilis
HIV
Diabetes
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20
Q

What antenatal screening is offered in NZ?

A

Down’s syndrome and other genetic conditions

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21
Q

When can antenatal screening be done?

A

First trimester combined screening or if less than 14 weeks, can be done with a blood test and ultrasound scan

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22
Q

What does a antenatal screening look for?

A

The thickness of the back of the neck, known as the nuchal thickness in Down Syndrome

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23
Q

What is rubella?

A

usually a mild viral illness associated with a rash, fever and swollen glands in children

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24
Q

Symptoms of rubella?

A

Rash
Swollen neck glands
Sore joints
Feeling unwell

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25
Q

Effects of rubella on an unborn child?

A

Blindness
Deafness
Heart defects
Brain damage

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26
Q

What causes rubella immunity?

A

Previous case of rubella

Immunisation (MMR)

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27
Q

What does the MMR vaccine cover?

A

Measles, mumps, and rubella

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28
Q

When can your child get the MMR vaccine?

A

At 12 and 15 months

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29
Q

What is listeria?

A

A common bacterium which can cause uncommon but potentially serious illness called listeriosis. Found in milk products, soft cheeses, and uncooked meats. also in soil, water, plants, and animal and human faeces

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30
Q

How do people get listeriosis?

A

Eating contaminated food, in particular, ready to eat products and food with a long refrigeration life

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31
Q

Who is at risk of listeriosis?

A

Pregnant woman and their foetus
Newborns
Weak immune system patients
Elderly

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32
Q

What are the symptoms of listeria?

A 
Takes days to weeks to show:
Mild fever
Headache
Aches and pains
Vomitting
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33
Q

What can listeria lead to?

A 
Meningitis
Sepsis
Miscarriage
Premature or still birth
Severe infection of a newborn baby
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34
Q

What does a baby need vitamin D supplement for?

A

To maintain healthy levels of calcium and phosphorus which helps build bones and teeth

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35
Q

What does low vitamin D put a baby at risk of?

A

Rickets which can lead to deformed and broken bones
Abnormal bone growth
Delayed physical development

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36
Q

Which food contains vitamin D?

A

Fatty fish
Eggs
Liver
Milk and yogurt

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37
Q

What are rickets?

A

Bone disease ,Bowed legs no vit d and phosphorus

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38
Q

When should a baby start on solids?

A

after 6 months

39
Q

How long does nz recommend breast feeding?

A

Until the baby is over 1 years old

40
Q

List 5 benefits of breast feeding?

A 
Antibodies build babies immunity
Helps with brain development
Bonding
Saves cost of formula
Less likely to develop breast and cervical cancer for mother
41
Q

What illness does breastmilk help to protect babies from?

A 
Eczema
Asthma
Bowel disease
Cancer
Type 2 diabetes
42
Q

What is meconium?

A

The dark green substance forming the first feces of a newborn infant.

43
Q

What is colostrum?

A

the substance that is released when a woman first begins to lactate, containing proteins and antibodies

44
Q

What hormone initiates lactation?

A

Prolactin

45
Q

What is oxytocin?

A

A hormone secreted by the posterior pituitary gland in the hypothalamus that causes increased contraction of the uterus during labour and stimulates ejection of milk into breast ducts

46
Q

What 5 things would you expect your 1 month old infant to be doing?

A

Can’t focus more than 8-12 inches away
Black and white patterns draw attention
Hearing is fully developed
Can lift head briefly and turn it to the side when on stomach
Jerky arm movements, can get them to the mouth

47
Q

List 5 red flags for a 1 month olds development?

A 
Doesn't suck well
Doesn't focus with eyes
Seems stiff or floppy
Doesn't react to loud sounds
Doesn't react to bright lights
48
Q

List 5 things to expect a 3 month old to do?

A 
Imitates facial expressions
Mimicks mum and dads sounds
Head doesn't need supporting
Open and close hands
Can lift head and chest
49
Q

What 5 things would you be concerned about if your 3 month old couldn’t do?

A 
Can't support head
Can't grasp objects
Can't smile
Doesn't react to loud sounds
Ignores new faces
50
Q

What should you expect your 7 month old to do?

A 
Smiles and laughs
Has babbling conversations
Rolls onto tummy and back
Can sit without help
Can support weight well enough to bounce when being held
51
Q

What 5 things would you be concerned about if your 7 month old couldn’t do?

A 
Seems stiff or floppy
Can't hold head steady
Can't sit on own
Doesn't respond to noises or smiles
Isn't affectionate to those close to her
52
Q

What would you expect your 8-12 old to be able to do?

A 
Explore
Crawl
Able to sit up
Might walk
First words
53
Q

What would you be concerned about in a 8-12 month old?

A 
Doesn't crawl
Can't stand with support
Doesn't say any words
Doesn't use gestures
Doesn't explore
54
Q

What would you expect a 1-2 yr old to do?

A 
Go up and down stairs
Stand on tip toes
Kick a ball
Run
Short sentences
55
Q

What would you be concerned about in a 1-2yr old?

A 
Can't walk by 18 months
Doesn't speak at least 6 words
Loses skills previously had
Can't follow simple instructions
Can't understand use of familiar objects
56
Q

What would you expect in a 2-3yr old?

A 
Imagination
Speech
Open doors and containers
Draws a circle
Develops friendships (empathy and affection)
57
Q

What would you be concerned about in a 2-3 yr old

A 
Struggles with separation anxiety
Doesn't interact with others
Avoids eye contact
Doesn't use more than 3 words in a sentence
Has trouble scribbling
58
Q

What are the 2 common types of middle ear problems?

A 
Acute otitis media (ear infection)
Glue ear (ear infection with effusion or secretions)
59
Q

How can ear infections occur following a cold?

A

Bacteria and virus travel to the eustachian tube which connects the space behind the ear drum to the back of the nose, the germs infect this space. This can cause swelling and blocking of the tube and fluid and pus in the ear drum

60
Q

What are s&s of an ear infection?

A

Fever
Pain in ear
Unwell
Reduced hearing

61
Q

What is the treatment for an ear infection?

A

pain relief

Antibiotics

62
Q

What are complications of an ear infection?

A

Hearing loss
Fluid collection usually lasting 12 weeks
A hole in the eardrum

63
Q

What immunisations are given to a child of 6 weeks?

A

Rotavirus 1 oral vaccine (Rotateq)
Diphtheria, tetanus, pertussis, polio, hepatitis B, haemophilus influenza type b 1 oral injection (infanrix)
Pneumococcal 1 injection (prevenar 13)

64
Q

What immunisations are given to a 3 month old?

A

Rotavirus 1 oral vaccine (rotateq)

Diphtheria, tetanus, pertussis, polio, hepatitis B, haemophilus influenza type b 1 oral injection (infanrix)

65
Q

When is rotavirus vaccine given?

A

6 weeks

3 months

66
Q

What vaccines are given at 5 months?

A

Rotaviras (Rotarix) oral

Diphtheria, tetanus, pertussis, polio, hepatitis B, haemophilus influenza type b (infanrix)

67
Q

What vaccines are given at 15 months?

A 
Haemophilus influenza type b 1 injection (ACT-HIB)
Measles mumps rubella 1 injection (MMR)
chicken pox (virecella)
68
Q

What immunisations are given at 4 years?

A

Diphtheria, tetanus, pertussis, polio, hepatitis B, haemophilus influenza type b 1 oral injection (infanrix)

69
Q

What vaccines are given at 11 -12 years?

A

Tetanus diphtheria pertussis 1 injection (boostrix)

Human papillomavirus 2 doses given over 6 months (GARDASIL)

70
Q

What vaccine is given at 45 years?

A

Diphtheria tetanus 1 injection (ADT booster)

71
Q

What vaccine is given at 65 years?

A

Diphtheria and tetanus 1 injection (ADT booster)
Influenza -anually
Shingles (Zostavax)

72
Q

What is naturally acquired active immunity?

A

Exposed to a live pathogen, develops the disease and becomes immune as a result of a primary immune response

73
Q

What is artificially acquired active immunity?

A

Can be induced by a vaccine a substance that contains the antigen

74
Q

What is passive immunity?

A

Naturally acquired during pregnancy

75
Q

How is measles spread?

A

Highly infections and contagious virus that spreads through the air, via breathing coughing and sneezing

76
Q

How long are you infectious for after measles?

A

5 days before and 5 days after the rash disappears

77
Q

What 5 complications can measles lead to?

A 
Ear infection
Diarrhoea
Pneumonia
Seizure
Swelling of the brain(encephalitis)
78
Q

What risks are involved in a pregnant woman getting measles?

A

Miscarriage
Premature labour
Low birth weight babies

79
Q

What are the symptoms of measles?

A 
A fever
A cough
Runny nose
Pink eye
Small white spots on the back inner cheeks of your mouth (Koplik spots)
A rash
80
Q

How is meningitis transmitted?

A

Difficult to spread as meningococcal bacteria doesn’t live outside the body for very long. But can pass from one person to another through secretions from the nose or throat during close or prolonged contact eg coughing kissing sharing eating or drinking utensils

81
Q

Who is at most risk of catching meningitis?

A 
Babies
Teenagers
Weak immune system
Respiratory infection
Tobacco exposed
Over crowded
82
Q

What is the bacteria from meningococcal?

A

Bacteria neisseria meningitidis. There are several different groups of meningococcal bacteria including groups A B C Y and W135. In NZ the most common strains are group B and W

83
Q

Can meningococcal be life threatening?

A

Yes it can cause sepsis or meningitis which is infection of the brain

84
Q

What comes under section 8A of the MHA?

A

Application for assessment

Application must be in writing

85
Q

What comes under section 9 of the MHA?

A

Notice to the patient to attend an assessment examination

Noticed is issued by a DAO

86
Q

What comes under section 10 of the MHA?

A

Certificate of the preliminary assessment

Done by a psychiatrist

87
Q

What comes under section 11 of the MHA?

A

Notice recruited to the patient to undergo a 5 day further period of assessment and treatment. It is compulsory

88
Q

What happens under section 14 of the MHA?

A

Certificate of final assessment
Application for compulsory treatment order
Completed up to 14 days after section 13
Patient now under section 15

89
Q

What occurs under section 29 of the MHA?

A

Compulsory COMMUNITY treatment order

Patient is still considered mentally disordered but can be managed out in the community

90
Q

What occurs under section 111 of the MHA?

A

Notice of intention to detain on hospital grounds. Nurse can detain a patient for more than 6 hours from the time when a nurse first calls for a medical practitioner to examine the patient

91
Q

How is a mental disorder defined by the MHA?

A

Abnormal state of mind characterised by delusions, disorders of mood or perception, volition or cognition of such a degree that poses a danger to the individual or others

92
Q

What are the patients rights under the MHA?

A 
Information
Cultural identity
Interpreter
Appropriate treatment
Informed regarding treatment
Able to refuse video recording
Independent psychiatric advice
Legal advice
Company and visitors
Make calls
Send and receive mail
93
Q

what vaccinations are given at 12 months?

A 
MMR (Priorix)
Pneumococcal disease (Synflorix)

STATE EXAM PREP (4 decks)

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