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MATERNAL CHILD HEALTH NURSING 2 > Pregestational Problems > Flashcards

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

Etiologic Agent of Candidiasis

A

Candida albicans

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17
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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18
Q

Symptoms of Candidiasis

A

a. thick yellow vaginal discharge
b. pruritus

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19
Q

What organism is Candida albicans

A

Fungus

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20
Q

Management of Candidiasis

A

a. Sitz bath
b. Not wearing under pants

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21
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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22
Q

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

A

Trichomoniasis

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23
Q

Medical Management of Trichomoniasis

A

a. discuss the importance of partner treatment
b. discuss the sexual transmission of this disease

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24
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

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25
Q

Etiologic Agent of Trichomoniasis

A

Trichomonas Vaginalis

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26
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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27
Q

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

A

Bacterial Vaginosis

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28
Q

Nitrogen-containing compounds produced by bacterial metabolism with strong odors

A

Vaginal amines

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29
Q

Etiologic agent of Bacterial Vaginalis

A

Gardnerella Vaginalis

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30
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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31
Q

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

A

Gynecologic

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32
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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33
Q

Medical Management of Bacterial Vaginalis by topical

A

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

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34
Q

Medical Management of Bacterial Vaginalis by Oral

A

a. Metronidazole - 500 mg orally twice daily
b. clindamycin 300 mg orally twice daily

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35
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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36
Q

Considered medication that is safe in pregnancy

A

There is no evidence that metronidazole is teratogenic or mutagenic

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37
Q

Etiologic agent of the STI Chlamydia

A

Chlamydia Vaginalis

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38
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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39
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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40
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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41
Q

Medical Management of Chlamydia

A

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

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42
Q

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

A

Syphilis

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43
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

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44
Q

Signs and symptoms of Shyphilis

A

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

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45
Q

Primary stage of Syphilis

A

small, hard based chancre or sore

46
Q

Secondary stage of Syphilis

A

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

47
Q

Latent stage

A

asymptomatic

48
Q

Tertiary stage

A

gumma formation (rubbery mass of tissue)

49
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

50
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).

51
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)

52
Q

It is causes due to sudden destruction of spirochetes

A

Jarish - Herxcheimer reaction

53
Q

How long does Jarish-Herxcheimer reaction last

A

24 hours

54
Q

Signs and symptoms of Jarish - Herxcheimer reaction

A

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

55
Q

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

A

Gonorrhea

56
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

57
Q

What is the Etiologic agent of Gonorrhea

A

Neiserria Gonorrhoeae

58
Q

Signs and Symptoms of Gonorrhea

A

a. yellow - green vaginal discharge

59
Q

Effects of Gonorrhea to fetus / pregnancy

A

a. severe eye infection (fetus) blindness
b. Endocervicitis
c. premature rupture of membranes

60
Q

Medical Management of Gonorrhea

A

a. Oral cefixime (Suprax)- 400 mg PO once
b. Ceftriaxone (Rocephin)- 125-250 mg IM once

61
Q

Common side effects of Oral Cefixime and Ceftriaxone

A

Nausea and Vomiting

62
Q

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

A

HIV

63
Q

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

A

AIDS

64
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

65
Q

Stages of HIV Infection

A

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

66
Q

Initial Invasion

A

flu-like symptoms

67
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

68
Q

Asymptomatic period

A

weight loss and fatigue (3-11 years old)

69
Q

Symptomatic period

A

opportunistic infections occur like oral and vaginal candidiasis, kaposi sarcoma, herpes complex, pneumocystis carnii

70
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

71
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

72
Q

Administration of medications as prescribed

A

acyclovir; antiretroviral therapy

73
Q

Provide health education on

A

a. breastfeeding
b. protected sexual activity

74
Q

Nursing Management for STD

A

a. assessment
b. diagnosis
c. interventions

75
Q

Assessment

A

a. history taking

76
Q

What to include in history taking

A

a. multiple partners
b. unprotected sexual intercourse

77
Q

Diagnosis

A

knowledge deficit

78
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

79
Q

Classifications of Substance Abuse

A

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

80
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

81
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

82
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

83
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

84
Q

Sedation to decrease irritability and tremors

A

Take caution on fetal depression

85
Q

Breastfeeding is contraindicated

A

Alcohol is excreted in the breastmilk

86
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

87
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

88
Q

How does cocaine abuse lead to placental vasoconstriction

A

stimulates sympathetic nervous system

89
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

90
Q

Take caution on pregnant women with;

A

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

91
Q

Signs and symptoms of cocaine abuse

A

a. mood swings
b. appetite changes

92
Q

Withdrawal symptoms on cocaine includes;

A

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

93
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

94
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)

95
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

96
Q

It is a CNS depressant narcotic

A

Heroin

97
Q

What Heroin Abuse do

A

alters perception and produces euphoria

98
Q

An addictive drug that is administered IV

A

Heroin

99
Q

Abuse of Heroin on pregnant women would lead to

A

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

100
Q

Abuse of Heroin on fetus would lead to

A

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

101
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

102
Q

When does withdrawal symptoms typically occur when withdrawing from heroin

A

appear within72 hours

103
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

104
Q

What will happen when pregnant women withdraws from methadone

A

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

105
Q

Abuse of methadone would lead to

A

Prenatal exposure

106
Q

Prenatal exposure

A

a. reduced head circumference
b. lower birth weight

107
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

108
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

109
Q

Preferred methods of pain relief

A

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

110
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

MATERNAL CHILD HEALTH NURSING 2 (3 decks)

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