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EPH > Spring 03a: Readmissions and Maternal Health > Flashcards

Spring 03a: Readmissions and Maternal Health Flashcards

1
Q

T/F: Transitions of care are times of high risk for lapses in care.

A

True

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2
Q

(X) method is a way to assess patient understanding. This method (increases/decreases) chance of readmission.

A

X = “teach back”

Decreases

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3
Q

To decrease chance of readmission, it’s a good idea to send discharge summary to (X) of patient.

A

X = PCP

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4
Q

T/F: Depression increases chance of readmission.

A

True

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5
Q

(Males/females) are more likely to be readmitted after discharge.

A

Males

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6
Q

(Weekend/weekday) discharge increases chance of readmission.

A

Weekend

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7
Q

It’s important to (restart/eliminate) home meds after discharge if they were stopped at time of admission. This will reduce chance of readmission.

A

Restart

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8
Q

T/F: Substance abuse increases chance of readmission.

A

True

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9
Q

A (local/state/federal) program, (X), penalizes hospitals with higher than expected (Y) day readmission rates.

A

Federal;
X = Hospital Readmission Reduction Program
Y = 30

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10
Q

In (X) payment method, hospitals have incentive to fill beds.

A

X = fee for service

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11
Q

RED, aka (X), is a program aimed to reduce hospital readmissions. Their checklist consists of (Y) number of components to reducing readmission.

A 
X = Re-Engineered Discharge;
Y = 11
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12
Q

Define maternal mortality ratio.

A

Number of maternal deaths per 100,000 live births

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13
Q

Maternal mortality ratio is measured based on woman who die in which stage(s) of pregnancy/birth?

A

Either during pregnancy or within 42 days after end of pregnancy, from cause related to it

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14
Q

Maternal mortality ratio globally is (X). and in the US is (Y).

A 
X = 216/100,000
Y = 14/100,000
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15
Q

List some of the most common causes of maternal mortality (from most to least common).

A
  1. Hemorrhage
  2. Infection
  3. BP-related
  4. Labor complications
  5. Unsafe abortions/lack of access
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16
Q

Define Neonatal mortality.

A

Number of newborn deaths (within 28 days of birth) per 1000 live births

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17
Q

Neonatal mortality in 2015, globally, is (X). This is (Y)% of all under-5 y.o. deaths.

A 
X = 2.7 million 
Y = 45
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18
Q

2015 Global neonatal mortality WITHIN first week was (X). And (Y) were on the day of birth.

A 
X = 2 million
Y = 1 million
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19
Q

Define Infant mortality.

A

Number of infant deaths (within first year of life) per 1000 live births

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20
Q

Infant mortality in 2015, globally, is (X). This is (Y)% of all under-5 y.o. deaths.

A 
X = 4.5 million
Y = 75
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21
Q

Infant mortality ratio globally is (X). and in the US is (Y).

A 
X = 32/1000
Y = 6/1000
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22
Q

List factors that would “pull” people to emigrate to US.

A
  1. Education
  2. Economics
  3. Reuniting with parents
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23
Q

List factors that would “push” people to emigrate to US.

A
  1. Violence (political turmoil, high child homicide rate, etc.)
  2. Poverty
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24
Q

T/F: Earlier abortions are both more common and safer.

A

True

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25
Q

Your patient wants to get pregnant. List some options you’d offer for (preconception/contraception) care.

A

Preconception;

  1. Prenatal vitamins
  2. Management of existing risk factors or health conditions
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26
Q

Your patient doesn’t want to get pregnant. You’d offer options for (preconception/contraception) care.

A

Contraception

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27
Q

Abortions are relatively (common/rare). Restrictions on abortions are (X)-specific.

A 
Very common (in US, 30% women had one by age 45);
X = State
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28
Q

Reproductive Health Life Plan refers to:

A

Thinking about when and if a patient/couple wants to have children

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29
Q

List some barriers to Reproductive Health Life Plan.

A
  1. Health
  2. Finances
  3. Timing (career, education, etc.)
30
Q

What’s the base of the “trauma” pyramid? This represents the (earliest/latest) event.

A

Adverse childhood experience

Earliest

31
Q

List the levels of the “trauma” pyramid, from bottom to top.

A
  1. Adverse childhood experience
  2. Social/emotional/cognitive impairment
  3. Adopts health-risk behavior
  4. Disease, disability, and social problems
  5. Early death
32
Q

T/F: For minors, reproductive health laws vary based on state.

A

True

33
Q

In MA, parental consent of (one/both) parent(s) is required for abortion care for minor, unless:

A

One;

  1. Medical emergency
  2. Judicial bypass obtaines
34
Q

T/F: In MA, minors can consent for services such as contraception.

A

True

35
Q

T/F: In MA, minors can consent for services such as STD testing.

A

True

36
Q

In MA, minors generally need parent/guardian permission for care with these exceptions:

A
  1. Married/parent
  2. In armed forces
  3. Living independently
  4. Determined to be a “mature” minor (understands nature/consequences of treatment)
37
Q

T/F: Today, 1st trimester abortions is an inpatient procedure, requiring a surgical team.

A

False - 2016 case made it outpatient procedure (no surgical team required)

38
Q

Preconception care is any intervention offered to (X), (before/during/after) pregnancy. Their aim is to improve (Y).

A

X = women/couples of childbearing age
Before;
Y = health outcomes (maternity/newborn/infant)

39
Q

T/F: Preconception care is provided, regardless of pregnancy status or desire.

A

True

40
Q

Pregnant women, who are unaware or not monitored, can be at risk for adverse outcomes. List some examples of this.

A
  1. Chronic diseases
  2. Not taking folic acid
  3. Teratogenic exposure (meds)
  4. Overweight/obese
41
Q

T/F: Current interventions to prevent adverse outcomes in pregnancy are often too late. Aka crucial development period has already occurred.

A

True

42
Q

(X)% of pregnant women smoke.

A

X = 10

43
Q

(X)% of women smokers quit during pregnancy.

A

X = 55

44
Q

Of women who stop smoking during pregnancy, (X)% go back to smoking afterwards.

A

X = 40

45
Q

(X) glasses per week of alcohol is the safe limit of consumption during pregnancy.

A

X = ZERO (no amount is safe)

46
Q

List some examples of chronic diseases that would be important to manage in preconception phase to allow for healthier pregnancy.

A
  1. Diabetes
  2. HT
  3. CVD
  4. Asthma
47
Q

In perconception phase, if patient has history of depression, it’s important to assess the risks/benefits of (X) action.

A

X = decreasing their meds during pregnancy

48
Q

(X) has highest risk of fatal injury deaths during pregnancy/postpartum period.

A

X = intimate partner (current or former) homicide

49
Q

List some medications that can serve as teratogens.

A

Certain statins, antidepressants, anticoagulants

50
Q

Your patient (BMI of 32) comes in for a check-up and discovers she’s 5 weeks pregnant. Do you recommend she wait until after pregnancy to lose weight?

A

No - during pregnancy

51
Q

T/F: Providing HIV treatment to pregnant woman doesn’t prevent transmission to child.

A

False

52
Q

T/F: It’s important to provide live vaccines (i.e. Rubella) during first trimester.

A

False - before pregnancy! Live vaccines cannot be given during pregnancy

53
Q

List some examples of Family Planning you should implement in preconception care.

A
  1. Genetic counseling/testing

2. Spacing out pregnancies

54
Q

(X) months between pregnancies is the safest range, to lower risk of (Y) outcomes.

A 
X = 18-59 (1.5-5 y)
Y = preterm birth/low birth weight
55
Q

T/F: Those most in need of preconception services are least likely to receive them

A

True

56
Q

T/F: Data shows that intervention for all conditions prior to conception is better than intervention early in pregnancy.

A

False - only certain conditions

57
Q

T/F: Effective health promotion messages requires motivated people on the receiving end.

A

True

58
Q

T/F: Clinical training often emphasizes risk assessment, but not health promotion skills.

A

False - emphasizes neither (a barrier to care)

59
Q

T/F: There is not enough reimbursement (thus, provider incentive) for risk assessment and health promotion activities.

A

True

60
Q

Weathering hypothesis first described by (X) in (Y). What’s the hypothesis?

A 
X = Geronimus
Y = 1992

Life stressors can impact health

61
Q

(X) refers to wear and tear on the body due to exposure to stress.

A

X = allostatic load

62
Q

Early life events plus the cumulative (X) over the course of life contributes to disparities in health outcomes. This phenomenon is called:

A

X = allostatic load

Life-course perspective

63
Q

T/F: Poor pregnancy outcomes continue to be higher than acceptable.

A

True - hence importance of preconception care

64
Q

T/F: Only pregnant women with previous adverse pregnancies are “at risk” for adverse pregnancy outcomes.

A

False! All women entering pregnancy are at risk

65
Q

Women “mean entry” into prenatal care is just prior to critical period of development of which structure(s)/system(s)?

A

After all critical periods have passed! Around week 12 from gestation

66
Q

Your patient has recently noticed she missed her period and thinks she may be pregnant. If true, which critical periods of development have already begun?

A

CNS and heart (week 5 of gestation)

67
Q

T/F: Maternal tobacco smoking puts baby at increased risk of cleft lip/palate.

A

True

68
Q

Maternal smoking cessation primarily reduces infant (X).

A

X = LBW and mortality

69
Q

T/F: Maternal diabetes, especially if poorly controlled, puts child at increased risk of developing diabetes.

A

True

70
Q

T/F: Poor glycemic control during pregnancy puts the infant/child at risk, but not so much the mother.

A

False - maternal health at risk also (retinopathy, nephropathy, hypertension)

EPH (7 decks)

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