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EPH > Spring 03b: Prenatal Care > Flashcards

Spring 03b: Prenatal Care Flashcards

1
Q

List the three main components of current prenatal care.

A
  1. Screen for health/socioeconomic conditions
  2. Education (for safe birth)
  3. Providing therapeutic interventions
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2
Q

What are the long term effects of perinatal stress?

A

Can lead to:

  1. preterm delivery
  2. poor fetal growth
  3. low birth weight
  4. infant mortality
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3
Q

Preconception care: Peridontal disease is risk factor for (X). It affects (Y)% of pregnant women, more common in patients with:

A

X = pre-term birth
Y = 40
Low SES

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4
Q

T/F: It’s ideal to treat periodontal disease prior to pregnancy, because it’s dangerous to treat during pregnancy (due to anesthesia).

A

False - it is ideal to treat before pregnancy, but it’s ok to treat during pregnancy too

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5
Q

Ratio of 1 in (X) reproductive age women are prescribed potentially teratogenic medication. This is problematic due to the unintended pregnancy rate of (Y)%.

A 
X = 6
Y = 50
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6
Q

(X)% of reproductive age women in US are overweight/obese.

A

X = 50

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7
Q

50-70% of neural tube defects can be prevented if Folic Acid is taken (X) (days/weeks/months) (before/after) conception.

A

X = 3

Months before and 3 months after conception

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8
Q

What’s the Folid Acid requirement if woman has no prior pregnancy with NTD?

A

0.4-1 mg daily

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9
Q

What’s the Folid Acid requirement if woman has prior pregnancy with NTD?

A

4 mg daily

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10
Q

Which travel-related diseases would you be concerned about with your pregnant patient?

A
  1. TB
  2. Zika
  3. Malaria
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11
Q

T/F: You should address preconception care for age-appropriate women at every visit.

A

True

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12
Q

T/F: One rationale for prenatal care is to reduce incidence of fetal anomalies.

A

False - preconception care (prenatal care too late)

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13
Q

T/F: Prenatal care has role in screening for perinatal infection/genetic risks.

A

True

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14
Q

T/F: There’s a relationship between adequate prenatal care and risk of preterm delivery.

A

True

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15
Q

The results of a study that explored predictors of preterm birth found that (X) was the culprit.

A

X = stress

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16
Q

At BMC, the most common indication (60%) of preterm births is associated with (X).

A

X = hypertension

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17
Q

A study has shown that preterm births due to HT can be prevented by (X).

A

X = taking low-dose aspirin

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18
Q

Centering pregnancy involves (X) element, which is not included in traditional prenatal care.

A

X = personal engagement in physical exam monitoring

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19
Q

T/F: You’d have a breastfeeding discussion in “centering pregnancy”, but not in traditional prenatal care.

A

False

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20
Q

In 2013 study of most common causes of US deaths, where does medical error fall?

A

3rd

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21
Q

Which element of patient safety does National Patient Safety Foundation consider most critical in 2016?

A

Patient identification

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22
Q

Use of preoperative checklist has been shown to decrease:

A

Surgical mortality and complications

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23
Q

T/F: Preoperative checklist has been shown to shorten surgical time.

A

False - increases time

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24
Q

Medical errors due to communication most common in (X) settings, such as (Y)

A 
X = fast-paced
Y = ICU, Labor/delivery unit, ER
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25
Q

What does hierarchy have to do with patient safety?

A

Analysis of medical errors shows that there’s at least one person in room who is aware of error but feels unempowered to speak up

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26
Q

Current resident work hour limitations:

A

80 hours per week (averaged over 2 weeks); no more than 24 hours on duty

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27
Q

T/F: Including pharmacists into patient rounds is one solution to errors in safe prescribing.

A

True

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28
Q

List the Hospital National Safety Goals of 2016.

A
  1. ID patients correctly
  2. Use meds/alarms safely
  3. ID patient safety risks
  4. Prevent infections/mistakes in surgery
29
Q

At BMC, we evaluate causes/prevention of error via (X) system. What are the steps?

A

X = I-PASS

  1. Standardized communication
  2. Frame communication with “Sender”/”Receiver”of tasks
  3. End with contingency plan
30
Q

List the Six Aims of QI.

A
  1. Patient-centered
  2. Effective
  3. Timely
  4. Safe care
  5. Efficient
  6. Equitable
31
Q

Remember when to implement the tools.. LEAN management is all about (X) and Six Sigma about (Y).

A 
X = saving money
Y = error reduction
32
Q

Understanding, evaluating, using, and engaging with written text to participate in the society, to achieve one’s goals and to develop one’s knowledge and potential.

A

Literacy

33
Q

T/F: Low literacy is associated with older adults.

A

True

34
Q

T/F: Low literacy can lead to higher health care costs.

A

True

35
Q

The degree to which individuals have the capacity to obtain, process and understand basic health information needed to make appropriate health decisions.

A

Health literacy

36
Q

T/F: Low health literacy always overlaps with low literacy.

A

False

37
Q

The ability to access, use, interpret and communicate mathematical information and ideas, to engage in and manage mathematical demands of a range of situations in adult life.

A

Numeracy

38
Q

The limited ability to read, speak, write or understand English

A

Limited English Proficiency

39
Q

(Interpretation/Translation) is conveying the meaning of spoken word from one language to another.

A

Interpretation

40
Q

(Interpretation/Translation) converting written text from one language to another.

A

Translation

41
Q

T/F: Patients tend to convey their illiteracy to the physician.

A

False - may feel shame/stigma

42
Q

T/F: Minor children can never be interpreters for the patient.

A

False - they legally shouldn’t be, but patient has autonomy to refuse interpreter and allow child to interpret

43
Q

T/F: You shouldn’t assume a patient speaks English.

A

True (but it’s ok to start encounter in English)

44
Q

What if your patient doesn’t want interpreter, but you feel more comfortable having one?

A

Decision on you - explain to patient that you want to use interpreter to “do good job”

45
Q

Title VI of the Civil Rights Act of 1964 requires recipients of (X) to take reasonable steps to make their programs (Y). Thus, there’s a legal requirement to (Z).

A 
X = federal financial assistance
Y = accessible by persons with LEP
Z = provide interpretation
46
Q

T/F: Education tends to be a good predictor of health literacy.

A

False - not necessarily

47
Q

Best way to arrange communication with patient and interpreter is (X) set-up. And physician should direct conversation to (Y).

A 
X = triangle;
Y = patient directly
48
Q

T/F: During interpreter and patient conversation, the physician should avoid chunking information since it may be conveyed improperly.

A

False

49
Q

T/F: During interpreter and patient conversation, the physician should avoid excess medical terminology.

A

True

50
Q

T/F: Low health literacy always overlaps with low english proficiency.

A

False

51
Q

Bulk of US is at which level of proficiency on literacy tasks?

A

Level 2 or 3 (out of 5)

52
Q

T/F: Years of school that patient has completed tends to be good measure of his/her literacy skills.

A

False - usually read 3-5 years below completed school year

53
Q

List some tools/advantages available in US hospital birth.

A
  1. Skilled attendants
  2. Meds/surgical services
  3. Neonatal resuscitation
54
Q

T/F: Per ACA, all qualified health plans must cover maternity care.

A

True

55
Q

T/F: Costs of care for birth are bundled into global payment for prenatal care and delivery. Post-partum care is separate.

A

False - post-partum included

56
Q

EMTALA, aka (X), is 1986 Act that states:

A

X = Emergency Med Treatment and Active Labor Act

If patient comes into your L&D/ER in active labor, you must care for them (regardless of their ability to pay); can’t send them to a different hospital

57
Q

(X) serve as middle ground between hospital birth and home births. They’re adjacent to hospital and attended by (physicians/nurses/midwives).

A

X = birth centers

Midwives

58
Q

T/F: At BMC, OBGYN, midwives, and family physicians all collaborate.

A

True

59
Q

T/F: About half US births are home births.

A

False - less than 1%

60
Q

T/F: Home births usually more common in minorities and young women.

A

False - white, older women (not first birth)

61
Q

Give some examples of collaborative care for birth at BMC.

A
  1. Partnering with CHC
  2. Centering pregnancy groups
  3. Birth sisters
62
Q

C-sections are (higher/lower) today than they used to be. According to WHO, (X)% of births is ideal portion for C-sections.

A

Higher;

X = 15

63
Q

Risks of C-section

A
  1. Longer hospital stay
  2. Increased resp problems in infant
  3. Greater complications in subsequent pregnancies
64
Q

List some factors that increase desirable birth outcome.

A
  1. Continuous labor support
  2. Access to meds/services
  3. Skilled attendance
  4. Exclusive breastfeeding for first month
65
Q

T/F: C-section causes increased risk of hemorrhage and transfusion.

A

False - decreased

66
Q

T/F: C-section causes decreased urinary incontinence in first year after birth.

A

True

67
Q

Optimal timing: C-section cannot be performed before (X) weeks of pregnancy.

A

X = 39

68
Q

Optimal time: “preterm” is anytime before (X) weeks. And “post-term” is (Y) weeks.

A 
X = 37
Y = 42
69
Q

T/F: Physician would almost never induce labor.

A

False - at 41 weeks (since “post-term” birth introduces complications)

EPH (7 decks)

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