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Pop Health 2 > Unit 1 > Flashcards

Unit 1 Flashcards

1
Q

A nurse is caring for an older client and their family. She decides to approach the family as a component of society. What does that her cares consist of?

A

—Monitors how families interact with other institutions in a community (schools, medical facilities, financial institutions, congregations)
—used to study and implement population-focused interventions (immunization campaigns)

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2
Q

What does it mean to care for a family as a system?

A

-studies how interactions among family members affect the whole family function
-used to promote family helath by directing interventions toward the way family members interact with each other

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3
Q

What does it mean to care for a family as a client?

A

-Examines the family unit functioning first, then individuals needs next
- used to see how the family health is impacted by each individual’s reaction to a health event

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4
Q

What does it mean to care for a family as context`

A

Focuses on an individuals first, and the family next.
Used to promote the health and recovery of an individual, using the family as a resource for service and support.

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5
Q

Viewing the client as the focus of care. With the family members viewed as a source of support for the client is an example of which family care approach

A

Family as context

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6
Q

Asking the family members how their family function overall has changed following the client’s stroke is an example of which family approach?

A

Family as a client

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7
Q

Asking individual family members how their life has changed following a client’s stroke is an example of which family care approach?

A

Family as a system

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8
Q

Examining how the family unit interacts with other parts of society, such as medical facilities or financial institutions is an example of which family care approach?

A

Family as a component of society

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9
Q

What are ecomaps?

A

Visual diagram of the family unit in relation to other units such as school, work, church, friends( used to understand the relationship among family members and the community

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10
Q

What is gravidity

A

Number of pregnancies the pregnant person has had, including the current

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11
Q

Primigravida means what

A

First pregnancy

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12
Q

What does T mean in GTPAL

A

Term—number of full term births
(Stillborn or living)

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13
Q

What is the time frame to be considered pre-term

A

Fetus is greater than 20 weeks but less than 37 weeks

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14
Q

What does A mean in GTPAL

A

Number of previous pregnancies that ended in abortion (spontaneous or induced) before 20 weeks

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15
Q

A woman is pregnant fore the first time:
G___T___P___A___L___

A

G 1 T 0 P0 A 0 L 0

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16
Q

A woman is pregnant for the 4th time. She previously delivered a child at 38 weeks and a child at 28 weeks. She had a spontaneous abortion at 16 weeks

A

G4 T1 P1 A1 L2

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17
Q

A woman is pregnant for the second time. Her last pregnancy resulted in the birth of twins at 36 weeks.

A

G 2 T0 P2 A0 L 2

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18
Q

What is considered full term pregnancy

A

37 + weeks

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19
Q

What does hCG stand for

A

Human chorionic gonadotropin

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20
Q

What is nagele’s rule estimate?

A

First day of LMP-3months+7days

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21
Q

What are some presumptive signs

A

Subjective
Experienced by the pregnant person
Ammonrrhea( lack of period)
Fatigue
Nausea
Breast changes
Urinary frequency
Quickening (16-20 weeks)

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22
Q

What are some probable signs in pregnancy

A

Objective
Observed by examiner
Hegar’s sing
Ballottement
Positive pregnancy test
Chadwick and Goodell signs

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23
Q

What are positive pregnancy signs

A

Objective
Auscultation of fetal heart rate
Visualization of fetus

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24
Q

What does hCG do

A

Maintains the corpus luteum production of estrogen and progesterone
Prevents menses until placental hormones take over (12-14 weeks)
Produces the trophoblast/chorionic layer

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25
Q

What does progesterone do

A

Promotes relaxation of all smooth muscle throughout the body
Increase basal body temp
Intimates development of milk ducts in breast tissue

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26
Q

What does estrogen do

A

Cause proliferation in the uterus
Causes increases in vascularity, uterine blood flow, and pigmentation
Causes relaxation of pelvic joint and ligaments

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27
Q

What are the names of hPL and hCS

A

They are the same hormone, different names
Human placental lactogen
Human chorionic somatomammotropin

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28
Q

What does hPL or hCS do in pregnancy

A

Increases protein synthesis
Contributes to placental and fetal growth
Aids in colostrum production
Causes creased insulin resistance

Produced by the placenta

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29
Q

What does cortisol do to insulin

A

Cortisol stimulates production of insulin

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30
Q

What does PTH do during pregnancy

A

PTH control calcium and magnesium metabolism

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31
Q

what is the general rule of fundus growth

A

1 cm a week up until 20 weeks

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32
Q

Near 20 weeks, where should the uterus be?

A

Al the level of umbilicus around 20 -22 weeks

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33
Q

Where should the uterus be at 12 weeks

A

Near symphysis around 12 weeks

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34
Q

What is hegar’s sign

A

6 weeks softening and compressibility of the lower uterus segment

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35
Q

What is ballottement>

A

Identifiable between 16-18 weeks; examiner bounces the floating fetus near the cervix

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36
Q

What what rate does uterine blood flow

A

140/650mL/min

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37
Q

What is runic soufflé

A

Sound of blood rushing through the umbilical veins
Should match maternal pulse

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38
Q

What are factors the decrease uterine blood flow?

A
  1. Low maternal arterial pressure
  2. Contractions of the uterus
  3. Maternal supine position
    After second trimester, urge not to lay on back
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39
Q

What is goodell’s sign>

A

Softening of the cervical tip around 6 weeks of pregnancy

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40
Q

What is Chadwick’s sign?

A

Violet-blue color of the vaginal mucosa and cervix around 6-8 weeks of pregnancy

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41
Q

What is leukorrhea?

A

Normal during pregnancy
Copious white/gray mucous discharge

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42
Q

What is the normal pH of a pregnancy

A

3.5-6
More susceptible to yeast infections

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43
Q

What is operculum?

A

Thick, jelly like mucus that falls the cervical canal to protect the fetus from infection that forms at 3 week s for gestation
“Mucus plug”

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44
Q

When do you see proliferation of milk ducts

A

2 and 3rd trimester

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45
Q

What is lactogensis stage 1 and when does it happen

A

Prolactin stimulates colostrum production; placental lactogen stimulates colostrum secretion 3rd trimester

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46
Q

How does pregnancy affect blood volume

A

Increases 40-50%
Fluid reserve

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47
Q

How does pregnancy affect cardiac output?

A

Increase 30-50%

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48
Q

What is supine hypotension syndrome

A

Supine hypotension syndrome is when uterus compresss inferior vena cava and aorta, which limits blood flow to fetus and mother

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49
Q

How does the structure of heart changes during pregnancy

A

Heart is elevated upwards and rotated forward to the left due to enlarged uterus
Third heart sound and murmur may be present

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50
Q

Potential physiologic anemia due to increased plasma volume T/F

A

T

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51
Q

How much does oxygen consumption increase during pregnancy

A

20-40%

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52
Q

What does progesterone do in the GI system

A

Pytalism (excessive salivation) and epulis (reddened gum nodules)
Decreases in motility of smooth muscle
Pyrosis (heartburn) and constipation
Gallstones

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53
Q

T/F dilation of the right ureter is more common

A

True

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54
Q

What is diastasis recti

A

Separation of the rectus abdomin is muscles

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55
Q

Why is carpal tunnel common in pregnancy

A

Edema compresses median nerve beneath the carpal tunnel ligament of wrist

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56
Q

Why are headaches common in pregnancy

A

Increased blood volume
Need to rule out hypertension

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57
Q

What are the 5 Ps in labor and birth

A

Passenger
Passageway
Powers
Position (of mother)
Psychological response

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58
Q

What are the three types of fetal presentation

A

Cephalon
Breech
Shoulder

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59
Q

What is fetal lie

A

Relation of the fetal spine to the maternal spine (longitudinal or vertical)

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60
Q

What is fetal position

A

Relationship of reference point on the presenting part of the four quadrants of the mother’s pelvis

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61
Q

What is the fetal attitude

A

Relation of the fetal body parts to one another

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62
Q

What is fetal station

A

Measure of the degree of descent of the presenting part of the fetus through the birth

63
Q

What is engagement

A

Usually corresponds to 0 and moving steady

64
Q

What is the first stage of labor

A

Onsent of regular uterine contractions to full dilation of the cervix

65
Q

What is the second stage of labor

A

Time the cervix is fully dilated to the broth of the infant

66
Q

What is the second stage of labor

A

Time the cervix is fully dilated to the broth of the infant

67
Q

What is the third stage of labor

A

Birth of the infant through delivery of the placenta

68
Q

What is the fourth stage of labor

A

Delivery of the placenta until delivery perosn’s condition is stable (usually an hour after birth)

69
Q

What is the normal bpm of fetus inutero

A

110-160

70
Q

T/F carbon dioxide increases during labor to initiate a breath

A

T

71
Q

What is the length of pregnancy?

A

280 days (40 weeks)
Calculated from the first day of LMP

72
Q

What are the three stages of development and describe them

A

Germinal (0-2 weeks)—zygote implants in the uterine wall, initial cells divide
Embryonic( week 3-8) embryonic disc differentiates, organs and body structure form
fetal (week 9+) organs and tissues develop, and refinement of structures and function

73
Q

What happens prior to conception

A

Gametogenesis and fertilization

74
Q

What is gametogenesis

A

Oogenesis— egg formation, begins during fetal life
Spermatogenesis—sperm formation begins during puberty

75
Q

What is capacitation

A

Removal of sperm’s protective coating

76
Q

When is conception

A

When a zygote forms (sperm and egg meet)

77
Q

when does implantation occurs

A

Blastocyst embeds in the endometrium between days 6-10

78
Q

What are the primary germ layers of the embryonic

A

Ectoderm—forms the epidermis, different glands, nails, nervous system, parts of eye, teeth enamel, part of the amniotic cavity (surrounds fetus)
Mesodermal— gives rise to bones, teeth, muscles, dermis, connective tissues, cardiovascular system, spleen, and UI tract
Endoderm— epithethial lining of respiratory and digestive tracts, granular cells and those systems (digestive enzymes and surfactant

79
Q

When are teratogens most harmful to fetus

A

Embryonic stage

80
Q

Where do you measure embryo in embryonic stage

A

Head to bottom

81
Q

List and describe two fetal membranes

A

Chorion- becomes the covering of the fetal side of teh placenta, contains umbilical blood vessels and chorionic billiard that degenerates into the smooth membrane
Amnion— thin membrane that covers the umbilical cord and forms a fluid filled sac around teh embryo; fuses with the chorion

82
Q

What does the yolk sac aids in?

A

Transferring maternal nutrients and oxygen for the first 5-6 weeks
Similar functions to the placenta in early pregnancy

83
Q

What is Wharton’s jelly

A

Surrounds vessels to prevent compression

84
Q

You can read brain waves at 8 weeks T/F

A

T

85
Q

When does the placenta start forming

A

Week 3, formed by 12 weeks

86
Q

What hormones does the placenta produce

A

HCG
HPL/hCS
Progesterone
Estriol

87
Q

What are the 4 functions of the placenta

A

Respiration, nutrition, excretion, storage

88
Q

What are the functions of the amniotic fluid

A

Thermoregualtion for fetus
Source of oral fluid
Repository for waste
Assists with fluid/electrolyte homeostasis
Provides fetal cushioning and aids musculoskeletal development
Antibacterial factors
Provides for auditory stimulation
Facilitates fetal lung development

89
Q

What is it called when there is <300 ml of amniotic fluid

A

Oligohydramnios

90
Q

What is it called when there is >2 liters of amniotic fluid

A

polyhydramnios

91
Q

ductus arteriosus

A

Connection between pulmonic artery and aorta

92
Q

Foramen ovale

A

Hole between Altria of the heart

93
Q

ductus venous

A

Connection that allows oxygenated blood to pass the liver and direct to the heart

94
Q

When does the ductuses close

A

Right after birth

95
Q

T/F fetal hemoglobin affinity is lower than maternal hemoglobin

A

False fetal oxygen affinity for oxygen 20% to 30% more than maternal hemoglobin

96
Q

When is respiratory fully developed

A

Surfactant present and functional at 32 weeks
Respiratory system fully developed at 34 weeks

97
Q

when is the GI tract developed

A

Begins forming in week 4 and matures until 36 weeks
Fetus swallowing in the fifth month
Meconium stool passed in the first 24 hours

98
Q

When is the hepatic system developed

A

Develops from foregut around 4 weeks
Liver is enlarged between weeks 7-9 weeks d/t hemotpoisesi
Glycogen stored in fetal liver

99
Q

When do kidneys form and function

A

Kidneys form by week 5 and function by week 9

100
Q

What is cervix caseosa

A

White, cheesy substance that protects fetal skin; thick around 24 weeks and thin by term

101
Q

What is the definition of the postpartum period

A

Internal between birth and return of the reporoductive organs to their non pregnant state
Also referred to as fourth trimester

102
Q

What is involution

A

Return of the uterus to its non pregnant state
Begins after delivery of placenta (oxytocin
Uterus is the same size as 20 weeks gestation by 24 hours after birth

103
Q

What is autolysis

A

Self-destruction of extra uterine tissue

104
Q

What is subinvolution

A

Failure of uterus to return to non pregnant state

105
Q

What is lochia?

A

Uterine discharge that appears after birth
Happens as uterine non lotion and endometrial change occurs

106
Q

What are the different kinds for lochia

A

Rubra—bright red— 1-3 days==blood from placental site, tissue debris, vernix, lanugo, active bleeding
Serous— pinkish brown—4-10 days==blood, wound, exudate, RBCs, WBCs, cervical mucosa
Alba—white-yellow—10-14 days (can last 3-6 weeks)== wbcs, trophoblastic tissue debris

107
Q

How do viral signs change during postpartum

A

Temperature may increase to 100.3 within first 24 hours
Pulse, stroke volume, and cardiac output elevated for first hour PP, normal within 48 hours
Blood pressure increases first few days PP, normalizes over weeks-months

108
Q

What is the normal blood loss for vaginal and C section

A

300-500ml—vaginal
500ml-1000ml—C section

109
Q

What are respiratory changes during postpartum

A

Decrease in intraabdominal pressure allows more room for diaphragm contraction and lung expansion
Chest wall complicate increases
Pulmonary blood flow decreases

110
Q

What are endocrine changes in postpartum

A

Decreased progesterone causes increased prolactin, which remain elevated as long as woman is breastfeeding

111
Q

What are some GI changes during postpartum

A

Peristalsis is slowed during labor
Diarrhea is common in the immediate perinatal period
Dehydration
—stool softeners are needed for he first several days
First stool usually happened 2-3 days PP

112
Q

What is melasma

A

Freckle like hyperpigmentation during pregnant

113
Q

What is the definition of infertility

A

Inability of become pregnant after one year of actively trying

114
Q

What is amenorrhea

A

Defined as the absence of menstrual flow for more than 45 days from first day of LMP
Pregnancy, hypogonadotropin (problems in central hypothalamic-pituitary axis), exercise-associated
Assessment:history, rule out pregnancy, cbc, chemistry, UA, hormone testing

115
Q

Why is dysmenorrhea

A

Pain shortly before and during menstruation
Primary—associated with ovulation cycle by release of prostaglandins
Secondary —develops later in life associated with pelvic pathology (typically after 25 years old)

116
Q

What is PMS

A

Complex poorly understood condition includes psychological and behavioral symptoms
Symptoms begin in literal phase
Diet and exercise can manage

117
Q

What is premenstrual dusphoric disorder PMDD

A

More severe variant of PMS where women have marked irritability, disphora, mood lability, anxiety, fatigue, appetite changes, and sense of feeling overwhelmed

118
Q

What is endometriosis

A

Defined as the presence and growth of endometrial tissue out of the uterus (5-10% of menstruating women)
Symptoms- dysmenorrhea, deep pelvic pain, painful intercourse, abnormal bleeding
Management- drug therapy (NSAIDs and hormone therapy), and surgical intervention

119
Q

Define menopause

A

Defined as asmenorrhea for 12 consecutive months, leads to cessation of menses
Usually occurs between ages 40 and 58; average duration is 4-8 years
Characteristics: cycles are irregular, genital atrophy: vaginal dryness, urinary incontinence, recurrent UTIs
Vasomotor instability: hot flashes, night sweats
Increased risk of osteoporosis and coronary heart disease
—hormone therapy is an option for some women

120
Q

What are some pain reliefs for clients with menstrual problems

A

Heat to lower abdomen
Certain exercises can relieve pelvic congestion
NSAIDs
OCPs if indicated (birth control)

121
Q

What is benign prostatic hyperplasia, incidence, and contributing factors

A

Condition where prostate gland increases in size, disrupting the outflow of urine from the bladder though the urethra
50% of men will have signs 50 years
>70% of men will have signs by 60-69 years
Does NOT increase risk of prostate cancer
Contributing risk factors—hormonal changes related to aging, obesity, lack of physical activity, diabetes, high intake of red meat and animal fat, alcohol use, smoking, family history

122
Q

What are some symptoms of BPH

A

Irritating symptoms—nocturnal, urinary frequency, dysuria, incontinence
Obstructive symptoms—difficulty starting stream of urine, weak stream of urine, intermittency, dribbling
Manifestationoccur gradually and worsen as urethra becomes more compressed

123
Q

What are some assessments, treatments, and complications of BPH

A

Assessments—digitical rectal exam, uroflowmetry, transrectal ultrasound
Treatments—drug therapies, PSA surveillance, prostatectomy, transurthral incision or resection of the prostate
Complications—- acute urinary retention, UTI, pyelonephritis, bladder calculi/stones, sepsis and renal failure

124
Q

Define prostatitis and what are the types

A

Describes a group of inflammatory and noninflammatory conditions that affect the prostate gland
Incidence: one of teh most common urologic disorders
4 types: acute bacterial prostatitis
Chronic bacterial prostatitis
Chronic prostatitis (non bacterial)
Asymptomatic inflammatory prostatitis (non bacterial

125
Q

What are the signs and symptoms of prostatitis

A

Acute__ fever, chills, back and perineal pain, rivalry symptoms, acute urinary retention
Chronic— back and perineal pain, ejaculatory pain, recurrent UTIs
Prostate is enlarged, soft, tender
Diagnosis—UA, CBC, PS, MRI/TRUS
Management: antibiotics, pain management, increase fluid intake
Urinary catheter isertion for retention (contraindicated for acute prostatitis)

126
Q

T/F prostate cancer is the first most common cancer among males and leading cause of cancer death

A

F
Prostate cancer is the second most common cancer among males and second leading cause of cancer death

127
Q

T/F white men are the highest risk of diagnosis/ death

A

F black men are higher risk

128
Q

What is considered to be the neonatal period

A

Birth-28 days

129
Q

When is the period of instability of a newborn

A

6-8 hours

130
Q

What are the three stages of transition and describe them

A

First- HR increases 160-180bpm until about 30 minutes, respiratory 60-80 (30-60 minutes), altertness (great for skin to skin, ideal meconium stool,
Period of decreased activity: 60-100 minutes after birth, well-circulated, active bowel
Second period of reactivity- brief tachycardia and tachypnea, 2-8 hours after birth, lasts several hours

131
Q

What initiates the first breath

A

Chemical: increased CO2 present during labor, cord clamping causes buildup of CO2
Mechanical: compression of chest with vaginal delivery and chest expansion once born, crying opens alveoli
Sensory:catecholamine surge shortly before labor stimulates fluid clearance from lungs and increases release of surfactants

132
Q

What are normal findings in the respiratory system

A

30-60 breaths per minute, shallow and irregular, chest and abdomen rise with inspiration, breath sounds are louder due to thin chest wall, shoulder sound clear over most areas but occasional rakes are common in the first two hours

133
Q

What are sings of respiratory distress

A

RR greater than 60 (without crying) or less than 30 RR. Diminished breath sounds, wheezes, or crackles after the first hour of life, expiratory grunts, cyanosis (circumoral), retractions, apnea for 20 seconds or more, nasal flaring (after 30 minutes)

134
Q

What are normal findings in newborn during cardiovascular system

A

-first breath triggers pressure changes that lead to the transition from fetal to neonatal circulation
-clamping of umbilical cord increases systemic pressure and forces flow of blood through the lungs
-murmurs are usually benign
-HR 12-160bpm
Rate is regular, although sinus dysrhythmias are common

135
Q

What are signs of cardiovascular distress

A

Persistent tachycardia (more than 160bpm)
Persistent bradycardia (less than 80bpm)
Absent pulses in extremities
Difference in BP between upper and lower extremities
Irregular heart rate past the first few hours
Poor feeding, apnea, cyanosis, pallor

136
Q

What is the normal rectal temperature for a newborn

A

36.5-37.5C (97.8-99.5F)

137
Q

what is the normal newborn BP

A

Systolic 60-80
Diastolic 40-50

138
Q

What do newborns create heat

A

Brown fatLconverted in glycogen more easily than white fat, rich vascularity and nerve supply

139
Q

What are characteristics of the hepatic system in a newborn

A

Iron storage is sufficient for 4-6 months
Serum glucose decreases
Bilirubin regulation: liver is immature and unable to conjugate bilirubin effectively

140
Q

T/F amylase and lipase not functional at birth

A

T

141
Q

What antibody is passive immunity for first 3 months

A

IgG

142
Q

When if IgM present

A

8th week— neonate can respond to new antigens

143
Q

Where does baby get IgA, and what does it do

A

IgA present in breast milk—helps maintain immune homeostasis

144
Q

What is erythema toxicum?

A

transient newborn rash that appears in first 24-72 hours of life and last up to 3 weeks of age

145
Q

What is caput succedaneum?

A

Benign fluid collection cause by pressure on presenting part of scalp during delivery
Edema crosses suture lines, resolves in 3-4 days

146
Q

What is cephalohematoma

A

Accumulation of blood under scalp, since bleeding is between skill bone and periosteum, doesn’t cross suture lines, resolves in 3-6 weeks

147
Q

What is purple crying?

A

Development normal cruing that increases to 2.5 hours/day and peaks around second month of life

148
Q

Fluid requirements of infants

A

2 days—60-80/kg/day
3-7–100-150/kg/day
8-30days—120-180ml/kg/day

149
Q

What are some contraindications to breastfeeding

A

Galactosemia in infant —(can’t break down glucose)
Maternal T cell luphotropic virus
Material HSV lesions on beast
Maternal HIV

150
Q

What is rich in colostrum

A

Rich in immunoglobulins, high concentrate of protein and minerals, binds bilirubin

151
Q

What are the formula feeding patterns

A

24-48 hours: 15-30mL per feeding
By second week: 90-150 mL
Every 3-4 hours thereafter

152
Q

What is the golden hour

A

Refers to the first hour of life after birth
Baby should be on mom’s chest if both are stable
Priorities: bonding, breastfeeding, identification, cord pH

153
Q

What is the normal infant glucose

A

40-45 in the first 72 hours

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