WEEK 1-ATI Flashcards
maternal newborn nursing today family, culture, and environment reproductive health promotion, prevention, and care
1
Q
fertility
A
ability to achieve pregnancy
2
Q
infertility
A
An inability to get pregnant when having regular, unprotected sexual intercourse for at least 12 months or difficulty with the client’s ability to reproduce.
3
Q
risk factors for infertility
A
advancing age
obesity
smoking
vigorous exercise
4
Q
what age does fertility begin to decline in females
A
age 32
oocytes declines at this age
5
Q
oocytes
A
immature egg cell in the ovary
decrease as age increase
6
Q
BMI and infertility
A
Clients who are overweight (a body mass index [BMI] of 25 to 29.9 kg/m2) or obese (a BMI of greater than 30 kg/m2) have decreased fertility rates
7
Q
diet and fertility
A
Diets with high amounts of whole grains, fish, unsaturated fats, and vegetables have been found to increase fertility in all sexes
8
Q
amenorrhea
A
The lack of a menstrual period in a female client who is of reproductive age.
9
Q
exercise and fertility
A
Vigorous exercise—such as running, fast cycling, aerobics, swimming, and gymnastics—has been associated with decreased fertility in female clients who have a BMI of less than 25.
10
Q
anovulation
A
a lack of ovulation
11
Q
Which of the following maternal clients have an increased risk for infertility?
A
A 23-year-old client who has a BMI of 21 who runs 10 miles a day
b
A 38-year-old client who has never been pregnant
A 25-year-old client who smokes
12
Q
healthy BMI
A
18.5-24.9
13
Q
united states birth rate
A
11 per 1,000 population
14
Q
postpartum hemorrhage (PPH)
A
Blood loss of greater than 500 mL after a vaginal birth, greater than 1,000 mL after a cesarean birth, or a cumulative loss of greater than 1,000 mL within 24 hr of delivery with manifestations.
15
Q
causes of PPH
A
Uterine atony
Trauma to tissues, such as cervical or vaginal lacerations
Retained placental tissue
Bleeding disorders (e.g., Von Willebrand’s disease)
16
Q
uterine atony
A
Loss of uterine tone due to ineffective contractions.
17
Q
A nurse is caring for a client who has just given birth. Which of the following conditions is required for the client to receive a diagnosis of postpartum hemorrhage?
A
Client gave birth vaginally, has a blood pressure of 86/54 mm Hg, and lost approximately 500 mL of blood.
18
Q
chorioamnionitis
A
An infection within the amniotic sac.
19
Q
endometriosis
A
An infection in the lining of the uterus.
20
Q
largest cause of maternal mortality
A
cardiovascular conditions
21
Q
Common Causes of Maternal Morbidity
A
Cardiovascular problems
Diabetes
High blood pressure
Infection
Blood clots
Hemorrhage
Anemia
Nausea/vomiting
Depression and anxiety
22
Q
A nurse is teaching a group of students about common causes of maternal morbidity. Which of the following should the nurse include in the teaching?
A
depression
DM
infection
23
Q
abortion
A
Any pregnancy loss prior to 20 weeks of gestation.
24
Q
sudden unexpected infant death (SUID)
A
The unexpected death of an infant under the age of 1 year. Prior to investigation, there may not be a known cause of death.
25
therapeutic communication
Communication techniques (active listening, repeating information, using open-ended questions) used to enhance the physical, mental, and emotional well-being of clients and their families.
26
active listening
The act of receiving the message, interpreting its meaning, and responding to the client; giving complete attention to the speaker.
27
beneficence
An ethical principle that addresses the obligation to protect others from harm and to act in a manner that promotes the health and well-being of others.
28
autonomy
The freedom and ability to make one’s own decisions.
29
Which of the following is an example of community-based care?
Home visits
b
A food bank for pregnant clients
c
A breastfeeding support class at a local school
d
A church group that supports new caregivers
30
A nurse is caring for a client who is planning a home birth. Which of the following should the nurse understand would be an indication for a transfer to a hospital setting?
a
Client fever of 37.8° C (100.0° F)
b
Meconium-stained amniotic fluid is noted
c
Blood pressure of 118/72 mm Hg
d
Client reporting abdominal pain
B
31
Which of the following responsibilities is appropriate for a PN to perform?
Perform fetal heart rate assessment.
b
Perform admission assessment of a client.
c
Reinforce education.
d
Delegate to other PNs.
C
32
ectopic pregnancy
Implantation of a pregnancy in an area outside the uterus, often occurring in the fallopian tubes.
33
uterine leiomyoma
Benign tumors that originate from the uterine smooth muscle; also known as fibroids.
34
neonatal encephalopathy
Central nervous system dysfunction in newborns.
35
Which of the following is one of the biggest risk factors for postpartum depression?
a
A history of depression
b
Partner violence
c
Younger than 25 years old
d
Family history of depression
A
36
social determinants of health
SDOH describe conditions, both physical and social, that influence health outcomes.
37
what are the SDOH
exonomic stability
social and community context
access to and quality of education
access and quality of health care
neighborhood and built environment
38
human trafficking
The unlawful practice of using people for commerce, often through forced labor or sexual exploitation.
39
preconception
The time of care before pregnancy.
40
prenatal
occuring prior to birth
41
postpartum
The time frame following birth that lasts for 6 to 8 weeks.
42
inter-conception care
Care given to maternal clients and their partners between one pregnancy and the next to optimize their health.
43
Discuss the social determinants of health that contribute to maternal and infant morbidity and mortality.
SDOH have been shown to contribute to unintended pregnancy, preterm birth, infertility, cervical and breast cancers, and maternal and infant morbidity and mortality. Of particular concern is the disparity in Black American maternal health. In the U.S., pregnant Black clients are three or four more times likely to die from complications related to pregnancy and have double the risk of experiencing severe maternal morbidity than non-Hispanic White maternal clients.
44
fetal alcohol spectrum disorder
A spectrum of manifestations, including medical issues, behavioral issues, and learning difficulties, that can manifest in a person who was exposed to alcohol before birth.
45
Maternal complications directly related to smoking include
damage to the structure and patency of the umbilical cord, spontaneous abortion, increased risk of ectopic pregnancy, and placental abruption.
46
sudden unexplained infant death (SUID)
The unexpected death of an infant under the age of 1 year. Prior to investigation, there may not be a known cause of death.
47
Which of the following maternal or fetal complications or outcomes are associated with smoking during pregnancy?
SUID
preterm birth
spontaneous abortion
48
preclampsia
A serious complication of pregnancy occurring after 20 weeks of gestation in which a client’s blood pressure value is above 140/90 mm Hg.
It can be accompanied by proteinuria, edema, headache, and vision changes. Preeclampsia can become severe, resulting in seizures.
49
Opioid use during pregnancy is correlated with increased risks of
miscarriage or stillbirth, preterm labor and birth, placental abruption, preeclampsia, and birth defects
50
neonatal abstinence syndrome
(NAS)
A condition caused by infant withdrawal from substances that the fetus was exposed to during pregnancy.
51
A pregnant client reports using opioids for more than 2 years. Which of the following pregnancy complications may result from opioid use?
preeclampsia
placental abruption
52
What factors may influence family structure?
Culture, religion, tradition, sexuality, community, and personal preference may all influence family structure.
53
cultural awareness
Having an understanding of one’s own differences when compared to individuals from other cultural, racial, or ethnic backgrounds.
54
cultural competence
Having the ability to deliver care that values the differences in others and includes cultural preferences in the care.
55
levels of prevention
primary
secondary
tertiary
quaternary
56
primary prevention
The purpose of primary prevention is to prevent diseases from occurring in a specific individual and is aimed at members of nondisabled populations.
57
examples of primary prevention
immunizations and tobacco cessation programs.
58
secondary prevention
Secondary prevention places significance on early detection of disease and is focused on individuals who have subclinical disease manifestations
59
examples of secondary prevention
. Standardized screening exams—such as Pap smears, colonoscopies, and mammography
60
tertiary prevention
Tertiary prevention is aimed at treating the outcomes of disease and is focused on clients who have a known disease to reduce the severity of disease and its manifestations
61
examples of tertiary prevention
Chemotherapy, pain management, and cardiac rehabilitation are examples of tertiary prevention.
62
quaternary prevention
Quaternary prevention is a protective method to prevent clients from undergoing medical treatments that may potentially do more harm than good.
63
examples of quaternary prevention
addressing overmedication for manifestations
64
Management of comorbidities achieved through home care services provides continuation of care,
such as monitoring blood pressures in maternal clients who have primary or pregnancy-induced hypertension, for example.
65
pregnancy-induced hypertension
Elevation of blood pressure during pregnancy after 20 weeks of gestation that was not previously present in the client.
66
three main components of the female reproductive system
external genitalia
internal reproductive organs
hormones
67
what is the female reproductive system responsible for
producing eggs
transporting eggs to the uterus, producing hormones that control the reproductive process.
68
pathophysiological conditions can affect the female reproductive system
endometriosis, ovarian cysts, uterine fibroids, and pelvic inflammatory diseases
69
what does the external female genitalia consist of?
clitoris
mons pubis
labia majora
labia minora
vaginal orifice
Bartholin's glands
hymen
70
clitoris
An organ that is important in female sexual sensation and orgasm. The development of this organ originates from the same cells as the glans penis.
71
mons pubis
A pad of fat over the pubic bone.
where pubic hair is
72
labia majora
An external structure that encloses and protects all female external genitalia. It begins posterior to the mons pubis.
73
labia minora
An external structure that surrounds the opening of the vagina and is inferior to the labia majora.
74
vaginal orifice
the opening of the vagina
75
Bartholin's glands
Bilateral glands near the entrance to the vagina that provide lubrication.
76
hymen
A thin membrane that covers part of the vaginal opening.
77
vulva
The external genitalia of the female reproductive organs.
78
internal organs
ovaries
fallopian tubes
uterus
cervix
vaginal canal
79
uterus
main organ that houses the fetus
80
cervix
bottom of the uterus which dilates to allow birth of the fetus through the vaginal canal
81
ovaries
location of the egg release
82
vaginal canal
during menstruation, blood will pass through the cervix and into the vaginal canal and out the vaginal opening
83
A nurse is caring for a client who is experiencing menstrual bleeding. Which of the following internal structures is most affected by the menstrual cycle?
uterus
84
estrogen
the hormone that causes the development of female sex characteristics, such as breast growth and the regulation of the menstrual cycle.
85
progestrogen
helps prepare the uterus for pregnancy and is essential for maintaining a pregnancy.
It also helps regulate the menstrual cycle and contributes to the production of breast milk
86
follicular phase
Begins on the first day of menstruation, lasts for 13 to 14 days, and culminates in ovulation.
estrogen levels increase while progestogen levels remain low
87
luteal phase
A phase of the menstrual cycle that pregnancy can occur when an egg travels to the uterus and ends when menstrual bleeding begins.
progestogen levels increase while estrogen levels remain constant
88
Human chorionic gonadotropin (hCG)
is another reproductive hormone, but the placenta produces it during pregnancy
89
purpose of hCG?
thicken the uterine lining to support a growing embryo and send a signal to the body to stop menstruation.
90
when do levels of hCG rise?
rise immediately after conception and increase until about 10 weeks into a pregnancy.
91
Levels of Prevention in Reproductive Care: PRIMARY
HPV immunizations to prevent STIs, cancer, etc
92
Levels of Prevention in Reproductive Care: SECONDARY
Pap smears & prostate cancer screenings
93
Levels of Prevention in Reproductive Care: TERTIARY
helping clients manage long term manifestations of exsisting conditions ( such as menstrual cycle pain or sexual dysfunction)
94
how far in advance should you prepare for pregnancy before actively trying to get pregnant?
3 months
95
trimesters
1st trimester: weeks 0-13 & 6 days
2nd trimester: weeks 14-26 & 6 days
3rd trimester: weeks 27-40 & 6 days
96
what day during menstrual cycle does conception happen
14
97
how to calculate estimated date of birth (EDB)
first day of period minus 3 months plus 7 days
for a normal 28 day cycle
98
symptoms during the first trimester
fatigue
nausea
breast tenderness
frequent urination
also when spontaneous abortions occur and congenital anomalies develop.
99
early warning signs of a spontaneous abortion
cramping and bleeding
100
symptoms in the second trimester
most clients describe significant improvement in fatigue or nausea
first fetal movements in weeks 16-20
101
what week should client be getting a complete prenatal ultrasound?
20
102
laboratory screenings at second trimester
gestational diabetes, anemia, and syphilis.
103
symptoms during third trimester
should be monitored for expected fetal growth with biweekly appointments through 36 weeks, after which visits should increase in frequency to weekly. Each visit will consist of screening questions for vaginal bleeding, fetal movement, and nausea or vomiting
104
when should client get a complete Tdap vaccine?
third trimester
105
spontaneous abortions
Spontaneous pregnancy loss that occurs prior to 20 weeks of gestation.
106
congenital anomalies
Functional or structural anomalies that occur during fetal development; also known as birth defects or congenital malformations. Examples include neural tube defects, Down syndrome, and cleft palate.
107
What medications should Terri tell Kailani to avoid, and what supplements should they tell Kailani to start taking?
dont take NSAIDS
start taking folic acid
108
infertility
classified as the inability to conceive after 1 year of unprotected intercourse for clients younger than 35 and after 6 months for clients over the age of 35
109
when does menstrual cycle usually start?
age 12
110
average length of menstrual cycle
28 days
but can be as short as 21 days and as long as 35 days
111
polycystic ovary syndrome (PCOS)
Medical condition that may result in ovarian cysts, lack of ovulation, infertility, and irregular menstrual periods.
112
dysmenorrhea
pain during menstruation
113
amenorrhea
lack of menstrual cycle for a female of reproductive age
114
secondary amenorrhea
lack of period for 3 months or more
115
physiological changes with premenopause
hot flashes, sleep disturbances, mood changes, vaginal dryness, night sweats, fatigue, and skin changes
116
menopause
The definitive diagnosis for menopause is 12 months of amenorrhea without cause
117
average age of female client getting menopause
51
118
advanced maternal age
age 35 and older
are at increased risk of pregnancy complications, such as gestational diabetes, high blood pressure, and chromosomal abnormalities.
119
What screenings should a nurse discuss with a female client of reproductive age?
During their reproductive years, female clients should receive a Pap smear every 3 years to screen for cervical cancer and HPV. If the client is sexually active, STI screening should be completed. If the client has any issues or episodes of irregular periods or heavy menstrual bleeding, a pelvic ultrasound should also be recommended.
120
basal body temperature
A person’s lowest temperature at rest on a given day, which can be used to help predict ovulation.
121
Match the menstrual cycle occurrence with the cervical mucus description.
least fertile period (less mucus with a clear, sticky apperance)
ovulation (largest amount of clear mucus present)
egg maturation (white or yellow mucus that is cloudy and sticky)
122
coitus inerruptus
natural contraception known as the pullout method
123
condoms
only form of birth control that can also protect against STIs
124
Make Contraception Most Effective
take more than one method
take pills same time each day
use barrier methods consistently and apply them correctly
125
does a copper IUD contain hormones
no
126
how long can an IUD protect from unintentional pregnancy
10 yrs
127
female sterilization
total hysterectomy (no uterus)
salpingectomy (no fallopian tubs)
tubal ligation (sealing or cuting fallopian tubes)
hysteroscopic sterilization (placing inserts or coils in the fallopian tubes through the cervix)
female sterilization is a permanent method of birth control.
