Wk 2 Monday slides Flashcards

1
Q

Number of live births in 1 yr per 1000 pop.

A

Birth rate

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2
Q

Number of birth per1000 women between ages 15 and 44

A

Fertility rate

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3
Q

of deaths of infants younger than 28 days of age per 1000 live births

A

Neonatal mortality rate

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4
Q

Most common causes of neonatal mortality rate

A
  • Preterm birth
  • Intrapartum-related complications
  • Infections and birth defects
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5
Q

infant at birth showing no signs of life (breathing, HR, voluntary muscles spasms)

A

still birth

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6
Q

of stillbirths and neonatal death per 1000 live births

A

perinatal mortality rate

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7
Q

Infant mortality rate

A

of deaths of infants <1 yr per 1000 live births

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8
Q

Most common causes of infant death in US…

A
  • Birth defects
  • Preterm birth and low birth wt
  • SIDS Sudden infant death syndrome
  • Pregnancy complications
  • Accidents (#1)
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9
Q

Most common causes infant death worldwide

A
  • Neonatal encephalopathy, problems w/ brain function. Results from birth trauma or lack of O2 to baby during birth
  • Infections, especially blood infections
  • Complications of preterm birth
  • Lower resp infect (flu, pneumonia)
  • Diarrheal diseases
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10
Q

Maternal mortality rate

A

of maternal deaths from birth and complications from pregnancy, birth, and puerperium, per 100000 live births

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11
Q

Family Systems Theory

A

Views family as a complex system of interconnected and interdependent individuals

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12
Q

Types of families

A

Traditional, non-traditional

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13
Q

Traditional and legal family definition:

A

Family mems are related by legal ties or genetic relationships

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14
Q

Non-traditional family def

A

2 people who say they are “family” and are bound by emotional ties

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15
Q

Family development theory

A

 Family is a developing group which goes through stages
 Fam members must perform certain time specific tasks
 Disequilibrium is common when entering a new stage, w/ goal of hemostasis w/I stages

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16
Q

Family systems theory

A

 Inter-relatedness
* A fam consists of more than just the “sum” of its parts-its members
* A change in one mem affects the whole fam
o V important in peds care
 Interaction
* ‘Who I am’ or ‘Who I have become’ dependent on fam relationships and interactions
* Is it helpful to blame our fam for our problems and issues
* We also interact w/the environment and community which also influences who we are
 Boundaries: Imaginary but real lines between fam mems and also between fam and the “outside world”

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17
Q

Family stress theory

A

 Stress is a definite part of fam life
 One fam’s crisis may be another fam’s challenge
 The ability to handle stress depends on 4 factors:
* Basic fam type or attributes (dysfunctional vs health/stable
* Amount of resources/support the fam has
* Fam’s perception of the stressful event
* Fam’s learned coping strategies: When stressors exceed the fam ability to cope crisis occurs

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18
Q

Family role theory:

A

 Role is defined by culture
 Most ppl assumes several roles (student, employee, spouse. Etc.)
 Role expectations: expectations about behaviors and feelings that a role should include
 Role stress/strain
* Subjective reaction when trying to meet all role expectations
 Role transitions

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19
Q

Myometrium

A

2nd or middle layer of the uterine wall
* Consists of smooth musc fibers arranged in 3 diff directions
o Longitudinal
o Transverse
o Oblique

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20
Q

Hypothalamus produces

A

o Gonadotropin-releasing hormone (GnRH)
 Aka Luteinizing hormone-releasing hormone (LHRH)
o GnRH are “sex hormone” for both males and females

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21
Q

Pituitary produces:

A

o Follicle-stimulating hormone (SH)
o Luteinizing hormone (LH)

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22
Q

Ovary produces:

A

o Estrogen
o Progesterone

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23
Q

When is mensuration

A

from the time vaginal bleeding starts to the time it ends

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24
Q

LMP

A

Last mensural period

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25
Q

Length of mensuration

A

5-6 days

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26
Q

What is menstruation

A

Blood and tissue from the previous cycle

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27
Q

When is the endometrium thinnest

A

during the menstruation period

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28
Q

What are hormones like during menstruation period

A

(estrogen and progesterone) = lowest, causing top layers of the lining to release and leave the body

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29
Q

Order of the uterine cycle

A

menstruation, proliferation, secretory

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30
Q

Mensuration (when)

A

from the time vaginal bleeding starts to the time it ends

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31
Q

Menstruation (length)

A

5-6 days (sometimes 8)

32
Q

Menstruation (What it is)

A

Blood and tissue from the previous cycle

33
Q

Proliferation (when/how long)

A

From end of period until ovulation: about 7 days

34
Q

Proliferation (what)

A

Proliferation = growing quickly. The uterus builds up a thick inner lining while the ovaries prepare eggs for release. The uterus thickens so a potential fertilized egg can implant and grow.

35
Q

Proliferation (hormones)

A

Estrogen is high during this phase. This signals the uterine lining to grow. (Estrogen is like lawn fertilizer, encouraging growth of the uterine lining

36
Q

Secretory (When)

A

last 2 wks of cycle (Days 14-28)

37
Q

Secretory (hormones)

A

Progesterone increases (“pro-gestation”). Stimulates the endometrium and the corpus luteum.

38
Q

Corpus luteum

A
  1. Empty follicle that releases the egg
  2. Temporary endocrine structure
  3. After ovulation, it becomes the corpus luteum
  4. Secretes large quantities of progesterone and estrogen to sustain a possible fertilized egg
  5. If no preg occurs, the corpus luteum begins to degenerate, hormone secretion declines and menstruation begins. Scar tissue remains.
39
Q

PMS

A

Premenstrual syndrome- may occur in the last wk

40
Q

3 phases of the ovarian cycle

A

Follicular -> Ovulation -> Luteal

41
Q

Which hormone is hight. during the follicular phase

A

FSH

42
Q

Where does FSH come from

A
  • Nerve cells in the hypothalamus make and release GnRH into the blood
  • This stimulates the pituitary gland to make and release FSH ad LH
43
Q

When is the follicular phase

A

From the start of the period until ovulation

44
Q

What does FSH in the follicular phase do

A

Follicle stimulating hormone (FSH) stims “Graafian follicles.” This preps the egg for ovulation

45
Q

What happens during the ovulation phase

A

o Egg is released into pelvic cavity
o Fimbriae at ends of fallopian tube brings egg into tube

46
Q

Luteal (what)

A
  • Empty follicle forms a gland called “corpus luteum”
  • If preg occurs, will maintain preg until placenta is mature enough to take over- around 12 wks gestation
47
Q

Luteal phase (hormone)

A

Corpus luteum produces progesterone

48
Q

Endometrial development during menstruation

A

The surface of the endometrium sheds off resulting in menses

49
Q

Endometrial development during proliferation/follicular phase

A

Endometrium cells proliferate and the lining thickens

50
Q

Endometrial development during Secretory/luteal phase

A

an egg is expelled from the ovary into the pelvic cavity

51
Q

Endometrial development during premenstrual phase

A

may begin about a week b4 period. The endometrium continues to mature until a sudden drop in hormone levels trigger menstruation

52
Q

Fallopian tube (what)

A

The site where fertilization happens:
* Hallow, muscular ducts that provide passageway for egg and sperm to meet
* Egg waits in the fallopian tube
* Finger-like structures (fimbriae) sweep the egg into the tube
* Conception happens in the outer third of the fallopian tube
* Powerful, muscular movements move the egg towards the uterus for implantation if fertilized

53
Q

process of conception

A

ovum -> fertilization -> fusion of egg and sperm pronuclei -> zygote -> cleavage (2, 4, 8 celled) -> morula -> blastocyst -> implanted blastocyst

54
Q

Chronological order of 4 hormones during menstrual cycle

A

GnRH -> FSH -> LH -> progesterone

55
Q

average cycle

A

28 days

56
Q

Testosterone

A

influences the muscular development; physical growth, sebaceous gland activity/acne; sex organ function, sperm maturation in males; and is present in both males and females

57
Q

Estrogen

A

Effects bone growth in females, as higher levels help close the epiphyseal lines of long bones around the time of menarche

58
Q

estriol

A

thought to have a role in parturition/ onset of labor, by increasing the sensitivity to prostaglandins and oxytocin. Changing levels of this compound are the spit/salivary estriol test to predict PTL risk

59
Q

Progesterone

A
  • Helps maintain pregnancy and also helps prepare the uterus for pregnancy
  • Progesterone elevation occurs after ovulation and spikes at 5-6 days after ovulation.
  • Progesterone is thermogenic -> the reason women’s temp is higher following ovulation
60
Q

Birth control options

A

*Condoms
*Female condom
*BCP
*Hormonal ring
*IUD
*Injections
*Surgical sterilization
*Subdural implant
*Coitus interruptus
*Calendar rhythm
*Patch
*Diaphragm
*Foams, jellies, creams

61
Q

Birth control pill (Effectiveness)

A

97-99%

62
Q

BCP mech of action

A

o Suppresses secretion of FSH and LH, inhibiting ovulation
o Actions of progesterone: Thickens cervical mucous and interferes w/ endometrial proliferation

63
Q

BCP risks

A

o Risk for cervical CA (not sure why)
o Risk of endometrial and ovarian CA

64
Q

BCP s/e

A

N/V, wt gain, possibility of breakthrough bleeding initially, mild HTN, breast tenderness, mood changes

65
Q

IUD effectivness

A

98-99.2%

66
Q

IUD types

A

copper (paragard), Progesterone-containing (Skyla, Mirena)

67
Q

IUD mech of action

A

o May damage sperm in transit, prevent fertilization
o Prevent implantation of fertilized egg through inflammatory response on endometrium, or decreased inflammatory proliferation

68
Q

IUDs are most appropriate for

A

o Heavy smokers >35yrs old
o HTN
o Coronary artery disease
o Strong familial hx of DI w/ vascular complications

69
Q

Cons of injections

A

Depo-provera injection is an injectable progesterone w/ SE like Nexplanon/implantation, w/ an additional slight risk of osteoporosis

70
Q

Types of surgical sterilization

A

tibial ligation and Essure

71
Q

Tibial ligation

A

after vaginal birth or c-section, small ABD incision around belly button if no c-section

72
Q

Essure

A

insertion of a small coil in each tube to permanently block tube w/I 3 mon. Requires back-up method initially

73
Q

Subdural implant types

A

Norplant (2 implants), implanon and Nexplanon (single rod)

74
Q

How long do implants stay active

A

3-5 years

75
Q

what is the mech of action of implants

A

Thickens cervical mucosa and affects/thins uterine lining

76
Q

Vasectomy

A

Cautery of the vas deferens

77
Q

pt education for vasectomy

A

need to be aware that it may takes to mons (or 15 ejaculations) to remove all sperm from sperm ducts