Maternal Newborn 1

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sdelap
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128797
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Maternal Newborn 1
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2012-01-18 20:30:43
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Maternal Newborn wk
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Maternal Newborn wk 1
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  1. CNM
    Certified Nurse Midwife
  2. Self-Care
    Desire to participate in and make choices in one's own health care.
  3. Negligence
    Omitting or committing an act that a reasonably prudent person would not omit or commit under the same circumstances. Need: Duty to provide care; Duty breached; Injury occurred; Breach caused the injury.
  4. Standards of care
    Establish minimum criteria for competent proficient delivery of nursing care
  5. Malpractice
    Negligent action of a professional person
  6. Informed consent
    Patient or legally designated decision maker has granted permission for a specific treatment or procedure based on full information about that specific treatment or procedure as it relates to that patient.
  7. Emancipated minor
    Self-supporting adolescent under 18 yrs, not subject to parental control
  8. Mature minors
    14 & 15 year olds able to understand treatment risks
  9. TI - therapeutic insemination
    Only sperm is handled - deposited into the woman.
  10. ART - Assisted reproductive technology
    Fertility treatment in which both the egg and sperm are handled.

    • NOT: artificial insemination or fertility drugs.
    • IS: IVF-ET (invitro fertilization and embryo transfer

    MULTIFETAL PREGNANCIES!!
  11. Birth Rate
    Number live births per 1,000 people
  12. Infant Mortality Rate
    Number of deaths of infants under 1 yr of age per 1,000 live births in a given population.
  13. Neonatal Mortality
    Number of deaths of infants less than 28 days of age per 1,000 live births.
  14. Maternal Mortality Rate
    Number of deaths from any cause related to or aggrivated by pregnancy or its management during the pregnancy cycle including 42 days post-partum per 100,000 live births.
  15. Family
    Group of two or more people related by birth, marriage, or adoption, residing together
  16. Family Power
    The potential or actual ability to change the behavior of other family members
  17. Family assessment
    collection of data regarding the family's current level of functioning, support systems, sociocultural information, environmental information, type of family, family structure and needs.
  18. Culture
    Beliefs, values, attitudes and practices that are accepted by a population, community or individual.
  19. Ethnicity
    Social identity that is associated with shared behaviors and patterns.
  20. Acculturation
    The process by which people adapt to a new cultural norm.
  21. Assimilation
    When a group completely changes their cultural identity to become part of the majority culture.
  22. Ethnocentrism
    the conviction that the values and beliefs of my own culture are the best or only acceptable ones.
  23. Complimentary Therapy
    Any procedure or product that is used together with conventional medical treatment.
  24. Alternative Therapy
    Used IN PLACE OF conventional medicine.
  25. Integrative medicine
    Approach that combines mainstream medicine with complimentary therapies for which there is evidence of safety and effectiveness.
  26. Benefits of Complimentary Therapies
    • Emphasis on prevention and wellness
    • Emphasis on healing versus cure
    • Noninvasive
    • Cheaper and easier access
  27. Risks of Complimentary Therapies
    • Lack of regulation and standardization
    • Lack of research
    • Inadequate training and certification
    • Financial and health risks of uproven methods
  28. Allopathy
    Traditional medicine - uses treatment or medicine that causes a different reaction in the body than the offending organism or event. I.e., anti-inflammatory prescribed for a person suffering from inflammation.
  29. Homeopathy
    "The same": Uses like to cure like. Remedies are minute dilutions of substances that (if ingested in larger quantities) would produce effects similar to the symptoms of disorder being treated.
  30. Naturopathy
    "Natural medicine": Focusses on body's natural healing power. May use diet, exercise botanical medicine, homeopathy, lifestyle modifications, and others.
  31. TCM - Traditional Chinese Medicine
    Yin and Yang balance.
  32. Ayurveda
    Hindu medicine - "life, health, vitality", focusses on five elements: ether, wind, fire, water and earth.
  33. Vitiligo
    White patchy areas r/t absence of melanin
  34. Lichen Sclerosus
    • 40's and 50's women.
    • White papules and plaques often with areas of bruising and redness
  35. Vulvar vestibulitis
    local irritation and inflammation of the vulvar vestibule, severe pain with vaginal penetration, burning, itching, urinary frequency or dysuria
  36. Cervicitis
    • Acute inflammation of the cervix
    • Usually from infection from Neisseria gonorrhoeae or Chlamydia trachomatis
    • Yellow/white discharge, copious purulent, malodorous
  37. Dyspareunia
    Painful intercourse
  38. Pap Smear
    • Screens for cellular abnormalities from cervix and endocervical canal.
    • Prep: nothing in the vagina 24h pre-test
    • Start at 21yrs
    • Q2y 21-29yrs
  39. Bethesda System
    standardized method of reporting cytologic pap smear findings.
  40. Factors that increase risk of cervical cancer:
    • Early age coitus (1st time before 16yrs)
    • Hx multiple partners
    • Partner with Hx multiple partners
    • Exposure to STIs
    • Hx HPV infection
    • Hx immunosuppressive therapy
    • Hx immunocompromised state (HIV)
    • Long-term oral contraceptive use
    • Smoking
    • Hx dysplasia
  41. Tx for abnormal cytology of cervix
    Surgical: loop excision, cryosurgery, laser, conization
  42. AUB - Abnormal Uterine Bleeding
    • Bleeding outside the normal cycle
    • Endometrium and cyclical hormones are not in sync
    • Thyroid disorder, DM, Infection, Hormon Imbal
    • Tx: control bldg & anemia, prev endomet. cx
    • Oral contraceptives or other hormonal
  43. Menorrhagia
    • Excessive bleeding
    • Regular intervals
    • May have clots
    • >80ml per cycle
  44. Metrorrhagia
    • Bleeding at irregular intervals
    • Between the menses
    • AKA Intermenstrual bleeding
  45. DUB - Dysfunctional uterine bleeding
    Bleeding w/o cycles
  46. Endometriosis
    • Endometrial-like tissue found outside the uterine cavity
    • Pain increased with menses, may be chronic
    • Pain abd, back, rectal or vaginal
    • Diarrhea, nausea, urinary complaints, fatigue
    • Chocolate cysts
    • Laparoscopy or laparotomy(open), biopsy confirms
  47. Cystocele
    Anterior bulge in uterus d/t descended bladder
  48. Rectocele
    Posterior bulge d/t weakness in wall b/t rectum/vagina
  49. TSS - Toxic Shock Syndrome)
    • Staph aureus
    • Fever, rash/sloughing skin on hands/feet/trunk, myalgia, n/v, cogn chgs to coma, inflamed mucosa
  50. Syndrome
    pathology involves 3 or more organ systems
  51. TSS DX and TX
    DX: Labs - elevated BUN, AST, ALT, Bili levels, DECR platelets (increased r/f bleeding)

    TX: IVs (elevate BP), Vasopresors (elevate BP), Ventilatory support, Renal dialysis, Antibiotics - until septicemia ruled out
  52. PID - Pelvic Inflammatory Disease
    • S/t STI (chlamydia or GC) w/or w/o abscess formation
    • S/S: pain, fever 102+, chills, discharge, malaise, n/v
    • Salpingitis (fallopian tubes)
    • Oophoritis (ovaries)
    • Peritonitis (peritoneum)

    PID = late infection. No s/s early, ignored.
  53. PID DX & TX
    • DX: tenderness & chandelier cervix, cervical cultures
    • LABS: CBC, UA; r/o syphilis and HIV
    • Elevated ESR & CRP (elevated w/inflammations)

    • TX: multiple abx (parenteral & po) Rocephin
    • Treat partner, follow-up care, education
  54. Cervical Dysplasia
    • Abnormal chgs in cells of cervix
    • Pre-cancerous, condition
    • Early detection w/PAP smear
    • Asymtomatic
    • Carcinoma in situ = severe dysplasia / will become cx

    TX: conization, cautery, cryosurgery, laser, LEEP
  55. Cervical CX = dysplasia undiagnosed and untreated
    • Dysplaisa undiagnosed and untreated
    • HPV LEADING trigger
    • Prevention: delay sexual activity, monogamy, no smoke, incr folic acid in diet
    • Vaccinate - Gardasil - series x3
  56. Leiomyomas - Uterine Fibroids
    • Estrogen Dependent
    • Benign growths in uterus, atrophy in menopause
    • More in women of color, obesity
    • Sx: heavier bldg, bladder/bowel sx

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