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What led to government involvement in maternity care?
increased mortality rates of mother and baby among poor women
Before the twentieth century, a primary cause of maternal death was:
A plan of client care that identifies client outcomes and specifies time lines for achievement of those outcomes is termed:
primary cause of infant deaths before the twentieth century.
Case management is a practice model that uses a systematic approach to identify specific clients and to manage care collaboratively to ensure optimal outcomes. True or False?
Semmelweis discovered that puerperal infections could be prevented by proper _____________________.
The health care birth system that uses health maintenance organizations and preferred provider organizations is termed ______________________.
A major concern about the use of complementary and alternative medicine is _________________.
communication technique of following up on a client statement to understand content and the feelings expressed.
communication technique of restating in words other than those used; a form of clarification
The practice of lowering health care costs while maintaining the quality of care
practice model that uses a systematic approach to identify specific clients and to manage care collaboratively to ensure optimal outcomes
communication technique of verbalizing comprehension of what the pt. said and what pt seems to be feeling
teaching methods for teenagers & adults in 30s
teenagers-videos, computer-basden lessons & group discussions
principles of teaching and learning
- readiness of client to learn is a principle
- repetition increases competence
- teaching should proceed from simple to complex
- active participation increases learning
- praise & postive feedback are powerful motivators
- retention greater when material is presented in small segments over time
An advanced practice RN that provides wellness-focused, primary, reproductive, and gynecologic care from adolescents to older adults is termed a _____________.
women's health nurse practicioner
The process directed toward finding solutions or forming opinions is termed _____________.
ABCDEs of critical thinking
- recognition of assumptionsexamination of personal biasesanalysis of the amount of pressure for closureexamination of how data are collected & analyzed
- evaluation of how emotions & environmental factors may interfere with critical thinking
ideas, beliefs or values that are taken for granted without basis in fact or reason
prejudices that sway the mind to particular conclusion or course of action bases on personal theories or stereotypes
need to come to a solution. not good with ambiguity(doubt or uncertainity). to overcome the need for early closure a conscious effort to suspend judgement must be made(reflective skepticism-doubt in the absence of conclusive evidence
- collect data
- validate date
- organize & analyze data
emotion & environmental factors
ex. fatigue, protect self-image, inexperience, anger fustrtation can impede critical thinking
nursing process- 5 steps (ADPIE)
- nursing dx
Determines the best course of action in a certain situation
A situation faced by a nurse in which no solution seems completely satisfactory can be termed a(n) _______________ _____________.
Rules or principles that govern right conduct, specifically those that relate to health care are termed ______________.
negligence by a professional person is termed ___________.
An approach determines what is right by applying ethical principles and moral rules. It does not vary the solution according to individual situations.
An approach that analyzes the benefits and burdens of any course of action to find one that will result in the greatest amount of good.
Belief that each person has human rights
human rights model
3 models that guide ethical decision making
deontologic, utilitarian, human rights
In applying ethical principles, the nurse should always show respect to the client, provide privacy, and ensure the client has the information needed to make decisions. This is called:
is stating that clients have the right to self-determination. This includes the right to respect, privacy, and information necessary to make decisions.
In applying ethical principles, the nurse should treat all clients equally, regardless of disease or social or economic status. This is termed:
states that all people should be treated equally and fairly. Nurses should be aware of their treatment of clients to prevent unfair actions because of a disease process or social or economic status.
ethical principles in health care
make a decision that produces the greatest good or least harm
keep promises and do not makes promises that can't be kept
Select which of the following statements are stipulated in the Roe v. Wade decision. (Select all that apply).
A. A woman can obtain an abortion at any time during the first trimester.
B. A woman can obtain an abortion at any time during the pregnancy when both mother and father sign releases.
C.The state can regulate abortions during the second trimester only to protect the woman's health.
D. The state can regulate or prohibit abortion during the third trimester, except when the mother's life might be jeopardized by continuing the pregnancy.
E. Late-term abortions are banned.
Select the elements listed that are necessary to prove negligence. (Select all that apply)
B. Breach of duty
E. Breaking the standard of care Incorrect
Select the tasks for which the nurse is responsible when delegating tasks to unlicensed assistive personnel. (Select all that apply).
A. Client assessment
B. Critical judgments to ensure client safety
C. Capabilities of each unlicensed person
D. Supervision of the unlicensed person
All of the above
Each state has a _____ that defines what the nurse is allowed to do when caring for client
nurse practice act
Late preterm(near-term) is
34 to 36 weeks
differentiation of external sex organs is complete at ___ weeks and begin internally at __ and externally at __.
12 weeks, 7 weeks, 9 weeks
collective external female reproductive is
the external female reproductive system includes
- monis pubis
- labia majora & minora
- structures of vestibule
structures of the vestibule include
- urinary meatus
- vaginal introitus
- ducts of Skene
- ducts of Bartholin
3 divisions of uterus
- isthmus-transition zone-(lower uterine segment during late pregnancy)
female reproductive cycle-menstrual cycle is driven by feedback loop with anterior pituitary secretion and ovaries. lasting normally
28 days on average but 20-45 possible
menstrual cycle divided into 2 cycles
- ovarian cycle
- endometrial cycle
during ovarian cycle, which hormones are secreted to mature & release ovum
FSH & LH from anterior pituitary gland
Follicular phase is
As FSH & LH rise slightly the ovum matures. Usually day 1 to 14.
near middle of 28 day cycle and 2 days before ovulation, LH rises greatly. This rise of LH and FSH cause follicular estrogen to production to fall & progesterone to rise that stimulates final maturation & release of ovum.
begins with ovulation. after ovulation & under influence of LH the remaining cells stay as corpus luteum for 12 days. The levels of FSH & LH decrease due to higher levels of estrogen & progesterone. If ovum fertilized then it secretes HCG and corpus luteum stays for early pregnancy. If not, then FSH & LH fall to low levels and corpus luteum regresses causing decrease levels of estrogen & progression which causes menstration as uterine lining breaks down. The loss of estrogen & progresterone from corpus luteum at end of one cycle stimulates anterior putitiary gland to secrete FSH & LH causing a new cycle to start.
Ovarian has 3 cycles what are they and what days are their range?
- Follicular phase- day 1-14
- Ovulatory phase- middle of 28 day cycle to 2 days before ovulation
- Luteal phase- begins with ovulation to day 28(start of menstruation if not pregnant)
occurs as ovum matures & is released during first half of ovarian cycle. Basal layer forms new endometrial epithelium & glands under stimulation of estrogen produced by maturing ovarian follicle. As ovulation approaches the endometrial glands secrete thin, stringy mucus that aid in entry of sperm into uterus.
endometrium has 2 layers
- basal layer-nearest myometrium & regenerates functional layer after menstruation & childbirth
- functional layer-above basal layer and sheds during period & after childbirth in the lochia
occurs during last half of ovarian cycle. endometrium thickens to thickest of 5-6mm under corpus luteum production of estrogen & progesterone
if not fertilization, the corpus luteum regresses & estrogen & progesterone fall. 2 days before menstruation vasospasms of endometrial blood vessels occur and causes endometrium to become ishemic & necrotic. necrotic areas seperate from basal layer and start the menstrual flow which normally last 5 days
endometrial cycle has 3 phases and how do they correlate with ovarian cycle
- proliferative-1st half of ovarian cycle to ovulation
- secretory-2nd half of ovarian cycle
- menstrual-occurs if no pregnancy occurs
cervical mucus changes during menstrual cycle are,
- normally thick, scant & sticky
- just before ovulation becomes it becomes clear, thin & elastic
refers to elasticity of cervical mucus
myoepithelial cells surround alveoli to contract and eject milk into ductual system when signaled by oxytocin produced in the _______ pituitary gland
acinar cells inside the alveoli extract necessary substances from mammary blood supply to create milk when breast are stimulated by _______ pituitary gland.
during pregnancy high levels of _____ & _______ produced by placenta stimulate growth of alveoli & ductual system
_____ secretions by anterior pituitary gland stimulate milk production but inhibited by estrogen & progesterone