Promoting Healthy Populations Exam 3 IU Indianapolis

Infant mortality rate goal for healthy people 2030

Less than 5 deaths per 1000 live births

____ ___ is a critical indicator of the health of a population

Infant death

Barriers to care

Financial issues:

Source of payment, access to providers, Insurance coverage, ability to pay.

Barriers to care

Culture Isssues:

Lack of communication, racial discrimination, women rely on men for healthcare decisions, religion.

Barriers to care

Gender Issues:

Provider gender, lesbians may not seek care due to fear of hostility, breach of confidentiality.

Barriers to care

____ abuse and fear of the ___

substance, law

Egg is fertilized in the fallopian tube by sperm which makes a?

zygote

Zygotes span ___ days before the next step

14

Sperm requirements for fertilization

Must be uniform, normally formed, secrete enzymes.

Egg requirements for fertilization

Basal body temperatures and fallopian tubes open without adhesions.

The zygote implants in the?

uterine lining

what the zygote implants in the uterine lining the ___ and ___ develope

embryo, placenta

Embryo time span

15 days - 8 weeks

Placenta previa

baby forms over cervix

Women should take ____ ___ during pregnancy

folic acid

Congenital defect

Abnormality during development

Problem with structure

Genetic defect

Abnormality during conception

Problem with DNA

Gravida

a pregnant woman

Nulligravida

a woman who has never been pregnant

Multigravida

a woman who has had two or more pregnancies

Term Pregnancy

pregnancy from 38 weeks to 42 weeks

Preterm

A pregnancy that is at least 20 weeks to 37 weeks

Post term

A pregnancy that goes beyond 42 weeks

Viability

Capacity to live outside uterus, around 22-25 weeks

Elective abortion

legal termination of a pregnancy for non-medical reasons

spontaneous abortion

miscarriage

Length of pregnancy months

9

Length of pregnancy lunar months

10

Length of pregnancy days

280

Length of pregnancy weeks

40

Length of pregnancy __ trimesters of __ weeks

3, 13

1st trimester time length

week 1-13

2nd trimester time length

week 14-26

3rd trimester time length

week 27-40

Negele's rule

Method used to calculate EDD or EDC

EDD

expected date of delivery

EDC

estimated date of confinement (due date)

LMP

last menstrual period

Negele's rule formula

[month of period - 3 months] [Last period + 7 days] [+1yr]

Chloasma

pigmentary skin discoloration usually occurring in yellowish brown patches or spots

Linea negra

dark line down abdomen

How do pregnancy tests work

detects presence of hCG (human chorionic gonadotropin)

Presumptive pregnancy signs are ___

subjective

Probable pregnancy sings are ___

objective

Presumptive pregnancy signs

amenorrhea, nausea, breast tenderness, deepening pigmentation, urinary frequency, quickening

Probable pregnancy sings

enlargement of uterus, positive test for hCG in maternal urine or blood, change in skin pigmentation.

Positive Signs of pregnancy

audible fetal heartbeat, fetal movement felt by examiner, ultrasound visualization of fetus

Prenatal visit schedule

Every 4 weeks till 32 weeks

one 32 weeks have been reach in the pregnancy the mother should visit the doctor every ___ weeks till 36 weeks

2

What is obtained on the first prenatal visit

Full history, determine EDD, Obtain labs

Routine lab tests

blood type and RH factor

determine if RH incompatibility between mother and father

Routine lab tests

CBC w/diff, Hgb, and Hct

Check for infection and anemia

Routine lab tests

Group B streptococcus

obtain vaginal culture at 35-37 weeks to assess for GBS infection

what does culture mean in terms of pregnancy

is a laboratory test used to diagnose infections in the female genital tract.

When the mother had reached 36 weeks in her pregnancy she should visit the doctor ____ till 40 weeks

weekly

When the mother reaches 40 weeks she should visit the doctor?

twice a week

Braxton kicks

way body practices contraction but no cervical dilation

Fundal height

fundus (top of the uterus) measures fetal growth

Breast changes in pregnancy

full and heavier, nipples and areola darken

Colostrum

A thick yellow pre milk fluid by 14 weeks "liquid gold"

symptoms in gastrointestinal system in pregnancy

constipation, heart burn, nausea, vomiting

Recommended weight gain for women in pregnancy

1st trimester

2-4 pounds

Recommended weight gain for women in pregnancy

2nd trimester and 3rd trimester

1 pound per week

Total normal weight gain for pregnant women

25-35 pounds

Spine bifida

A birth defect in which a developing baby's spinal cord fails to develop properly.

Pica

non food cravings

Integumentary changes in pregnancy

melasma, stria , Linea nigra

Cardio vascular and renal changes in pregnancy

Increased heart output by 30-50 percent, increased heart volume by 30-45 percent

Filtration rate increases, same amount of urine produced

Peripheral vascular system changes in pregnancy

vena cava syndrome

occurs from laying flat on back, resolves if laying on left side

Respiratory changes during pregnancy

maternal oxygen need increases, enlarged chest last trimester, rate of capacity decreases.

Musculoskeletal changes in pregnancy

weight increase, pelvic joints relax

Endocrine changes in pregnancy

very active hormones

Avoid these substances during pregnancy

heroin, cocaine, narcotic, maternal marijuana

Potential hazard substances during pregnancy

mercury, lead, radiation, teratogens

Ultra sound

Images produced by sound waves to check for possible birth deffects

When does the fetal heart rate start

10-12 weeks

Leopold maneuvers

Palpation technique to assess fetal position.

Vertex position

a birth in which the infant is delivered head first

Complete breach position

when both of the baby's knees are bent and his feet and bottom are closest to the birth canal

Footling breach position

one or both feet are present first at the cervix

Frank Breach Position

hips flexed, knees extended

Transverse lie and shoulder presentation

A fetus with excessive amniotic fluid is at risk for what malpresentation birth method?

Face presentation

the face as the first presenting part at the vaginal opening during birth

Brow presentation

fetal head is partially extended

Compound presentation

fetal extremity presenting alongside the vertex or breech

Papanicolaou test (pap)

Hpv screening

Vaginal culture

Detects STIs such as gonorrhea, Chlamydia

Rh blood group incompatibility

Occurs when the mother has Rh-negative red blood cells and the fetus has Rh-positive red blood cells, inherited from a father who has Rh-positive blood. In this disorder, maternal antibodies develop, cross the placental membranes, and destroy the Rh-positive red blood cells of the fetus.

___ is given to the mother with Rh negative to prevent antibodies

RhoGAM

Torch Screening

Done to detect 5 teratogenic infections (toxoplasmosis, hepatitis B, Rubella, Cytomegalovirus, Herpes simplex).

Pregnant women are encouraged to exercise ___ a day

30 mins

Known teratogens

Accutane

antibiotics (long term)

Tetracyclines cause?

discoloration of developing teeth

TRUE OR FALSE pregnant women can have short term antibiotics

True

3 multiple choice options

Anticonvulsants

prevent or control seizures (hydronation, barbiturates)

Opioids if used by pregnant women

can cause NA's (Neonatal abstinence syndrome)