NSG 2421 Trimester 1 Exam

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Cycle of Violence

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107 Terms

1

Cycle of Violence

Tenson → Battering → Honeymoon

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2

When do you have a legal obligation to contact the police.

When the victim of abuse is a child.

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3

ABCs of visual pediatric assessment

Appearance breathing circulation (colour)

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4

Friedman’s Structure

Views famliy structure as acomplishing two things, it is affective (it provides affection), and it provides socialization and social placement

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5

Calgary family assessment

Assesses family structure (losses, broad), developmental milestones (walking etc), family function (how well the family works)

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6

Mcgill model

Assesses fmaily, health, collaboration, and learning

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7

Medication reconciliation

The process of a patient informing the healthcare team of all their previous medication use prior to arriving in the hospital setting (prevents med errors)

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8

Near miss

Potential error no harm

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9

No harm event

Error, no harm

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10

Medication error

Causes harm

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11

Crtitical Incident

Causes serious harm

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12

Dexamethasone

Long acting corticosteroid

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13

Pregnisone

Short acting corticosteroid, can disrupt sleep patterns

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14

Where is fluid kept

65% intercellular, 25% interstitial, 10% plasma

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15

Magnesium

More important in pedes due to MALNUTRITION

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16

HIT YOUR LYTES GOOD

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17

Calculation for pediatric fluid balance.

100ml/Kg for first 10, 50ml/Kg for next 10, 20ml/kg for remaining weight.

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18

Typical pediatric urine output

0.5-2.0ml/Kg

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19

Dehydration s/s in neonate

Sunken fontanels, delayed cap refil, adult dehydration symptoms

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20

Fluid overload s/s in neonate

Expanded fontanells, crackles, pulmonary/cerebral edema

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21

Normal pCO2

35-45mmHg, Under 2 its 26-41

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22

Normal HCO3

21-28mmol/L, Infant 16-26

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23

Growth vs development

Growth=size, development=personhood

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24

Freud’s Oral stage

B to 1yr - Sucking, biting, just kinda jamming stuff in there

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25

Freud’s Anal Stage

1 to 3yrs - Potty training, bladder control

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26

Freud’s Phallic Stage

3 to 6yrs - Relationship with parents forms, being away from trusted adults in school/daycare

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27

Freud’s Latent stage

6 to 12yrs - Learning about gender roles

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28

Freud’s Genital Stage

12 to Adult - I want to have sex

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29

Piaget’s Sensory-Motor

B to 2yr - Reflexes, basic shit

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30

Piaget’s Preoperational Stage

2 to 7yr - Egocentric, magical thinking, very creative

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31

Piaget’s Concrete opperational stage

7-11yrs - Less self-centered, thinking more coherent, very curious

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32

Piaget’s Formal Operational Stage

11-A - Thoughts more adaptable, flexible, abstraction possible

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33

Eriksons Trust vs Mistrust Stage

B to 1y - Depends on the childs needs being met

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34

Erikson’s Autonomy vs Shame/Guilt Stage

1 to 3y - Increased indepence, testing the limits of their role

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35

Erikson’s Initiative vs Guilt Stage

3 to 6y - Playing, starting to express themselves

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36

Erikson’s Industry vs Inferiority Stage

6 to 12y - Self worth linked to activities and social groups

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37

Erikson’s Indentity vs Role Confusion Stage

13 to 17y - Problems assessing with the parents in the room due to increased independence, modesty, forming of a new identity

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38

Infant Developmental Milestones

Holds head up without help, Voice recognition, Supports most of it’s own weight when held upward, supported walking

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39

Toddlerhood Developmental Milestones

Throwing, Scribbling, Push and pull toys, Talking, Can undress and kinda dress

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40

Parallel Play

Typicall engaged in by toddlers, playing beside someone else but not engaged with them directly

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41

Preschool Aged Play

Want to emulate parents, whisks, trainers etc, safety scissors as motor skill develops

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42

School Aged Play

Can do stuff that requires concentration like sports

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43

Adolescent Play

Mostly social

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44

Separation Anxiety Cycle

Fear → Despair → Withdrawl/Denial

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45

Dealing with Seperation Anxiety

Look to the parents first, be firm about tasks

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46

Coming methods of childhood coping

Regression, Repression, Rationalization, and Fantasy

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47

Assessing a B to 6m

Usually fine, no stranger anxiety

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48

Assessing 6m to 1y

Stranger danger, keep them with the parent, least invasive → most invasive

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49

Assessing 1 to 3y

Assess quick as you can, usually anxious an hyperactive, still working least to most invasive

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50

Assessing 3 to 6yr

Usually fine unless traumatized, more private, can start to integrate play into assessment. Involve positive feedback. “Thank you for staying still!”

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51

Assessing 6 to 13yr

Usually willing to cooperate, modesty more and more important.

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52

Assessing 13 to 18yr

Can take a more head to toe approach, modesty is very very important.

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53

Thrush

White spots coating the back of the throat, common side effect of corticosteroid therapy

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54

Tylenol Max Pediatric Dose

10-15mg/Kg daily max

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55

APGAR

Apperance, Pulse, Grimace, Activity, Respirations

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56

Egg and sperm viability window

Egg is viable for about 24 hours, sperm is viable for about 48

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57

Due date calculation

The first day of the last menstrual period - 3 months + 7 days

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58

Considered Term

After 37 weeks before 42 weeks

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59

Recommended maternal assessment schedule pre-natal

Every 4 weeks for the first 28 weeks, every 2 weeks 28-36 weeks, once a week 36+

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60

What is assessed at a prenatal visit

Vital signs, weight, uterine size, fetal heartbeat, urinalysis, blood tests, GBS status, psych

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61

G TPAL

Gravita, Term, Preterm, Abortions, Living

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62

Different between stillbirth and abortion

Stillbirth is part 20 weeks

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63

What placental side is maternal and what side is fetal

Maternal = Red/fleshy, fetal = shiny/grey

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64

Subjective signs of pregnancy

Morning sickness, “feeling” pregnant, subjective

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65

Probable signs of pregnancy

A positive pregnancy test, objective tests that do not 100% confirm a pregnancy. Can be cause by other things.

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66

Positive signs of pregnancy

Can only mean you’re pregnant, no other explanation. Ultrasound.

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67

Fetal Development at 4th Week

Fetal Heart Beat Begins to Beat

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68

Fetal Development at 8th Week

All Body Organs Formed

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69

Fetal Development at 8-12th Week

Fetal heart rate can be detected

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70

Fetal development at 16th Week

The sex of the fetus can be detected

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71

Fetal development at 20th week

Heart beat can be detected, mother experiences quickening, baby develops a regular sleep/wake schedule, vernix and lanugo present, head hair, eyebrows, eyelashes present

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72

Fetal development at 24th week

weighs 780g (1lb 10oz), increasingly active, respiratory movements begin, sucking movements

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73

Fetal development at 28th week

Eyes open/close, baby can breathe, surfactant is develpoped, baby is 2/3 final lenght

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74

Fetal Development at 32nd week

Fingernails and toenails form, subcutaenous fat is developing, less red and wrinkled

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75

Fetal Development at 38+ weeks

Baby fills entire utereus, receiving antibodies from mother

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76

Trimester 1 S/S

Extreme fatigues, N/V, Swolen Breasts, Taste changes, Heartburn, Mood Swings, Constipation, Urinary Frequency, Weight Changes

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Trimester 2 S/S

Body aches, stretch marks, linea nigra, skin darkening around nipples, darker patches on face, carpal tunnel, ankel edema, insomnia, vivid dreams

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78

Trimester 3 S/S

SOB, Heartburn, Swelling, Hemorrhoids, Tender breasts, colostrum excretion, Umbilical protrusion, Lightening, Braxton-hicks contractions

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79

Safe sex and pregnancy

Sex safe 6 weeks after delivery, sex fine throughout pregnancy if no complications

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80

Caffiene Limit Pregnant

1-2 Cups/Day

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81

Foods to avoid when pregnant

Unpasturized dairy, raw fish/canned tuna, raw eggs, deli meat

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82

Lightening timeframe pregnancy

2 weeks pre-pregnancy, baby moves down into pelvis

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83

Normal fetal orientation

ROA or LOA (Right occipit anteroir or Left occipit anteroir)

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84

4 P’s of labour

Pelvis, Passenger, Power, and Psyche

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85

Different Pelvis’s

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86

Position (4 P’s)

Use of gravity to hasten labour, we want people to ambulate when we can.

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87

Powers (4 P’s)

Refers to how strong a woman’s contractions are

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88

Psychological (4 P’s)

Assessment of mental state, providing reassurance.

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89

Contraction Frequency vs Duration

Frequency= Start to Start, Duration = Start to end

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90

Expected FHR During Labour

110-160

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91

Cardinal Movements

Engagement → Descent → Flexion → Internal Rotation → Extension → External rotation/restitution → Expulsion

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92

Where is the 1st stage of labour typically conducted, and until when

At home, and typically until the active phase

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93

Entering Active Phase

4-7cm dilation, 40-80% effacement

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94

Entering Transition Phase

8-10cm dilation, 80-100% effacement, More frequent strong contractoins, q1-2mins, 60-90s each, can experience lack of control, n/v

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95

Entering the Second Stage

Full dilation to birth, most influence of the 4 p’s

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96

Laceration Degrees

1st - Superficial, 2nd - Through the perineum, 3rd - Through anal sphincter muscle, 4th - Through Rectum

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97

Third Stage of labour

Delivery of placenta

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98

Fourth stage of labour

Return to hemodynamic state, can experience bladder hypotonia

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99

R.E.E.D.A Post Partum assessment

Redness, edema, ecchymosis, discharge, approximation

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100

Lochia progressoin

Rubra → Serosa → Alba

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