NUR 2513 Final Exam 1 (Latest 2023) Maternal Child Nursing -Rasmussen

NUR 2513 Maternal-Child Nursing MCN Exam 1 What trends are currently influencing maternal child care? - An expansion of community-based services - Accidents are a leading cause of injury/mortality in the school aged population and therefore education focused on this topic would be considered high priority. What influences the changes in the types of care required to support maternal child health issues? - Families are smaller, with a higher number of single parent families as well as moms working outside the home. - When planning care, consideration must be given to these structural shifts. What are the 2020 National Health Goals for pregnancy? - Stop smoking/alcohol use - Eat a healthy diet - Take PNV - Take folic acid - Achieve optimal nutrition status prior to conception What are the strategies for smoking cessation? - Follow a designed smoking cessation plan - Ask the MD if any medications can help - Get a friend involved in the plan What are the phases of the menstrual cycle? - Proliferative - Secretory/luteal - Ischemic - Menses What happens during the proliferative phase of the menstrual cycle? - First half of the menstrual cycle: Ovary begins to produce estrogen. Endometrium proliferates quickly-- increases thickness by eightfold from day 5-14. What happens during the Secretory/luteal phase of the menstrual cycle? - Progesterone forms in the corpus luteum -- glands of endometrium become corkscrew/twisted and dilated w/ glycogen and mucin (protein). Appearance: Rich, spongy velvet. What happens during the Ischemic phase of the menstrual cycle? - Corpus luteum in the ovary regresses after 8-10 days. Progesterone DECREASES-- endometrium of uterus degenerates (day 24/25 of cycles). Capillaries rupture, minute hemorrhages, and the endometrium SLOUGHS off. What happens during the Menses phase of the menstrual cycle? - Mix of blood, mucin (protein), endometrial tissue, and unfertilized ovum are released from the body. When is conception possible? - Can occur 2-3 days before ovulation and 1 day afterwards What is the life expectancy of sperm and the length of time an ova is ripe for fertilization? - Sperm survival: 3-5+ days. Ova ripe: 1 day How do combination oral contraceptives (COC) work? - estrogen acts to suppress follicle-stimulating hormone (FSH) and LH to suppress ovulation. Progesterone decreases permeability of cervical mucus (limits sperm motility/access to ova). Also interferes w/ tubal transport and endometrial proliferation (implantation significantly decreased) How are combination oral contraceptives (COC) taken/administered? - Monophasic pills (fixed doses est./progest. in 21-day cycle) Biphasic pills (constant amount of est. w/ varying progest. amounts) Triphasic/tetraphasic pills (varying est./progest. throughout the cycle) How effective are combination oral contraceptives (COC)? - 99.9% effective How do intrauterine devices (IUDs) work? - prevent fertilization as well as to create a local sterile inflammatory reaction that prevents implantation. How is an intrauterine device (IUD) administered? - mall plastic device that is inserted into the uterus through the vagina. Add copper to device to decrease sperms ability to cross the uterine space. How effective are intrauterine devices (IUDs)? - 99% ParaGard (CopperT380: nonhormonal) effective for 10 years. Mirena or Liletta (levonorgestrel: hormonal) effective for 5 years (up to 7) What are contraindications for IUDs? - abnormalities in uterine shape such as bicornate uterus (pictured below) or uterine septums How does the Depo provera work? - inhibits ovulation, alters the endometrium, and thickens the cervical mucus so sperm progress is difficult How is Depo provera administered? - IM progesterone injection given every 12 weeks (3 months) How effective is Depo provera? - Almost 100% What are the contraindications for Depo provera? - Should be used cautiously in diabetic patients because is may impair glucose tolerance. Increase risk for osteoporosis (need 1,200 mg/day calcium)