NUR 128 Final exam blueprint

NUR 128 Final exam blueprint Week 13: Sexuality 19.2 Family Planning o Preconception health promotion ▪ Helping the couple be in the best possible health state so they don’t enter pregnancy with unnecessary health risks. ▪ Stop smoking and limit secondhand smoke. ▪ Avoid or limit caffeine. ▪ No alcohol or drugs ▪ Discuss the use of RX drugs with HCP. This includes prescription & non- prescription drugs. Accutane (acne medication) was mentioned. ▪ If woman has thyroid disorders, seizures, HTN, DM, she should see appropriate specialist to be sure pregnancy is advised and to change meds if needed. ▪ Determine possible environmental hazards such as radiation or chemical expose in their community or at work. o Physical exam ▪ Both parents should have a physical to identify health problems so they can be corrected if possible. ▪ Genetic counseling if woman is over 35 and has a family history of genetic disorders. ▪ Dental exam before pregnancy to avoid x-rays, local anesthetic, and infection during pregnancy ▪ Age less than 16 is also a problem. o Nutrition ▪ Woman should be average weight for build and height. BMI= 18-24 ▪ Underweight women should gain. ▪ Overweight women should lose ▪ Follow nutritious diet rich in essential nutrients: calcium, protein, iron, B- complex, vitamin C, magnesium and folic acid. ▪ Avoid vitamins in excess. They can cause severe fetal problems. ▪ Cultural norms that affect nutritional intake should also be assessed. ▪ Normal weight gain is 25-35lbs. ▪ PICA - eating weird things because you crave them. Example dirt, ass, clay, just weird things in general. o Exercise ▪ Continue present pattern of exercise or begin regular exercise 3 months before pregnancy. ▪ Aerobic exercise and general muscle toning will improve circulation and general health. ▪ 30 min of mod exercise daily. ▪ Don’t start anything during pregnancy that you were not doing before pregnancy. o Immunizations ▪ DO THIS!! ▪ All immunizations should be complete 3 months prior to conception, especially rubella. ▪ flu at anytime during pregnancy o Infertility possible causes and common medications ▪ Infertility- lack of conception despite unprotected sex for 12 months. ▪ Subfertility- both partners have reduced fertility. ▪ Secondary infertility- couples unable to conceive after one or more successful pregnancies or who cannot sustain a pregnancy. (These women can get Progesterone to help maintain pregnancy) ▪ Men – alcohol abuse, tobacco or drugs, exposure to environmental toxins, certain RX drugs, or previous cancer treatment and age (higher risk in women) ▪ Women – excess alcohol intake, tobacco use, stress, poor diet, being under or overweight, athletic training, health problems that affect hormones, STIs, or age. ▪ Women over 35 – smaller # of eggs, eggs left aren’t as healthy, prone to miscarriage. Eggs are old as shit. o Genetics ▪ Abnormal chromosomal number ● Most often caused by nondisjunction, a failure of paired chromosomes to separate properly during cell division. ● If nondisjunction occurs in either the sperm or the egg before fertilization, the zygote will have an abnormal chromosome makeup in all the cells. o Each cell that develops will be monosomic (having only one copy of a particular chromosome). o Or trisomic (having 3 copies of a particular chromosome). ● If nondisjunction occurs after fertilization, the developing zygote will have cells with 2 or more different chromosomal makeups, evolving into 2 or more different cell lines (mosaicism). ● Mosaics have trisomy occurring in some but not all of the cells of the body, in which case the manifestations are not as severe. ● Trisomies – product of the union of a normal gamete with a gamete that contains an extra chromosome. o Down syndrome is the most common trisomy. o Extra chromosome 21. o Common - 21, 18, 13 ● Monosomies – occur when a normal gamete unites with a gamete that is missing a chromosome. o Most common monosomy is Turner Syndrome. o If a fetus with monosomy survives, it is due to mosaicism. ▪ These individuals are sterile females. ▪ Abnormal chromosomal structure ● Involve only parts of the chromosome and occur in 2 forms: o Translocation o Deletions or additions ● Some people with down syndrome have an abnormal rearrangement of chromosomal material known as a translocation o Clinically the 2 types of down syndrome are indistinguishable unless you do a chromosomal analysis. ● Structure abnormality also caused by additions or deletions of chromosomal material. o Depending how much chromosomal material is involved, the clinical effects may be mild or severe.