Special needs Chapter 24

  1. Teenage pregnancy is a major health problem in the united states.  Adolecscents need to receive accurate information about contraceptive and how to set limits on sexual behaviours.
  2. Adolescent pregnancy poses serious physiologic risks that result in a higher incidence of complications for the mother and fetus
  3. Teenage pregnancy interrupts the development tasks of adolescence and may result in childbirth the parents are capable of providinga nurturing home for the infant without a great deal of assistance
  4. the mature primigravida often has finacial and emotional resources taht younger women do not have.  SHe may experience anxiety about recommended antepartum testing however and about her ability to be an effective parent
  5. Polydrug abuse is a widespread problem that can have fetal and neonatal effects.  These may become longterm developmental problems for the child
  6. Lifestyle associated with illicit drug abuse includes inadequate  nutrition inadequate prenatal care and an increased incidence of STDs.  It requires interdisciplinary interventions to prevent injury to the exectant mother and to the fetus
  7. THe birth of an infant with congenital anomalies produces strong emotions of shock and grief in the family.  A sensitivie strong emotions of shock and grief in the family.  A sensitive response from nurses can help the family grieve for the loss of the perfect or "fantasy" infant and to form an attachment to the newborn.
  8. Pregnancy loss at any stage produces grief that must be acknowledged and expressed.  Nurses realize that mourining requires memories and they intervene to arrange unlimited contact between the family and the stillborn infant and to prepare mementos for the family
  9. Nursing care for the mother who is placing her infant for adoption is based on knowledge that relinquishment for adoption is an act of love not abandonment
  10. Multiple factors are associated with intimate partner violance. IT is deliberate sever and generally repeated in a predictable cycle that often causes severe physical harm (or death) to the woman
  11. All perinatal nurses come into contact with abused woman who requires assistance to protect themselves and their children from serious injury
  12. Highly addictive form of cocaine
  13. Interest centered on self rather than on others
  14. Fetal disorders associated with maternal alcohol use
    Fetal alchohol syndrome
  15. Long acting drug to substitute for heroin or morphine
  16. Substance containing opium or any of its derivatives
  17. Symptoms seen when and individual who is addicted to a specific drug abstains
    Withdrawl symptoms
  18. Explain how pregnancy affects the adolescents- development of independence?
    Development of independence from parents is interrupted. The teenage girls usually becomes more dependent on them, rather than becoming more independent of her family home.
  19. Explain how pregnancy affects the adolescents- Education
    Education is often interrupted and may never be completed. Overall eductional level is lower
  20. Explain how pregnancy affects the adolescents-Employment opportunities
    Reliance on welfare system is more likely because of incomplete education and limtied job skills
  21. What pregnancy risks are higher for adolescents than for adults?
    Pregnancy induced hypertension anemia and nutritional deficiencies UTI's depression and high incidence of STDs
  22. List complications the mature pregnant woman is more likley to encounter- Genetic
    There is a higher incidence of chomosome abnormalites such as Down syndrome
  23. List complications the mature pregnant woman is more likley to encounter- Preexisting disorders
    Older women are more likely to have underlying chronic medical conditions that complicate pregnancy, such as diabetes, hypertension
  24. List complications the mature pregnant woman is more likley to encounter-obstetric complications
    There is a higher incidence of multifetal gestation preterm labor dysfunctional labor vaginal bleeding preeclampsia gestational diabetes c-section  Infants are more likely to be small for gestational age.
  25. What problems is the mature mother likely to encounter in terms of the following- Fatigue
    She may have less energy to cope with the demands of an infant plus the day-to-day activities of living
  26. What problems is the mature mother likely to encounter in terms of the following- Support of friends or family
    She may have less peer support because most other women her age have teenagers for young adults
  27. Why do substances ingeted by the mother tend to have a more pronounced effect on her fetus than on her?
    Most substances ingested by the mother cross the placenta and enter the fetal circulation.  The fetusl cannot metabolize the substance as quickly, so the substance lingers for a prologned time in the fetal body
  28. WHy might the birth center staff screen a woman for cocaine if she is admitted in preterm labor and having intense contractions?
    Cocaine directly stimulates uterine contractions.  Preterm labor contractions are rarely abrupt and intense at their onset.  The fetus or neonate may have problems related to maternal cocaine such as abruptio placentae premature rupture of the membranes precipitous birth stillbirth tachycardia irritabitlity muscular rigidity hypertension and an exaggerated startle reflex
  29. What therapeutic managemant is necessaryf for a pregnant woman who desires to stop her use of heroine during the pregnancy
    Withdrawl of heroin can be fatal for the fetus. The mother can ve put on methadone during the pregnancy but the neonate wil need to withdrawl from that medication after birth.
  30. list antepartal signs associated with drug abuse? Behaviors
    late prenatal care failing to keep appointments not following recommendations
  31. list antepartal signs associated with drug abuse? Physical apperance
    Poor grooming inadequte weight gain, weight gain pattern that does not conform to that expected for the gestational age
  32. list antepartal signs associated with drug abuse? obstetric history
    Spontaneous abortions premature births abruptio placentae, stillbirths
  33. list antepartal signs associated with drug abuse? Emotional reaction to pregnancy
    Anger or apathy toward pregnancy particularly if these are evident at a time when the normal ambivalence of early pregnancy should be resolved
  34. What signs might the woman have during the intrapartum period if she has recently ingested these drugs? Cocaine
    Profuse sweating HTN irregular resp lethargic response to labor lack of intrest in interventions dilated pupils increased body temp sudden onset of severly painful contractions emotional lability and paranoia fetal tachycardia and fetal hyperactivity
  35. What signs might the woman have during the intrapartum period if she has recently ingested these drugs? Heroin
    Withdrawl symptoms such as yawing diaphoresis rhinorrhea restlessness and excessive tearing
  36. Describe the risks to an abused pregnant woman and her fetus
    Woman: multiple injury sites  late entry into prenatal care increased risk for low maternal weight gain and anemia; more substance abuse.  

    Fetus: prmaturity low birth weight and noenatal death
  37. Describe each phase of the violence cycle
    Tension building: when theats and angry behaviors escalate; increased use of alcohol and drugs; the woman tries to avoid or placente her abuser

    • battering: with hitting burning beating or raping the woman. the woman often simply endures the abuse.  
    • Honeymoon phase: when the abuser is overly solicitous and tries to make up with his partner.  He often insists on having intercourse to prove that she forgives him.  THe woman wants to believe that he will never abuse her again
  38. The best way for the nurse to evaluate the quality of a pregnant adolescents diet is to?
    Ask her to describe what she ate the previous day
  39. Correct advise for women who ask about using alcohol during pregnancy is that it is?
    important to avoid it entirely throughout pregnancy
  40. When first presenting an infant with an anomaly to parents the nurse should?
    Emphasize the most normal aspects of the infant before showing them the anomoly
  41. A woman who had a stillborn infant at 37 weeks  of gestation angrily asks the nurse why her physician didnt "take the baby early".  The nurse should understand that the mothers behavior?
    Should be expected as part of the normal grieving process
  42. THe main goal when caring for battered women is to?
    Emphasize that they have the right not to be hurt.
  43. A nurse is teaching a group of cllient who are pregnant about behaviors to avoid during pregnancy.  The nurse determines that a client needs further instruction when the client states.  "I can have a drink of wine with dinner"
    No alcohol should be consumed during pregnancy.
  44. A client who is at 8 weeks of gestation tells the nurse that she isnt sure she is happy about being pregnant.  The nurse should respond to the client by stating?
    It is normal to have feelings during the first few months of pregnancy.
  45. A client who is pregnant should promptly report which of the following symptoms to the primary care provider?

    A) Vaginal bleeding

    B) Swelling of the ankles

    C) Heartburn after eating

    D) Faintness when lying on back
    A) Vaginal bleeding
  46. A client who is at 7 weeks of gestation is experiencing nausea and vomiting in the morning.  THe nurse in the prenatal clinic provides teaching that should include which of the following?
    Eat crackers or plain toast before getting out of bed.
Card Set
Special needs Chapter 24
Special needs Chapter 24 SPC nursing