NUR2513 Exam 1 Blue Print
Maternal Child Health – Exam 1 Blueprint
GENERAL
Know trends influencing maternal and child healthcare?
● A changing discipline
● Variations in social, structure, family, lifestyle, and responsibilities change in addition to
patterns of illness
● Birth rates, fertility rate, fetal death rate, neonatal death rate, infant mortality rate,
maternal mortality rate, and child mortality rate
● Trend of where and how babies are delivered
● Increasing use of technology
● Meeting the needs of the working mother and breastfeeding
Smoking and pregnancy:
● Associated with infertility in women
● If used when pregnant, can cause fetal growth restriction
● Greater risk for stillborn and after birth greater risk for sudden infant death syndrome
● Low birth weight results from vasoconstriction of uterine vessels, an effect of nicotine.
This limits blood supply to fetus
● Secondary smoke or inhaling smoke of another can be as harmful as actually smoking
● Preterm birth
Nutrition counseling/health counseling:
● Calorie needs
○ 2,500 (300 extra/day)
○ At least 1500 for obese
● Protein needs
○ 71 g/day (normal 34-46 g/day)
● Fat needs
○ 200-300 mg/day omega 3
● Vitamin needs
○ Folic acid
● Fluid and fiber needs
● Foods to avoid or limit
○ Alcohol, caffeine, artificial sweeteners, weight-loss diets, raw foods, cold cuts,
saccharin (long ½ life=toxic to fetus)
What vitamins/minerals are encouraged? What dosage? What indication?
Vitamins- D, A, C & Folic acid (400 micrograms / .4-.8mg daily). Folic acid is the only vitamin
recommended for daily supplementation to prevent neural tube defects.
Minerals- Calcium, Iodine, Iron (30-60 mg elemental iron daily), Fluoride, Zinc. Iron is the only
mineral usually found with a deficiency.
, Calcium is indicated for women with low dietary intake, Iodine for populations without iodized
salt, Iron supplementation reduces maternal anemia, puerperal sepsis, low birth weight, and
preterm birth, Fluoride for areas without fluoridated water, Zinc in context of research
CONTRACEPTION/BIRTH CONTROL
IUD:
● Types
○ Copper T380 (ParaGard): T-shaped plastic device wound with copper. Effective
10 years
○ Levonorgestrel-releasing intrauterine system 52 mg (Mirena or Liletta):
progesterone in drug reservoir gradually diffuses into the uterus through plastic;
prevents enfometrium proliferation and thickens cervical mucus. Effective 5 years
(or 7).
○ Levonorgestrel-releasing intrauterine system 13.5 mg (Skyla) IUD. Lower dose of
progesterone in stem. Effective 3 years.
○ Levonorgestrel-releasing intrauterine system 19.5 mg (Kyleena): lower dose of
progesterone in stem then Mirena but higher than Skyla. 5 years
● Contraindications
● Considerations
● Populations
○ Used by women who have never had children as well as those who have
● Patient education
DIAPHRAGM:
• A diaphragm is a circular rubber disk that is placed over the cervix before intercourse. It
mechanically stops the passage of sperm. With the use of spermicide, the failure rate is as
low as 6% (ideal) to 18% (typical).
● A second fitting should occur when: pregnancy occurs, miscarriage, cervical surgery, or
loss of more than 15 lb.
● Diaphragms should remain in place for at least 6 hours after intercourse, and as long as
25 hours. Longer than 24 hrs can = inflammation or urethral irritation
● After use, a diaphragm should be washed in mild soap and water, dried gently, and stored
in a protective case. Replace after 2 years.
● Contraindications: prolapsed uterine, acute cervicitis, herpes virus infection, or
papillomavirus infection, hx of TSS, allergy to rubber or spermicides, or hx of recurrent
UTIs. (may cause UTIs) Do not use during period
VAGINAL ESTROGEN/PROGESTIN RINGS:
• (Nuvaring) releases a combination of estrogen and progesterone in the vagina
continuously. Inserted by the patient and left in place for 3 weeks then removed for 1
week with menstrual bleeding. Rings do not need to be removed for intercourse.
Maternal Child Health – Exam 1 Blueprint
GENERAL
Know trends influencing maternal and child healthcare?
● A changing discipline
● Variations in social, structure, family, lifestyle, and responsibilities change in addition to
patterns of illness
● Birth rates, fertility rate, fetal death rate, neonatal death rate, infant mortality rate,
maternal mortality rate, and child mortality rate
● Trend of where and how babies are delivered
● Increasing use of technology
● Meeting the needs of the working mother and breastfeeding
Smoking and pregnancy:
● Associated with infertility in women
● If used when pregnant, can cause fetal growth restriction
● Greater risk for stillborn and after birth greater risk for sudden infant death syndrome
● Low birth weight results from vasoconstriction of uterine vessels, an effect of nicotine.
This limits blood supply to fetus
● Secondary smoke or inhaling smoke of another can be as harmful as actually smoking
● Preterm birth
Nutrition counseling/health counseling:
● Calorie needs
○ 2,500 (300 extra/day)
○ At least 1500 for obese
● Protein needs
○ 71 g/day (normal 34-46 g/day)
● Fat needs
○ 200-300 mg/day omega 3
● Vitamin needs
○ Folic acid
● Fluid and fiber needs
● Foods to avoid or limit
○ Alcohol, caffeine, artificial sweeteners, weight-loss diets, raw foods, cold cuts,
saccharin (long ½ life=toxic to fetus)
What vitamins/minerals are encouraged? What dosage? What indication?
Vitamins- D, A, C & Folic acid (400 micrograms / .4-.8mg daily). Folic acid is the only vitamin
recommended for daily supplementation to prevent neural tube defects.
Minerals- Calcium, Iodine, Iron (30-60 mg elemental iron daily), Fluoride, Zinc. Iron is the only
mineral usually found with a deficiency.
, Calcium is indicated for women with low dietary intake, Iodine for populations without iodized
salt, Iron supplementation reduces maternal anemia, puerperal sepsis, low birth weight, and
preterm birth, Fluoride for areas without fluoridated water, Zinc in context of research
CONTRACEPTION/BIRTH CONTROL
IUD:
● Types
○ Copper T380 (ParaGard): T-shaped plastic device wound with copper. Effective
10 years
○ Levonorgestrel-releasing intrauterine system 52 mg (Mirena or Liletta):
progesterone in drug reservoir gradually diffuses into the uterus through plastic;
prevents enfometrium proliferation and thickens cervical mucus. Effective 5 years
(or 7).
○ Levonorgestrel-releasing intrauterine system 13.5 mg (Skyla) IUD. Lower dose of
progesterone in stem. Effective 3 years.
○ Levonorgestrel-releasing intrauterine system 19.5 mg (Kyleena): lower dose of
progesterone in stem then Mirena but higher than Skyla. 5 years
● Contraindications
● Considerations
● Populations
○ Used by women who have never had children as well as those who have
● Patient education
DIAPHRAGM:
• A diaphragm is a circular rubber disk that is placed over the cervix before intercourse. It
mechanically stops the passage of sperm. With the use of spermicide, the failure rate is as
low as 6% (ideal) to 18% (typical).
● A second fitting should occur when: pregnancy occurs, miscarriage, cervical surgery, or
loss of more than 15 lb.
● Diaphragms should remain in place for at least 6 hours after intercourse, and as long as
25 hours. Longer than 24 hrs can = inflammation or urethral irritation
● After use, a diaphragm should be washed in mild soap and water, dried gently, and stored
in a protective case. Replace after 2 years.
● Contraindications: prolapsed uterine, acute cervicitis, herpes virus infection, or
papillomavirus infection, hx of TSS, allergy to rubber or spermicides, or hx of recurrent
UTIs. (may cause UTIs) Do not use during period
VAGINAL ESTROGEN/PROGESTIN RINGS:
• (Nuvaring) releases a combination of estrogen and progesterone in the vagina
continuously. Inserted by the patient and left in place for 3 weeks then removed for 1
week with menstrual bleeding. Rings do not need to be removed for intercourse.
