UNRS 402 Exam 1 Study Guide Graded A 2024

Explain emergence of medical management? What was the woman's role? - o Physicians managed all of antepartum, intrapartum, and postpartum care o Lay midwifery became illegal in many areas and nurse-midwifery was not well established at the time (late 19th century) o Woman's role was passive; primary functions of nursesassist physician and follow prescribed medical orders after childbirth o Even though technology was advancing and shift from home to hospital, maternal and infancy mortality rates declined slowlylarge health disparities between the wealthy who could afford prenatal care and the poor who could not (also didn't get much education either) o 2 concurrent trends: federal government involvement and consumer demandschanges in maternity care What led to the change in government involvement in maternal-infant care? - High rates of infant/maternal mortality among poor women oSheppard-Towner Act of 1921first federal program for provided funds for state-managed programs for mothers and childrenset stage for future allocation of federal funds oDistribution is still unequal Effects of consumer demands on health care? - o Starting in 1950's, bigger demand for patients to be involved in their own health carewanted more information and education on planning, and to have a bigger say in way that child is born o New methodsLamaze and Bradley to control maternal fear and pain management to allow for nonpharmalogic management; research affirmed that early parent-newborn contact outweighed risks for infection in most situationspractice of separating infant from family was abandoned when infection didn't increase in nurseries o Family-centered maternity care=standard!! Main goal of family-centered care? - Foster family unity while maintaining physical safety Basic principles of family-centered care? - Childbirth is usually normal, healthy event in life of family Childbirth affects entire family, and family relationships will need to be restructured Families can make decisions about care if they are given adequate info and professional support Maintaining focus on family or other support can benefit woman as she seeks to maintain health 4 Main goals of perinatal and women's health care? - o Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death o Achieve health equity, eliminate disparities, and improve health of all groups o Create social and physical environments that promote good health for all o Promote quality of life, healthy development, and healthy behaviors across all life stages What happens to ovum leading up to ovulation? - By 30th week of gestation, female fetus has all ova she will ever have (many regress during childhood) When a girl's reproductive cycles begin at puberty, some of primary follicles present at birth begin maturing Process of gamete maturation continues throughout her reproductive years until climacteric When oocyte matures, two meiotic divisions reduce chromosome number from 46 paired chromosomes to 23 unpaired chromosomes Right before ovulation (release of mature ovum from ovary), primary oocyte completes first meiotic cell divisionsecondary oocyte (23 chromosomes) What happens to ovum at ovulation? - At ovulation, secondary oocyte begins to form mature ovum (second meiotic division) Second meiotic division is prolonged and mature ovum remains suspended in metaphase until fertilization occurs (IF it does) When mature ovum is released from ovary, it's surrounded by 2 layerszona pellucida and cells of corona radiataprotect ovum and prevent fertilization by 1 sperm What must happen for fertilization to occur?? Sperm must penetrate both zona pellucida and corona radiata to reach ovum's cell nucleus Explain the role of a CNM? - ): CNM's are RN's who have completed extensive program of study and clinical experienceMS or DNP and passed certification test o Qualified to take complete health histories and perform physical examinations o Can provide complete care during pregnancy, childbirth, and postpartum period o Committed to providing info to prevent problems and facilitate normal pregnancy and childbirth o Provides annual well woman exams, gynecology services, family-planning information, and counseling o Practice approach of CNM to childbirth is noninterventionist and supportive to low-risk patientspregnancy and birth are regarded as normal processes Explain the role of an NP? - RN's with advanced prep at master or doctoral level and certification wo provide primary care for specific groups of patients o Obtain complete health history, perform physical exams, order and interpret labs and other diagnostics, and provide primary care for health maintenance and health promotion o May collaborate with physicians regarding administering treatments and meds, but it depends on scope of practice and board of nursing mandates for each statemay still work independently and prescribe meds