2023 NURS 676, ADVANCED PHARMACOLOGY FINAL EXAM 1 REVIEW GUIDE (SPRING QTR) WITH 100% CORRECT ANSWERS WITH RATIONALE AND GRADED A+ (SUCCESS GUARANTEE): WEST COAST UNIVERSITY Chapter 1: 1. What are the risk factors for infant and maternal mortality? a. Mortality is the incidence or number of individuals who have died over a specific period b. Infant Mortality : number of deaths occurring in first 12 months of life; reflects neonatal mortality and post -neonatal mortality i. Ratio: deaths during first 12 months per 1000 live births ii. Risk Factors: prematurity, low birth weight (< 2500 g), congenital anomalies, SIDS , respiratory distress syndrome (* congenital anomalies leading cause in U.S.*) 1. *African American and American Indian/Alaska Native infants have higher infant mortality rates* c. Maternal Mortality: annual number of female deaths from any cause related to or aggravated by pregnancy or its management (excludes accidental/incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy (irrespective of duration and site of pregnancy) i. Ratio: deaths per 100,000 live births for specified year ii. Risk Factors: low socioeconomic status, limited/no insurance coverage, bias among healthcare providers, quality of care available, language/legal barriers, lack of care during pregnancy, prenatal care 1. *African American women* 2. What are the greatest impact to families attempting to access healthcare? a. Finances i. *hospital maternity and newborn charges exceed those for any other condition* b. Transportation c. Language/Culture i. Knowledge barriers, low health literacy, gender attitudes, health beliefs, retention of information, spiritual barriers d. Low Health Literacy: degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions i. Ability to understand instructions on prescription drug bottles, appointment slips, education brochures, provider’s directions, consent forms, negotiate health care systems ii. Vulnerable: older adults, immigrants, minorities, low-income populations iii. poor health outcomes, increased emergency visits, higher morbidity and mortality rates, less use of preventive health services e. Health Care Delivery System i. 58% of employed families w/ insurance are covered by some type of managed health care plan ii. Improve access to preventative services, but limit access to specialty care iii. Clinic hours must meet the needs of patients 3. What is informed consent? Who can give it? a. Informed Consent i. Purpose: to ensure patient autonomy is respected in decisions about their health care ii. Requires competence and capacity (ability to understand alternatives and consequences of treatment and choose best option) 1. *be aware of effects of medications * 2. If patient is unable to provide consent, person closest may give consent in emergency treatment 3. Verbal consent via telephone requires two witnesses and a signature on consent form iii. Key Components: disclosure, comprehension, competency, voluntariness 1. Ensuring consent form is completed w/ signatures 2. Serving as a witness to signature 3. Determining whether client understands by asking pertinent questions 4. In certain states, mature minors and emancipated minors may consent to their own health care and certain health care may be provided without parental notification iv. Key Elements: 1. Decision maker must be of legal age w/ full civil rights and competent 2. Information is presented in simple, concise, appropriate manner (level of education and language) 3. Decision must be voluntary (w/out coercion) 4. Must be a witness 5. Witness must sign consent form Chapters 15 & 16: 1. Terminology: a. Chapter 15: i. Attachment: formation of a relationship between a parent and his/her newborn through a process of physical and emotional interactions 1. begins before birth during prenatal period 2. *encourage breastfeeding* ii. Engorgement: postnatal physiological painful condition in which distention and swelling of breast tissue as a result of increase in blood and lymph supply as precursor to lactation 1. Peaks 3-5 days postpartum, subsides within 24-36 hours 2. Key: frequent emptying, warm showers/compresses before feeding, cold compresses between feedings 3. Alleviation: a. Breast feeding: frequent feedings every 2-3 hours, manual palpation to soften breast before feeding, feed on breast until soft before switching b. Non breast feeding: self-limiting phenomenon that disappears as increasing estrogen suppress milk formation; avoid stimulation that would foster milk production (warm showers or pumping breast); reduce salt intake, use ice packs or cool compress inside bra 4. *tight supportive bra and avoid breast stimulation* iii. Engrossment: time of intense absorption , preoccupation, and interest by the significant other (*in relation to dads*) Visual awareness of the newborn —the partner perceives the newborn as attractive, pretty, or beautiful. Tactile awareness of the newborn —the partner has a desire to touch or hold the newborn and considers this activity to be pleasurable. Perception of the newborn as perfect —the partner does not “see” any imperfections. Strong attraction to the newborn —the partner focuses all attention on the newborn when they are in the room. Awareness of distinct features of the newborn —the partner can distinguish his/her newborn from others in the nursery. 6. Extreme elation —the partner feels a “high” after the birth of his/her child. 7. Increased sense of self-esteem —the partner feels proud, “bigger,” more mature, and older after the birth of his/her child iv. Involution: rapid reduction in size of uterus and return to prepregnant state 1. Three Retrogressive Processes: 1. 2. 3. 4. 5.
