...chromosomal abnormality seen in live-born babies? (b)What is the prevalence of this disorder? (c)What is the relationship between maternal age and the risk of having a baby with this disorder? 2. Dr. Cohen explains how multiple prenatal assessment measures can be used together to make decisions regarding whether further medical monitoring procedures, such as amniocentesis, are necessary. Does he recommend an amniocentesis for Eleanor? Why or why not? 3. (a)Describe the ultrasound procedure as performed by Dr. Cohen. (b)What is the position of the baby? 4. Describe two structural abnormalities and/or markers of chromosomal abnormalities discussed by Dr. Cohen as he performs the ultrasound. 5. (a)What risks are associated with various prenatal assessment measures? (b)What are some ethical considerations in the use of prenatal monitoring procedures? 6. How prevalent are birth defects resulting from genetic factors? 7. What are some other, non-genetic factors (not due to hereditary) that can affect prenatal development? 8. Eleanor began taking prenatal vitamins three months prior to conception, and she stopped consuming alcohol in the month prior to conception. What problems will her careful, planned approach likely rule out with (a)use of prenatal vitamins and (b)non-alcohol consumption 1(a) Down syndrome (b) Down syndrome have varying degrees of intellectual disability characteristic facial features and, often heart defects and other problems. (c) Down syndromes varies...
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...Nursing Implications and Interventions A generalized nursing diagnosis for Latino mothers is the need for further patient education related to the importance of prenatal appointments and checkups as evidenced by a history of poor attendance by Latina mothers and families. When working with Latino families it is vital to explain the worth of prenatal appointments and checkups in the process of pregnancy and labor. As present-oriented people, the value of prevention might not seem relevant; if all seems to be going well in the moment, why go to the doctor’s office? Poma (1987) writes, “the value of these visits need to be repeatedly emphasized, otherwise many Hispanic women will stop the visits because they are feeling fine and they are used...
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...to 2010. Eighteen percent of children ages six to 19 years are obese as well and has become a major health concern (Centers for Disease Control and Prevention, 2013). Chronic diseases are also an issue with one in two adults having at least one chronic health condition (Centers for Disease Control and Prevention, 2013). To reduce the obesity rates and chronic diseases for the future generation, promoting a healthy lifestyle from childhood years is highly recommended. This report reviews the importance of breastfeeding, Minnesota’s health themes for 2020, the different agencies and surveillance systems involved in addressing these issues, and the type of data used. Health Issue: Breastfeeding Healthy Minnesota 2020 The health assessment for Minnesota recognizes a healthy start early in life. The themes for Healthy Minnesota 2020 to promote health are: * “Capitalize on the opportunity to influence health in early childhood” (MDH, 2012, p.11) * “Assure that the opportunity to be healthy is available everywhere and for everyone” (MDH, 2012, p. 11) * “Strengthen communities to create their own healthy futures” (MDH, 2012, p. 11) The focus of this report will be on indicator 1.2 which states “By 2020, more Minnesota children are exclusively breastfed for six months” (MDH, 2012, p. 13). Statistics indicates that four out of five Minnesota infants are breastfed from the beginning but then more than half of the infants stop breastfeeding by the age of six...
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...Prenatal development can be divided into three stages: preimplantation, embryonic, and fetal. The preimplantation period, between fertilization and implantation of the conceptus in the uterine wall, takes an average of 7 days. The embryonic period is considered to be the major period of organogenesis, lasting about 2 months from conception. During the fetal period, lasting until about 38 weeks after conception, growth, functional maturation, and further differentiation of tissues occur. The prenatal period is highly sensitive to disruption by toxic substances because of the high rate of cell division and the intricate and complex coordination among chemical, cellular, and genetic processes that is necessary for normal development. Toxic insults to the conceptus are thought more likely to be lethal during the preimplantation and embryonic periods than the fetal period. The timing of an exposure or event has a dramatic influence on the developmental effects that will likely result. For example, alterations of hormones such as prostaglandins and the progesterone-estrogen balance can prevent implantation, resulting in embryonic death. During organogenesis, when the molecular, cellular, and morphological structural organization of tissues and organs takes place, the embryo is considered to be most susceptible to structural defects. Animal experiments show that the exact timing of exposure to a teratogen affects the pattern of structural malformations. However, malformations usually...
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...HEALTH SERVICE DELIVERY MODULE 8.1 Overview This chapter presents the health delivery module of the assessment. Section 8.1 defines health service delivery and its key components. Section 8.2 provides guidelines on preparing a profile of health service delivery for the country of interest, including instructions on how to customize the profile for country-specific aspects of the health delivery process. Section 8.3 presents the indicator-based assessment, including detailed descriptions of the indicators. Section 8.4 discusses how to summarize the findings and develop recommendations. 8.1.1 What Is Health Service Delivery? The World Health Organization (WHO) defines service delivery as the way inputs are combined to allow the delivery of a series of interventions or health actions (WHO 2001b). As noted in the World Health Report 2000, “the service provision function [of the health system] is the most familiar; the entire health system is often identified with just service delivery.” The report states that service provision, or service delivery is the chief function the health system needs to perform (WHO 2000). As such, Figure 8.1 (see also Chapter 1, Figure 1.1) shows the relationship between service delivery and the other modules of this health systems assessment and their relationship with health system objectives. Because of the limited time to conduct this assessment, more emphasis will be placed on personal health (as opposed to public health) services and service delivery...
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...of interdisciplinary health care providers d. Managing care to cure health problems after they have occurred 1-3 To assess for the risk of having a low-birth-weight (LBW) infant, which one of the following factors is the most important for the nurse to consider? a. African-American race b. Cigarette smoking c. Poor nutritional status d. Limited maternal education 1-4 A 23-year-old African-American woman is pregnant with her first child. Based on knowledge of the statistics related to infant mortality, which one of the following plans is most important for the nurse to implement? a. Perform a nutrition assessment b. Refer the woman to a social worker c. Advise the woman to see an obstetrician and not a midwife d. Teach the woman about why keeping her prenatal care appointments is so important 1-5 When managing health care for pregnant women at a prenatal clinic, the nurse should recognize that which of the...
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...percent of these women indicated they had engaged in binge drinking during the same time frame (Nuñez, Roussotte, & Sowell, 2011). Children who show symptoms of fetal alcohol syndrome have differences in brain structure. They suffer from major and incapacitating cognitive and behavioral impairments that impact their daily living. Magnetic resonance imaging (MRI) is a non invasive imaging technique use to see a detailed picture of the brain and find the exact location of any abnormalities. Postmortem studies of children who are severely affected from prenatal alcohol exposure have shown smaller head sizes and brains. The frontal region of the brain is responsible in executive functioning and attention or working memory. Neuropsychological studies have shown that nearly most cognitive domain examined is affected by prenatal exposure to alcohol and that these deficits are present in children with fetal alcohol syndrome and prenatal exposure to alcohol (Nuñez, Roussotte, & Sowell, 2011). Alcohol damaging effects on the brain An alcohol blackout is a sign of drinking problem and cited by most researchers as evidence of alcohol misuse in most diagnostic systems. Heavy drinking young adults are more frequent and widely reported to experience multiple blackouts. There are two types of amnestic experience due to misuse of alcohol: en bloc (EB) and fragmentary blackouts (FB) (Wetherill, & Fromme, 2011). EBs may start and end at definitive points with long lasting amnesia for interim...
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...economic status or educational level is out of healthcare providers’ hands. However, adapting communication, care and patient education in regards to a patient’s health literacy level is feasible. The goal of this paper is to analyze the current body of literature on health literacy’s relationship with prenatal outcomes and identify areas for future research. This paper will also synthesize from the literature which interventions may be most appropriate for narrowing the gap between patients with low and high health literacy. Additionally, this paper will summarize the main implications for practice brought forward by the...
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...Erythroblastosis Fetalis by Jeanifer Aggarao Mrs. Carrig July 23, 2007 Table of Contents Definition 1 Pathophysiology 2 Signs and Symptoms 3 Risk Factors 5 Diagnosis 6 Treatment 8 Nursing Responsibilities 10 Psychosocial Implication 10 Bibliography 12 Definition Erythroblastosis fetalis is a fatal hemolytic disease of the newborn (HDN) caused by incompatibilities in the blood groups between the mother and her unborn child during pregnancy. Because of the incompatibility, the mother's immune system may launch an immune response against the red blood cells of the fetus through the placenta, resulting in the destruction of the red blood cells (hemolysis). In the destruction of the red blood cells, the fetus can develop anemia. The red blood cell destruction ranges from mild to very severe, and fetal death from heart failure can occur, as well as life-threatening problems for future pregnancies. The Rhesus system (Rh) blood group antigen is responsible for most of the fatal cases of erythroblastosis fetalis, hence, the term Rh incompatibility disease. However, other alloimmune antigens belonging to the Kell (K and k), Duffy (Fya), Kidd (Jka and Jkb), MNSs (M, N, S, and s), Diego, Xg, P, Ee, Cc antigen systems, as well as other antigens may also produce the disease. Incompatibilities of Landsteiner (A, B and O) blood group systems do not cause erythroblastosis fetalis. A French midwife reported the first case of HDN in a set of...
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...having amniocentesis for other reasons such as decreased fetal movement have been diagnosed with unexpected prenatal SMS. On-going medical assessment of the child with SMS along with genetic counseling and psychosocial support for parents and family members are required due to the complex nature of this disorder, multiple organ involvement, and diverse symptomology presented with this condition. According to Foster (2010) parents and siblings of children with SMS suffer of a high level of depression and anxiety. Medical tests commonly underwent by children with Smith-Magenis syndrome included but are not limited to renal ultrasound, echocardiogram, spine radiographs, electroencephalogram, magnetic resonance imaging, computed tomography, and blood work. The recommendation to perform these...
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...“Rhesus (RH) Incompatibility Disease” Sharon C. Clatterbuck Ottawa University In partial fulfillment of the requirements for the Proseminar Class Dr. Richard Kimberly. November 9, 2004 All the technology of our medical institutions and doctors do no good unless each female who becomes pregnant takes advantage of the prenatal care that is offered to them. According to the article titled “Routine ABO and RH Typing: An Introduction”, Phillip Levine and R.E. Stetson were the first scientists to discover the rhesus blood groups in 1939. Soon after their amazing discovery, Karl Landsteiner and A.S. Weiner discovered the ABO blood typing system in the late 1940’s, which ultimately lead to discovery of the Rh differences. Several medical studies and journals have concluded that the father is the basis of all fetal blood typing. The problem arises when the father’s blood type is positive and the mother’s blood type is negative, thus causes a condition called Rhesus (RH) Incompatibility or the RH Incompatibility Disease. (Mark-Maris) Women who receive proper treatment and testing during their first prenatal visit and subsequent visits can avoid most complications in their pregnancy, including the Rhesus Incompatibility. John M Bowman of the Canadian Medical Association states “the condition was first described as a medical problem in pregnancies in 1609, during the birth of a set of twins by a French midwife. The first twin had a severe case of Rh Incompatibility...
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...Jack Mendez Community Assessment RN 402-Community Health Nursing March 10, 2010 One of the most significant assessment findings within North Minneapolis is the prevalence of crime. When asked, many people around the metro will say that North Minneapolis is a “bad area” or that it is “unsafe”; this usually comes with a non-verbal look of concern from the person giving their input. How much worse is North Minneapolis than other metro areas? To find the answer to this question statistics and data from North Minneapolis will be analyzed. Assessment data will look at physical-environment, psychological, biophysical, sociological and behavioral aspects of Minneapolis as well as more specific areas within Minneapolis. Physical Environmental Community Assessment Minneapolis consists of 5 precincts or geographical areas that are controlled by different policing bodies. North Minneapolis falls primarily under the 4th precinct. “Its service area is bounded by Interstate 94 W on the East, Interstate 394 on the South and the city limits on the West and North” (City of Minneapolis, 2010). The fourth precinct consists of 16 zones which comprise the farthest north and northwest areas of Minneapolis. The nursing assessment will also focus in on the residents living within the Victory zone, one of the many zones within the city of North Minneapolis. Victory runs along Victory Memorial Parkway to Xerxes on the west, down to Dowling Avenue, and east to Newton Avenue. Victory...
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...Lifelong Learning The Infants and Toddlers with Disabilities Program portion of the Individuals with Disabilities Education Act (IDEA) addresses the area of the development of infants and toddlers with disabilities. The thought behind this program was to reduce educational costs by providing early intervention services to children with disabilities before they reach school age. The intention was to encourage the collaboration of agencies that provide health, education, and human services. The neural circuits which are a part of the brain that creates the foundation for learning, behavior, and health, are most susceptible to change during the first three years of life. In order to intercept and encourage the effectiveness of intervention, early diagnosis and identification is critical. Extreme poverty, abuse and neglect, or severe maternal depression leads to damage that can have a life time effect in learning, behavior, and physical and mental health. Intervention in these areas can provide education and resources for proper nutrition, health and mental health screenings. Positive early experiences strengthens the brain while early social and emotional development provides a firm foundation for the building of cognitive and language skills. (Goode, Diefondorf, and Colgan, 2011). Recognizing early childhood is a distinct period prime for intervention, IDEA requires all states and localities to develop a system of services to target this age group. This requirement is to...
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...Postpartum Case Study May 26, 2016 Postpartum Case Study Admission Assessment J.B. a 38-year-old female, G5, P3 (SAB 2, L3) admitted on 5/09/16 at 0930 for a scheduled repeat cesarean section. The patient’s chief complaint is minor contractions and concern from previous SAB (Spontaneous Abortions). J.B’s 1st pregnancy ended at 13 weeks with a SAB. 2nd pregnancy ended by C-section at 37 weeks due fetal intolerance. Her 3rd pregnancy ended at 38 weeks with a repeat C-section and her 4th pregnancy ended at 11 weeks with a SAB. Bringing us to this pregnancy number 5. J.B. chose to have a repeat C-section, because her physician recommended it due to a prior C-section. Multiple scars on uterus increase the risk for several serious problems for women and fetus. These risks include: scar rupture, placenta previa, placental abruption, and placenta accrete (Tobah, 2015). A high-risk pregnancy involves at least one of the following; the woman or baby is more likely to become ill or die more than usual. Complications before or after delivery are more likely to occur than usual. High-risk pregnancies must be closely monitored. Some risk factors are present before women become pregnant. These risk factors include certain physical and social characteristics of women, problems that have occurred in previous pregnancies, and certain disorders women already have. In J.B.’s case she had a high-risk pregnancy due to several reasons, she has advanced maternal age > 35, prior miscarriages...
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...Since the late 1970s, many studies have reported on the prevalence of fetal alcohol syndrome ( FAS) , alcohol-related birth defects ( ARBD) , and alcohol-related neurodevelopmental disorders (ARND) . The three main types of research methods used in these studies are passive surveillance, clinic-based studies, and active case ascertainment. This article describes each of these methods, including their strengths and weaknesses, and summarizes the estimated prevalence of FAS produced by each of these approaches. The maternal risk factors associated with FAS and other alcohol-related anomalies include advanced maternal age, low socioeconomic status, frequent binge drinking, family and friends with drinking problems, and poor social and psychological indicators. Overall, the available literature points to a prevalence rate of FAS of 0.5 to 2 cases per 1,000 births in the United States during the 1980s and 1990s. KEY WORDS: fetal alcohol syndrome; prevalence; epidemiological indicators; alcohol-related neurodevelopmental disorder; birth defects; statistical estimation; data collection; clinical aspects; population dynamics; risk factors; research in practice; research quality Establishing the prevalence 1 (1 See the sidebar on page 160 for the definition of prevalence as it is used in this article.) and other epidemiological characteristics of fetal alcohol syndrome ( FAS) , alcohol-related birth defects ( ARBD) , and alcohol-related neurodevelopmental disorder ( ARND) 2 (2 FAS is...
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