Midwife Licensure Exam Fundamentals of Care & the Health-Care Process — Basic Oxygenation, Elimination & NutritionConcept Map

Concept

Oxygenation

Sub Concepts

• Oxygen delivery devices (nasal cannula, face masks, Venturi)
• Signs of hypoxia (early vs. late)
• SpO₂ assessment and monitoring
• Airway clearance techniques
• Patient positioning for breathing ease
• Safety precautions with oxygen therapy

Relationship To Central

Core physiologic need requiring patent airway, effective breathing, and intact circulation for tissue oxygen delivery

Concept

Bowel Elimination

Sub Concepts

• Constipation management
• Diarrhea assessment and intervention
• Enema administration techniques
• Ostomy care and assessment
• Factors affecting bowel patterns

Relationship To Central

Normal elimination pattern maintenance prevents complications like impaction and dehydration

Concept

Urinary Elimination

Sub Concepts

• Normal urine output parameters (30 mL/hr minimum)
• Urinary catheterization technique and care
• CAUTI prevention strategies
• Promoting normal voiding
• Bladder training and Kegel exercises

Relationship To Central

Urine output monitoring reflects renal perfusion and fluid-electrolyte balance

Concept

Nutrition

Sub Concepts

• Macronutrients (carbohydrates, proteins, fats)
• Micronutrients (vitamins, minerals)
• Nutritional assessment
• Therapeutic diets
• Protein and vitamin C for wound healing

Relationship To Central

Macronutrients and micronutrients support tissue healing, immune function, and energy metabolism

Concept

Enteral Tube Feeding

Sub Concepts

• Tube placement verification (pH, tube length, X-ray)
• Aspiration prevention (HOB elevation)
• Residual volume monitoring
• Feeding administration safety
• Medication administration via tube

Relationship To Central

Alternative nutrition route when patient cannot eat but has functioning GI tract

Concept

Fluid Intake and Output (I&O)

Sub Concepts

• Daily weight as fluid-status indicator
• Fluid volume deficit (dehydration) signs
• Fluid volume overload signs
• I&O calculation and documentation
• Electrolyte balance monitoring

Relationship To Central

Accurate I&O monitoring detects fluid imbalance and maintains homeostasis

Concept

Wound Care and Healing

Sub Concepts

• Phases of wound healing
• Primary, secondary, and tertiary intention
• Wound assessment parameters
• Aseptic dressing change technique
• Infection and complication prevention
• Dehiscence and evisceration management

Relationship To Central

Proper wound assessment and management supports healing and prevents complications

To

Patient Positioning

From

Oxygenation

Strength

strong

Relationship

High-Fowler's and orthopneic positioning optimize lung expansion for dyspneic patients

To

SpO2 Assessment

From

Oxygenation

Strength

strong

Relationship

SpO₂ monitoring is the primary assessment tool; <90% indicates hypoxemia requiring intervention

To

Airway Clearance

From

Oxygenation

Strength

strong

Relationship

Patent airway is prerequisite for effective oxygenation; clearing secretions maintains airway patency

To

Fluid Intake

From

Bowel Elimination

Strength

moderate

Relationship

Adequate hydration prevents constipation; dehydration increases risk of impaction

To

Physical Activity

From

Bowel Elimination

Strength

moderate

Relationship

Immobility increases constipation risk; activity promotion is primary intervention

To

Fluid Intake and Output

From

Urinary Elimination

Strength

strong

Relationship

Urine output reflects hydration status and kidney perfusion; <30 mL/hr indicates inadequate perfusion

To

CAUTI Prevention

From

Urinary Catheterization

Strength

strong

Relationship

Sterile technique, closed system, and early removal are key interventions to prevent catheter-associated infection

To

Wound Healing

From

Nutrition

Strength

strong

Relationship

Protein, vitamin C, and zinc are essential micronutrients that directly support tissue repair and collagen synthesis

To

Nutrition

From

Enteral Tube Feeding

Strength

strong

Relationship

Tube feeding provides alternative route for nutrient delivery when patient cannot eat orally

To

Aspiration Prevention

From

Enteral Tube Feeding

Strength

strong

Relationship

HOB elevation 30-45° during and after feeding is critical safety measure to prevent aspiration pneumonia

To

Daily Weight

From

Fluid Intake and Output

Strength

strong

Relationship

Daily weight is most accurate indicator of fluid balance; 1 kg change = 1 liter of fluid

To

Bowel Elimination

From

Dehydration

Strength

moderate

Relationship

Dehydration contributes to constipation; increased fluid intake helps maintain normal bowel patterns

To

Wound Healing Phases

From

Wound Care

Strength

strong

Relationship

Understanding healing phases (hemostasis, inflammatory, proliferative, maturation) guides appropriate wound assessment and management

To

Infection Prevention

From

Wound Care

Strength

strong

Relationship

Aseptic technique, clean-to-dirty dressing changes, and monitoring for signs prevent infection complications

To

Surgical Emergency

From

Wound Dehiscence and Evisceration

Strength

strong

Relationship

Evisceration is surgical emergency requiring immediate surgeon notification, sterile saline dressing, and positioning

To

COPD Patients

From

Oxygen Therapy

Strength

strong

Relationship

Venturi mask with precise FiO₂ control and target SpO₂ 88-92% prevents blunting of hypoxic respiratory drive

To

Restlessness

From

Early Signs of Hypoxia

Strength

strong

Relationship

Restlessness is earliest sign of hypoxia and should never be dismissed or attributed to anxiety alone

To

Feeding Safety

From

Tube Placement Verification

Strength

strong

Relationship

pH testing (≤5), tube length measurement, and X-ray confirmation prevent feeding into airway

To

Philippine DOH Protocol

From

Diarrhea Management

Strength

strong

Relationship

ORS and zinc supplementation per DOH guidelines for acute diarrhea in children

To

Oxygenation, Elimination, Nutrition

From

Maslow's Hierarchy

Strength

strong

Relationship

All three concepts address physiologic safety needs in first tier; survival depends on meeting these needs