1538 exam 1 practice questions
very premature
28-32 weeks
huntington disease
36 or more CAG repeats
syphilis
4 phases: primary: highly infectious secondary: infectious latent: non-infectious after 4 years late: non-infectious
acetone breath odor
a nurse is assessing a client who has gestations diabetes. which of the following manifestations are findings of hyperglycemia? a. acetone breath odor. b. decreased urinary output. c. tinnitus. d. diarrhea.
you should consume 6 ounces of protein foods daily.
a nurse is teaching a client who is at 8 weeks of gestation about nutrition during pregnancy. which of the following statements should the nurse include in the teaching? a. you should consume 2 cups of milk daily. b. you should consume 4 ounces of grains each day. c. you should consume 2 cups of veggies each day. d. you should consume 6 ounces of protein foods daily.
tachypnea
an expected manifestation of fetal exposure to SSRIs
magnesium sulfate
anecdote is calcium gluconate
female condom
barrier method 95% effective when used correctly 79% effective with typical use
male condom
barrier method 98% effective when used correctly and 86% effective with typical use
emergency contraceptives
emergency contraception pill emergency contraception IUD
LOA
facing right and posterior with chin tucked and the top of the head in the position
chlamydia
gram negative bacterium
0
halfway there
increased risk for preterm labor
less than 15 years and over 35 years
sti prevention
secondary: treat infection, teach how to take meds, disclose to partners
contractions
tightening of the uterus that progresses through labor
baseline FHR
110-160
have calcium gluconate readily available.
a nurse is caring for a client who has preeclampsia and is receiving a continuous infusion of magnesium sulfate IV. which of the following actions should the nurse take? a. restrict hourly fluid intake of 150 mL/hr. b. have calcium gluconate readily available. c. assess deep tendon reflexes every 6 hr. d. monitor intake and output every 4 hr.
explain to the client this is an expected occurence.
a nurse is caring for a client who is at 22 weeks of gestation and reports concern about the blotchy hyperpigmentation on her forehead. which of the following actions should the nurse take? a. tell the client to follow up with a dermatologist. b. explain to the client this is an expected occurrence. c. instruct the client to increase her intake of vitamin D. d. inform the client she might have an allergy to her skin care products.
place the client in a lateral position.
a nurse is caring for a client who is in labor and has an epidural anesthesia block. the client's blood pressure is 80/40 mmHg and the fetal heart rate is 140/min. which of the following is the priority nursing action? a. elevate the client's legs. b. monitor vital signs every 5 min. c. notify the provider. d. place the client in a lateral position.
you should not eat or drink anything after midnight the night before the test.
a nurse is discussing an oral glucose tolerance test with a client who is at 22 weeks of gestation. which of the following statements should the nurse make? a. you should plan to have the test when you are 32 weeks pregnant. b. you should be on a low carb diet for 3 days before testing. c. you should not eat or drink anything after midnight the night before the test. d. you should avoid smoking 2 hours prior to the test.
massage the client's fundus
a nurse on a postpartum unit is caring for a client who is experiencing hypovolemic shock. after notifying the provider, which of the following actions should the nurse take next? a. massage the client's fundus. b. insert an indwelling urinary catheter. c. administer oxygen at 10 L/min. d. elevate the client's right hip.
hypoglycemia
an expected manifestation of fetal exposure to SSRIs
low birth weight
an expected manifestation of fetal exposure to SSRIs
klinefelter syndrome
extra X chromosome, XXY = increased estrogen, decreased androgen = increased breast tissue and increased risk of breast cancer in men
chvostek's sign
facial twitching when facial nerve is tapped
chromosomal abnormalities
failure to separate, deletions, duplications, inversions, translocations
early huntington symptoms
figity, falls, slurred speech
3 types of biopsy
fine needle, punch/core, and open biopsy
primigravida
first pregnancy
viral STIs
herpes HPV genital warts hep B HIV
levonorgestrel
hormonal IUD
ED treatment options
intraurethral: vasoactive drugs which are gels, pellets or injections, that increase blood flow into penile arteries inducing erection vasoconstrictive device: pulls blood into penis with a vacuum pump, a constricting band is at the base of the penis that retains venous blood. implants: surgery to place semirigid or inflatable prosthesis into penis. for severe ED. complications: mechanical failure, infection, and erosion. counseling before and after treatment.
most common types of breast cancer
invasive ductal carcinoma invasive lobular carcinoma
false labor
irregular contractions
common huntington symptoms
irritability and depression
copper iud
iud 99% correctly 99% typically
insufficient placental perfusion
late decelerations
15 to 20 years
lifespan expectancy after huntington disease onset
preliminary signs of labor
lightening braxton hicks contractions cervical changes energy (nesting, cleaning, etc.) weight loss
placenta previa
marginal, partial, complete
every 4 weeks
maternal/fetal assessments from conception to 28 weeks
gonorrhea
men: urethritis dysuria profuse, purulent drainage painful/swollen testes
sti prevetion
primary: teach abstinence, vaccines, drug free, condoms
true labor
progressive cervical dilation and effacement
huntington disease
progressive, degenerative brain disorder
trichomonas
protozoa
incompetent cervical os
purse string procedure to sew cervix shut
oligohydramnios
requires further assessment using electronic fetal monitoring.
breast cancer treatments
surgery chemo HRT biologic therapy radiation complimentary alternative medicine
early decelerations
*safe* Begin prior to peak of the contraction and end by the end of it. they are caused by head compression. no need for intervention if variability is within normal range (6-10) and the FHR is within normal range.
normal
< or = to 35 CAG repeats
terbutaline
Beta 2 agonist used to suppress premature labor, but cardiac stimulatory effects may be hazardous to mother and fetus
Magnesium Sulfate
Used to treat pre-eclampsia & control seizures. Also used to stop preterm labor
chorea
abnormal/excessive involuntary movements
tocometer
applied at uterine fundus
late / deep decels
bad
herpes type 2
below the waist
labetalol
beta blocker used to treat HTN in pregnancy may be given PO or IV monitor for dizziness
descent phase of labor
characterized by active pushing with contractions every 1-2 minutes lasting 90 seconds.
bacterial STis
chlamydia gonorrhea syphilis
ethinyl estradiol and norethrindone pill
combo contraceptive pill
> repeats
early onset
hemorrhagic disorders with surgical treatment
ectopic pregnancy placenta previa abortion abruptio placentae
early decelerations
fetal head compression
upper pane
fetal heart tracing is displayed
gender dysphoria
formally called gender identity disorder defined: experience gender incongruence resulting in gender dysphoria feel themselves to be a different gender than their biologic assigned gender dysphoria is more appropriate and consistent: removes connotation the patient has a disorder.
44-64%
hct normal range for a newborn < 24 hours old
oxytocin
induces uterine contractions
washing and urinating
instruct patient in hygienic measures, such as __________ and __________ after intercourse to flush out some organisms
fourth cardinal movement
internal rotation
tocometer
measures duration and frequency of contractions
ultrasound
measures fetal heart rate
autosomal dominant
mutated gene carries the disease process ex: huntington's disease
morphine
narcotic drug derived from opium, used to treat severe pain
fertility awareness method
natural contraceptive 99% effective when used correctly 75% effective typically
anthropoid pelvis
oval shaped, with a wider anteroposterior diameter
increases risk 1.5-3 times
positive breast cancer in first degree female relative
misoprostol
prostaglandin used to induce uterine contractions and ripen the cervix
true labor
regular contractions
ED
the inability to attain or maintain an erection that allows for satisfactory sexual performance may be organic, functional, or a combo can occur at any age but increases with increasing age
one minute
the interval between the vertical red lines on FHR monitor
hydramnios
too much amniotic fluid
lower pane
uterine activity is displayed
hpv
vaccine available: ages 9-26 (2 and 3 dose series)
large for gestational age
above the 90th percentile
herpes type 1
above the waist
variable deceleration
abrupt decrease in FHR from baseline
hormone contraceptives
combo pill hormonal patch hormonal ring minipill hormonal injection
true labor
contractions become closer
RDS
respiratory distress syndrome
placenta accreta
risk for infection and hemorrhage
gonorrhea
vaginal, anal, or oral sex: men and women spread by direct physical contact with infected host
STIs treatment
start before confirming culture received one time dose of antibiotic to insure compliance with treatment all sexual contacts must be evaluated and tested as needed no sexual contact during treatment
in situ
stays confined to origin
active phase of stage 1 labor
cervical dilation of 4-7 cm and contractions every 3 to 5 minutes lasting 40-70 seconds
chlamydia
treatment: azithromycin 1 gram PO in one dose (may treat gonorrhea as well)
oral acyclovir (zovirax)
the nurse teaches a patient about drugs used to treat genital herpes. which drug should the nurse include in the patient's instructions? a. acyclovir ointment b. oral acyclovir c. HPV vaccine d. podofilox topical gel.
partial placenta previa
the placenta partially covers the internal os.
effacement
thinning of the cervix
intrapartum
4 stages
mongolian spots
A bluish-black pigmented area on the newborn's buttocks or back. Seen in newborns with dark skin and typically fade over time. Can easily be confused for bruising.
misoprostol
A prostaglandin used in medical abortions; Induces contractions
hydrocodone (norco)
a common oral narcotic pain medication used to treat moderate to severe pain
huntington disease
autosomal dominant - gene is expressed
spermicide
barrier method 85% effective with correct use 73% effective with typical use
cervical cap
barrier method 86% effective with typical use
contraceptive sponge
barrier method 91% effective when used correctly 84% effective with typical use
spina bifida manifesta
the form of a myelomeningocele that is open external indications of this neural tube defect include an open area over the defect that allows for leakage of cerebrospinal fluid and entry of microorganisms.
bacterial STI
treat with antiinfectives, no vaccines
station
where the baby is in the pelvis
multigravida
woman who has been pregnant more than once
gonorrhea
women: typically asymptomatic but may have swelling of cervix or urethra and may have a greenish/yellow discharge or difficulty with urination
hypertensive disorders
chronic hypertension gestational hypertension preeclampsia eclampsia chronic hypertension with preeclampsia
herpes
clinical manifestation: recurrent episodes: occurs in 50-80% in 1st year triggers: stress, fatigue, sunburn, general illness,immunosuppression, menses may note tingling, burningh, and itching prior to lesions less severe than initial and heals faster at 3-12 days
40 years
huntington disease onset typically
moderate variability
6-25 bpm variation from baseline
herpes
clinical manifestation primary: burning, itching, or tingling at the site of inoculation multiple small, vesicular, lesions on inner thigh, penis, scrotum, vulva, perineum, perianal region, vagina, or cervix vesicles contain large quantities of infectious viral particles lesions rupture and form shallow, moist ulcerations that finally crust and heal pain, fever, headache, malaise, myalgia, regional lymphadenopathy, with primary episode lesions lasts 7-20 days
sixth cardinal movement
external rotation
stage 1 of labor
has 3 stages
hormonal iud
iud 99% correctly 99% typically
stage 2 of labor
lasts 1-3 hours with patient pushing with contractions to deliver the fetus
hypertension
most common medical condition associated with pregnancy
+2
nearly there
reportable infections to CDC
syphilis gonorrhea chlamydia HIV
lightening
where the baby drops and turns getting closer to delivery
multipara
woman who has given birth to two or more children
Ketorolac (Toradol)
*class*: nonsteroidal anti-inflammatory agents, nonopioid analgesics *Indication* pain *Action*: Pain relief due to prostaglandin inhibition *Nursing Considerations*: -may cause GI bleeding, Stevens-Johnson Syndrome, anaphylaxis, drowsiness - should not exceed 5 days of therapy - bleeding risk increased with garlic, ginger, and ginkgo - may decrease effectiveness of hypertensive medications and diuretics
postcoital bleeding may occur.
a nurse in a clinic is teaching info about cervical polyps with a client with a new diagnosis. which of the following info should the nurse include in the teaching? a. avoid using tampons during menstruation. b. cervical polyps are a precursor to the development of cervical cancer. c. cervical polyps affect women before the age of 40. d. postcoital bleeding may occur.
swelling of the face
a nurse is assessing a client who is at 30 weeks of gestation during a routine prenatal visit. which of the following findings should the nurse report to the provider? a. swelling of the face. b. varicose veins in the calves. c. nonpitting 1+ ankle edema. d. hyperpigmentation of the cheeks.
chin quivering
a nurse is assessing a newborn following a circumcision. which of the following findings should the nurse identify as an indication that the newborn is experiencing pain? a. decreased heart rate. b. chin quivering. c. pinpoint pupils. d. slowed respirations.
substernal chest retractions while sleeping.
a nurse is assessing a newborn who is 12 hr old. which of the following manifestations requires intervention by the nurse? a. acrocyanosis of the extremities. b. murmur at the left sternal border. c. substernal chest retractions while sleeping. d. positive babinski reflex.
vomiting
a nurse is assessing the newborn of a client who took SSRIs during pregnancy. which of the following manifestations should the nurse identify as an indication of withdrawal from an SSRI? a. large for gestational age. b. hyperglycemia. c. bradypnea. d. vomiting.
HR 110/min
a nurse is caring for a client who is 12 hr postpartum. which of the following findings should alert the nurse to the possibility of a postpartum complication? a. orthostatic hypotension. b. fundus palpable at the umbilicus. c. urine output of 3000 mL in 12 hr. d. HR 110/min
initiate continuous external fetal monitoring
a nurse is caring for a client who is at 35 weeks of gestation and has placenta previa. which of the following actions should the nurse take? a. perform a vaginal exam to determine cervical dilation every 2 hr. b. instruct the client to ambulate in the hallway once every 4 hr. c. administer betamethasone to the client via IM injection. d. initiate continuous external fetal monitoring.
continue to monitor the client.
a nurse is caring for a client who is having labor augmented with oxytocin. the fetal monitor tracing reveals early decelerations. which of the following actions should the nurse take? a. continue to monitor the client. b. discontinue the oxytocin. c. assist the client to a trendelenburg position. d. administer oxygen 2 L/min via nasal cannula.
contractions lasting longer than 90 seconds
a nurse is caring for a client who is in the active phase of the first stage of labor. when monitoring the uterine contractions, which of the following findings should the nurse report to the provider? a. contractions lasting longer than 90 seconds. b. contractions occurring every 3 to 5 min. c. contractions are strong in intensity. d. client reports feeling contractions in lower back.
feb 22
a nurse is conducting an initial assessment for a client. the client reports, my last period began may 15. using nagele's rule, the nurse should calculate that which of the following dates is the expected date of birth? a. feb 22 b. jan 22 c. feb 8 d. jan 8
the client has pelvic relaxation
a nurse is reinforcing teaching about contraceptive methods with a client. which of the following should the nurse recognize as a contraindication for diaphragm use? a. the client is 42 years old. b. the client smokes cigarettes. c. the client has pelvic relaxation. d. the client has a 3 month old infant.
bilirubin 9 mg/dL
a nurse is reviewing laboratory results of a newborn who is 4 hr old. which of the following findings should the nurse report to the provider? a. bilirubin 9 mg/dL b. hgb 18 g/dL c. platelets 175,000/mm3 d. hct 45%
hgb 12 g/dL
a nurse is reviewing the lab results of a newborn who is 22 hr old. which of the following findings should the nurse report to the provider? a. platelet count 165,000/mm3. b. hgb 12 g/dL. c. bilirubin 5 mg/dL. d. blood glucose 50 mg/dL.
fill the sitz bath half full with water.
a nurse is teaching a client who is 2 hr postpartum and had a midline episiotomy. which of the following instructions should the nurse include in the teaching? a. fill the sitz bath half full with water. b. use the sitz bath once daily. c. cleanse your perineum with an iodine solution after voiding. d. change your perineal pad 3 times per day.
you can share your room with your baby for the next few weeks.
a nurse is teaching a new parent about newborn safety. which of the following instructions should the nurse include in the teaching? a. you can share your room with your baby for the next few weeks. b. cover your baby with a light blanket while sleeping. c. check the temp of your baby's bath water with your hand. d. it's okay for your baby to sleep in the carseat during the day.
a client who is at 34 weeks of gestation and reports epigastric pain.
a nurse on an antepartum unit is caring for four clients. which of the following clients should the nurse identify as the priority? a. a client who has gestational diabetes and a fasting blood glucose of 120. b. a client who is at 34 weeks of gestation and reports epigastric pain. c. a client who is at 28 weeks of gestation and has an Hgb of 10.4 g/dL. d. a client who is at 39 weeks of gestation reports urinary frequency and dysuria.
left mentotransverse
baby faces left and left side with back on right side with face presenting
Left occipitotransverse (LOT)
baby faces right and right side with top of the head presenting
left sacroanterior
baby is breech facing right and back with head under ribs and butt presenting
late decelerations
bad - placental insufficiency - begin toward peak of contractions and last until almost the onset of the next contraction
marginal placenta previa
edge of the placenta is at the margin of the internal os
emergency pill
emergency contraceptive n/a correctly or typically
emergency iud
emergency contraceptive n/a correctly or typically
pain management
epidural or natural method
LOP
facing right and front with chin tucked and the top of the head presenting
natural contraception
fertility awareness methods
position
fetal - breech, etc.
+3
get the crown
hormonal injection
hormonal contraceptive 99% effective correctly 99% effective typically
acceleration
okay
late decelertaions
onset occurs at peak of contraction
active phase of stage 1 labor
patient will have trouble concentrating due to contractions
late
placental insufficiency
safer sex practices
reduced number of sex partners condoms
10-20 days
sickle cell lifespan of RBC
sterilization
surgical/nonsurgical sterilization: female surgical sterilization: male
treatment
teach patient about the need for _____________ of sexual partners to prevent transmission of disease.
intrapartum
the fetus descends into the pelvis (station) and through the birth canal for delivery
mag sulfate
used to treat preeclampsia or eclampsia loading dose then a maintenance dose monitor DTR, mag levels antidote is calcium gluconate
huntington s/s
weight loss, aspiration, pneumonia, increased hunger, decreased coordination during eating, anxiety, stress triggers, choreiform movements
advise all sexual partners of the need for treatment.
when caring for patients with an SIT, it is important that the nurse teach them to: a. advise all sexual partners of hte need for treatment. b. use a condom for sexual intercourse during treatment. c. engage in monogamous relationships to prevent reinfection. d. wash the genital s before sexual intercourse to prevent disease transmission.
severe preeclampsia
BP > 160/100 proteinuria - >500 mg/24 hr or >3+ on dispstick no seizures yes hyperreflexia headach, oliguria, blurred vision, thrombocytopenia, epigastric or RLQ pain, HELLP
nucchal translucency
extra fluid at the base of the neck
blood blood products perinatal auto-inoculation
how STIs are transmitted aside from being bacterial or viral
abstain
instruct patient to ___________ from sexual intercourse during treatment and to use condoms when sexual activity is resumed to prevent spread of infection and prevent reinfection.
late decelerations
insufficient placental perfusion
membranes
intact, ruptured (spontaneous or artificial)
late decelerations
mean decreased O2
concurrent STIs
more than one at the same time
chlamydia
most common STI
labor augmentation
pitocin
ED assessment
self administered assessment may be helpful international index of erectile function review of sexual health, general health, psychological health
Meperidine hydrochloride (Demerol)
short acting narcotic opioid given intramuscularly for premedication
placenta
should deliver intact with 1 vein and 2 arteries
para
term or preterm
14 to 24 g/dL
the expected range for a newborns hgb.
Butorphanol (Stadol)
*class*: Opioid Analgesic *Indication*: moderate to severe pain, labor pain, sedation *Action*: alters perception and response to pain by biding to opiate receptors in CNS *Nursing Considerations*: -use caution with concurrent use of MAOIs - may cause confusion, hallucinations, sedation - monitor for CNS depression - assess blood pressure pulse and respirations during administration - administer slowly through IV line
valacyclovir (valtrex)
Antiretrovirals. Uses: genital herpes, shingles, HIV. Precautions: administer with food, increase fluid intake, and begin therapy with first onset of symptoms.
eclampsia
BP > 160/100 proteinuria - marked yes seizures yes hyperreflexia severe headache, generalized edema, RUQ or epigastric pain, cerebral hemorrhage, renal failure, HELLP
cullen's sign
a blue discoloration similar to ecchymosis around the umbilicus
first cardinal movement
engagement
-1
settling in
attitude
tolerance
nulipara
never given birth to viable offspring
marked variability
> 25 bpm variation from baseline
LOA
left occiput anterior
placenta previa
no cervical exams; no labor
false labor
no change in contraction pattern
viral STI
no cure, treat symptoms, suppression of virus, vaccine
8-10
normal Hgb for sickle cell
autosomal recessive
normal gene is the dominant gene and the person is a carrier ex: sickle cell, cystic fibrosis
0-5
abnormal score for biophysical profile need to induce labor asap
HPV
16 and 18 are oncogenic - causes most all abnormal pap smears in women
iron
a nurse in a women's health clinic is providing teaching about nutritional intake to a client who is at 8 weeks of gestation. the nurse should instruct the client to increase her daily intake of which of the following nutrients? a. calcium. b. vitamin E. c. iron. d. vitamin D.
headache that is unrelieved by analgesia.
a nurse is teaching a client who is at 35 weeks of gestation about manifestations of potential pregnancy complications to report to the provider. which of the following manifestations should the nurse include? a. SOB when climbing stairs. b. swelling of feet and ankles at the end of the day. c. headache that is unrelieved by analgesia. d. braxton hicks contractions.
syphilis
a spirochete
safer sex practices
abstinence: the most reliable way to avoid infection is to not have sex vaccination: vaccines are safe, effective, and recommended ways to prevent infection and spread. mutual monogamy: mutual monogamy means that you agree to be sexually active with only one person who has agreed to be sexually active only with you, being in a long term mutually monogamous relationship with an uninfected partner is one of the most reliable ways to avoid STIs, but you must both be certain you are not infected with STIs. it is important to have an open and honest conversation with your partner.
40-60 mg/dL
blood sugar normal range for a newborn < 24 hour old
bloody show
bloody discharge / mucous plug
post-term infants
born after 42 week of gestation about 12% of births are post-term some can grown > 8-13 lbs placing them at higher risk for birth injuries when pregnancy is prolonged the placenta's function begins to deteriorate oligohydramnios cord compression
herpes
both types can be found in both locations. virus enters nerve endings
hemolysis
breakdown of cells carrying blood
placenta previa
c-section
true labor
contractions increase in duration and intensity
true labor
contractions increase in intensity with ambulation
false labor
contractions may be relieved with ambulation
methylergonovine
contraindicated in CAD, hepatic or renal impairment
misoprostol
contraindicated in HTN, CAD
abortion
control hemorrhage
false labor
discomfort that is localized to the abdomen
fetal head compression
early decelerations
-2
in the right direction
HIV treatment
support immune system: monitor CD4 count suppress control viral load prevent opportunistic infections multi drug approach life long therapy
ectopic pregnancy
surgical treatment
oxytocin
used to induce labor or induce uterine contractions to stop heavy postpartum bleeding
dinoprostone
used to soften/ripen the cervix as well as increase contractions to minimize postpartum bleeding
herpes
HSV: herpes simplex viurs type 1 or type 2
focused assessment
objective: fever, lymphadenopathy lesions: appearance, location, pain, single or in clusters discharge or drainage labs: gram stain, smears, cultures, serology
retinopathy of prematurity
occurs in infants < 28 wks or < 1500 g caused by damage to immature blood vessels in the retina high levels of oxygen thought to be cause of damage to retina fluid leakage and hemorrhages may cause scarring
periventricular-intraventricular hemorrhage
occurs most often in infants < 32 wks of < 1500 g first few days of life are most critical rupture of fragile blood vessels in and around the brain associated with hypoxic injury to blood vessels fluctuations in BP fluctuations in cerebral blood flow
increased repeats
offspring usually have _______________ in huntington disease
early decels / variability
ok
3rd trimester bleeding
painless or painfull
placenta previa
painless vaginal bleeding
abruptio placentae
part or all of placenta pulls away from uterus before delivery
transition phase of stage 1 labor
patient will become very quiet or angry
platypelloid pelvis
pelvis that is flat in its dimensions with a very narrow anterior-posterior diameter and a wide transverse diameter; this shape makes it extremely difficult for the fetus to pass through the bony pelvis
organic ED
physical problem: diabetes: micro-circulation changes impair engorgement of corpus cavernous HTN decrease hormone production side effects of meds
sickle cell anemia
autosomal recessive
left sacroposterior
baby is breech facing right and front with back on left posterior and butt presenting
left sacrotransverse
baby is breech facing right and right side with back on left side and butt presenting
-3
floating high
BRCA treatment
genetic counseling early detection preventative surgery
dyspareunia
genital pain before during or after intercourse present in both sexes, more prevalent in femalse with the pain initiating in several areas, from vulvar surfaces to deep pelvidc structures. pain: mild to excruciating pain description: burning, stinging, sharpness, extreme tenderness.
2-6 mg/dL
bilirubin normal range for a newborn < 24 hour old
altered libido/sexual desire
causes: physical, psychological, relationship issues treatment: counseling, lifestyle and home remedies
14-24 g/dL
hemoglobin normal range for a newborn < 24 hours old
HELLP
hemolysis, elevated enzymes of liver, low platelets
< repeats
late onset
cardinal movements of labor
1. Engagement 2. Descent 3. Flexion 4. Internal Rotation 5. Extension 6. External Rotation 7. Expulsion
glucose tolerance test
50 gm solution 1 hour test normal < 140 if > 140, then 3 hour test 100 gm solution blood draws hourly 2 or more > 140 = gestational diabetes
chlamydia
75% women, 50% men are asymptomatic
trisomy 21
95% of DS
sickle cell treatment
< 16 yrs may have bone transplant
extremely preterm
< 26 weeks
minimal variability
< 5 bpm variation from baseline
premature
<37 completed weeks
medication categories for pregnancy
A and B are ok C is ok, but not a first choice D & X are not ok
chadwick's sign
Bluish purple discoloration of the cervix, vagina, and labia during pregnancy as a result of increased vascular congestion.
variable decelerations
HR up or down, cord compression = VERY BAD Prolapsed cord= push head up, change mom position
epistaxis (nosebleed)
a nurse is discussing common discomforts that may occur during the first trimester of pregnancy with a client who is at 6 weeks of gestation. which of the following manifestations should the nurse include? a. heartburn. b. periodic tingling of the fingers. c. pruritus. d. expistaxis
acceleration
abrupt increase in FHR from baseline
painful 3rd trimester bleeding
abruptio placentae or uterine rupture
variable deceleration
onset varies with contractions
dilation
opening of the cervix
breast cancer risk factors
over 50 genetic mutations BRCA1 or BRCA2 family history personal history of breast CA or endometrial CA, etc. early menarche (before 12) late menopause (after 59) first pregnancy after 30 or nuliparity weight gain after menopause having dense breasts HRT
sickle cell mutation
prevents malaria
trichomonas
treatment: metronidazole (flagyl) 2 grams PO x 1 dose
syphilis
treatment: penicillin G 2.4 million units IM single dose
herpes
treatment: good genital hygiene, loose fitting cotton under garments, keep lesions clean and dry drugs to decrease the severity and length of outbreak or suppression of outbreak
hypertensive disorders
triad of symptoms: edema, increased BP, proteinuria
variable decelerations
umbilical cord compression
Sildinafil (Viagra)
used to treat erectile dysfunction
ED clinical manifestations
usually self reported identify if sudden or gradual onset personal issues: anger, anxiety, depression
signs of RDS
usually show in hours after birth tachypnea, tachycardia, nasal flaring, retractions, cyanosis, and grunting CXR shows ground glass look
veal chop
variable cord compression early head compression accelerations okay late placental insufficiency
umbilical cord compression
variable decelerations
trichomonas
women: irregular vaginal bleeding painful intercourse frothy green discharge cervix and vaginal walls may have strawberry appearance men: painful urination discharge associated with low birth weight, preterm labor, etc.
intrapartum
begins with the onset of regular uterine contractions and lasts until the expulsion of the placenta.
you can miss your period for several other reasons. describe your typical menstrual cycle.
a nurse in a prenatal clinic is caring for a client who reports that her menstrual period is 2 weeks late. the client appears anxious and asks the nurse if she is pregnant. which of the following responses should the nurse make? a. you can miss your period for several other reasons. describe your typical menstrual cycle. b. if you have been sexually active and haven't used protection, it is likely that you are pregnant. c. let's check to see if you have any other signs of pregnancy. have you noticed any abdominal enlargment? d. because you have missed your period, you should try taking a home pregnancy test.
jitteriness
a nurse is assessing a newborn for manifestations of hypoglycemia. which of the following findings should the nurse expect? a. jitteriness. b. hypertonia. c. abdominal distention. d. mottling.
i will need this medication if i have an amniocentesis.
a nurse is teaching a client who is Rh negative about Rh0 immune globulin. which of the following statements by the client indicates an understanding of the teaching? a. i will receive this medication if my baby is Rh negative. b. i will receive this medication when i am in labor. c. i will need a second dose of this medication when my baby is 6 weeks old. d. i will need this medication if i have an amniocentesis.
vomiting
an expected manifestation associated with fetal withdrawal from SSRIs
dyspareunia causes
physiological: menopause, estrogen deficiencies, med side effects, drug abuse pelvic disorders: PID, endometriosis, STDs, vaginitsmus, vluvodynia, vestibulitis, infection, inflammation of penis, testes, urethra. psychological or emotional related to child abuse stress, depression.
ultrasound
placed above symphysis pubis (wherever heartbeat is found)
total placenta previa
placenta completely covers internal cervical os
placenta accreta
placenta grows into the uterine muscle and parts are retained
painless 3rd trimester bleeding
placenta previa
HPV
100 types, 90% by type 6 and 11
if both parents are carriers
24% will have disease 50% carriers 25% normal
pregnancy expectations
25 to 30 pound weight gain increase calories by 300 additional increase water to 2 qt/day increase fruits and veggies decrease saturated fat but increase fiber
preterm
< or = to 37 weeks and 6 days
term
> or = 38 weeks
syphilis
clinical manifestations change in each phase
mild preeclampsia
BP > 140/90 proteinuria - 300 mg/24 hr or 1+ on dipstick no seizures no hyperreflexia mild facial or hand edema / weight gain
Tadalafil (Cialis)
Phosphodiesterase-5 enzyme inhibitor used to treat erectile dysfunction
cullen's sign
a nurse in the ED is caring for a client who comes to the ED reporting severe abdominal pain in the left lower quadrant. the provider suspects a ruptured ectopic pregnancy. which of the following signs indicates to the nurse that the client has blood in the peritoneum? a. chvostek's sign b. cullen's sign d. chadwick's sign d. goodell's sign
emotional lability
a nurse in the antepartum clinic is assessing a client's adaptation to pregnancy. the client states that she is happy one minute and crying the next. the nurse should interpret the client's statement as an indication of which of the following? a. emotional lability. b. focusing phase. c. cognitive restructuring. d. couvade syndrome.
d/c the oxytocin infusion
a nurse is administering oxytocin to a client for augmentation of labor. the nurse observes uterine contractions every 1 to 2 minutes with a duration of 70 to 80 seconds. which of the following actions should the nurse take? a. d/c the oxytocin infusion. b. check the client's cervix. c. administer misoprostol d. ambulate the client.
continuous contraction lasting 2 min
a nurse is admitting a client who is at 38 weeks of gestation and is in the first stage of labor. which of the following assessment findings should the nurse report to the provider first? a. expulsion of a blood tinged mucous plug b. continuous contraction lasting 2 min c. pressure on the perineum causing the client to bear down. d. expulsion of clear fluid from the vagina.
erythema on the breast.
a nurse is assessing a client who is 10 days postpartum and reports manifestations of mastitis. which of the following findings should the nurse identify as a manifestation of this condition? a. breast engorgement. b. a small white pearl visible on the tip of the nipple. c. erythema at the breast. d. temp of 99.9.
deep tendon reflexes 4+
a nurse is assessing a client who is 4 hr postpartum following a vaginal delivery. which of the following findings should the nurse identify as the priority? a. saturated perineal pad in 30 min. b. deep tendon reflexes 4+. c. fundus at level of umbilicus. d. approximated edges of episiotomy.
decreased platelet count.
a nurse is assessing a client who is postpartum and has idiopathic thrombocytopenia purpura. which of the following findings should the nurse expect? a. decreased platelet count. b. increased erythrocyte sedimentation rate. c. decreased megakaryocytes. d. increased WBC.
left lower quadrant
a nurse is assessing fetal heart tones for a client who is pregnant. the nurse has determined the fetal position as left occipital anterior. to which of the following areas of the client's abdomen should the nurse apply the ultrasound transducer to assess the point of maximum intensity of the fetal heart? a. left upper quadrant. right upper quadrant. c. left lower quadrant. d. right lower quadrant.
ED treatment options
drugs include: sildenafil tadalafil (cialia) vardenafil (levitra) note these end with fil may cause headache, stomach upset, nasal congestion, flushing
leakage of fluid from the vagina
a nurse is caring for a client following an amniocentesis at 18 weeks of gestation. which of the following findings should the nurse report to the provider as a potential complication? a. increased fetal movement. b. leakage of fluid from the vagina. c. upper abdominal discomfort. d. urinary frequency.
determine respiratory function.
a nurse is caring for a client who becomes unresponsive upon delivery of the placenta. which of the following actions should the nurse take first? a. determine respiratory function. b. increase the IV fluid rate. c. access emergency medications from cart. d. collect a maternal blood sample for coagulation studies.
expressions of excitement
a nurse is caring for a client who experienced a vaginal birth 12 hr ago. the nurse recognizes the client is in the dependent, taking in phase of maternal postpartum adjustment. which of the following findings should the nurse expect during this phase? a. expressions of excitement b. lack of appetite. c. focus on the family unit and its members d. eagerness to learn newborn care skills.
increase the iv fluid rate.
a nurse is caring for a client who is at 39 weeks of gestation and is in labor. the fetal monitor tracing reveals a series of late decelerations. after placing the client in a lateral position, which of the following actions should the nurse take? a. prepare the client for an amnioinfusion. b. increase the iv fluid rate. c. administer oxygen at 2 L/min via nasal cannula. d. apply fundal pressure.
biophysical profile
a nurse is caring for a client who is at 41 weeks of gestation and has a positive contraction stress test. for which of the following diagnostic tests should the nurse prepare the client? a. percutaneous umbilical blood sampling. b. amnioinfusion. c. biophysicadl profile. d. chorionic villus sampling.
position the client on her side.
a nurse is caring for a client who is in active labor and notes late decelerations on the fetal monitor. which of the following is the priority nursing action? a. elevate the client's legs. b. position the client on her side. c. administer oxygen via face mask. d. increase the infusion rate of iv fluid.
transition
a nurse is caring for a client who is in labor and reports increasing rectal pressure. she is experiencing contractions 2 to 3 min apart, each lasting 80-90 seconds, and a vaginal examination reveals that her cervix is dilated to 9 cm. the nurse should identify that the client is in which of the following phases of labor? a. active. b. transition. c. latent. d. descent.
apply sacral counterpressure.
a nurse is caring for a client who is in labor and whose fetus is in the right occiput posterior position. the client is dilated to 8 cm and reports back pain. which of the following actions should the nurse take? a. apply sacral counterpressure. b. perform transcutaneous electrical nerve stimulation (TENS). c. initiate slow paced breathing. d. assist with biofeedback.
apply sacral counter pressure
a nurse is caring for a client who is in labor and whose fetus is in the right occiput posterior position. the client is dilated to 8 cm and reports back pain. which of the following actions should the nurse take? a. apply sacral counterpressure. b. perform transcutaneous electrical nerve stimulation. c. initiate slow paced breathing. d. assist with biofeedback.
just above the symphysis pubis
a nurse is caring for a client who is pregnant and is at the end of her first trimester. the nurse should place the doppler ultrasound stethoscope in which of the following locations to begin assessing for the fetal heart tones? a. just above the umbilicus. b. just above the symphysis pubis. c. the right lower quadrant. d. the left lower quadrant.
apply perineal pressure to the emerging fetal head.
a nurse is caring for a client who presents to a labor and delivery unit experiencing rapidly progressing labor. which of the following is the priority action for the nurse to take? a. cut the umbilical cord. b. apply perineal pressure to the emerging fetal head. c. prevent the perineum from tearing. d. promote delivery of the placenta.
cover the newborn's eyes while under the phototherapy light.
a nurse is caring for a newborn who is undergoing phototherapy to treat hyperbilirubinemia. which of the following actions should the nurse take? a. cover the newborn's eyes while under the phototherapy light. b. keep the newborn in a shirt while under the phototherapy light. c. apply a light moisturizing lotion to the newborn's skin. d. turn and reposition the newborn every 4 hr while undergoing phototherapy.
verify the newborn's identification.
a nurse is caring for a newborn who was transferred to the nursery 30 min after birth because of mild respiratory distress. which of the following actions should the nurse take first? a. confirm the newborn's apgar score. b. verify the newborn's identification. c. administer vitamin K to the newborn. d. determine obstetrical risk factors.
you will have a strep B culture at 35 weeks of your pregnancy
a nurse is discussing prenatal care with a primigravida client at her first prenatal visit. which of the following statements should the nurse make? a. you should feel your baby moving at 12 weeks. b. you should expect your blood glucose level to be checked during every visit. c. you will have a group B strep culture at 35 weeks of your pregnancy. d. you will have an appointment every other week starting at 36 weeks.
monitor the client's blood pressure every 5 min following the first dose of anesthetic solution.
a nurse is planning care for a client who is in labor and is requesting epidural anesthesia for pain control. which of the following actions should the nurse include in the plan of care? a. place the client in a supine position for 30 min following the first dose of anesthetic solution. b. administer 1,000 mL of dextrose 5% in water prior to the first dose of anesthetic solution. c. monitor the client's blood pressure every 5 min following the first dose of anesthetic solution. d. ensure the client has been NPO 4 hr prior to the placement of the epidural.
instruct the client to press the provided button each time fetal movement is detected.
a nurse is planning care for a client who is to undergo a nonstress test. which of the following actions should the nurse include in the plan of care? a. maintain the client NPO throughout the procedure. b. place the client in a supine position. c. instruct the client to massage the abdomen to stimulate fetal movement. d. instruct the client to press the provided button each time fetal movement is detected.
apply cabbage leaves to the breasts.
a nurse is planning discharge for a client who is 3 days postpartum. which of the following nonpharmacological interventions should the nurse include in the plan of care for lactation suppression? a. place warm, moist packs on the breasts. b. apply cabbage leaves to the breasts. c. wear a loose fitting bra. d. put green tea bags on the breasts.
obtain a 30 min electronic fetal monitoring strip prior to induction.
a nurse is preparing a client who is in active labor for epidural analgesia. which of the following actions should the nurse take? a. have the client stand at the bedside with her arms at her side. b. administer 500 mL bolus of 5% dextrose in water prior to induction. c. inform the client the anesthetic effect will last for approximately 6 hours. d. obtain a 30 min electronic fetal monitoring strip prior to induction.
vigorously shake the contents of the vial before drawing up the medication.
a nurse is preparing to administer medroxyprogesterone to a client. which of the following actions should the nurse plan to take? a. massage the injection site for 15 seconds after administration. b. vigorously shake the contents of the vial before drawing up the medication. c. administer the medication every 4 to 6 weeks after menstruation. d. teach the client that fertility returns within one month of stopping the medication.
flaccid uterus. excess vaginal bleeding.
a nurse is preparing to administer oxytocin to a client who is postpartum. which of the following findings is an indication for the administration of the medication? select all that apply. a. flaccid uterus. b. cervical laceration. c. excess vaginal bleeding. d. increased afterbirth cramping. e. increased maternal temperature.
palpate the client's fundus to identify the fetal part. determine the location of the fetal back. palpate for the fetal part presenting at the inlet. palpate the cephalic prominence to identify the attitude of the head.
a nurse is preparing to perform leopold maneuvers for a client. identify the sequence the nurse should follow.
I will eat foods that taste good instead of balancing my meals.
a nurse is providing dietary teaching to a client who has hyperemesis gravidarum. which of the following statements by the client indicates an understanding of the teaching? a. i will eat foods that taste good instead of balancing my meals. b. i will avoid having a snack before i go to bed each night. c. i will have a cup of hot tea with each meal. d. i will eliminate products that contain dairy from my diet.
i will resume taking my prenatal vitamins i will call my doctor if i have discharge from my incision i should not have unrelieved pain in my abdomen
a nurse is providing discharge teaching to a client who is 3 days postop following a c-section. which of the following client statements should indicate to the nurse that the teaching is effective? select all that apply. a. i am likely to have a fever during the first week i am home. b. i will resume taking my prenatal vitamins. c. i will call my provider if i have discharge from my incision. d. i should not have unrelieved pain in my abdomen. e. i will rest in my recliner until my incision is healed.
you should leave the diaphragm in place for at least 6 hr after intercourse.
a nurse is providing teaching about family planning to a client who has a new prescription for a diaphragm. which of the following statements should the nurse include in the teaching? a. you should replace the diaphragm every 5 years. b. you should leave the diaphragm in place for at least 6 hr after intercourse. c. you should use an oil based product as a lubricant when inserting the diaphragm. d. you should insert the diaphragm when your bladder is full.
placenta previa
a nurse is reviewing the electronic medical record for a client who is at 39 weeks of gestation and has a prescription for oxytocin. which of the following findings is a contraindication for the medication? a. placenta previa. b. bishop score of 10. c. vertex presentation. d. fetal heart rate of 120/min.
anticonvulsants
a nurse is reviewing the health history of a client who has a new prescription for a combined oral contraceptive. the nurse recognizes that which of the following client medications can interfere with the effectiveness of the COC? a. antihypertensives b. anticonvulsants c. antioxidants d. antiemetics.
platelet 50,000/mm3
a nurse is reviewing the lab findings of a client who is at 37 weeks of gestation and has hypertension. which of the following results should the nurse notify the provider? a. bun 19 b. hct 37% c. creatinine 0.9 d. platelet 50000
hgb 10 g/dL
a nurse is reviewing the lab results for a client who is at 10 wks of gestation. which of the following lab findings should the nurse report to the provider? a. hgb 10 g/dL b. wbc 15000/mm3 c. rbc count 5.8 million/mm3 d. hct 34%
preeclampsia
a nurse is reviewing the medical history of a client who is at 30 weeks of gestation and has a prescription for terbutaline. which of the following conditions should the nurse identify as a contraindication for the administration of terbutaline? a. hypothyroidism. b. preeclampsia. c. history of ectopic pregnancy. d. RA
platelets 50,000/mm3
a nurse is reviewing the medical record of a client who is postpartum and has preeclampsia. which of the following laboratory results should the nurse report to the provider? a. Hct 39% b. serum albumin 4.5 g/dL c. WBC 9,000/mm3 d. platelets 50,000/mm3.
oligohydramnios
a nurse is reviewing the medical record of a newly admitted client who is at 32 weeks of gestation. which of the following conditions is an indication for fetal assessment using electronic fetal monitoring? a. oligohydramnios. b. hyperemesis gravidarum. c. leukorrhea. d. periodic tingling of the fingers.
prepare for birth of the fetus
a nurse is reviewing the results of a biophysical profile for a client who is at 37 weeks gestation. the nurse notes the results are 3 out of 10. which of the following actions should the nurse plan to take? a. prepare for birth of the fetus. b. assess the client's deep tendon reflexes. c. initiate fundal massage. d. administer a tocolytic medication.
before menstruation begins.
a nurse is speaking with a 35 year old client who has fibrocystic disease of the breasts. at which of the following times should the nurse inform the client that manifestations are most evident? a. before menstruation begins. b. after menstruation ends. c. during cold weather. d. during hot weather.
SOB
a nurse is teaching a client who has a new prescription for combined oral contraceptives about potential adverse effects of the medication. for which of the following findings should the nurse instruct the client to notify the provider? a. SOB b. breakthrough bleeding. c. vomiting. d. breast tenderness.
i will continue taking my insulin if i experience n/v.
a nurse is teaching a client who has pregestational type 1 diabetes mellitus about management during pregnancy. which of the following statements by the client indicates an understanding of the teaching? a. i should have a goal of maintaining my fasting blood sugar between 100 and 120. b. i should engage in moderate exercise for 30 minutes if my blood glucose is 250 or greater. c. i will continue taking my insulin if i experience n/v. d. i will ensure that my bedtime snack is high in refined sugar.
a blood glucose of 130 to 140 is considered a positive result.
a nurse is teaching a client who is at 24 weeks of gestation regarding a 1 hr glucose tolerance test. which of the following statements should the nurse include in the teaching? a. you will need to drink the glucose solution 2 hours prior. b. limit your carb intake for 3 days prior. c. a blood glucose of 130 to 140 is considered a positive result. d. you will need to fast for 12 hours prior to the test.
you will be offered orange juice to drink during the test.
a nurse is teaching a client who is at 36 weeks of gestation and has a prescription for a nonstress test. which of the following statements should the nurse include in the teaching? a. you will receive IV fluids prior to this test. b. the procedure will take approximately 10 to 15 minutes. c. you will be offered orange juice to drink during the test. d. you will need to sign an informed consent form each time you have this test.
i will have blood tests because my potassium might decrease.
a nurse is teaching a client who is in preterm labor about terbutaline. which of the following statements by the client indicates an understanding of the teaching? a. i will get injections of the medication once daily until my labor stops. b. my blood sugar may be low while i'm on this medication. c. i will have blood tests because my potassium might decrease. d. my blood pressure may increase while i'm on this medication.
spinach and beef
a nurse is teaching a client who is postpartum and has been diagnosed with iron deficiency anemia. which of the following dietary recommendations should the nurse include in the teaching plan? a. yogurt and mozzarella b. spinach and beef c. milk and turkey slices. d. fish and cottage cheese.
stop suctioning when the newborn's cry sounds clear.
a nurse is teaching a new mother how to use a bulb syringe to suction her newborn's secretions. which of the following instructions should the nurse include? a. insert the syringe tip before compressing the bulb. b. suction each of the nares before suctioning the mouth. c. insert the tip of the syringe into the center of the mouth. d. stop suctioning when the newborn's cry sounds clear.
staff members who take care of your baby will be wearing a photo id.
a nurse is teaching a postpartum client about steps the nurses will take to promote the security and safety of the client's newborn. which of the following statements should the nurse make? a. the nurse will carry your newborn to the nursery for procedures. b. we will document the relationship of visitors in your medical record. c. your baby will stay in the nursery while you are asleep. d. staff members who take care of your baby will be wearing a photo id.
the test is a screening tool for chromosomal syndromes.
a nurse is teaching about the quadruple marker screen to a client who is pregnant. which of the following information should the nurse include in the teaching? a. the sample is collected during an amniocentesis. b. the test is a screening tool for chromosomal syndromes. c. the test uses ultrasound to measure the fetus. d. the screening is done before 12 weeks of gestation.
you should take the medication within 72 hours following unprotected intercourse.
a school nurse is providing teaching to an adolescent about levonorgestrel contraception. which of the following info should the nurse include in the teaching? a. you should take the medication within 72 hours following unprotected intercourse. b. you should avoid taking this medication if you are on an oral contraception. c. if you don't start your period within 5 days of taking this medication, you may be pregnant. d. one dose of this medication will prevent you from becoming pregnant for 14 days after taking it.
mammograms
ages 50-74 twice per year for prevention/early detection
hyperglycemia
an adverse effect of terbutaline
hypokalemia
an adverse effect of terbutaline
hypotension
an adverse effect of terbutaline
sickle cell anemia s/s
anemia decreased Hgb pain swelling of the hands and/or feet frequent infections delayed growth vision problems
necrotizing enterocolitis therapeutic management
antibiotics DC oral feeds gastric suction parenteral nutrition to rest intestines surgery if perforation occurs
ED treatment options
drugs: erectogenic: PDES inhibitors: causes smooth muscle relaxation with increased blood flow into corpus cavernosum with penile erection onset of erection in 30-60 minutes once a day only contraindicated if taking nitrates r/t potentiating the hypotensive effects
left mentoposterior
baby faces left and back with back on right anterior side with face presenting
left mentoanterior (LMA)
baby faces left and front with back on right anterior side with face presenting
Left Occipitoanterior (LOA)
baby faces right and back with top of the head presenting
Left occipitoposterior (LOP)
baby faces right and front with the top of the head presenting
true labor
back discomfort that spreads to the abdomen
diaphragm
barrier method 94% effective when used correctly 82% effective with typical use
small for gestational age
below the 10th percentile
acceleration
can occur at any time during labor
accelerations
caused by fetal movement, vaginal examination, electrode application, and fetal scalp stimulation.
respiratory distress syndrome
caused by insufficient production of surfactant
latent phase of stage 1 labor
cervical dilation of 0-3 cm and contractions every 5-30 minutes lasting 30-45 seconds
transition phase of stage 1 labor
cervical dilation of 8-10 cm and contractions every 2-3 minutes lasting 45-90 seconds
dinoprostone
cervical ripening agent that also increases contractions
latent phase of stage 1 labor
cervix 0-6 cm with contractions every 10-30 minutes lasting 30-40 seconds with moderate intensity
active phase of stage 1 labor
cervix 6-8 cm with contractions every 2-5 minutes and lasting 40-60 seconds with moderate to strong intensity
transition phase of stage 1 labor
cervix 8-10 cm with contractions every 1.5-2 minutes lasting 60-90 seconds with strong intensity
misoprostol
cervix ripening agent that stimulates contractions
bronchopulmonary dysplasia
chronic lung disease occurs mostly in infants weighing <1500 g at birth mortality rate of 10-25% results from high levels of oxygen use, oxygen free radicals, high PPV that damage the bronchial epithelium results in inflammation, atelectasis, edema, airway hyperactivity with loss of cilia, thickening of walls of airway, and fibrotic changes
variable
cord compression
placenta accreta
d&c after
periventricular-intraventricular hemorrhage nursing considerations
daily head measurements observe for changes in neurological status keep handling to minimum reduce environmental stressors strict I&O to prevent fluid overload
severe variable deceleration
deep dip on monitor
stage 3 of labor
delivery of the placenta (usually within 20-30 minutes of delivery of the fetus) need to check the color and presentation of the placenta
manifestations of periventricular-intraventricular hemorrhage
depend on severity of hemorrhage lethargy, poor muscle tone, decreased resp status with cyanosis or apnea, decreased HCT, decreased reflexes, bulging fontanels, seizures
second cardinal movement
descent
hyperemesis gravidarum
detect and treat complications assist medical management
once
explain the importance of follow up examination and reculture at least ___________ after treatment if appropriate to confirm complete cure and prevent relapse.
all, 1-2
explain the importance of taking ___ antibiotics as prescribed. symptoms will improve after ____ days of therapy, but organisms may still be present
seventh cardinal movement
expulsion
fifth cardinal movement
extension
spina bifida occulta
external indications of this neural tube defect include a dimpled area over the defect and the presence of a birthmark or hairy patch above the area.
ROA
facing left and back with chin tucked and the top of the head presenting
ROP
facing left and front with the top of the head presenting
third cardinal movement
flexion
stage 4 of labor
immediate recovery, 1-4 hours post birth patient will either be in the delivery area or postpartum area
ED treatment/goal
goal: satisfactory sexual relationship treatment will nto restore tactile sensation or ejaculation if absent before treatment started is it reversible? psychological counseling
late deceleration
gradual, symmetrical decrease in FHR with it returning to baseline after contraction ends
gonorrhea
gram negative diplococcus
increases
having one STI __________________ the risk of acquiring another STI
early
head compression
presentation
head first, breach, etc.
intrauterine devices
hormonal IUD copper IUD
combo pill
hormonal contraceptive 99% effective when used correctly 96% effective with typical use
hormonal patch
hormonal contraceptive 99% effective when used correctly 98% effective with typical use
hormonal ring
hormonal contraceptive 99% effective when used correctly 98% effective with typical use
minipill
hormonal contraceptive 99% effective with correct use 95% effective with typical use
HELLP syndrome management
hospitalization lower BP prevent with mag sulfate correct coagulopathies blood or FFP to treat hemolytic anemia steroids for fetal lungs prepare for preterm delivery
lie
how baby sits in uterus
HIV
human immunodeficiency virus that can lead to acquired immune deficiency syndrome
HPV
human papillomavirus: genital warts
+1
inching out
necrotizing enterocolitis manifestations
increased abdominal girth increased gastric residuals decreased or absent bowel sounds loops of bowel seen through abdominal wall vomiting signs of infection occult blood in stool
manifestations of bronchopulmonary dysplasia
increased need for ventilation inability to wean from vent tachycardia, tachypnea, retractions, rales, wheezing, resp acidosis, increased secretions, bronchospasms
increased BMI
increased risk of breast cancer
methylergonovine
increases strength and duration of contractions to slow/stop heavy postpartum bleeding
substernal chest retractions
indicate respiratory distress syndrome
labor and delivery
intrapartum
sickle cell complications
ischemic stroke acute chest syndrome pulmonary HTN organ damage blindness priapism
anti-infective
kills and inhibits growth of bacteria
STI risk factors
longer sexual life span increased number of hosts r/t increased population more sexual freedom less barrior method use (condoms) increased media emphasis on sex substance abuse that decreases inhibition, and increases poor judgment
huntington disease
lots of treatments to manage the s/s but no cure
barriers
male condom female condom cervical cap diaphragm contraceptive sponge spermicide
breast cancer screenings
mammogram clinical breast exam breast MRI
spina bifida manifesta
manifests in the form of a myelomeningocele that is closed. external indications of this neural tube defect include a herniated sac over the site of the defect that is covered with skin.
every 2 weeks
maternal/fetal assessments 29-36 weeks gestation
weekly
maternal/fetal assessments 37 weeks to birth
herpes
medications: valacyclovir (valtrex), famvir, acyclovir primary outbreak, recurring outbreak, suppressive therapy
gynecoid pelvis
most favorable pelvis for successful labor.
breast cancer warning signs
new lump thickening/swelling irritation or dimpling redness, flaky skin discharge from nipple pain
gestational HTN
new onset of elevated BP >140/90
false labor
no cervical change
120 days
normal lifespan of RBC
8-10
normal scoring for biophysical profile
autosome
numbered chromosome
150,000-300,000
platelets normal range for a newborn < 24 hours old
herpes
prevalence: 80-90% population carry HSV 1 40-50% carry HSV 2 (90% of these do not know)
herpes
primary outbreak is the longest and most severe
3 types of down syndrome
robertsonian translocation mosaic down syndrome trisomy 21
subcutaneously
route of terbutaline administration given every 4 hr for no longer than 24 hr
retinopathy of prematurity therapeutic management
screen infants at risk to detect changes in eye laser photocoagulation for advancing ROP reattachment of retina
necrotizing enterocolitis
serious inflammation of intestinal tract that can lead to cellular death of intestinal mucosa mortality rate 25-30% 25% of survivors has long term intestinal probs immaturity of intestines thought to be major cause interference of blood supply to intestines
dominant gene
shows no matter what
recessive gene
shows only if inheriting from both parents
mild variable deceleration
slightly dipped on monitor
goodell's sign
softening of the cervix
metastasis
spreads to other areas
invasive
spreads to other tissues
surgical sterilization: male
sterilization 99% effective correctly or typically
surgical/nonsurgical sterilization: female
sterilization 99% effective correctly or typically
bacterial or viral
sti may be __________ or _____________
functional ED
stress or anxiety
focused assessment
subjective: past health history: contact with individual with STIs, multiple sexual partners, pregnancy medication: use of oral contraceptives, allergy to any antibiotics, especially penicillins review of systems: shared needles if IV drug use, malaise, n/v, anorexia, pharyngitis, oral lesions, itching at infected site, chills, alopecia, UTI symptoms, urethral discharge, proctitis, anthralgia, HA, painful/burning lesions, dysparenia, menstrual abnormalities.
chlamydia
symptoms: discharge burning on urination dyspareunia vaginal bleeding between periods lower abdominal and back pain rectal pain/anal sex sore throat - oral sex with infected individual
abruptio placentae
tender abdomen
sti prevention
tertiary: prevent reinfection, manage symptoms, take viral meds as ordered, maintain healthy lifestyle
huntington disease treatment
tetrabenazine haloperidol antidepressants antipsychotics speech therapy PT and OT
infection
the greatest risk following an amniotomy
orange juice during nonstress test
the high glucose stimulates fetal movement during the procedure helping to obtain results.
mode of transmission
the link in the chain of infection that needs to be broken
android pelvis
the typical male pelvis; in the woman, the heart shape of the android pelvis is not favorable to a vaginal delivery
diagnostic mammograms
to determine cancer and monitor potential changes
gonorrhea
treatment: ceftriaxone (rocephin) 250 mg IM PLUS azithromycin 1 gram PO
HIV
weight loss malaise dry cough white spots in the mouth or throat or tongue recurring fever lymphadenopathy
gonorrhea
women: typically asymptomatic redness swelling at site of contact green/yellow purulent exudate dysuria
