Exam 1 nursing 3
After inoculation with HPV, genital warts may begin to grow. They usually manifest as soft, raised fleshy lesions on the external genitalia of either male or female. What is the incubation period for HPV-induced genital warts?
6 weeks to 8 months
APGAR scoring
A= appearance (color all pink, pink and blue, blue [pale]) P= pulse (>100, < 100, absent) G= grimace (cough, grimace, no response) A= activity (flexed, flaccid, limp) R= respirations (strong cry, weak cry, absent)
A pregnant client arrives for her first prenatal appointment. She reports her previous pregnancy ended at 19 weeks, and she has 3-year-old twins born at 30 weeks' gestation. How will the nurse document this in her records?
G3 T0 P1 A1 L2 G indicates the total number of pregnancies (2 prior, now pregnant = 3); T indicates term deliveries at or beyond 38 weeks' gestation (none = 0); P is for preterm deliveries (at 20 to 37 weeks = 1; multiple fetus delivery are scored as 1); A is for abortions or pregnancies ending before 20 weeks' gestation (1); and L refers to living children which is 2. Thus, G3 T0 P1 A1 L2 is what the nurse should note in the client's record.
A pregnant woman comes to the clinic for a prenatal visit for her third pregnancy. She reveals she had a previous miscarriage at 12 weeks and her 3-year-old son was born at 32 weeks. How should the nurse document this woman's obstetric history?
G3, T0, P1, A1, L1 The woman's obstetric history would be documented as G3, T0, P1, A1, L1. G (gravida) = 3 (past and current pregnancy), T (term pregnancies) = 0, P (number of preterm pregnancies) = 1, A (number of pregnancies ending before 20 weeks viability to include miscarriage) = 1, and L (number of living children) = 1.
Which event is associated with the primary stage of syphilis?
Genital chancres
A client infected with HIV comes into the clinic. What symptoms may be the focus of a medical complaint in women infected with HIV?
Gynecologic problems
Newborn vital signs
HR 110-160 RR 40-60 BP 60-80 systolic; 40-50 diastolic Temp 97.9 to 99.5 F
Which STI could be transmitted perinatally?
Herpes simplex
A female client presents at an STD clinic. She is in the first trimester of pregnancy and has tested positive for gonorrhea. Because strains of N. gonorrhoeae have become resistant to penicillin, the current treatment recommendation includes:
High-dose cefixime given in a single dose
A man 68 years of age comes to the clinic complaining that he is having difficulty obtaining an erection. When reviewing the client's history, what might the nurse note that contributes to impotence?
History of hypertension
newborn heart
Postnatally the fetal structures of foramen oval, ductus arterioles, + ductal venosus should close - if they do not, cardiac + pulmonary compromise will develop
The provider is assessing a client with a history of erectile dysfunction (ED) who is requesting a prescription for treatment. When assessing for additional information related to causes of ED, which information should the provider solicit from the client?
Presence of arterial occlusive disease
PP hemorrhage VS findings:
Tachycardia and hypotension
A school health nurse is providing education to a group of adolescents regarding the proper procedure for male condom use. The nurse knows the teaching has been effective when which statement is made by a student?
Withdraw the penis erect, holding the condom firmly against the penis
Which of these cardiac variations, if found in the client who is pregnant, should the nurse recognize as a normal finding in pregnancy?
Soft systolic murmur A soft systolic murmur is common in pregnancy secondary to the increased blood volume. The other findings are not normal and require further assessment by the nurse.
A primigravida client has come to the clinic for a prenatal checkup. What teaching topics would help to promote a healthy pregnancy for this client?
Swimming in a pool is a recommended exercise during pregnancy.
The nurse in the urology clinic is reviewing the chart of a client with erectile dysfunction. Which factor in the client's history does the nurse recognize is a hormone-based condition that may contribute to erectile dysfunction?
hypogonadism
The nurse is caring for a newborn whose pregnant parent drank an undetermined amount of alcoholic beverages. Which assessment technique does the nurse use to identify if the newborn has common findings of fetal alcohol spectrum disorder?
inspection
A client is experiencing symptoms associated with menopause. What is a likely recommendation to increase the client's interest in sexual activity?
low-dose androgens Low-dose androgens are added to the hormone replacement regimen to restore an interest in sexual activity.
A postmenopausal female client diagnosed with osteoporosis asks the nurse how a decrease in estrogen can cause problems with bone density. Which statement is the best response from the nurse?
"A decrease in estrogen levels, which occurs at menopause, results in increased resorption of bone."
A woman is to undergo chorionic villus sampling as part of a risk assessment for genetic disorders. What statement would the nurse include when describing this test to the woman?
"A small piece of tissue from the fetal placenta will be removed and analyzed."
The nurse is discussing the physical changes related to menopause with a 48-year-old woman. The client asks, "How long will it take before I am through these changes and finally reach menopause?" Which statement is an appropriate response by the nurse?
"Most women experience symptoms for about 4 years."
Which statement would be most appropriate when explaining endometriosis as a cause of a woman's infertility?
"Ovulation does take place; however, the misplaced endometrial tissue interferes with transport of the ovum."
The nurse is caring for a client diagnosed with preeclampsia-eclampsia in the third trimester of pregnancy. Which information should the nurse provide the client about this condition?
"This is a serious condition that can affect your kidney function and how your blood clots."
A primigravida at her 12-week prenatal visit expresses concern that she hasn't felt her baby move yet. What is the best response from the nurse?
"You usually cannot feel them until approximately 16 to 20 weeks."
Newborn Reflexes: Moro
"startle reflex" elicited by a sudden stimulus - the infant flails out and then draws inward. The movement should be symmetrical. This disappears by age 3-4 months. infant makes an "embracing" motion by arching back, extending legs, throwing arms outward, and the bringing arms in toward the body (may have helped infant cling to mother)
Episiotomy and Lacerations
(Episiotomy)-the surgical enlargement of the vagina during birth, the physician preforms a repair on an episiotomy. (Laceration)- is an uncontrolled tear of the tissue that results in a jagged wound
NST (non-stress test)
**reactive vs. non reactive know difference** Widely used method of evaluating fetal status [alone or as part of biophysical profile (BPP)] Adequately oxygenated fetus with intact fetal central nervous system *should demonstrate accelerated fetal heart rate (FHR) in response to fetal movement* - you want to see an increase when baby moves!! Avoid supine position Reactive (desired result) If decelerations are noted, notify doctor for further evaluation of fetal status
Rhogam is given when?
- Given at 28 weeks, & 72 hours post partum, IM. - Only needs to be given to Rh NEGATIVE mother
umbilical cord care
- Observe for any bleeding from cord - Ensure that the cord is clamped securely to prevent hemorrhage -keep clean, dry, clean stump with water, watch swelling/redness/purulent d/c - fold diaper edge down to keep stump dry - will fall of after 7-14 days
nipple care
- vary infant position - proper removal from the breast - do not use soap on the nipples - lanolin - expose nipples to air - breast shell
Menopause signals the end of the menstrual cycle. It is caused by the end of ovarian function and the decreased levels of estrogen this brings to the body. What problems can arise from the onset of menopause? Select all that apply.
-Nocturia -Urinary stress incontinence -Vaginitis
Episiotomy care
-Perineal care; (wait 24hrs)fill a squeeze bottle with warm water and an ounce of povidone/iodine solution; lavage perineum with several squirts and blot dry instead of rubbing; avoid anal area -Use sitz baths -apply ice packs right after the birth -take ibuprofen for pain -Keep the area around the stitches clean and dry REPORT: episiotomy, lacteration or incision pain that does not resolve with analgesics/ could smelling drainage, redness, or incision pain
bottle feeding
-formula should be iron-fortified -necessary for women with infectious illnesses -does not reduce emotional bonding between mother and baby
risk for postpartum hemorrhage
-multiple gestation -excessive amniotic fluid -big baby (>8lb 13oz) -labor longer than 24 hrs -anesthesia
Normal FHR
110-160 bpm
A woman is to undergo quad screening testing. The nurse would anticipate that this test would be done at which time?
16 weeks gestation
A woman comes to the clinic for her first prenatal visit. As part of the assessment, the woman is screened for rubella antibodies. The nurse determines that a client has immunity against rubella based on which rubella titer?
1:8
Post Partum Hemorrhage treatment
1st line: Uterine massage 2nd: Meds: *Oxytocin*, methylergonovine, carbopost tromethamine
Umbilical cord/Ava
2 arteries and 1 vein Artery - carry deoxygenated blood Vein - carry oxygenated blood Artery
The nurse is assessing a client at her first prenatal visit and notes the fundal height is palpable at the level of the umbilicus. The nurse predicts the client is at which gestational age?
20 weeks
Testosterone therapy would be recommended for all these patients except for a:
35-year-old male with erectile dysfunction due to diabetes mellitus.
At which gestational age will the nurse no longer associate fundal height directly with week's gestation?
36 weeks
According to the DASH diet, how many servings of vegetables should a person consume each day?
4 or 5
Mag therapeutic level
4-7
The nurse is preparing to assess a new client who has arrived for her initial visit with a gynecologist specializing in menopause issues. The nurse anticipates the client will be in which age group?
47-55
Which client is at greatest risk for the impairment of spermatogenesis?
A 15-year-old male who is diagnosed with mumps orchitis
A primipara at 36 weeks' gestation is being monitored in the prenatal clinic for risk of preeclampsia. Which sign or symptom should the nurse prioritize?
A dipstick value of 2+ for protein
A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis?
A painless genital ulcer that appeared about 3 weeks after unprotected sex
respiratory distress syndrome (RDS)
A respiratory disorder that affects premature infants born without enough surfactant in the lungs. It is treated with respiratory support and surfactant administration
A client is diagnosed with chlamydia and gonorrhea and is receiving azithromycin as treatment. In addition to this medication, the nurse anticipates that the client will also be prescribed which drug?
Ceftriaxone
A G4P3 client with a history of controlled asthma is upset her initial prenatal appointment is taking too long, making her late for another appointment. What is the nurse's best response when the client insists she knows how to handle her asthma and needs to leave?
Acknowledge her need to leave but ask her to demonstrate the use of inhaler and peak flow meter before she goes; remind her to take regular medications.
Probable/presumptive signs of pregnancy are?
All urine and blood tests, Chadwick's sign, Goodell's sign, Hegar's sign
During the physical examination at the first prenatal visit a speculum examination is performed and a bluish-colored cervix is noted. How will the nurse interpret this finding?
Chadwick sign
The nurse is reviewing the uses and side effects of azithromycin. For which infection is azithromycin the antibiotic of choice?
Chlamydial
post partum hemorrhage
Bleeding in excess of 500cc after delivery. FUNDAL MASSAGE and put infant to breast. Place pad over vaginal opening and treat for shock, elevate hips.
PP hemorrhage
Blood loss of more than 500ml for vag birth and more than 1000 for c-section. Complications can include anemia and hypovolemic shock. If uterus is found to be boggy, massage until firm. Provide O2 @2 - 3 LPM NC to increase RBC saturation, elevate pt's legs to promote venous return.
LGA (large for gestational age)
Defined as a newborn who's weight is above the 90th percentile or more than 8 lb 12 oz
SGA (small for gestational age)
Defined as a newborn whose birth weight is at or below the 10th percentile and who has intrauterine growth restriction
Issues with premature infants
Difficulty regulating body temperature Risk of nutrient deficiencies Bonding Retinopathy (eye disease) Anemia, respiratory distress syndrome, necrotizing enterocolitis, Peri ventricular - intraventricular hemorrhage, delays
A woman, who is 18 weeks' gestation, is at a follow-up appointment regarding the test results of alpha-fetoprotein testing. Which would the nurse suspect with if the woman has low levels of alpha-fetoprotein?
Down syndrome
When is syphilis highly contagious?
During its primary stage
What can cause erectile dysfunction?
Dysfunction of pudendal nerves
Which finding is most worrisome in a client in her 26th week of pregnancy?
Facial edema Generalized hair loss, hyperpigmented maxillary rash (chloasma), and nosebleeds are usually benign and common in pregnancy. Facial edema after the 24th week of gestation may indicate gestational hypertension.
The client is asking if there is a pill that can be ordered to control the symptoms of menopause. Which assessment finding is most important in determining nursing care in association with hormone replacement therapy?
Family history of breast cancer The risk of endometrial or breast cancer in women prescribed HRT may outweigh the benefits of relieving symptoms of menopause and preventing kyphosis or hip fractures associated with osteoporosis.
The primary care provider has prescribed estrogen replacement therapy (ERT) for a menopausal woman who has been diagnosed with pelvic organ prolapse (POP). The client asks the nurse why she needs to be on hormones. Which would be the nurse's best response?
Hormone replacement will increase blood perfusion and the elasticity of the vaginal wall.
A client asks how his condition, Condylomata acuminata, is caused. What is the nurse's bestresponse?
Human papillomavirus (HPV) is the cause of your condition."
best contraceptive method
IUD
A pregnant woman tells the nurse she often has allergic responses to drugs. She is concerned that she will be allergic to her fetus or her body will reject the pregnancy. The nurse's reply would be based on which statement?
Immunologic activity is decreased during pregnancy.
placenta previa risk factors
Increased maternal age, multiple gestation, history of placenta previa, uterine scarring/tumors, and closely spaced pregnancies.
nipple care
Instruct mother to clean nipples with water no soap and dry thoroughly; expose breast to air. Advise mother to lubricate the nipples with a few drops of expressed breast milk before feeding. Wear breast pads and to replace often to reduce risk of infections.
A 51-year-old woman has been experiencing signs and symptoms of perimenopause and has sought help from her family physician. A deficiency in estrogen levels has been determined to be a contributing factor. Which phenomenon could potentially underlie the woman's health problem?
Insufficient estrogen production within the smooth endoplasmic reticulum of the relevant cells.
A 54-year-old diabetic client has come to the urology clinic complaining of erectile dysfunction. His history includes obesity, coronary artery disease which required bypass graft 3 years ago, hypertension, and gout. The nurse practitioner is reviewing his record in order to prescribe medication. The practitioner is considering prescribing sildenafil. Which home medication is contraindicated if taken concurrently with sildenafil?
Isosorbide mononitrate, a vasodilator
Dark room for preeclamptic Moms- what do you they do? And caution?
Lay on left side and quiet to decrease stimuli Seizure precautions
The nurse is reviewing laboratory values of a 70-year-old female client and observes the client's low-density lipoprotein (LDL) level is elevated. The nurse understands a possible reason for this is:
Long-term estrogen deprivation
A male client presents at the clinic with flulike symptoms and reports a weight loss of 10 pounds without trying. On physical examination, the client is found to have splenomegaly and large, tender, fluctuant inguinal lymph nodes. While taking the nursing history, it is discovered that the client prefers male sexual partners, and that 2 weeks ago the client had small, painless papules. What disease would the nurse suspect the client has?
Lymphogranuloma venereum
Neuroprotactant
Mag sulf
PP depression
Manifests by 4w after delivery (pp blues never went away) mild-moderate. Mood swings, irritability, food cravings, guilt. Function can be affected. Requires psychiatric interventions Occurs within the first 12 months Unable to safely care for herself or Baby
When screening for a sexually transmitted disease (STD), a microscopic evaluation of a discharge culture reveals hyphae and a pH level of 4.2. Which conditions are not likely to present based on these findings? Select all that apply
N. gonorrhoeae C. trachomatis T. vaginalis
A client requests a prescription for sildenafil to assist him with achieving and maintaining an erection. Which type of medication would contraindicate the use of sildenafil?
Nitrate
MAB
Non viable, retained for 6 weeks
A woman reports that her last menstrual period (LMP) occurred February 1, 2017. Using the Naegele rule, what would be her estimated date of delivery (EDD)?
November 8, 2017
A client is diagnosed with early latent syphilis of unknown duration. Which medication treatment will the nurse expect to be prescribed for this client?
Penicillin G benzathine, three intramuscular injections at 1-week intervals
The nurse knows that for a client who still has her ovaries intact, estrogen must be paired with what other drug when used to treat menopausal symptoms?
Progestins When estrogen is used to treat menopausal symptoms in a woman with an intact uterus, progestins must also be used to decrease the risk of endometrial cancer. Antispasmodics are used to treat issues of the bladder. Androgen hormone inhibitors are used to treat benign prostatic hypertrophy. Aromatase inhibitors are used to treat breast cancer.
APGAR test/score
Quick assessment performed 1 and 5 minutes after birth to determine need for resuscitation. Measure appearance, pulse, grimace, activity, and respiratory effort. Score of 8-10 is normal, 4-6 is moderate depression, and 0-3 requires aggressive resuscitation.
magnesium toxicity symptoms
RR less than 20 & urine output less then 30 ml
The nurse is instructing a client who will be taking finasteride for treatment of benign prostatic hypertrophy and gives the client information about which possible sexual side effects? (Select all that apply.)
Reduced libido • Impotence • Shriveled testicles • Decreased volume of ejaculate
Babinski reflex
Reflex in which a newborn fans out the toes when the sole of the foot is touched
sucking reflex
Reflex that causes a newborn to make sucking motions when a finger or nipple if placed in the mouth
Change it to the body system at birth
Resp:newborns =increase O2 contributes to closing of the lungs ductus arteriosus (becomes a ligament) Heart: pressure from left to right greater causing foremen oval to close Hepatic: (liver) Ductus venosus closes (becomes a ligament)
Meconium Aspiration Syndrome (MAS)
Respiratory disease of term, postterm, and SGA newborns caused by inhalation of meconium or meconium-stained amniotic fluid into the lungs; characterized by mild to severe respiratory distress, hyperexpansion of the chest, hyperinflated alveoli, and secondary atelectasis.
newborn reflexes
Rooting, sucking, grasping, moro reflex (startle), Babinski
The nurse is caring for a client who is at 37 weeks' gestation and has a biophysical profile of 10. Which nursing action is best?
Schedule a health care provider appointment for one week.
A female client experiencing hot flashes during perimenopause asks the nurse about hormone therapy (HT). What is the appropriate response by the nurse?
Short term HT can be used to reduce symptoms.
The nurse is preparing to teach a client how to conduct the basal body temperature method to determine her fertile window. Which instruction should the nurse prioritize?
Temperature should be taken prior to any activity every morning.
At a prenatal class, the nurse educator describes the function of the placenta. What information would the nurse likely include? Select all that apply.
The placenta makes hormones to control the way the fetus is supplied with nutrients and oxygen. The placenta removes the waste products that the fetus produces. The placenta stimulates the mother to bring more food to the placenta. The placenta produces hormones that ready fetal organs for life outside the uterus.
A college student has just received a positive HIV test result. How can the nurse most accurately interpret and respond to this finding?
The student has HIV antigens and further testing should be done.
Why is mag sulfate given to a mother 24 hours before a premie is to be delivered?
To reduce incidence of cerebral palsy (brain protectant)
When to give magnesium sulfate
Traditional tocolytic of choice for preterm labor; also used for treatment of preeclampsia to prevent progression to E
Labor pain management
Tranquilizers (ataractics and phenothiazines) like phenergan and vistaril, are used in labor as analgesic-potentiating drugs to decrease the amount of narcotic needed and to decrease maternal anxiety. Agonist narcotic drugs (morphine) produce narcosis and have a higher risk for causing maternal and fetal respiratory depression. Antagonist drugs (Stadol, Nubain) have less respiratory depression but must be used with caution in a mother with preexisting narcotic dependency because withdrawal symptoms occur immediately
Breast engorgement Treatment
Treatments to reduce the pain of breast engorgement include heat or cold applications, cabbage leaf compresses, breast massage and milk expression, ultrasound, breast pumping, and antiinflammatory agents. A nonprescription antiinflammatory medication can also be taken for the breast discomfort and swelling resulting from engorgement. These measures will also enhance the let-down reflex. Between feedings, applying cold compresses to the breasts helps reduce swelling. To maintain milk supply, the breasts need to be stimulated by a nursing infant, a breast pump, or manual expression of the milk.
A nurse is interviewing a client about issues with infertility. Which condition contributes to the risk of infertility in both men and women?
Trichomoniasis
A nurse practitioner is examining a female client who presents with symptoms of pain during intercourse. The nurse notes the presence of small hemorrhagic areas on the cervix. Based on this observation, which sexually transmitted infection does the nurse suspect?
Trichomoniasis
While educating a group of adolescents about sexually transmitted infections, the nurse will mention which infection that is more prevalent than gonorrhea and considered to be a marker for high-risk sexual behavior?
Trichomoniasis
RhoGAM
Used to prevent an immune response to Rh positive blood in people with an Rh negative blood type
VEAL CHOP
V- Variable C- Cord Compression E- Early Decels H- Head Compression A- Accelerations O - OK L-Late Decels P - Placenta
has been assessed and prescribed sildenafil (Viagra). When providing patient education to this man, the nurse should tell him:
You might find that your face becomes flushed or you get a headache after you take Viagra."
A woman is 40 years old and a heavy smoker. She has a single sexual partner but has very irregular menstrual cycles. She wants a highly reliable contraceptive. Which method would be the best recommendation?
a diaphragm and spermicide Women over 40 who smoke should not take ovulation suppressants; irregular menstrual cycles make natural methods difficult; women over 40 may have vaginal dryness, so a spermicidal suppository would not be activated.
postpartum psychosis
a severe postpartum psychological disorder that may include delusions, hallucinations, and extreme mental disorganization Requires immediate hospitalization At risk for harming self and infant psychiatric consultation; psychosocial therapy, pharmacotherapy, ECT treatment has been successful for those unresponsive to pharmacotherapy
Which possible complication associated with back pain can lead to premature contractions?
bladder or kidney infection
Labor pain management may include which one(s) of the following interventions? (Select all that apply.) A. Cool, damp washcloths on the face and neck B. Decreasing bright lights in the room C. Keeping the woman clean and dry D. Administering pain medication as ordered E. Offering simple snacks every 2 hours
a. Cool, damp washcloths on the face and neck b. Decreasing bright lights in the room c. Keeping the woman clean and dry d. Administering pain medication as ordered Providing comfort measures are important during labor. A laboring woman may have clear liquids by mouth but no solid food during active labor.
A client has been prescribed a PDE5 inhibitor for penile erectile dysfunction. Medication education should strongly discourage the use of what drug classification while on this medication?
alpha blockers
A patient with erectile dysfunction is receiving an injection directly into the cavernosum. The nurse identifies this drug as:
alprostadil
Presumptive signs of pregnancy
amenorrhea, nausea, breast tenderness, deepening pigmentation, urinary frequency, quickening
The nurse discovers a new prescription for Rho(D) immune globulin for a client who is about to undergo a diagnostic procedure. The nurse will administer the Rho(D) immune globulin after which procedure?
amniocentesis
grasping reflex
an infant's clinging response to a touch on the palm of his or her hand
The nurse is describing changes in the male that occur with aging and parallel the changes that occur in women. The nurse is describing:
andropause
stillborn
born dead (death of fetus after 20 weeks of pregnancy)
A nurse at the health care facility assesses a client at 20 weeks' gestation. The client is healthy and progressing well, without any sign of complications. Where should the nurse expect to measure the fundal height in this client?
at the level of the umbilicus Explanation: In the 20th week of gestation, the nurse should expect to find the fundus at the level of the umbilicus. The nurse should palpate at the top of the symphysis pubis between 10 to 12 weeks' gestation. At 16 weeks' gestation, the fundus should reach halfway between the symphysis pubis and the umbilicus. With a full-term pregnancy, the fundus should reach the xiphoid process.
A nurse is working with a patient in the clinic who has erectile dysfunction. The patient has been prescribed sildenafil (Viagra). The patient wants to do everything he can to promote effectiveness of the drug. The nurse will instruct him to
avoid taking the drug with a high-fat meal.
A woman experiencing menopausal symptoms asks the nurse about herbal products that might help. Which would the nurse include in the response?
black cohosh
Antidote for magnesium sulfate
calcium gluconate
displaced fundus
can indicate increased bleeding or bladder distention
A client comes to the clinic and informs the nurse that he is having difficulty obtaining and maintaining an erection, which had never happened before. When assessing the client, which system should the nurse be sure to focus on?
cardiovascular system
A client with a family history of cervical cancer is to undergo a Papanicolaou test. During the client education, what group should the nurse include as at risk for cervical cancer?
clients who have genital warts Explanation: The presence of genital warts (condyloma) increases the risk of developing cervical cancer. Women with metrorrhagia or irregular menstrual cycles are at an increased risk of developing breast cancer, not cervical cancer. Clients who have never had a baby or those with a history of fibrocystic breast disease have an increased risk of developing breast cancer, but not cervical cancer.
A woman calls the prenatal clinic and says that she thinks she might be in labor. She shares her symptoms over the phone with the nurse and asks what to do. The nurse determines that she is likely in true labor and that she should head to the hospital. Which symptom is an indicator of true labor?
contractions beginning in the back and sweeping forward across the abdomen
Leiomyomas are smooth-muscle fibroid tumors that usually develop in which part of the reproductive system?
corpus of uterus
Which finding from a woman's initial prenatal assessment would be considered a possible complication of pregnancy that requires reporting to a primary care provider for management?
episodes of double vision
Breast feeding benefits
decrease incidence of SIDS and breast and ovarian cancer, appropriate weight gain, decrease risk of obesity in childhood, decrease allergens, prevention/reduction in diarrhea, decrease in respiratory infections, bacterial infections, UTI and denser bones, decrease childhood cancer.
jaundice of newborn
during first 24 hours: jaundice is pathological (r/t liver problems) after 24 hours: physiological jaundice r/t inc amount of unconjugated bilirubin in system
What is the most common early symptom of a sexually transmitted infection?
dysuria
A nurse is reviewing the history and physical examination of a client diagnosed with secondary dysmenorrhea for possible associated causes. Which etiology would the nurse need to keep in mind as being the most common?
endometriosis Secondary dysmenorrhea is painful menstruation due to pelvic or uterine pathology. Endometriosis is the most common cause of secondary dysmenorrhea. Other recognized causes include adenomyosis, fibroids, pelvic infection, an intrauterine device, cervical stenosis, or congenital uterine or vaginal abnormalities.
Probable signs of pregnancy
examiner suspects a women is pregnant. such as abdominal enlargement, hegar's sign(softening and compressibility of the lower uterus), chadwick's sign (deepened violet-bluish color of the cervix and vaginal mucosa), goodell's sign(softening of the cervical tip), ballottement, braxton hicks, positive pregnancy test, fetal outline felt by examiner.
A nurse is conducting a presentation about prenatal care and preexisting maternal conditions. When discussing the various risks to the mother and infant, the nurse would include information about which condition as the leading cause of intellectual disability in the United States?
fetal alcohol spectrum disorder Fetal alcohol spectrum disorder is a lifelong yet completely preventable set of physical, mental, and neurobehavioral birth defects. It is the leading cause of intellectual disability in the United States.
Fundus after birth
funudus steadily descends into the pelvis fundal height decreases one finger breadth (1cm) per day after 10 days fundus is no longer palpable abdominally. A flaccid fundus indicates of uterine atony and should be massaged until firm. A tender fundus indicates an infection. Should be below the umbilicus.
23-year-old sexually active woman tells the nurse practitioner that she is worried because she has been having abnormal vaginal bleeding, dysuria, and weird vaginal discharge. What sexually transmitted infection would the nurse suspect?
gonorrhea
A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection?
gonorrhea Gonorrhea can be transmitted to the newborn in the form of ophthalmia neonatorum during birth by direct contact with gonococcal organisms in the cervix. The newborn would develop congenital syphilis if exposed in utero. Exposure to Candida would cause thrush in the newborn. Exposure to HIV during gestation could lead to the birth of an HIV-positive newborn.
A young woman comes to the walk-in clinic seeking treatment for chronic chlamydia trachomatis. Which finding is most likely because it often correlates with this diagnosis?
gonorrhea There is a common co-infection of chlamydia and gonorrhea when chlamydia is not treated with the necessary antibiotic medication combination. Anemia does not correlate with chlamydia, and there is no evidence that it precipitates liver disease. CNS disorders would be from syphilis.
GTPAL
gravida, term births, preterm births, abortions, living children
Newborn evaporation
heat loss from moisture on skin as result of wet linens, diapers, hair wet from bath or insensible water loss from lungs
An 18-year-old pregnant woman asks the nurse why she has to have a routine alpha-fetoprotein serum level drawn. The nurse explains that this:
may reveal chromosomal abnormalities.
A client is receiving tamoxifen. Which adverse effect would be most specific to the action of this drug?
menopausal effects
Newborn conduction
movement of heat away from the body when newborns have direct contact with objects that are cooler than their skin, cold hands, stethoscope, scale, or circumcision board
A nurse is reviewing the history of a client diagnosed with pelvic inflammatory disease. Which factors would the nurse identify as placing the client at increased risk for this condition? Select all that apply.
multiple sex partners vaginal douching approximately once a week intrauterine contraceptive device inserted 3 weeks ago
The nurse is advising a pregnant woman during her first prenatal visit regarding the frequency of future visits. Which schedule is recommended for prenatal care?
once every 4 weeks for the first 28 weeks, then every 2 weeks until 36 weeks, and then weekly until the birth
A female client has the Huntington's disease gene. She and her husband want to have a child but are apprehensive about possibly transmitting the disease to their newborn child. They have strong views against abortion (elective termination of pregnancy). They would also like to have their "own" child and would consider adopting only as a last resort. Which action would be mostappropriate in this situation?
opting for a preimplantation genetic diagnosis
Taking-hold phase (Rubin)
second maternal adjustment phase usually lasts several weeks after the delivery. This phase is characterized by both dependent and independent behavior, with increasing autonomy.
A young woman is newly married and is seeking advice on contraception. She is in a monogamous relationship and would like a temporary contraceptive, as she plans to have children in the future. Her husband dislikes the feel of condoms. Also, she mentions that she typically experiences dysmenorrhea and has a history of recurrent urinary tract infections. Which method should the nurse recommend?
oral contraceptive pills (OCPs)
A woman comes to the clinic for an evaluation. During the visit, the woman tells the nurse that her menstrual cycles have become irregular. She states, "I've also been waking up at night feeling really hot and sweating." How should the nurse interpret these findings?
perimenopause
Letting-go phase (Rubin)
phase in which the mother reestablishes relationships with others and accepts her new role as a parent.
A perimenopausal woman asks for help in selecting a contraceptive. She reports vaginal dryness during intercourse and says that her partner does not like the feel of condoms. Which method should the nurse recommend?
spermicide
During a routine prenatal visit, a client is found to have 1+ proteinuria and a blood pressure rise to 140/90 mm Hg with mild facial edema. The nurse recognizes that the client has which condition?
preeclampsia without severe features Explanation: A woman is said to have gestational hypertension when she develops an elevated blood pressure (140/90 mm Hg) but has no proteinuria or edema. If a seizure from gestational hypertension occurs, a woman has eclampsia, but any status above gestational hypertension and below a point of seizures is preeclampsia. A woman is said to have preeclampsia without severe features when she has proteinuria and a blood pressure rise to 140/90 mm Hg, taken on two occasions at least 6 hours apart and mild facial or extremity edema. A woman has progressed to preeclampsia with severe features when her blood pressure rises to 160 mm Hg systolic and 110 mm Hg diastolic or above on at least two occasions 6 hours apart at bed rest (the position in which blood pressure is lowest) or her diastolic pressure is 30 mm Hg above her prepregnancy level. Marked proteinuria, 3+ or 4+ on a random urine sample or more than 5 g in a 24-hour sample, and extensive edema are also present. A woman has passed into eclampsia when cerebral edema is so acute a tonic-clonic seizure or coma has occurred.
Leading cause of death in newborns
prematurity
When a 19-year-old male client tells the nurse that he has never been able to achieve an erection, the nurse recognizes that the client is experiencing:
primary impotence. Explanation: Primary impotence refers to a man who has never been able to achieve an erection necessary for intercourse; secondary impotence refers to a man who was once successful in attaining and maintaining erections but who has subsequently experienced difficulty. Causes of impotence, whether primary or secondary, can be physiologic, psychological, or both. Certain manifestations may indicate the probability that the problem is secondary to a physiologic or a psychological factor.
Which hormone is associated with menopause? Select all that apply.
progesterone • estrogen
Screening for which disease process should be done prior to beginning testosterone replacement therapy?
prostate cancer
Which two tests are generally performed on urine at a prenatal visit?
protein and glucose Explanation: Protein is assessed to help detect hypertension of pregnancy; glucose is assessed to help detect gestational diabetes.
A client who is taking estrogen therapy calls the clinic and tells the nurse that she is experiencing sudden, sharp chest pain. The nurse suspects the client is experiencing what adverse reaction related to estrogen therapy?
pulmonary embolism
Types of Heat loss in a Newborn
radiation, evaporation, conduction, convection
As part of a 31-year-old client's prenatal care, the nurse is assessing immunization history. Which immunization is most relevant to ensuring a healthy fetus?
rubella Maternal exposure to rubella during pregnancy poses a particular fetal risk that supersedes the significance of hepatitis, measles, diphtheria, tetanus, or pertussis.
Newborn Reflexes: Rooting
stroke cheek near corner of mouth (helps infant find nipple) Sucking - infant sucks finger (permits feeding)
1 minute/ 1 contraction pattern if not
tachystole
A nurse is preparing a class on the various drugs used to treat erectile dysfunction. Which would the nurse include?
tadalafil
Phases of maternal postpartum adjustment
taking-in phase, taking-hold phase, letting-go phase.
placenta previa
the abnormal implantation of the placenta in the lower portion of the uterus implantation of the placenta over the cervical opening or in the lower region of the uterus
meconium
the greenish material that collects in the intestine of a fetus and forms the first stools of a newborn
TAKING IN PHASE (POST PARTUM)
the time immediately after birth (1-2 days) when the client needs sleep, depends on others to meet her needs, and relives the events surrounding the birth process. This phase is characterized by dependent behavior. They help mom integrate the birth experience into reality When interacting with the newborn, new mothers spend time claiming the newborn and touching them, and identifying specific features in the newborn,
placenta previa s/s placental abrution s/s
there is no pain, but there is bleeding (bright red) there is pain, but no bleeding (board like abd)
A couple has chosen fertility awareness as their method of contraception. The nurse explains that the unsafe period for them during the menstrual cycle would be at which time?
three days before and three days after ovulation Typically, the unsafe period during the menstrual cycle is approximately 3 days before and 3 days after ovulation. An ovum is released from the ovary 14 days before the next menstrual period.
Newborn senses
touch, taste, smell, hearing, vision
Newborn radiation
transfer of heat from heated body to cooler surfaces
Newborn convection
transfer of heat from the infant to cooler surrounding air when drafts come from open doors, air conditioning, or air currents
baby blues
transitory symptoms of depression in a mother 24 to 48 hours after her baby is born Characterize by emotional lability, crying, easily and for no apparent reason, a let-down feeling, restlessness, fatigue, insomnia, headache, sadness, anger Symptoms are usually mild and short lived The "blues" are normal *Can take care of self and baby *
The nurse is performing a health history of a client being evaluated for erectile dysfunction. Which disorder places the client at highest risk for the erectile dysfunction?
type 2 diabetes
Lochia rubra, serosa, and alba
vaginal discharge after birth 1) rubra = delivery to day 3; dark red, contains mostly blood 2) serosa = day 4-10; pink, contains old blood, serum, leukocytes, tissue debris 3) alba= day 10-6 weeks; white, leukocytes, epithelial cells serum bacteria SHOULD NEVER REGRESS
A nurse is planning strategies to address factors that affect sexual dysfunction in older adults. Which interventions would be appropriate? Select all that apply.
• Educate elderly patients, intimate partners, and family about the sexual side effects of specific medications. • Assist in attitude and value clarification about substance use, sexuality, and sexual behavior. • Encourage elderly patients to have a thorough physical evaluation by a health care provider. • Provide an open, nonjudgmental response when older patients display a need for warmth, close contact, and companionship.
PP hemorrhage meds
• Oxytocin (pitocin) Promotes uterine contraction • Methylergonovine Controls PP bleed Don't give to HTN pt • Misoprostol Control PP bleed • Carboprost tromethamine Control PP bleed
