NURS 629 MVU exam 1
How do you measure fundal height - correct answer symphysis pubis to top of uterus
When can you start to hear fetal heart
... [Show More] tones? - correct answer around 12 wks
What is quickening? - correct answer fetal movements felt by the mother
When is quickening felt - correct answer between 16-20 weeks
Abnormal Complaints in first trimester - correct answer 1st trimester: Vaginal bleeding
Book: spotting, bleeding, cramping, painful urination, severe vomiting and/or diarrhea, fever > 100.4, symptoms of vaginal infection or STI; persistent or severe low abdominal pain, lightheadedness or dizziness (particularly if accompanied by shoulder pain)
What vaccines should be avoided during pregnancy? - correct answer Live vaccines: MMR ,HPV, varicella, and live attenuated influenza vaccine
What labs are drawn at first visit? - correct answer CBC, RH (antibody screen) & TYPE, HIV, RPR, MMR TITER, HEP B TITER, R/O STI's, FULL UA
What info is obtained at first OB visit? - correct answer PMH, Fx history, Genetic hx (mom & dad)
What is indicated when clu cells are seen? - correct answer BV
What is the treatment for BV - correct answer metronidazole (Flagyl) 500mg BID x 7 days
What are presumptive (subjective) signs of pregnancy? - correct answer Amenorrhea, N/V, FATIGUE, urine frequency, breast changes, quickening, pigment, striae
What are probable (objective) signs of pregnancy? - correct answer + HCG, enlarged Abdo, fetal outline, Balloment, Braxton, Chadwick's, Goodall's, Hegar's signs
What are positive signs of pregnancy? - correct answer Fetal HT, U/S, fetal movement
What does a bluish cervix indicate? - correct answer Chadwick's sign
How to use Nageles rule - correct answer + 7 days - 3 mos
What are signs of preeclampsia? - correct answer rapid weight gain, edema to hands and face, HTN, H/A, visual changes, proteinuria, epigastric pain
What is the treatment of preeclampsia? - correct answer Bedrest, (nifedipine, hydralazine) if severe delivery of the fetus
What does HELLP stand for? - correct answer hemolysis, elevated liver enzymes, low platelets
S/S of HELLP - correct answer EDEMA, N/V, RUQ pain
What should 'at home' plan be for preeclampsia? - correct answer high protein diet, daily kick counts, wkly non-stress test & contraction monitor, monitor for hand and face edema, visual changes, B/P, epigastric pain
When will you see a drop in the fundal height? - correct answer at 36 weeks as the head drops into canal
When is subinvolution suspected - correct answer when lochia turns bright red with clots
How would you treat subinvolution? - correct answer Methergine 0.2mg PO TID for up to a week
what education should be given with a subinvolution? - correct answer if filling pad in an hour or lemon size clots go to ED, if fever culture discharge
Clinical presentation of mastitis? - correct answer unilateral breast red, painful, warm to touch usually clogged milk duct
What education do you give with mastatitis - correct answer Continue to BF, Pump if breast are still hard after feeding, warm compress
What B/C is used if still breastfeeding? - correct answer Progesterone only
When and how to screen for 1 hr GTT - correct answer between 24-28 wks, no need to fast, if over 140 then 3 hr GTT is needed
How is gestational diabetes diagnosed? - correct answer if the 1 hr gtt is >180 auto dx; if 3 hr gtt is 95 fasting, >180 @ 1hr, >153 @ 2 hr, >140 @ 3 hr
What is considered a good kick count? - correct answer 10 or more movements in 2 hrs
What are normal PAP guidelines? - correct answer 1st at age 21 regardless of sexual activity
Q 3 yrs until 29
Q 5 yrs 30-65
What can be used to treat nausea in pregnancy - correct answer zofran 4 mg up to 3 times a day, can cause Extrapyramidal symptoms (EPS) inform provider
What to educate on with N/V - correct answer keep a list of associated factors (food/activity), rest when nauseated, avoid stress & triggers (smells/sights), avoid tight clothing, meditation/relaxation techniques
What is the treatment for trichomoniasis - correct answer metronidazole (Flagyl) 2g, single-dose, notify partner, no sex for 7 days after treatment, educate on using condoms
How to treat vaginal candidiasis - correct answer Miconazole (monostat) cream or vaginal suppository QHS x 7 days
3 danger signs to report to provider - correct answer bleeding, severe cramping/abdo pain, painful urination
What to educate on intercourse during pregnancy - correct answer generally safe, but some contraindications are threatened miscarriage (spotting/bleeding), avoid inserting anything into the vaginal for at least 2 weeks after bleeding stops
screening tests in the 2nd trimester - correct answer 1 hr gtt, fetal anatomy scan (U/S)
how to prevent neural tube defect in first trimester - correct answer folic acid (400 MCG) and vitamins 3 months prior to pregnancy
What is the should average weight gain be for BMI of 18.5-24.9 - correct answer 25-35 pounds
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