NR 602 Midterm Exam Study Guide; Guaranteed A+ Guide; Latest Updated

Presumptive Signs of Pregnancy Amenorrhea, N&V, breast tenderness or changes, deepening pigmentation, urinary frequency, fatigue, increased basal body temperature, and quickening (at 16 weeks). Probable Signs of Pregnancy Goodell's sign (cervical softening at 4wk), Chadwick's sign (blue color of vagina & cervix at 6-8 wk), enlarged uterus, (+) urine or blood pregnancy test. Positive Signs of Pregnancy Palpation of fetus, ultrasound visualization of fetus, and fetal heart tones. 12 week Fundal Height The fundus should be at the level of the symphysis pubis 16 week Fundal Height The fundus should be between the symphysis pubis and umbilicus 20 week Fundal Height The fundus should be at the level of the umbillicus 25-35 week Fundal Height The fundus should measure from the symphysis pubis and correlate with with gestational week (+/- 2 cm) Naegele's Rule Add 7 days to LMP, subtract 3 months, add 1 year; Used to calculate due date Tier 1 Birth Control Fail rate 1%; IUD, DMPA (Depo), Progestin implant, sterilization Tier 2 Birth Control Fail rate 2-3%; OCP, COC's, transdermals, cervical ring. Tier 3 Birth Control Fail rate roughly 20%; Barrier methods, can protect against STIs Caldwell-Moloy Classification Four basic pelvic types: gynecoid, android, anthropoid, and platypelloid FSH Gonadotrophin: targets the ovaries, where it stimulates the growth and development of the primary follicles and results in the production of estrogen and progesterone. LH Gonadotrophin: targets the developing follicle within the ovary; it is responsible for ovulation, corpus luteum formation, and hormone production in the ovaries. Hypothalamus Releases gonadotropin-releasing hormone (GnRH) in a pulsatile manner to initiate negative feedback system. Stimulates gonadotrophins-FSH&LH release- Estrogen/Progesterone release- Pituitary gland notes Estrogen/Progesterone levels and regulates the cycle by altering further FSH/LH release. Ovarian Cycle The 28 days of the menstrual cycle as they apply to events in the ovary. The ovarian cycle has three subphases: the follicular phase, ovulation, and the luteal phase. Follicular Phase The first phase of the ovarian cycle, during which a follicle (an oocyte and its surroudning cells) enlarges and matures. This phase is under the control of FSH from the anterior pituitary, and typically lasts from day 1 to day 14 of the menstrual cycle. The follicle secretes estrogen during this time period. Ovulatory Phase The second stage of the general menstrual cycle, when the mature ovum is released. Approximately 10 to 12 hours after the LH peak Luteal Phase The third phase of the ovarian cycle, during which a corpus luteum is formed from the remnants of the follicle that has ovulated its oocyte. The corpus luteum secretes progestrone and estrogen during this time period, which typically lasts from day 15 to day 28 of the menstrual cycle. Formation of the corpul luteum is triggered by the same LH surge that triggers ovulation, however in the absence of LH (levels quickly decline after the surge) the corpus luteum begins to degenerate. Endometrial Cycle The 28 days of the menstrual cycle as they apply to the events in the uterus. The endometrial cycle is also known as the uterine cycle, and has the three subphases: menstruation, the proliferative phase, and the secretory phase. Menstruation phase Decline in progesterone levels causes functional layer of endometrium to discharge resulting in vaginal bleeding called menstruation. This marks the end of one cycle and the beginning of the next cycle. Begins with the initiation of menses and lasts 4 to 6 days Proliferative phase The second phase of the uterine (endometrial) cycle, during which the endometrium is "rebuilt". This phase of the cycle is under the control of estrogen, secreted from the follicle developing in the ovary during this time period. Typically lasts from day 6 to day 14 of the menstrual cycle. Secretory phase The third phase of the endometrial cycle, during which the "rebuilt" endometrium is enhanced with glycogen and lipid stores. Primarily under the control of progestone and estrogen (secreted from the corpus luteum during this time period);typically lasts from day 15 to day 28 of the menstrual cycle. Gravida The total number of pregnancies the woman has had (this number should total the TPAL numbers) Term Those occurring from 37 to 42 weeks' gestation Preterm Those occurring after the point of viability, which is usually interpreted as gestational age greater than 20 weeks and less than 37 weeks and/or fetal weight greater than 500 gm Abortions Abortions: spontaneous and induced prior to 20 weeks' gestation A Rating Recommendation to screening all women aged 21 to 65. for cervical cancer w/ PAP test every 3 years For women aged 30 to 65 who would like to lengthen the screening interval recommendation to co-testing with a combination of Pap test and human papillomavirus (HPV) testing every 5 years. D Rating Harms or potential harms outweigh the benefits and therefore recommends against Screening women younger than age 21 Screening women older than 65 years who have been screened adequately and who are not at increased risk for cervical cancer Screening women who have had a hysterectomy with removal of the cervix and have no history of high-grade precancerous lesions or cervical cancer Screening women younger than age 30 with HPV testing either with Pap test or alone