MARYVILLE NURS 629 MVU EXAM 1 | 100% Correct Answers | Verified | Latest 2024 Version

MARYVILLE NURS 629 MVU EXAM 1 | 100% Correct Answers | Verified | Latest 2024 Version How do you measure fundal height - symphysis pubis to top of uterus When can you start to hear fetal heart tones? - around 12 wks What is quickening? - fetal movements felt by the mother When is quickening felt - between 16-20 weeks Abnormal Complaints in first trimester - 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? - Live vaccines: MMR ,HPV, varicella, and live attenuated influenza vaccine What labs are drawn at first visit? - 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? - PMH, Fx history, Genetic hx (mom & dad) What is indicated when clu cells are seen? - BV What is the treatment for BV - metronidazole (Flagyl) 500mg BID x 7 days What are presumptive (subjective) signs of pregnancy? - Amenorrhea, N/V, FATIGUE, urine frequency, breast changes, quickening, pigment, striae What are probable (objective) signs of pregnancy? - + HCG, enlarged Abdo, fetal outline, Balloment, Braxton, Chadwick's, Goodall's, Hegar's signs What are positive signs of pregnancy? - Fetal HT, U/S, fetal movement What does a bluish cervix indicate? - Chadwick's sign How to use Nageles rule - + 7 days - 3 mos What are signs of preeclampsia? - rapid weight gain, edema to hands and face, HTN, H/A, visual changes, proteinuria, epigastric pain What is the treatment of preeclampsia? - Bedrest, (nifedipine, hydralazine) if severe delivery of the fetus What does HELLP stand for? - hemolysis, elevated liver enzymes, low platelets S/S of HELLP - EDEMA, N/V, RUQ pain What should 'at home' plan be for preeclampsia? - 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? - at 36 weeks as the head drops into canal When is subinvolution suspected - when lochia turns bright red with clots How would you treat subinvolution? - Methergine 0.2mg PO TID for up to a week what education should be given with a subinvolution? - if filling pad in an hour or lemon size clots go to ED, if fever culture discharge Clinical presentation of mastitis? - unilateral breast red, painful, warm to touch usually clogged milk duct What education do you give with mastatitis - Continue to BF, Pump if breast are still hard after feeding, warm compress What B/C is used if still breastfeeding? - Progesterone only When and how to screen for 1 hr GTT - between 24-28 wks, no need to fast, if over 140 then 3 hr GTT is needed How is gestational diabetes diagnosed? - 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? - 10 or more movements in 2 hrs What are normal PAP guidelines? - 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 - zofran 4 mg up to 3 times a day, can cause Extrapyramidal symptoms (EPS) inform provider What to educate on with N/V - 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 - metronidazole (Flagyl) 2g, single-dose, notify partner, no sex for 7 days after treatment, educate on using condoms How to treat vaginal candidiasis - Miconazole (monostat) cream or vaginal suppository QHS x 7 days 3 danger signs to report to provider - bleeding, severe cramping/abdo pain, painful urination What to educate on intercourse during pregnancy - 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 - 1 hr gtt, fetal anatomy scan (U/S) how to prevent neural tube defect in first trimester - 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 - 25-35 pounds What OTC should be avoiding - Aspirin