NUR 507 Exam 3
Bacterial Vaginosis - correct answer-S/S:
50-75% asymptomatic
Unpleasant, fishy smell
White/gray thin discharge
Less common S&S: pruritus, dyspareunia, erythema, inflammation
Treatment:
Metronidazole (oral or vaginal)
Clindamycin (oral or vaginal)
Tinidazole (oral)
Benign Breast Conditions - correct answer-Fibrocystic:
The most common benign breast problem
Condition, not a disease
Typically occurs in women in the 20s and 30s
No known etiology
Thought to be hormonally related
Palpable lumps or thickenings in the breast
Usually bilateral
Mobile
Tender
Fluctuate w/ menstrual cycle
Risk Factors:
Nulliparity
Low parity
Late menopause
Estrogen Therapy
Treatment:
Conservative Measures
Salt Restrictions
Caffeine Restrictions
Vitamin E
Primrose Oil Capsules
Support Bra
Heat
NSAIDS
Fibroadenoma:
,Solid mass
Unilateral
Size does not alter with menstrual cycle
Usually non tender
Found in UOQ
Mobile
Diagnostics
Ultrasound
Mammogram
MRI
Possible FNA
Excision if suspicious
Treatment
Periodic observation, Mammography
Possible excision
Lipoma
Bilirubin - correct answer-Conjugated (direct):
Water soluble, converted form which is excreted by colon & kidneys
Unconjugated (indirect):
Fat soluble, unconverted form derived from the breakdown of RBCs
Produces jaundice & can cause kernicterus (neurotoxicity)
Value at birth <3 mg/dl
Range: 4 mg-12 mg within 3 days
Blood Coagulation - correct answer-Immature liver hinders coagulation
Gut sterile at birth
Intestinal flora (bacteria) needed to synthesize vitamin K
Vitamin K given IM at birth
Blood Transfusions - correct answer-Whole Blood or blood component transfusion
Decreases risk of circulatory overload
15ml/kg (usual amount)
10ml/kg/hr (usual rate)
Isotonic solution
Safety:
Typing and cross-matching
Prevention of infections
Consent
Baseline VS
, Careful administration
Reactions:
Most occur within first 15 minutes
Hemolytic Reaction:
RBC destruction that occurs due to incompatibility
May be immediate or delayed
Signs / Symptoms??
Treatment: Fluids, corticosteroids, vasopressors
Febrile Reaction:
Occurs when recipient develops antibodies to a component of the transfused product
S/S: fever, chills, diaphoresis
Treatment: Acetaminophen and corticosteroids
Prevention
Pre-treat with antipyretic and corticosteroids
Use leukocyte depleted blood products
Allergic Reaction:
Non-hemolytic reaction
Occurs when donor blood contains plasma proteins or other antigens to which the recipient
is hypersensitive
Prevention
Pre-treat with antihistamine and corticosteroid
"Wash" red blood cells before transfusing
Carbohydrate Metabolism - correct answer-Glycogen stored in liver & converts after birth
before feedings are started
Glucose: 50-60 mg
Neonatal stress depletes glycogen stores
Results of low glucose:
Respiratory distress
Apnea
Lethargy
Tremors/convulsions
Bacterial Vaginosis - correct answer-S/S:
50-75% asymptomatic
Unpleasant, fishy smell
White/gray thin discharge
Less common S&S: pruritus, dyspareunia, erythema, inflammation
Treatment:
Metronidazole (oral or vaginal)
Clindamycin (oral or vaginal)
Tinidazole (oral)
Benign Breast Conditions - correct answer-Fibrocystic:
The most common benign breast problem
Condition, not a disease
Typically occurs in women in the 20s and 30s
No known etiology
Thought to be hormonally related
Palpable lumps or thickenings in the breast
Usually bilateral
Mobile
Tender
Fluctuate w/ menstrual cycle
Risk Factors:
Nulliparity
Low parity
Late menopause
Estrogen Therapy
Treatment:
Conservative Measures
Salt Restrictions
Caffeine Restrictions
Vitamin E
Primrose Oil Capsules
Support Bra
Heat
NSAIDS
Fibroadenoma:
,Solid mass
Unilateral
Size does not alter with menstrual cycle
Usually non tender
Found in UOQ
Mobile
Diagnostics
Ultrasound
Mammogram
MRI
Possible FNA
Excision if suspicious
Treatment
Periodic observation, Mammography
Possible excision
Lipoma
Bilirubin - correct answer-Conjugated (direct):
Water soluble, converted form which is excreted by colon & kidneys
Unconjugated (indirect):
Fat soluble, unconverted form derived from the breakdown of RBCs
Produces jaundice & can cause kernicterus (neurotoxicity)
Value at birth <3 mg/dl
Range: 4 mg-12 mg within 3 days
Blood Coagulation - correct answer-Immature liver hinders coagulation
Gut sterile at birth
Intestinal flora (bacteria) needed to synthesize vitamin K
Vitamin K given IM at birth
Blood Transfusions - correct answer-Whole Blood or blood component transfusion
Decreases risk of circulatory overload
15ml/kg (usual amount)
10ml/kg/hr (usual rate)
Isotonic solution
Safety:
Typing and cross-matching
Prevention of infections
Consent
Baseline VS
, Careful administration
Reactions:
Most occur within first 15 minutes
Hemolytic Reaction:
RBC destruction that occurs due to incompatibility
May be immediate or delayed
Signs / Symptoms??
Treatment: Fluids, corticosteroids, vasopressors
Febrile Reaction:
Occurs when recipient develops antibodies to a component of the transfused product
S/S: fever, chills, diaphoresis
Treatment: Acetaminophen and corticosteroids
Prevention
Pre-treat with antipyretic and corticosteroids
Use leukocyte depleted blood products
Allergic Reaction:
Non-hemolytic reaction
Occurs when donor blood contains plasma proteins or other antigens to which the recipient
is hypersensitive
Prevention
Pre-treat with antihistamine and corticosteroid
"Wash" red blood cells before transfusing
Carbohydrate Metabolism - correct answer-Glycogen stored in liver & converts after birth
before feedings are started
Glucose: 50-60 mg
Neonatal stress depletes glycogen stores
Results of low glucose:
Respiratory distress
Apnea
Lethargy
Tremors/convulsions
