NURS 629 Exam 1 Study Guide | Latest Update 2024

NURS 629 Exam 1 Study Guide | Latest Update 2024. ○ Recommendations for discomforts during pregnancy Tylenol ○ Routine prenatal testing and important education that should go along with it Initial prenatal visit ● Lengthiest visit during pregnancy ○ Full medical history ○ Full physical exam ○ Lab work ○ Educa onal aspect At first visit ● Confirma on of pregnancy ○ Pregnancy test and ultrasound ● History ● Menstrual history (LMP) and obstetric history ● Past medical history ● Nutri on and habits: tobacco, alcohol, drugs ● Gene c history: mom, father and 1 st rela ve ● Social history including work, abuse, coping ● Current symptoms ● Physical exam and labs ○ Pelvic exam and pap smear ○ Blood type and an body screen ○ Rubella and hepa s B ter ○ GC, RPR, HIV, Hep C ○ CBC ○ Urinalysis with culture ○ UDS (?) Subsequent visits ● Every visit ○ Weight and BP 7 | Page ○ Quickening and fetal movement ○ Urine: blood, ketones, protein, glucose ○ Fundal height a er 17 weeks ○ Fetal heart tones a er 12 weeks Education: ● travel: avoid fa gue & stress ○ no flying a er week 30 ● Sex: ok unless bleeding, preterm labor, or placenta previa: then nothing in vaginal vault for 2 weeks a er stopped ● Nutri on, vitamin & iron supplementa on ○ Folic acid 400mcg = 0.4mg/day ○ non anemic: Iron 30mg/day ○ anemic: Iron 120mg/ day x 6 weeks ● Avoid heavy liing, fa gue, and stress ● Exercise: ok @ same level as pre pregnancy ● Smoking cessa on: nico ne replacement is ok ○ This will decrease risk of LBW, abrup on previa, fetal death, SIDs, pre-term labor, and premature rupture of membrane ● No alcohol: no safe amount ● Avoid OTC and herbal meds except what is ok ○ How to prevent neural tube defects Folic acid supplementa on: 400mcg/day ○ How to differentiate Trich , BV, and Candida infections and how to treat each Trichomonas ● Protozoa-based infecon ● Grey/yellow thin, foamy discharge, foul odor ● Itching/burning: vagina & cervix: strawberry spots ● + mo le protozoa on wet mount ● Treatment: metronidazole (Flagyl) 2g, single dose BV ● + whiff test ● Clue cells present on saline wet mount ● White-yellow malodorous or fishy smelling vaginal discharge, creamy consistency @ entrance of vagina, normal vagina, vulva, and cervix ● Vaginal discharge pH level above 4.5 ● Treatment: metronidazole (Flagyl) 500mg BID x 7 days or suppository vaginal of Metrogel x 5 nights; can use clindamycin in pregnancy or recurrent cases Candida infections ● Yeast infec on of the vaginal vault; white colored that is thick and curd like stuck to vaginal walls 8 | Page ● Vulva is erythematous & itching, no discharge to cervix ● + hyphae or Yeast buds on wet mount ● Treatment: Miconazole or Diflucan 150mg a single dose ○ Symptoms of various STIs Chlamydia ● Yellow odorless discharge, burning/itching, drainage on introitus & cervical os ● normal vulva, + purulent drainage to cervix ● Male partner may have itching/burning and penile discharge ● +WBC to wet mount ● Treatment: azithromycin 1 g single dose ● Reportable disease of health department ● Test of cure: 3 months Gonorrhea ● Yellow odorless discharge, burning/itching, drainage on introitus & cervical os ● normal vulva, + purulent drainage to cervix ● Male partner may have itching/burning and penile discharge ● +WBC on wet mount ● Treatment: ce riaxone 250mg IM injec on, single dose ● Must co-treat chlamydia ● Reportable disease of health department ● Test of cure: 3 months PID ● Inflamma on of the upper genital tract ● Dull, con nuous lower abdominal or pelvic pain ● Fever, voming, vaginal discharge, irregular vaginal bleeding ● Lateral mo on tenderness or cervix and adnexal ● Within a week a er onset of menses, depends on e ology ● Laboratory findings: leukocytosis, elevated ESR, elevated CRP; adnexal mass on u/s. ● Treatment: ce riaxone 250mg IM once, plus doxycycline 100mg BID x 14 days plus metronidazole 500mg BID x 14 days ○ How do you treat different forms of STIs? HPV: genital warts ● immiqoid cream, cryotherapy, podophyllin resin, T acid, B acid, or surgical removal ○ Guidelines for PAP smears Start at 21, regardless of sexual ac vity Every 3 years ll 29 Every 5 years 30 – 65 Excep ons to the rule