NURS 629 exam 1 questions with correct solutions

NURS 629 exam 1 questions with correct solutions What are probable (objective) signs of pregnancy? - Hegar's sign goodells sign, chadwicks sign, ballottement, + pregnancy test, Braxton hicks fetal outline felt by examiner Presumptive (subjective) signs of pregnancy - amenorrhea (absence of menses) N/V excessive fatigue urinary frequency breast tenderness and skin changes quickening- mothers perception of fetal movement Positive (diagnostic) signs of pregnancy - Fetal Heartbeat Fetal Movement (felt by an examiner) Visualization of Fetus (ultrasound) 12 week fundal height - the fundus should be at the level of the symphysis pubis Naegele's Rule - add 7 days to LMP, subtract 3 months, add 1 year s/s of preeclampsia - HA, hyperreflexia, visual changes, irritability, RUQ pain, edema, proteinuria, HIGH BP Goodell's sign - softening of the cervix Chadwick's sign - Bluish-purple coloring vaginal mucosa and cervix Hegar's sign - softening of the lower uterine segment How do you measure fundal height? - -top of the pubic bone to the top of the uterus (fundus) cm= # of wks until 36 wks how often do you see your OB? - 0-28wk=4wks 28-36wks=2wks >36wks=every week placent previa vs abruption - abruption=detaches from uterus previa=placenta covers the cervix What vaccines are contraindicated in pregnancy? - MMR Varicella Live vaccines s/s mastitis - - -unilateral, warm, swollen -chills -body aches (flu-like s/s) Tx for mastitis? - abx? continue BF warm showers/compress Tx for morning sickness - *pyridoxine (vit b6)* *doxylamine* (unisom) antihistamine(unisom, Benadryl) antiemetics *(promethazine)* morning sickness education - small, frequent meals. crackers, ginger When is quickening felt? - 16-20 weeks When can you hear fetal heart tones? - 10-12 wks education for PIH - increase protein, kick counts, weekly NST, monitor for edema and s/s of pre-e GDM risks - neonatal hypoglycemia, microsomia Meds to avoid during pregnancy - NSAIDs, pepto, levaquin (certain abx), tetracyclines Labs at initial prenatal visit - CBC, hep B, RPR, Hcg, G/C, Rh factor, rubella, hep c, HIV. UA Pap smear guidelines - ages 21-29 pap every 3 years ages 30-65 cotesting every 5 years (if 2 normal paps) or pap alone every 3 >65 none unless cervical/uterine cancer Tx for UTI in pregnant women? - Macrobid, reflex, ampicillin (bactrim only 13-36wk) concerning s/s in pregnancy - vag bleeding, visual changes, decreased FM, palpitations, SOB at rest, oliguria A pt takes 1hr GTT and blood sugar is 156. What is next? - She must take 3hr glucose test. OCP counseling for breastfeeding mom - progestin only pill. IUD, depo, and diaphragm are other non pill options folic acid for pregnant women - 400mcg/day. Prevents neural tube defects s/s of HELLP - HTN, edema, HA, visual changes, RUQ pain, elevated LFTs, low platelets & H/H, proteinuria