NURSG 5432-400 Module 3 Questions With Complete
Solutions
How are hemorrhoid managed pharmacologically during
pregnancy? Correct Answers Refer to PLLR
Anusol
Witch hazel
Stool softners
How are hemorrhoids managed non pharmacologically during
pregnancy? Correct Answers High fiber diet
Increased fluids
Avoid straining
Avoid sitting on toilet for long periods
Warm sitz baths
Ice pack prn
How are the symptoms managed for Klinefelter's syndrome?
Correct Answers REFERRAL TO PEDIATRIC OR ADULT
ENDOCRINOLOGIST
Start testosterone @ age 11-12; titrate to normalize FSH, LH
levels
Gynecomastia treated w/aromatase inhibitors (anastrazole) or
SERMs (clomiphene, tamoxifen)
Speech therapist
Genetic counseling
,How does smoking affect breastfeeding? Correct Answers
Reduces prolactin levels & milk vol
Impairs taste, composition & protective properties
Nicotine excreted in breast milk @3 x mother's plasma levels
Increases infant respiratory infections, cardiac rhythm disorders,
leukemia risk, obesity, & allergies
Increases risk of colic in infant by 50%
How is ankle edema managed during pregnancy? Correct
Answers Hydration
Optimal caloric/protein intake; limit sodium
Elevate legs
Twice daily rest x 1 hr
Avoid restrictive bands around legs
Support hose
Foot massage, reflexology
Lt lateral position for maximizing venous return
How is breastfeeding jaundice managed? Correct Answers
Breastfeeding support & education
Frequent feedings optimally started 1 hr after birth
Assessment of adequate breast milk transfer
Avoid formula supplementation
Serum bilirubin measurement
Bilirubin blanket or lights
R/O pathological causes & ankyloglossia (tongue tie)
How is candidal infection of the breast managed? Correct
Answers Infant-Oral nystatin (Mycostatin)
Mother-Topical agent (antifungal)
Both need to be treated
,Apply sparingly after feedings
DO NOT FREEZE BREAST MILK; may contain fungal spores
Resistant cases may require oran fluconazole (200mg/d, then
100mg/d x 7-10d)
DO NOT USE fluconazole in combo w/ domperidone or EES d/t
potential for prolonged QT
How is engorgement prevented? Correct Answers Frequent
breastfeeding w/in first 48 hrs
Ongoing frequency of feedings w/effective latch
Supportive, nonrestrictive, well-fitting bra
Anticipatory guidance
How is GERD treated nonpharmacologic in pregnancy? Correct
Answers Lifestyle modifications
Eat sm meals more frequently
Avoid bending
Elevate head of bed
Avoid tight fitting close
Avoid bending
Avoid fried, fatty, spicy foods
Avoid eating 2-3 hrs before bed
Drinking less fluid during meals
Avoid constipation
How is GERD treated pharmacologic in pregnancy? Correct
Answers PLLR
H2 blockers; tums, maalox
Protein pump inhibitor: Lansoprazole
, How is inadequate letdown reflex managed? Correct Answers
Allow infant ample time to nurse
Massage breasts before nursing
Apply warm compresses before feeding
Use relaxation & breathing techniques
Adequate rest & nutrition
Referral to lactation consultant
How is PPD described? Correct Answers Major depression that
begins around 4 wks after delivery but may occur up to 12 wks
postpartum; interferes w/ADLs & requires tx; includes feelings
of sadness, despair, anxiety, & irritability to a severe degree
How is premature labor managed? Correct Answers Fetal
fibronectin (FFV) sample; + results indicates sac has separated
from uterus and expect delivery w/in 7 d
BPP-gestational age
Hospitalization
Tocolytic therapy (MgSO4, endomethacin, nifedipine,
terbutaline)
Beclomethasone steroid inj twice a week for <34wks for lung
development
Bed rest
If contractions subside, home w/oral tocolytics
Vag/bed rest
Weekly cervical checks
How is premature labor prevented? Correct Answers Identify
and eliminate risk factors
Assess every trimester
Educate warning signs
Solutions
How are hemorrhoid managed pharmacologically during
pregnancy? Correct Answers Refer to PLLR
Anusol
Witch hazel
Stool softners
How are hemorrhoids managed non pharmacologically during
pregnancy? Correct Answers High fiber diet
Increased fluids
Avoid straining
Avoid sitting on toilet for long periods
Warm sitz baths
Ice pack prn
How are the symptoms managed for Klinefelter's syndrome?
Correct Answers REFERRAL TO PEDIATRIC OR ADULT
ENDOCRINOLOGIST
Start testosterone @ age 11-12; titrate to normalize FSH, LH
levels
Gynecomastia treated w/aromatase inhibitors (anastrazole) or
SERMs (clomiphene, tamoxifen)
Speech therapist
Genetic counseling
,How does smoking affect breastfeeding? Correct Answers
Reduces prolactin levels & milk vol
Impairs taste, composition & protective properties
Nicotine excreted in breast milk @3 x mother's plasma levels
Increases infant respiratory infections, cardiac rhythm disorders,
leukemia risk, obesity, & allergies
Increases risk of colic in infant by 50%
How is ankle edema managed during pregnancy? Correct
Answers Hydration
Optimal caloric/protein intake; limit sodium
Elevate legs
Twice daily rest x 1 hr
Avoid restrictive bands around legs
Support hose
Foot massage, reflexology
Lt lateral position for maximizing venous return
How is breastfeeding jaundice managed? Correct Answers
Breastfeeding support & education
Frequent feedings optimally started 1 hr after birth
Assessment of adequate breast milk transfer
Avoid formula supplementation
Serum bilirubin measurement
Bilirubin blanket or lights
R/O pathological causes & ankyloglossia (tongue tie)
How is candidal infection of the breast managed? Correct
Answers Infant-Oral nystatin (Mycostatin)
Mother-Topical agent (antifungal)
Both need to be treated
,Apply sparingly after feedings
DO NOT FREEZE BREAST MILK; may contain fungal spores
Resistant cases may require oran fluconazole (200mg/d, then
100mg/d x 7-10d)
DO NOT USE fluconazole in combo w/ domperidone or EES d/t
potential for prolonged QT
How is engorgement prevented? Correct Answers Frequent
breastfeeding w/in first 48 hrs
Ongoing frequency of feedings w/effective latch
Supportive, nonrestrictive, well-fitting bra
Anticipatory guidance
How is GERD treated nonpharmacologic in pregnancy? Correct
Answers Lifestyle modifications
Eat sm meals more frequently
Avoid bending
Elevate head of bed
Avoid tight fitting close
Avoid bending
Avoid fried, fatty, spicy foods
Avoid eating 2-3 hrs before bed
Drinking less fluid during meals
Avoid constipation
How is GERD treated pharmacologic in pregnancy? Correct
Answers PLLR
H2 blockers; tums, maalox
Protein pump inhibitor: Lansoprazole
, How is inadequate letdown reflex managed? Correct Answers
Allow infant ample time to nurse
Massage breasts before nursing
Apply warm compresses before feeding
Use relaxation & breathing techniques
Adequate rest & nutrition
Referral to lactation consultant
How is PPD described? Correct Answers Major depression that
begins around 4 wks after delivery but may occur up to 12 wks
postpartum; interferes w/ADLs & requires tx; includes feelings
of sadness, despair, anxiety, & irritability to a severe degree
How is premature labor managed? Correct Answers Fetal
fibronectin (FFV) sample; + results indicates sac has separated
from uterus and expect delivery w/in 7 d
BPP-gestational age
Hospitalization
Tocolytic therapy (MgSO4, endomethacin, nifedipine,
terbutaline)
Beclomethasone steroid inj twice a week for <34wks for lung
development
Bed rest
If contractions subside, home w/oral tocolytics
Vag/bed rest
Weekly cervical checks
How is premature labor prevented? Correct Answers Identify
and eliminate risk factors
Assess every trimester
Educate warning signs
