NUR2513 Concept Review – Final Exam
MODULE 1- GYN
• Management of dysmenorrhea
o Painful and/or heavy menstruation
▪ Management options will begin with NSAIDS:
▪ Ibuprofen- first line
▪ Naproxen
▪ Begin 1-2 days before expected onset of menses and continued throughout
duration of cycle
▪ Block prostaglandins that cause dysmenorrhea
• Other options for management include contraceptive methods intended to
regulate hormones or block menstruation
• In vitro fertilization- understand sperm and egg donation, storage
o Most often used for couples who have not been able to conceive because the woman
has obstructed or damaged fallopian tubes
o Also used when the man has oligospermia or a very low sperm count
o Donor ovum, rather than the woman’s own ovum, can be used for a woman who does
not ovulate or who carries a sex-linked disease she does not want to pass on to her
children.
o Oocytes chosen are incubated for at least 8 hours to ensure viability. In the meantime,
the male partner or donor supplies a fresh or frozen semen specimen
o Any eggs that are not used can be cryopreserved for use at a later time
• Breast self exam - what is normal and what is abnormal and should be reported?
o Breast examination is part of every annual gynecological examination and is done more
frequently for women who have a high risk for breast cancer. It is recommended at
yearly intervals for all women older than 20 years.
o All women after age 20 years should perform BSE at about the same time each month.
o The best time for BSE is 1 week after the beginning of the menstrual period.
o The woman who does regular BSE knows what is usual for her own breasts- she learns
what is normal for her
o ABNORMAL: changes in tissue such as new lumps, thickening, consistency of the skin,
and any nipple discharge in a woman who is not pregnant or lactating
MODULE 2- PREGNANCY
, • GTPAL statements
o Gravid-
▪ How many total pregnancies
• Term-
▪ How many pregnancies delivered at term
• Preterm-
▪ How many preterm deliveries
• Abortions-
▪ how many miscarriages or abortions
• Live births-
▪ How many living children were delivered
• EDC from LMP
o Naegel’s rule:
▪ LMP -3 months + 7 days (then add a year)= EDD
▪ LMP +280 days= EDD
• Manifestations of ARDS in newborn
o Respiratory distress syndrome
▪ Retractions
▪ Grunting
▪ Nasal flaring
• Assessing fetal position - how would you assess (know the positions), where would you find
heart tones
o Vertex head down
▪ Vertex- below the umbilicus
• Breech feet or bottom presenting first
▪ Breech- Above the umbilicus
• Transverseinfant is positioned transverse in the uterus
MODULE 3- PREGNANCY COMPLICATIONS AND LABOR
• Placenta previa: what is it and how would it manifest?
o The placenta is completely covering the cervical os
o Must be delivered via c-section
o Bedrest until bleeding stops
o Pelvic rest until previa resolves or delivery
o What will you see…
▪ Painless bright red vaginal bleeding, FHR may not be affected earlier on…as it
progresses, it can be potentially life threatening for both mom and baby
secondary to blood loss
, • Understand uterine hyperstimulation and appropriate management
o Hyperstimulation (i.e., tachysystole) is usually defined as five or more contractions in a
10-minute period or contractions lasting more than 2 minutes in duration or occurring
within 60 seconds of each other, situations that have the potential to interfere with
placenta filling and fetal oxygenation.
o The danger of hyperstimulation is that a fetus needs 60 to 90 seconds between
contractions in order to receive adequate oxygenation from placenta blood vessels.
o If uterine hyperstimulation should occur, several interventions such as asking the woman
to turn onto her left side to improve blood flow to the uterus, administering an IV fluid
bolus to dilute the level of oxytocin in the maternal blood stream, and administering
oxygen by mask at 8 to 10 L are all helpful.
o The surest method to relieve tachysystole, however, is to immediately discontinue the
oxytocin infusion..
o Because the half-life of oxytocin is approximately 3 minutes, the falling serum level and
effects are apparent almost immediately after discontinuation of IV administration.
o In addition, a primary care provider may prescribe terbutaline to relax the uterus.
• Drug use in pregnancy- what are appropriate assessments? What manifestations might be
observed?
o With longstanding use of opiate medications withdrawal symptoms may be observed in
the neonate
o In the instance of suspicion for illicit drug use, the nurse must document assessment
findings and communicate those to the ordering provider
▪ Urinalysis can be ordered to confirm the presence of illicit drug use in mom
• Some indications of illicit drug use:
▪ Abnormal behavior
▪ Vaginal bleeding and/or symptoms of placental abruption
▪ Nonreassuring FHR
• Signs and symptoms of placental abruption
o Contractions every minute
o Firm/rigid abdomen (uterus is not able to relax)
o Dark red vaginal bleeding
o NRFHR or fetal distress
o Management - intrauterine resuscitation and rapid delivery (usually C/S)
MODULE 4- POSTPARTUM
• Risk factors for postpartum hemorrhage
MODULE 1- GYN
• Management of dysmenorrhea
o Painful and/or heavy menstruation
▪ Management options will begin with NSAIDS:
▪ Ibuprofen- first line
▪ Naproxen
▪ Begin 1-2 days before expected onset of menses and continued throughout
duration of cycle
▪ Block prostaglandins that cause dysmenorrhea
• Other options for management include contraceptive methods intended to
regulate hormones or block menstruation
• In vitro fertilization- understand sperm and egg donation, storage
o Most often used for couples who have not been able to conceive because the woman
has obstructed or damaged fallopian tubes
o Also used when the man has oligospermia or a very low sperm count
o Donor ovum, rather than the woman’s own ovum, can be used for a woman who does
not ovulate or who carries a sex-linked disease she does not want to pass on to her
children.
o Oocytes chosen are incubated for at least 8 hours to ensure viability. In the meantime,
the male partner or donor supplies a fresh or frozen semen specimen
o Any eggs that are not used can be cryopreserved for use at a later time
• Breast self exam - what is normal and what is abnormal and should be reported?
o Breast examination is part of every annual gynecological examination and is done more
frequently for women who have a high risk for breast cancer. It is recommended at
yearly intervals for all women older than 20 years.
o All women after age 20 years should perform BSE at about the same time each month.
o The best time for BSE is 1 week after the beginning of the menstrual period.
o The woman who does regular BSE knows what is usual for her own breasts- she learns
what is normal for her
o ABNORMAL: changes in tissue such as new lumps, thickening, consistency of the skin,
and any nipple discharge in a woman who is not pregnant or lactating
MODULE 2- PREGNANCY
, • GTPAL statements
o Gravid-
▪ How many total pregnancies
• Term-
▪ How many pregnancies delivered at term
• Preterm-
▪ How many preterm deliveries
• Abortions-
▪ how many miscarriages or abortions
• Live births-
▪ How many living children were delivered
• EDC from LMP
o Naegel’s rule:
▪ LMP -3 months + 7 days (then add a year)= EDD
▪ LMP +280 days= EDD
• Manifestations of ARDS in newborn
o Respiratory distress syndrome
▪ Retractions
▪ Grunting
▪ Nasal flaring
• Assessing fetal position - how would you assess (know the positions), where would you find
heart tones
o Vertex head down
▪ Vertex- below the umbilicus
• Breech feet or bottom presenting first
▪ Breech- Above the umbilicus
• Transverseinfant is positioned transverse in the uterus
MODULE 3- PREGNANCY COMPLICATIONS AND LABOR
• Placenta previa: what is it and how would it manifest?
o The placenta is completely covering the cervical os
o Must be delivered via c-section
o Bedrest until bleeding stops
o Pelvic rest until previa resolves or delivery
o What will you see…
▪ Painless bright red vaginal bleeding, FHR may not be affected earlier on…as it
progresses, it can be potentially life threatening for both mom and baby
secondary to blood loss
, • Understand uterine hyperstimulation and appropriate management
o Hyperstimulation (i.e., tachysystole) is usually defined as five or more contractions in a
10-minute period or contractions lasting more than 2 minutes in duration or occurring
within 60 seconds of each other, situations that have the potential to interfere with
placenta filling and fetal oxygenation.
o The danger of hyperstimulation is that a fetus needs 60 to 90 seconds between
contractions in order to receive adequate oxygenation from placenta blood vessels.
o If uterine hyperstimulation should occur, several interventions such as asking the woman
to turn onto her left side to improve blood flow to the uterus, administering an IV fluid
bolus to dilute the level of oxytocin in the maternal blood stream, and administering
oxygen by mask at 8 to 10 L are all helpful.
o The surest method to relieve tachysystole, however, is to immediately discontinue the
oxytocin infusion..
o Because the half-life of oxytocin is approximately 3 minutes, the falling serum level and
effects are apparent almost immediately after discontinuation of IV administration.
o In addition, a primary care provider may prescribe terbutaline to relax the uterus.
• Drug use in pregnancy- what are appropriate assessments? What manifestations might be
observed?
o With longstanding use of opiate medications withdrawal symptoms may be observed in
the neonate
o In the instance of suspicion for illicit drug use, the nurse must document assessment
findings and communicate those to the ordering provider
▪ Urinalysis can be ordered to confirm the presence of illicit drug use in mom
• Some indications of illicit drug use:
▪ Abnormal behavior
▪ Vaginal bleeding and/or symptoms of placental abruption
▪ Nonreassuring FHR
• Signs and symptoms of placental abruption
o Contractions every minute
o Firm/rigid abdomen (uterus is not able to relax)
o Dark red vaginal bleeding
o NRFHR or fetal distress
o Management - intrauterine resuscitation and rapid delivery (usually C/S)
MODULE 4- POSTPARTUM
• Risk factors for postpartum hemorrhage
