NUR113 Exam 1 Study Guide

NUR 113 Exam 1 Study Guide


Sexually Transmitted Infections (STI’s)
 STIs: caused by bacteria; transmitted by vaginal, oral, and anal intercourse/contact
 STDs: caused by viruses (HPV, HSV, HIV)
 The 5 P’s:
o Partners
o Practices
o Protection from STIs
o Past history of STIs
o Prevention of pregnancy
 Risk Factors:
o multiple sexual partners/new sexual partner
o drug/alcohol use (lowers inhibition)
o immune suppression caused by HIV
 Prevention:
o based on principles of:
 education
 detection
 effective diagnosis
 treatment of infected individual
 evaluation/treatment/counseling of sex partners of infected individual
Human Papilloma Virus (HPV)
 most common STI
 causitive agent to many genital cancers; genital warts
 diagnosed due to abnormal pap
 often women DO NOT have symptoms
Expected findings:
 bumps in genital area (might not itch or hurt)
 vaginal discharge
 dyspareunia
 bleeding after intercourse
 small warts in genital area with cauliflower appearance
Client Education:
 Vaccines recommended; indicated for 9-26 yr of age; typically given at 11-12; 3 doses in 6 mo
period
 If therapy deferred until after pregnancy, lesions are still infectious
Herpes Simplex Virus (HSV)
 Not a reportable STI HSV-1 (cold sores)
 HSV-2 transmitted during sexual activity/childbirth
 Prodromal symptoms (painful blisters, tender lymph nodes, lesions)
 Treatment focuses on relieving symptoms and preventing spreading
Chlamydia
 Most commonly reported bacterial STI in US
 Most women asymptomatic
 If left untreated, can lead to PID, causing infertility and ectopic pregnancy
 Invades cervix in women, urethra in men
 If untreated during pregnancy, can cause premature ROM, preterm labor, postpartum
endometriosis
 If transmitted to neonate, can cause conjunctivitis and pneumonia after delivery
 Pregnant patients should be retested 3 wks after completing treatment

,Expected findings:
 Men
o penile discharge
o dysuria
o testicular edema/pain
 Women
o dysuria
o urinary frequency
o spotting/postcoital bleeding
o vulvar itching
o gray-white discharge
Medications:
 Doxycycline (contraindicated during pregnancy); reduces effectiveness of oral contraceptives
 Azithromycin/Amoxicillin (prescribed during pregnancy)
 Erythromycin (administered to neonate following birth)
Gonorrhea
 2nd most common reported STI in US
 many men/women asymptomatic
 can cause blindness in newborns (opthalmia neonatorum)
Expected findings:
 anal lesions (if present): itching, irritation, rectal bleeding, diarrhea, painful defecation
 oral lesions (if present): lip ulcerations, tender gums, pharyngitis
 Men:
o dysuria
o testicular edema/pain
o penile discharge (white, green, yellow, clear)
 Women:
o Often no manifestations
o dysuria
o vaginal bleeding between periods
o dysmenorrhea
o yellowish-green vaginal discharge
Medications:
 Ceftriaxone (IM)
 Azithromycin (PO)
Syphilis
 Reportable STI; caused by spirochete
 Can infect almost any body tissue/organ
 If not treated appropriately, will progress in 4 stages
o Can be transmitted to neonate and cause stillborn birth/congenital defects
o Infection of eye (blindness)
o Infection of nervous system (H/A, numbness, paralysis, dementia)
Stages:
 Primary: presence of sore (on genital area), large lymph nodes
 Secondary: rash (hands/soles of feet), sore throat, flu-like symptoms
 Latent: no symptoms; transmission possible
 Tertiary: damage to internal organs; manifestations include blindness, difficulty coordinating
muscle movements
Medications:
 Penicillin IM G (safe during pregnancy)

,  Doxy/tetracycline (if penicillin allergy; contraindicated in pregnancy)
TORCH Infections
 Infections that cross the placenta and have teratogenic effects on fetus
 T – Toxoplasmosis
 O – Other (Hep B, Syphillis, Varicella)
 R – Rubella (German measles)
 C – Cytomegalovirus (Herpes family)
 H – Herpes Simplex Virus (HSV)
Medications:
 Antibiotics (as prescribed)
 For toxoplasmosis:
o Sulfanomides
o OR combination of pyrimethamine and sulfadiazine


Antepartum Care
 Naegele’s Rule: 1st day of LMP + 7 days – 3 months + 1 yr = Estimated Due Date
 GTPAL:
o Gravida – number of pregnancies
o Para – number of births after 20 wks
o Five-digit system
 G – total number of pregnancies
 T – full-term pregnancies (37-40 wks)
 P – preterm deliveries (20-36 wks)
 A – abortions/miscarriages (before 20 wks)
 L – living children
 Umbilical cord:
o 1 vein
o 2 arteries
 Fundal height:
o bladder must be empty
o tape measure stretched from top of pubic bone to top of fundus
o approximately equal to number of months pregnant
 Biophysical Profile (BPP):
o assessment of 5 variables over 30 min; used when there’s risk of placental
insufficiency/fetal compromise
o B – breathing/movement of fetus
o A – amniotic fluid volume
o T – tone of fetus
o M – movement of fetus
o N – non-stress test (NST)
Intrapartum Care
 5 P’s (Birthing Process):
o
HTN Disorders
 HTN disorders in pregnancy 2nd leading cause of maternal death (behind maternal hemorrhage)
 Gestational HTN diseases associated with placental abruption, kidney and liver failure, preterm
birth, and fetal/maternal mortality
Medications:
 Methyldopa (Aldomet) (anti-HTN)
 Nifedipine (Procardia) (anti-HTN)
 Hydralazine (Apresoline) (anti-HTN)