Exam (elaborations) Nur 221

types of families️️ nuclear family️️Mother, father and children living as a unit multigenerational families️️a family with three or more generations alive at the same time; considers the needs of middle generation, not just young and old as with intergenerational extended family️️a family that extends beyond the nuclear family, including grandparents, aunts, uncles, and other relatives, who all live nearby or in one household. no-biologic-parents️️those in which children live independently in foster or kinship care such as living with a grandparent married-blended families️️those formed as a result of divorce and remarriage, consist of unrelated family members who join to create a new household Cohabitating-parent families️️those in which children live with two unmarried biologic parents or two adoptive parents single-parent family️️comprise an unmarried biologic or adoptive parent who may or may not be living with other adults. homosexual families️️lgbtq+ families that live together and may or may not have children Anemia️️common medical disorder of pregnancy, results in reduction of the oxygen-carrying capacity of the blood; thus the heart tries to compensate by increasing cardiac output, may result in CHF, increased risk of req blood transfusions, higher instance of postpartum complications. iron deficiency anemia️️most common anemia of pregnancy 75% of cases. check hemoglobin (normal above 11) and hematocrit (normal above 33) what do we do for Iron deficiency?️️iron supplementation: vitamin C helps absorb iron so eat foods high in iron, no milk may have constipation; increase fiber, water and exercise. physiologic anemia of pregnancy️️Apparent anemia that results because during pregnancy the plasma volume increases more than the erythrocytes increase. baby also leaches iron. what can the nurse delegate to the UAP️️UAP cannot TAPE T- teaching A- assessment Pplanning E- evaluating Dilation and curettage or D&C️️surgical procedure in which the cervix is dilated and the endometrium of the uterus is scraped away by a curette can be done with suction Medical abortion️️a method of abortion using drugs rather than surgery to terminate a pregnancy usually for ectopic pregnancy; methotrexate therapy Methotrexate therapy️️therapy given that can prevent the need for surgery manages many cases of tubal pregnancy, non invasive. is a cancer drug, education must include double flush the toilet and put the lid down. side effects include gi distress, nausea and vomiting, stomatitis, and dizziness can include neutropenia, reversible hair loss and pneumonitis Mag Sulfate️️tocolytic used in preterm labor smooth muscle relaxant, gives babies a decreased rate of cerebal palsy, helps with pre-eclampsia, given 4 g over 30 mins, then decrease to 2g an hour. Magnesium toxicity️️depresses the function of the CNS essential that nurses assess pt respiratory status, deep tendon reflexes, and level of consciousness to identify toxicity treatment is calcium Gluconate because it contracts. Terbutaline️️tocolytic, anticontraction med to delay premature labor for up to 72 hrs. given sub q things to watch out for; maternal s/e: tachy, nervousness, tremors, h/a, and pulmonary edema. fetal s/e: tachy and hypoglycemia. Nifedipine️️calcium channel blocker, tocolytic agent that can suppress contractions do not give with mag sulfate or terbutaline; educate on orthostatic hypotension, oral given with corticosteroids antenatal glucocorticoids️️given IM to the mother to accelerate fetal lung maturity by stimulating fetal surfactant production Betamethasone and dexamethasone️️* Corticosteroids that increase the production of surfactant to accelerate fetal lung maturity & reduce the incidence or severity of RDS. * Used for a client in preterm labor between 28-32 weeks' gestation whose labor can be inhibited for 48 hrs without jeopardizing the mother or fetus. ADVERSE REACTIONS: * May decrease the mother's resistance to infection. * Pulmonary edema secondary to Na+ & fluid retention can occur. * Elevated blood glucose levels can occur in a client with diabetes mellitus. INTERVENTIONS: * Monitor maternal vital signs, lung sounds, & for edema. * Monitor mother for signs of infection. * Monitor WBC. * Monitor blood glucose levels. endometriosis️️Growth of endometrial tissue outside of uterus symptoms include; pelvic pain, dysmenorrhea, dyspareunia (painful intercourse), abnormal bleeding, pain in thighs, constipation, diarrhea or pain with defication. treatment based on severity of symptoms and goals from nsaids surgery oligomenorrhea️️infrequent menstruation hypomenorrhea️️non normal intervals menorrhagia️️excessive menstrual bleeding metrorrhagia️️bleeding between periods Chlamydia️️most frequently reported infectious disease in the U.S., many asymptomatic cases, expensive to culture. causes PID, increased risk of ectopic pregnancy, infertility, inflammation of cervix, cervical ulceration, increased risk of acquiring HIV, premature rupture of membranes, preterm labor, postpartum endometriosis. 50% of infants born to mothers with chlamydia, will develop conjunctivitis or pneumonia after exposure to infected cervix. causes low birth weight. treatment doxycycline or azythromiacin Gonorrhea️️oldest communicable disease in U.S. gram negative Neisseria gonorrhoeae, exclusively sexually transmitted. women often asymptomatic but when symptomatic may have greenish-yellow purulent endocervical discharge, menstrual irregularities, pelvic or abdominal pain, can be rectal, can cause miscarriage, preterm labor, amniotic infection syndrome, chorioamnitis, postpartum endometriosis, postpartum sepsis,, premature rupture of membranes. fetal effects: IUGR. Dx. with vaginal and rectal swab. treatment is ceftriaxone given IM once Syphilis️️Treponema pallidum, can be transmitted sexually, through kissing, biting, or oral sex. transplacental transmission may occur during pregnancy, degree of risk is calculated by amount of spirochetes in mothers bloodstream. causes genital ulcers, rash on palms or feet, fever, headache, malaise can cause miscarriage, preterm labor, neurological, cardiovascular, musculoskeletal. or multi-organ system complications in late stage. fetal effects; IUGR, stillbirth, congenital infection. Dx. blood test, treatment, Penicillin G, or if allergic to PG tetracycline, doxycycline, erythromycin. pelvic inflammatory disease (PID)️️infectious process that most commonly involves uterine tubes, causes endometritis, increases risk for ectopic pregnancy, infertility, chronic pelvic pain, dysparenuria, pyosalpinx (pus in uterine tubes) after ectopic pregnancy risk for more potential ectopic pregnancy is x7, treatment education, broad-spectrum antibiotic; ceftriaxone plus doxycycline Human Papillomavirus (HPV)️️also known as condylomata alumina or genital warts, approx 100 types, 40 of those cause anogenital infections, several that cause cancer, two highly cancerous types are type 16 and 18, primary cause of cervical cancer. infections more common in pregnancy, symptoms can include; irritating vaginal discharge, itching, dispareunia, postcoidal bleeding, bumps on vulva or labia. Dx. physical inspection of vulva, perineum, anus, vagina and cervix, abnormal pap, biopsy, colposcopy. treatment; education, prevention guardasil vaccine herpes simplex️️HSV type 1 (non sexually transmitted), mouth sores HSV type 2 (sexually transmitted) genital sores or lesions, initial infection signs and symptoms; painful lesions, fever, chills, malaise, severe dysuria may Last 2-3 wks. during pregnancy, maternal infection with HSV2 can have adverse effects on mother and fetus, congential infection is possible. primary infections in 1rst trimester have been associated with miscarriage. DX lab test, management anti viral acyclovir used for mother and child. Hepatitis B virus️️most threatening virus to fetus and neonates. found in all body fluids, a disease of the liver, could be fatal. symptoms include; arthralgias, arthritis, Lassitude, anorexia, nausea, vomiting, headache, fever, mild abdominal pain, clay colored stool, dark urine, jaundice. DX lab TX. education, symptoms management Zika Virus️️spread to people primarily through the bite of an infected Aedes species mosquito but also through sex. increased risk of neonates with microcephaly, risk for Guillane barre syndrome Group B strep️️Is considered normal vaginal flora in a women who are not pregnant. infection is associated with poor pregnancy outcomes. infects infant in birth canal. can cause UTI, chorioamnitis, postpartum endometriosis. sepsis, Meningitis, culture performed by 36 weeks. antibiotics given to all who test positive. if test has not been given at onset of labor antibiotics are given. rapid test is available for in labor pts. TX is Penicillin G 5million units IV loading dose, and then 2.5 million units IV every 4 hours during labor preterm labor️️cervical changes and uterine contractions occurring between 20 and 37 weeks of pregnancy, risk factors; History of genital tract colonization, infection or instrumentation, African American, bleeding of uncertain origin in pregnancy, history of previous spontaneous preterm birth between 16 and 36 weeks, uterine anomaly, use of reproductive technology, multifetal gestation, smoking, substance abuse, pregnancy underweight (bmi below 19.6) or overweight (bmi above 30), periodontal disease, limited education, low socioeconomic status, late prenatal care, stress common causes of indicates preterm birth️️preexisting or gestational diabetes, chronic hypertension, pre-eclampsia, obstetrical disorders or risk factors in current or past pregnancy, previous c section, choleostasis, placental abruption or previa, seizures, thromboembolism, connective tissue disorders, asthma and chronic bronchitis, maternal HIV or HSV infection, obesity, smoking, advanced age, fetal compromise, poor fetal growth, acute (abnormal results on a NST or BPP), excessive or inadequate amniotic fluid, fetal hydrops, ascites, blood group alloimmunization, birth defects, fetal complications of multifetal gestation. signs and symptoms of spontaneous pre term labor️️infection, changes in cervical length. signs and symptoms of pre term labor️️change in type of vaginal discharge (watery, mucus or bloody), increase in amount of vaginal discharge, pelvic or lower abdominal pressure, constant low, dull backache, mild abdominal cramps with or without diarrhea, regular or frequent contractions or uterine tightening often painless, ruptured membranes, diagnosis of preterm labor️️gestational age between 20 weeks and 36 wks 6 days. regular uterine activity accompanied by a change in cervical effacement, dilat