NURSG 5432 400 Module 3 Questions And Answers
With Verified Solutions
What can medications be taken for during pregnancy? ANS N/V
Constipation
Preeclampsia
Chronic Disorders
Infectious Diseases/ CA
Drug abuse
What are the physiologic changes during pregnancy & impact on drug disposition & dosing? ANS In third
trimester:
Renal blood flow is doubled; renal excretion is accelerated
Tone & mobility of bowel decreases which prolongs drug effects
What are some adverse effects of heparin during pregnancy? ANS Osteoporosis
What are the adverse effects of prostaglandins during pregnancy? ANS Stimulate uterine contractions
What are adverse effects of pain relievers during delivery? ANS Depress respiration in neonates
What birth defects can be caused by teratogenic medications? ANS Gross malformations:
Cleft palate, clubfoot, & hydrocephalus
Neurobehavior & metabolic anomalies
Congenital anomalies <1%
What is the most critical time during pregnancy to avoid medications? ANS Embryonic period: Weeks 3-8
is when gross malformations produced by teratogens
What are the 3 stages of development? ANS Conception through week 2
,Embryonic period: Week 3-8 when gross malformations can be produced (organ development)
Fetal period: Week 9-delivery when functions are disrupted
What is the PLLR? ANS Pregnancy & lactation labeling rule provides the prescriber w/ relevant
information for critical decision-making when treating pregnant or lactating women
What immunizations can be administered during pregnancy? ANS Viruses that are killed or inactivated:
Influenza
TDaP (protects infant from pertussis); given w/ q pregnancy
Which immunizations are contraindicated during pregnancy? ANS Live attenuated vaccines; should avoid
trying to get pregnant 28 d after vaccine:
Nasal spray influenza
MMR
Varicella
HPV
Pneumococcal polysaccharide (PPSV23)
Pneumococcal conjugate (PCV13)
Meningococcal conjugate (MenACW)
Meningococcal polysaccharide (MPSV4)
Smallpox
When is the TDaP administered during pregnancy? ANS Between 27-36 weeks; optimizing duration of
antibody protection until after birth
Which vaccines can be given under special conditions? ANS HepB
Inactivated polio
HepA
Yellow fever
,What is included in the Women's health assessment? ANS Complete PX
Past medical Hx
GYN Sx
OB Hx: menstrual, contraceptive, sexual, reproductive & complications
Nutrition
Cultural Hx
Support system
Risk Factors
Complete Genetic Hx
Immunizations
Diagnostics
What is preventive care during pregnancy? ANS Nutrition: Maintain avg body wt for ht
Folic acid (0.4mg/d)
Exercise
Smoking Cessation
What symptoms occur during first trimester (up to 12 weeks) of pregnancy? ANS Amenorrhea
N/V
Fatigue
Breast tenderness (first sign)
Urinary frequency
What symptoms occur during second trimester (13-27 weeks)? ANS Fetal movement
Abdominal discomfort (round ligament pain)
Cholasma (brown or gray-brown patches on face)
, Syncopal episodes
What symptoms occur during third trimester (28-40 weeks)? ANS Abdominal growth
Braxton-Hicks
Return of urinary frequency w/descent of presenting part
Increased respiratory effort until descent
What is expected during the first trimester PE? ANS Softening of cervix (Goodell's sign)
Cervical cyanosis (Chadwick's Sign)
Softening of cervicouterine junction (Hegar's sign)
Breast enlargement
Fetal heart tones by 10-12 weeks
What is expected during the second trimester PE? ANS Striae
Fundus palpable at umbilicus @ 20 wks; grows 1 cm/wk
Leopold maneuvers after 20 wks
What is expected during the third trimester PE? ANS Lightening 3-4 wks prior to delivery
Loss of mucus plug
Increase Braxton-Hicks
Contractions/rupture of membranes
What diagnostics are done first trimester? ANS Pregnancy test
CBC
UA
U-Preg
Blood type, Rh, antibody screen
Rubella titer
Syphilis
Chlamydia
With Verified Solutions
What can medications be taken for during pregnancy? ANS N/V
Constipation
Preeclampsia
Chronic Disorders
Infectious Diseases/ CA
Drug abuse
What are the physiologic changes during pregnancy & impact on drug disposition & dosing? ANS In third
trimester:
Renal blood flow is doubled; renal excretion is accelerated
Tone & mobility of bowel decreases which prolongs drug effects
What are some adverse effects of heparin during pregnancy? ANS Osteoporosis
What are the adverse effects of prostaglandins during pregnancy? ANS Stimulate uterine contractions
What are adverse effects of pain relievers during delivery? ANS Depress respiration in neonates
What birth defects can be caused by teratogenic medications? ANS Gross malformations:
Cleft palate, clubfoot, & hydrocephalus
Neurobehavior & metabolic anomalies
Congenital anomalies <1%
What is the most critical time during pregnancy to avoid medications? ANS Embryonic period: Weeks 3-8
is when gross malformations produced by teratogens
What are the 3 stages of development? ANS Conception through week 2
,Embryonic period: Week 3-8 when gross malformations can be produced (organ development)
Fetal period: Week 9-delivery when functions are disrupted
What is the PLLR? ANS Pregnancy & lactation labeling rule provides the prescriber w/ relevant
information for critical decision-making when treating pregnant or lactating women
What immunizations can be administered during pregnancy? ANS Viruses that are killed or inactivated:
Influenza
TDaP (protects infant from pertussis); given w/ q pregnancy
Which immunizations are contraindicated during pregnancy? ANS Live attenuated vaccines; should avoid
trying to get pregnant 28 d after vaccine:
Nasal spray influenza
MMR
Varicella
HPV
Pneumococcal polysaccharide (PPSV23)
Pneumococcal conjugate (PCV13)
Meningococcal conjugate (MenACW)
Meningococcal polysaccharide (MPSV4)
Smallpox
When is the TDaP administered during pregnancy? ANS Between 27-36 weeks; optimizing duration of
antibody protection until after birth
Which vaccines can be given under special conditions? ANS HepB
Inactivated polio
HepA
Yellow fever
,What is included in the Women's health assessment? ANS Complete PX
Past medical Hx
GYN Sx
OB Hx: menstrual, contraceptive, sexual, reproductive & complications
Nutrition
Cultural Hx
Support system
Risk Factors
Complete Genetic Hx
Immunizations
Diagnostics
What is preventive care during pregnancy? ANS Nutrition: Maintain avg body wt for ht
Folic acid (0.4mg/d)
Exercise
Smoking Cessation
What symptoms occur during first trimester (up to 12 weeks) of pregnancy? ANS Amenorrhea
N/V
Fatigue
Breast tenderness (first sign)
Urinary frequency
What symptoms occur during second trimester (13-27 weeks)? ANS Fetal movement
Abdominal discomfort (round ligament pain)
Cholasma (brown or gray-brown patches on face)
, Syncopal episodes
What symptoms occur during third trimester (28-40 weeks)? ANS Abdominal growth
Braxton-Hicks
Return of urinary frequency w/descent of presenting part
Increased respiratory effort until descent
What is expected during the first trimester PE? ANS Softening of cervix (Goodell's sign)
Cervical cyanosis (Chadwick's Sign)
Softening of cervicouterine junction (Hegar's sign)
Breast enlargement
Fetal heart tones by 10-12 weeks
What is expected during the second trimester PE? ANS Striae
Fundus palpable at umbilicus @ 20 wks; grows 1 cm/wk
Leopold maneuvers after 20 wks
What is expected during the third trimester PE? ANS Lightening 3-4 wks prior to delivery
Loss of mucus plug
Increase Braxton-Hicks
Contractions/rupture of membranes
What diagnostics are done first trimester? ANS Pregnancy test
CBC
UA
U-Preg
Blood type, Rh, antibody screen
Rubella titer
Syphilis
Chlamydia
