exam 3 study guide.docx
Post on 04-Jun-2018
236 Views
Preview:
TRANSCRIPT
-
8/14/2019 Exam 3 Study Guide.docx
1/16
Exam 3 Study Guide
1.Identify and describe the four phases or the menstrualcycle.
Menstrual First day of menses
Proliferative Period of rapid growth; endometriallayer thickens
Secretory Day of ovulation
Ischemic
Functional layer separates after blood
supply is cut off and necrosis develops;
right before menses begins
2.What is the significance or function of the structuresidentified below?
Uterus
Pair shaped muscle; Fundus is at the top;
Corpus is in the middle; Isthmus is at
the bottom. Functions include: Pregnancy
and Menstruation
Squamocolumnar
Junction
Most likely to grow cancer; this is the
site that cells are scraped for pap smear
Fallopian Tubes
(Four Segments)
Infundibulom is closest to the cervix;
Ampula is the site of fertilization;Isthma is the portion of the tube that
tubal ligation occurs within;
Interstitial is closest to the uterus
Functions include: Passageway and
Fertilization
OvariesFunctions include: Hormone production of
estrogen and progesterone, and Ovulation.
Mons Pubis
Fatty pad that has pubic hair; Function
is to protect pubis bone during sexualintercourse
Labia MinoraHairless folds of skin on either side of
the vaginal orifice
Labia MajoraFolds of skin WITH hair on either side of
the vaginal orifice
Clitoris Function is primarily sexual arousal
Prepuce Equivalent of male foreskin
-
8/14/2019 Exam 3 Study Guide.docx
2/16
3.Last menstrual cycle 7/09/2013. 34-day cycle. Calculatenext menses and the probable date of ovulation
Next menses is calculated by adding the cycle days to the
LNMP: 7/09/2013 + 34 days = 43. There are 31 days in July
therefore next menses will be on 8/12/2013.
Next ovulation date is calculated by subtracting 14 from th
cycle days: 34 days 14 days = 20; than by adding the LNMP
to this number: 20 + 7/09/2013 = 7/29/2013 therefore next
ovulation date will be 7/29/2013.
4.What is the nurses role in identifying intimate partnerviolence?
RADAR- Routinely ask all patients; Ask directly, kindly, an
nonjudgmental; Document all findings; Assess client safety;
Review options and offer referrals.
5.Identify clues that might alert a health care provider ofpartner abuse.
The abuser will get defensive easily, they will not want to
leave their partners side and they will answer questions
for their partner. 2nd
trimester is the most common time forfirst abuse, abdominal pain of unknown origin, and injuries
in different stages healing. Safety is priority!
6.List and describe the cycle of violence.Tension
Building
Jealousy, Tantrums, verbal abuse, silent
treatments, threats
Violent
Incident
Emotion, psychological, and physical abuse
occurs
Honeymoon
StageOverly kind and generous gifts, apologetic
-
8/14/2019 Exam 3 Study Guide.docx
3/16
7.Describe (cause, manifestations, diagnostic test, treatmentof the following:
STI NAME CAUSE SYMPTOM DIAGNOSTIC TREATMENT
Chlamydi
aTrachomatis
Clear to
creamy mucoid
drainage
Culture
Mycins
Cyclins
Floxin
Gonorrhe
aNeissearia
Cervical
motion
tenderness
Gram Stain
Suprax
Rocephin
Cipro
Floxin
Report to CDC
SyphilisTreponema
Pallidum
Painless
ulcer or wartRash on palm
and soles
Systemic
SerologyVDRL and
RDR
Cyclin
HPV
DES
Exposure,
sex and
oral
transmission
Single/Cluste
r or lesions
that are
painless
(cauliflower)
in mouth and
throat
Biopsy
(colposcopy
) Pap smear
Prevent with
Gardasil. Trea
with topical
condylox/ardel
ra
Or cryotherapto remove the
lesions
Herpes
Direct
contact
with
lesions
Painful
reoccurring
ulcers,
bleeding
cervix. First
outbreak isthe worst.
Visual
inspection
Culture
Serology
Zovarix
Valtrex
Topical
Acyclovir
Active Lesion
require C-Section
delivery
-
8/14/2019 Exam 3 Study Guide.docx
4/16
STI NAME CAUSE SYMPTOM
DIAGNOSTI
CTREATMENT
Hepatitis
B
Maternal-
Fetal
transmissio
n
Jaundice Serology
If the mothe
is positive
the baby get
HBIG as wel
as HEP B
Vaccine prioto
breastfeedin
HIV
Blood and
body fluids
transmissio
n
Asymptomatic
, flu like
symptoms
Serology
AZT Prenata
IV AZT durin
labor. NO
BREASTFEEDIN
!
VaginitisGardenella
HaemophilusFishy odor
Wet smear
withpositive
clue
cells
Boric acid
suppositoryFlagyl
Avoid alcoho
or
Clindamycin
Candidiasi
s
Yeast
Infection;
steroids,
antibiotics
,
pregnancy,immune
suppression
Cheese like
patches
Itching
Wet smear Nystatin
Trich
Protozoan
that
thrives in
alkaline
environment
Speckled
strawberry
marks on
cervix
Christmas
tree colors
Speculum
examFlagyl
GBS
Once
positive,
always
positive
Asymptomatic
GBS
culture
between
35-37
weeks
Penicillin mg loading
and 2.5 mg
every 4 hour
until birth
Ampicillin
gram loadin
and 1 gram
every 4 hour
until birth
-
8/14/2019 Exam 3 Study Guide.docx
5/16
8.What does BRAIDED stand for? (Contraceptives)B- Benefits
R- Risk
A-AlternativesI- Inquiries
D- DecisionsE- Explanation
D- Documentation
9.What does PAINS stand for? (IUD)P- Period late or abnormal
A- Abdominal pain, pain with intercourse
I- Infection exposure, abnormal discharge
N- Not feeling well, fever or chillsS- Shorter or longer strings
10. What does ACHES stand for? (OCP)A- Abdominal pain, liver area
C- Chest pains or shortness of breath
H- Headaches, persistent rapid onset and unrelieved
E- Eye problems
S- Severe leg pain, blood clot
11. Describe coitus interruptus.Coitus interruptus is also known as the PULL OUT method;
know that pre-ejaculation fluid still contains sperm and
there is no STD or HIV protection.
12. Describe natural family planningNatural family planning involves avoidance of intercourse
during fertile periods. In order to use this method, one
must know their ovulation period so they must keep track of
their length of cycles with a calendar method for 6-12
months, chart their temperature prior to getting out of bed
each morning, and monitor their cervical mucus discharge.
-
8/14/2019 Exam 3 Study Guide.docx
6/16
13. Describe the barrier methods
Spermicides
Trap and immobilize sperm; forms include
foams, tablets, suppositories and creams.
These can cause irritations and allergies
Cervical Cap
Flexible latex cup that fits over the
cervix and remains in place by suction
acting as a barrier between sperm and thecervix. Leave in place 6 hours before and
48 hours after sexual intercourse.
Condom
Intended for one time use only. Leave
FLAT empty space at the tip of penis when
applying condom.
Diaphragm
Shallow dome-shaped rubber device with a
flexible ring that covers the cervix.
Needs to be washed with soap and water
after every use; inserted up to 6 hours
prior and 6 hours after last intercourse.
Should be replaced every 2 years; and
should be replaced if significant weight
loss >15 pounds occurs.
14. Describe hormonal contraceptive
Oral Contraceptive
Estrogen and progestin or just
progestin only pills. Side effects
include hair loss, weight gain.Patient should report ACHES
symptoms.
Depo Provera Shot
Do not rub site after injection.
Administer within 5 days of cycle.
Lasts 90 days. Works by delaying
fertility. Side effects include
weight gain, decreased libido.
Patient should have adequate Vitamin
D and Calcium intake
Norplant Subdural
Implant
Releases progesterone for 3 years.
Patient should report any abnormal
bleeding
Emergency
Contraceptive
PLAN B pill. Effective only 12-72
hours after sexual intercourse.
Common side effects include nausea
and vomiting so take an antiemetic
an hour before taking each pill.
Basically a high dose oral
contraceptive.
-
8/14/2019 Exam 3 Study Guide.docx
7/16
IUD
Safe contraceptive during lactation;
copper type serves as Spermicides
and inflames the Endometrim. Check
for the presence of strings every
month after menstrual period.
15. What are recommendations for BSE & Mammography?
20-39 years old > 40 years old
BSE
Once a month 2 weeks
prior or 1 week
after period
Same day every month
if no longer having
period
Clinical Exam Every 3 years Once a year
MammographyHigh risk patients
ONLYOnce a year
16. Describe the following:Fibroadenoma
Painless, solid lumps. Ultrasound to
biopsy
Fibrocystic
ChangesPainful, multiple, fluid filled lumps
Lipoma Fatty tumor
Leiomyomas
Fibroid tumor that has heavy bleeding;
Patient will complain of anemia.
Treatment includes stopping ovulation orhysterectomy even though it is not
recommended.
Ovarian CystTreatment includes observation and pain
control
17. Describe newborns transition to extrauterine life.
First period ofreactivity
Lasts up to 30 minutes after delivery; HR
160-180; Fine crackles, audible grunting,
nasal glaring and chest retractions all
demonstrated. Breast feed, but do not
bottle feed during this time.
-
8/14/2019 Exam 3 Study Guide.docx
8/16
Period of
Decreased
Response
Lasts 60-100 minutes after delivery; HR
100-120; Infant is sleeping or has
decreased motor activity during this time;
infant is pink, respirations are rapid,
shallow and unlabored up to 60
breaths/minute; audible bowel sounds
present; This is a difficult time to feed
but a good time for kangaroo care and
parent bonding.
Second period
of reactivity
Occurs 2-8 hours after delivery; Brief
periods of tachycardia and tachypnea,
increased muscle tone, increased mucus
production; Meconium is commonly passed
during this time.
-
8/14/2019 Exam 3 Study Guide.docx
9/16
18. Describe the following menstruation and infertilitydisorders:
Premenstrual
Syndrome
PMS cannot occur in women who do not
ovulate; rule out psych disorders and
depression. Keep calendar for symptoms.
Treat symptoms with SSRI, OCP, and
decrease salt and sugar intake
Primary
Dysmenorrhea
Teens-20s; prostaglandins overproduction
causes cramping on the first two days of
period. Treatment is with NSAIDS
Secondary
Dysmenorrhea
>25 years old; organic pelvic disorder;
chronic pain of cramping. Treat the
underlying cause and treat
symptomatically.
Endometriosis
Over growth of endometrial lining anywhere
else in the body; Primary symptom is pain.
Treatment includes pain medication, OCP,and annovulations to cease ovulation. Risk
factors include obesity, 20-40 short
cycles, heavy bleeding, and Caucasian.
Diagnostic tests involve ultrasound,
hysteroscopy, and laparoscopy.
Amenorrhea
No bleeding; primary cause is pregnancy.
Always rule out pregnancy before any
further investigation.
Endometrial
Biopsy
Removal of a sample of tissue form
Endometrim for testing; you should be
menstruating to have the procedure. Side
effects: referred shoulder pain.
Semen Analysis
Test indicated for infertility. Clean cup
specimen for semen or condom without
spermicidal for specimen. Avoid extreme
temperatures with specimen.
TDI Sperm donor insemination
GIFT Fertilization occurs in the fallopian tube
ZIFTFertilization occurs outside the body and
transferred into the fallopian tube.
IVF-ET
Egg is produced and then retrieved from
ovary; a sperm sample is provided; the
eggs and sperm are then mixed together in
a Petri dish to allow fertilization and
the fertilized eggs are reintroduced into
the uterus
-
8/14/2019 Exam 3 Study Guide.docx
10/16
Gestational
Carrier
No biological connection; embryo host
ONLY
Surrogate
Mother
Biologically connected via the womans egg
and a partners sperm
19. Newborn Physical assessment:Heart Rate 110-160 bpm
Respiration 30-60 breaths/minute
Temperature 97.7-99.5 F
Length 18-22 inches
Head circumference
32-37 cm; about 2 cm larger
than chest circumference.
Report any measurement >2 cm
Chest circumference 30-35 cm
Caput Succadeum
Swelling of tissue crossing
suture lines caused by pressure
on head during delivery
Cephalohematoma
Swelling of the tissue NOT
crossing suture lines caused by
accumulation of blood
Tonic Neck Reflex
When the infants head is
turned to one side, the arm andleg on that side extend while
the extremities on the opposite
side flex (fencing position)
Eyes Clear with bluish white sclera
NoseListen for air movement or look
for snot
Rooting/Sucking Reflex
When side of face is stroked,
newborn turns their head toward
that side and opens their lips
to suck
Epstein PearlsSmall white specks on the
newborns gum lines
Grasp ReflexNewborn will firmly hold finger
placed in palm
-
8/14/2019 Exam 3 Study Guide.docx
11/16
Moro Reflex
Startling the newborn elicits
responding with flexion of
thighs, fanning of fingers,
clenching of fist, arms thrown
out and then brought together
again.
Breasts Witchs milk whitish discharge
Abdomen Soft, may have linea nigra
Cord Care
Two arteries, One vein (AVA)
From moist to dry; cord clamp
in place for 24 hours; usually
falls off by 14 days
Spine
Spine straight and flexible;
Dimple at base of spine is
indicative of Spina bifida
Anus
Patent as evidence by passage
of first Meconium stool; norectal temps prior!
Galant ReflexStroking the spine causes the
pelvis to turn to that side
Male Circumcision Care
Do not wash with soap until
healed by day 5-6; monitor for
bleeding and infection. Keep
area clean!
Female Genitalia
May have psedomeses- blood
tinged mucous noted in diaperas a result of maternal
hormones.
Barlows Maneuver
Newborns thighs are pulled
towards the body and pressure
downward gently. Dislocation
is felt as the femoral head
lips out of the hipbone socket.
Planter Grasp
Finger firmly placed against
newborns foot; resulting in
flexion of the toes
Babinskis Reflex
Newborns toes hyperextend and
spread apart when the foot is
stroked upward from the heel
towards to toes
AcrocyanosisPeripheral cyanosis; blue color
of hands and feet
LanugoFine hair covering body; most
common in preterm infants
-
8/14/2019 Exam 3 Study Guide.docx
12/16
Vernix CaseosaWhiteish sticky, cheese like
substance on skin of newborn
-
8/14/2019 Exam 3 Study Guide.docx
13/16
20.Newborn heat lossConvection
Loss of cooler air
currents
Example: Newborn
exposed to cold room
Radiant
Indirect heat
transfer from body
to cold surfaces
Example: Newborn
loss of heat to cold
window or wall
EvaporationLoss of heat due to
wet skin
Example: Newborn not
fully dried off
after bathing
Conduction
Direct heat transfer
from body to cold
surfaces
Example: Newborn
placed on cold crib
without being warmed
first
21. Integumentary system:
Mongolian Spots
Dark flat pigmented areas noted
usually on buttocks or lower
back
Stork Bites
Pink flat birthmark on
forehead, eyelids, and back of
neck that fade when pressed
upon.
Desquamation Peeling of skin
MiliaTiny white pimples on newborns
face and chin
22.Calculate Apgar score.Sign Score 0 Score 1 Score 2
A Activity Flaccid Some Flexion Active Motion
P Pulse Absent < 100 bpm > 100 bpm
G Grimace None GrimaceSneeze, Cough,
Cry
A Appearance Pale/BlueBlue
ExtremitiesCompletely Pink
R Respiration Absent Weak, Slow Good Cry
-
8/14/2019 Exam 3 Study Guide.docx
14/16
23.Calculate gestational age, neuromuscular score, and physica
maturity.
Gestational age is calculated by using the chart to
determine neuromuscular maturity and physical maturity than
adding the two together to determine gestational age in
weeks.
24. Describe hypoglycemia in a newborn.Hypoglycemia in the newborn is generally caused by materna
diabetes, LGA, Perinatal asphyxia, or IUGR. Symptoms
include: blood glucose
-
8/14/2019 Exam 3 Study Guide.docx
15/16
Necrotizing Enterocolitis
NEC
The death of intestinal tissue
most likely due to decreased
blood flow to the intestines;
newborn will have abdominal
distention, upset GI, unable to
tolerate feedings, and
diminished bowel sounds.
Encourage strict breastfeeding
to prevent NEC;
27. Differentiate between premature and post mature newborns.
Pre-Mature Newborns Post-Mature Newborns
AgeGestational age < 37
weeks
Gestational age >42
weeks
Physical
Symptoms
Low birth weight,
lanugo, abnormalbreathing patterns,
undescended testes,
poor feeding, less body
fat, thin and shiny
skin
Wasted appearance, dr
cracked skin, long
nails, intrauterine
passage of Meconium,
profuse scalp hair,
absent Vernix Caseos
Respiratory
Function
Monitor for RDS
Give Exogenous oxygen
Administer surfactant
Monitor for RDS
Suction often
Thermoregulation Decreased brown fat Lack of subcutaneoustissue
Nutritional
Status
Unable to suck and
swallow before 34 weeks
Insensible water loss
Macrosomic
Infection
ControlImmature immune system Invasive procedures
ParentalAdaptation
Anticipatory grief
Resuming attachmentAdjusting the home
environment
Anticipatory griefResuming attachment
ConsequencesROP
BPD
Hypoglycemia
Meconium Aspiration
Syndrome
Central Cyanosis
-
8/14/2019 Exam 3 Study Guide.docx
16/16
top related