exam 1 Flashcards
When do you start a pap smear? Why do we do it?
screen starting at age 21 eery 3 years in order to search for cervical cancer, abnormal cervical cells, HPV
What is the priority with someone you suspect is being abused or suffering from intimate partner violence?
safety; isolate them, get them out of view; be direct
Contraindications for hormone contraception include
women who breast feed (the hormones affect lactation)
-women who have a history of clotting
what is a surgical abortion? what are some complications?
invasive procedure which is typically done by uterine aspiration; takes a few minutes and is considered very safe.
after the surgery, observe the patient for 30 minutes afterwards for hemorrhage and intraabdominal bleeding by vital signs, pain assessments, and evaluation of bleeding.
what is medication abortion? what are some complications?
avoids invasive surgery but takes two days to complete.
can only be done in the first 70 days of pregnancy.
prolonged cramping and bleeding. most women describe a mix of relief, sadness, loss, and guilt.
What are the presumptive signs of pregnancy?
lack of menses, breast tenderness, fatigue, nausea, urinary frequency, darkening of pigment of skin
What are the probable signs of pregnant women?
Braxton Hicks contractions (may be reported but may or may not be observable by clinician), positive pregnancy test, abdominal enlargement, Goodell’s sign (softening of the cervix), Hegar’s sign (softening of the lower portion of the uterus), and Chadwick’s sign (slight blueing of female genitalia)
What are the positive signs of pregnancy?
visualization by ultrasound, fetal movement, fetal heartbeat. All positive signs are considered confirmatory of a pregnancy
How does the endometrial cycle and the hormonal cycle relate to each other?
The drop in progesterone levels causes the lining of the uterus to fall away. This is known as menstruation.
The endometrial cycle is simply the portion within the menstrual cycle that has to do with your endometrium, aka the lining of your uterus. It’s a very important component of helping your body prepare for pregnancy, since it’s essential that a fertilized egg nestles into the right spot in the womb
What are the Physical signs of person ovulating
stretchy discharge
What are the rH negative considerations if they deliver a positive baby?
they are going to receive Rhogam right after delivery to prevent the mother from antibodies that will reject pregnancy
What do you do with a mom who is a diabetic?
monitor baby’s growth, monitor maternal glucose, monitor control of maternal glucose
What are the nursing considerations for a woman who has multiples?
more nutrients need; prepare for anxiety; caesarean birth
care considerations for ectopic pregnancies
ectopic: pregnancy that occurs outside the uterus
risks: pelvic infection, cigarette use, STI
treatment: medically, surgically, or the woman’s body absorbs the embryo
care considerations with women with preeclamapsia and eclampsia
preeclampsia: characterized by high blood pressure and signs of damage to another organ system; livers and kidneys
symptoms: weight gain, edema, hypertension
assess; protein in the urine, liver enzymes, oliguria,
–> SEVERE PREECLAMPSIA: decreased platelet count (thrombocytopenia), high blood pressure, progressive renal insufficiency , visual changes
treatments: magnesium sulfate
risk factors and care considerations of magnesium sulfate
1) assessments:
- -> urine output, RR, DTR, heart rate
2) toxicity:
- -> signs include: respiratory depression, oliguria, absent reflexes, lethargy, slurred speech, muscle weakness, loss of consciousness
3) interventions
- -> stop the infusion
- -> administer calcium gluconate
- 4 grams IV bolus over 30 minutes and then 2 grams an hour; assess fetal heart rate, watch for respiratory depression with decreased central nervous system
what do you assess in pregnant women?
the fetal heart rate at 12 weeks
fundal height: tells us how the uterus is ground and detects any abnormal fetal growth, either large or small
screening: group B strep, STIs
routine lab tests: hemoglobin and hematocrit
what are some characteristics of pregnant women?
frequent urination, edema in the low extremities (when edema becomes upper on the face, it becomes concerning)
What do you use to confirm a fetus with no heart tone?
ultrasound
What is the age of viability?
24 weeks
How do you know if a person is viable? What do you want to do when someone is calling about bleeding in pregnancy>
if a nonviable person calls about bleeding, we want them to come in and be evaluated; if someone is just spotting then bedrest; the limit in the amount of blood is if they are filling a pad
What is molar pregnancy? interventions?
A noncancerous tumor that develops in the uterus as a result of a nonviable pregnancy.
either surgically (hysterectomy) or DNC; followup visits include a lowering ACG,
What are the stages of labor?
1) first stage:
* latent phase: cervix is 0-3 cm–> document every 1 hr
* active phase: cervix is dilated from 3-7 cm–> every 15-30 minutes
* transition phase: cervix is dilated from 7-10 cm–> document every 5-15 minutes
2) second stage: 10cm to the birth of the baby
3) third stage: neonate birth to the birth of the placenta
4) fourth stage: birth of the placenta and then 4 hours later
- -> assess fundus every 15 minutes
What are the nursing interventions for late decelerations? What causes it?
poor placental function
- move the woman to lateral position/ to the left side
- if hypotensive, elevate legs and increate the IV
- stop oxytocin and palpate abdomen
- inform the provider
- administer O2 via a non-breather mask
What are the nursing interventions for early decelerations? What causes it?
a benign change, occurring because of pressure on top of the fetal head.
interventions are see where the baby is and check the perineum and then may change position
What are the nursing internvetions for variable decelerations?
look like V’s; cord compression
interventions are to change positions, give oxygen and IV bolus and decrease pitocin (oxytocin), this is all called intrauterine resuscitation
What are the nursing interventions for prolonged decelerations? What causes it?
do all the same thing but also call the charge nurse and let them know to get a provider, look at the strip, get the OR ready and come in and help
What does station mean?
- how far in or out the baby is
* 0 means engaged baby is not moving
what do assess when there is bleeding?
assess vitals, low BP and heart rate would increase, would want to notify provider afterwards
What happens when pateients are in bed for too long?
blood clotes, PE
assess pulses, lungs, SOB, clotting in extremities, and kegel exercises
What are newborn adaptations?
lungs have fluid in them- they learn how to breathe
cardiovascular changes:
dilatation of the pulmonary vasculature–> reducing pulmonary vascular resistance–> increase in blood return. ( increase pulmonary blood flow)
the clamping of the cord also eliminate the blood flow through the ductus venosus, which begins atrophy. Closure to the ductus arterios, shunts blood from the artery to the aorta
What does a baby look like when its born full term?
first active stage–> 30 minutes: active and alert, hr is 120-160 bpm RR are 40-60, likely to startle and cry. active bowel sounds, makes a poopy
second stage: sleep for several hours, no grunting, crackles. Hungry when it wakes up
final state of transition: reactive and poopy
dont have sex for the next six weeks
duh.
How much does the baby hold at birth?
15 mL
Apgar score… what is it?
tells us about infant status. 7-10 show cases excellent condition of the neonate.
activity and muscle tone pulse grimace with stimulation appearance respirations
what do we need to look out for in women with asthma?
dyspnea is common with many pregnant women but dyspnea with WHEEZING and cough suggest asthma
–> maintain O2 above 95%
spirometry,
assess fetal heart rate between 110-160
–> dont smoke
.
pregnant women with gestational diabetes
- glucose checks
- baby may be fat, experience respiratory distress,
- the more severe diabetes, the more high risk is the pregnancy
- after delivery, the mom’s insulin drops. monitor with glucose checks.
- breast feeding is not contraindicated
- adhere to diet, exercise and meds
diabetic women’s children are at risk for what…
mothers are at risk for hypertension and preeclampsia that should be treated with angiotensin receptor blocks.
–> congential anomalities
–> accelerated fetal growth
_-> diabetic ketoacidosis
when should women with SLE (lupus) try to have a baby? care considerations?
its autoimmune disease that has flare ups. When you dont have a flare up for 6 months, try to conceive.
monitor CBC. educate prior to conception.
cardiovascular complications in women? signs and symptoms? care considerations?
cardiac decompensation signs: edema of the face!!!!, frequent moist cough, cyanosis, tachypnea, crackles,
care considerations–> pulmonary edema and hemorrhage
Look at vitals, pulse ox—> they can still be in shock
Tissue O2 saturation is lower with patients with septic shock
Do you give antibiotics to immunocompromised patients?
no… not immediately.
Penicillins such as penicillin and amoxicillin
Cephalosporins such as cephalexin (Keflex)
Macrolides such as erythromycin (E-Mycin), clarithromycin (Biaxin), and azithromycin (Zithromax)
Fluoroquinolones such as ciprofolxacin (Cipro), levofloxacin (Levaquin), and ofloxacin (Floxin)
Sulfonamides such as co-trimoxazole (Bactrim) and trimethoprim (Proloprim)
Tetracyclines such as tetracycline (Sumycin, Panmycin) and doxycycline (Vibramycin)
Aminoglycosides such as gentamicin (Garamycin) and tobramycin (Tobrex)
How is gout formed?
Penicillins such as penicillin and amoxicillin
Cephalosporins such as cephalexin (Keflex)
Macrolides such as erythromycin (E-Mycin), clarithromycin (Biaxin), and azithromycin (Zithromax)
Fluoroquinolones such as ciprofolxacin (Cipro), levofloxacin (Levaquin), and ofloxacin (Floxin)
Sulfonamides such as co-trimoxazole (Bactrim) and trimethoprim (Proloprim)
Tetracyclines such as tetracycline (Sumycin, Panmycin) and doxycycline (Vibramycin)
Aminoglycosides such as gentamicin (Garamycin) and tobramycin (Tobrex
