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NRSG 238- Assessment > Pregnancy + Older Adult > Flashcards

Pregnancy + Older Adult Flashcards

1
Q

presumptive signs pregnancy

A

n/v
breast tenderness
cessation periods
inc fatigue around 3 months

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2
Q

probable signs preg.

A

analyzed by provider- enlarged uterus

positive preg. test

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3
Q

positive signs preg.

A

direct evidence fetus (feeling/ ultrasound)

fetal heart tones

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4
Q

1st trimester

A

1-12 weeks
embryonic period
breast tingling/tenderness bc inc estrogen
n/v (50%)- can be affected by low blood sugar
slowed peristalsis
emotional factors
fatigue

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5
Q

2nd trimester

A 
dec blood pressure 8mm
12-27 weeks
improved n/v
fetal mvmnt 18 weeks
inc breasts, colostrum
heartburn , inc blood volume
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6
Q

3rd trimester

A 
28 weeks to delivery
blood vol peaks (40-50%inc)
bp rises to pre-preg lvls, SOB, inc pulse rate
systolic heart murmur (90%)
edema, varicosities, hemorrages
lordosis (sway back)
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7
Q

primigravida

A

1st preg

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8
Q

primipara

A

1st birth

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9
Q

multigravida

A

1+ preg

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10
Q

multipara

A

1+ birth w/ viable offspring

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11
Q

fetal tones present

A

9-12 weeks w/ doppler

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12
Q

uterus palpable (fundus)

A

12 weeks

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13
Q

engagement

A

2 wks before labor, baby drops into pelvis

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14
Q

full term

A

37-42 wks

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15
Q

gestation calculation- estimated due date

A

1st day LMP + 7 days and - 3 months

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16
Q

HCG

A

human chorionic gonadotropin present after implantation

detected in urine

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17
Q

conception

A

around 14 day of menstrual cycle

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18
Q

norm preg weight gain

A

25-35lbs
28-40 if underweight
15-25 if overweight

25% fetus
11% placenta/fluid

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19
Q

chloasma

A 
in second trimester
common in dark complected
50-70%
inc melanocyte distribution
bc sunlight exposure
common in face or arms
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20
Q

linea nigra

A

line from umbillicus to pubic symph
inc in darker women
inc melaocytes
may not fade after preg

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21
Q

striae gravidarum

A

stretch marks w/ preg

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22
Q

angiomas

A

sm, red spider like bursts on skin

from inc estrogen

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23
Q

increase sebaceous gland secretion results in what

A

=acne

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24
Q

hair and nail in preg

A

inc growth

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25
Q

ear/nose/ and mouth changes in preg

A

ear fullness
nasal stuffiness and epistaxis
gingival hypertrophy or bleeding
bc inc vascularity

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26
Q

thyroid in preg

A

may be palp

smooth, non-t, no nodules

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27
Q

transverse diam- pregn

A

across/lateral inc by 2 cm

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28
Q

costal angle during pregnancy

A

can be greater than 90

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29
Q

breathing as pregnancy progresses

A

thoracic - chest based instead belly

SOB

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30
Q

CO and blood vol in preg

A

inc co

blood vol inc 40-50%

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31
Q

HR and BP in preg

A

hr- inc 10-15bpm
bp- norm in 1st+ 3rd semesters, drops 5-10mmHg in 2nd
bp should not be higher than pre-preg 130/80

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32
Q

murmurs in preg and ortho hypotension

A

95% common
common bc compression on vena cava
lay on side and stand up slowly

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33
Q

breast changes

A

inc size, tender, inc sensitivity, inc nipple erectility
hypertrophy Montgomery’s tubercles (secrete lubricant w/ lactation, dots around areola)
areola darker and bigger
blood v more visible

34
Q

colostrum

A

around week 16

discharge norm

35
Q

taste and smell preg

A

heightened

36
Q

diastasis rectus abdominus

A

common in preg
not true hernia
midline ridge

37
Q

fundus palpable at

A

12 weeks

38
Q

fetal outline determined at

A

30 weeks

feel through abdomen

39
Q

Fetal heart tones

A

9-12 weeks w/ doppler
20 weeks w/ stethoscope (bell)
120-160 norm

40
Q

weeks of gestation in relation to cm in size

A

should be equal

measure pubic symph over belly and to top fundus

41
Q

involution of uterus

A

after delivery 10 days- 2 weeks should shrink to pre-preg size

42
Q

chadwick’s sign

A

cervix blue color- norm

after delivery cervix opening less round and tight

43
Q

vaginal discharge preg

A

thin, white

abnorm= thick, purulent, foul smelling

44
Q

urinary freq in preg r/t

A

inc renal output/perfusion and mechan pressure

45
Q

lordosis

A

sway back

inward curvature

46
Q

musculoskel changes preg

A

low back pain, leg cramps, numbness/tingling hands

47
Q

deep tendon reflexes preg

A

should be norm

48
Q

integument changes- older adult

A 
dec elasticity, thin
dec melanocytes (gray hair and dev terminal hair)
thick, brittle nails
skin tag
delayed wound healing
dec temp reg
49
Q

lentigines

A

macules
areas exposed to skin
big freckles

50
Q

seborrheic keratosis

A

fair- brown in color

small points raised skin bc exposure to sun

51
Q

lymph nodes- elderly

A

dec w/ age. usually not palpable

52
Q

thyroid-elderly

A

non-palp

53
Q

cataracts

A

common, cloudy vision

54
Q

eye changes elderly

A

dec near vision bc lens hardening- presbyopia

dry eyes

55
Q

enophthalmos

A

sunken eyes bc loss of fat

56
Q

arcus senilis

A

white ring lipid deposits outer edge cornea

57
Q

entropion

A

inward eyelid

58
Q

ectropion

A

outward eyelid

59
Q

zanthelsma

A

lipid deposition on external eyes
can be familial
or indicate in lipid levels in blood

60
Q

pupillary size elderly

A

dec, w/ dec accom

need bright light to see

61
Q

fundoscopic changes- elderly

A

more pale

62
Q

glaucoma

A

dec peripheral vision not norm
bc inc intraocular P
nerve degneration

63
Q

presbycusis

A 
age-related nerve degen
dec sensorineural hearing (inner ear CN 8)
age 65 40% loss
age 85 80% loss
lose high freq tones
64
Q

otosclerosis

A

middle ear hearing loss

dec vibration

65
Q

tinnitus

A

ringing bc damage cochlear hair cells

66
Q

otoscopic changes- elderly

A

tympanic more dull
light reflex same
5 oclock- R
7 oclock- L

67
Q

nose changes elderly

A

dec smell
inc nasal hair (terminal)
elongated nose bc dec fat and dec elasticity

68
Q

mouth changes elderly

A

dec taste and dec papillae on tongue
inc risk tooth decay bc dec salivation
mucosa dry and pale

69
Q

kyphosis

A

stooped/bent forward posture

thoracic spine curved

70
Q

respiratory changes elderly

A 
dec excursion (expansion chest)
breath sounds quiet and dec bc stiff lung tissue
71
Q

cardiovascular changes elderly

A 
inc Peripheral vasc. dis (venous and arterial)
dec pedal pulses 1+ v 2+
stiff arteries
slight inc systolic bp and wider pulse p
inc risk ortho. hypotension
varicosities
72
Q

bowl sounds elderly

A

dec and quieter

73
Q

organ and abdom musculature- elderly

A

organs easier palp

musculature soft

74
Q

dysphagia and dypepsia

A

dysphagia not norm

dyspepsia- heart burn common

75
Q

female reprod changes elderly

A 
breast more pendulum bc dec elasticity
dec pubic hair, size external genitalia
pale vaginal walls
dec lubrication
uterus and ovaries dec
76
Q

male reprod changes elderly

A 
possible gynecomastia
dec pubic hair
dec scrotum and penis
testes hang lower
enlarged prostate id w/ diff urinating
77
Q

musculoskeletal changes elderly

A

Rom dec
gait changes
dec muscle strength
dec agility

78
Q

get up and go test

A

stand and walk ten feet

should take about 10 sec

79
Q

benefits exercise elderly

A 
inc Cardiovascfunction, posture, balance, flexibi, strenght, ROM
dec falls
dec depression
helps w/ cog. and memory
maximizes independance
80
Q

neuro changes elderly

A 
mem may dec
slower response time
relfex can dec but should be equal
dec vibratory sensation (check feet)
Romberg should be neg but can have more swaying
81
Q

febrile response, weight and acute infection response in elderly

A

dec systemic/lymphatic response
inc weight r/t dec BMR
dec febrile response (fever)

NRSG 238- Assessment (11 decks)

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