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NURS 629 EXAM 1 | QUESTIONS AND ANSWERS |
2025 - 2026 | GRADED A+
Routine office visit times Every 4 weeks until 28 weeks Every 2 weeks until 36 weeks Every week from 36 to delivery Biweekly after 40 weeks First trimester normal findings Breast pain, enlargement, changes in pigmentation, constipation, excessive salivation and bad taste in mouth, fatigue, flatulence, headache, hemorrhoids, nausea and vomiting, urinary frequency and incontinence, varicosities of vulva and legs. Second trimester normal findings Backache, dyspnea, epistaxis, leukorrhea, ligament pain, muscle cramps in the calf, thigh, or buttocks, pica, syncope. Third trimester normal findings
Braxton-hick's contractions, discomfort in the upper extremities, edema, heartburn, insomnia, joint pain/ pelvic girdle pain. First trimester danger signs Spotting or bleeding, cramping, painful urination, severe vomiting and/ or diarrhea, fever higher than 100.4f, symptoms of vaginal infection or stis, persistent or severe low abdominal pain, lightheadedness, dizziness, abdominal trauma. Second trimester danger signs Regular uterine contractions (6 or more per hour), unilateral leg or calf pain, edema, pain with movement, redness, heat, and tenderness or coldness, numbness and paleness to extremity, sudden gush or consistent leaking of fluid, absence of fetal movement for more than 24 hours after quickening, sudden weight gain, significant edema of the face and/ or hands, severe upper abdominal pain, headache with visual changes and/ or photophobia. Third trimester danger signs Decrease in daily fetal movement, after 37 weeks gestation, when contractions are 3-5 minutes apart if a primipara or 5-8 minutes apart if a multipara lasting 45 - 60 seconds and strong in intensity or with the characteristics of true labor.
3 hour > 140 What is the treatment for mild pregnancy induced hypertension? Lifestyle modification: smoking cessation, healthy diet, regular exercise. Implement close observation Signs and symptoms of mastitis Flu-like symptoms including malaise, fever, and chills. Tender, hot, red, painful area, or lump in the breast. Fever is often high, tachycardia, breast exam reveals warmth, redness, tenderness, and swelling. Nipple may be cracked or abraded and breast distended with milk. What is the first line therapy for mastitis Dicloxacillin 250-500mg every 6 hours for 10-14 days. Erythromycin 500mg every 6 hours for 10 days if pcn allergy. Tylenol as needed. Ice or warm packs. Continue to nurse infant on both breasts but begin on unaffected side. Increase fluid intake. What antibiotic cannot be given if an infant is nursing and less than 1 month Sulfa
When should you suspect a breast abscess If there is no resolution of symptoms after several days of antibiotics. Pitting edema is possible and fluctuation may be felt over the affected area. This usually requires both abx and drainage. Refer to physician. Culture and sensitivity of breast milk. S/s of gestational hypertension Bp greater than 140/90 after mid-pregnancy but no proteinuria Fundal height at 12 weeks Symphysis pubis Fundal height at 16 weeks Between symphysis pubis and umbilicus Fundal height at 20 weeks Umbilicus and measures 20 cm
Fetal development at 5.5 weeks Secondary yolk sac Fetal development at 6 weeks Visible embryo and heart motion Fetal development at 7-8 weeks Fetal limbs are identifiable and fetal head is proportionately larger than the body Fetal development at 9-12 weeks Fetal movement, the stomach, bladder, umbilical cord, and spine can be seen Fetal development at 11-14 weeks Most normal fetal anatomic features can be identifiable by sonography
Fetal development at 13-16 weeks External sex organs are formed. The outer ear begins to develop. The fetus can swallow and hear. The neck is formed. Kidneys are functioning and begin to produce urine. Fetal development at 17-20 weeks The sucking reflex develops. The skin is wrinkled, and the body is covered with vernix and lanugo. You may be able to feel him or her move. The fetus sleeps and wakes regularly. The gallbladder begins producing bile, which is needed to digest nutrients. In female fetuses, the eggs have formed in the ovaries. In male fetuses, the testes have begun to descend. It may be possible to tell the sex of the fetus on an ultrasound exam Fetal development at 21-24 weeks The fetus may hiccup. The brain is rapidly developing. Tear ducts are developing. Finger and toe prints can be seen. The lungs are fully formed but not yet ready to function outside of the uterus. Fetal development at 25-28 weeks The eyes can open and close and sense changes in light. The fetus kicks and stretches. The fetus can make grasping motions and responds to sound. Lung cells begin to make a substance that will enable breathing.
Treatment for n/v in pregnancy Vitamin b6 with doxylamine combination 10mg/ 10mg (a) 2 tabs at hs and 1 tab in morning or midday if needed. Diphenhydramine 25-50mg (b) every 4-6 hours.
- dimenhydrinate (dramamine) 25-50mg (b) every 4-6 hours. Prochlorperazine 5 - 10mg (c) every 4-6 hours or 25mg rectal bid. Promethazine 12.5-25 mg (c) every 4-6 hours. Metoclopramide 5-10 mg (b) po or im every 6-8 hours. Zofran 4mg (b) tid. Avoid clothing that is tight and constricting, hypnosis, acupuncture, relaxation techniques, acupressure, autogenic training, meditation, visual imagery, massage, eat small, frequent meals, eat crackers on arising, adequate hydration, ginger maxing 1 gm per day. What otc medications cannot be given during pregnancy Nsaids, aspirin, cimetidine, iodine Large doses of which vitamins can be harmful to mom and baby A and d Recommended weight gain during pregnancy Underweight: 28-40lb Normal weight: 25-35lb
Overweight: 15-25lb Obese: 11-20lb Initial visit blood testing Abo blood group/ rh factor, cbc, rubella titer, syphilis screening, hepatitis b surface antigen, urinalysis and culture, chlamydia screening, gonorrhea screening, cervical cytology, hiv antibody screening. Second trimester blood testing Genetic and congenital screening tests. Quad screening. If rh negative re-do antibody titer, glucose screening for gestational diabetes, h&h. Third trimester blood testing Retest for chlamydia, gonorrhea, syphilis, and/ or hiv if needed How to improve breast pain Avoid use of caffeine, sleeping in a bra, pain often improves in the second trimester.
How to improve headache Acetaminophen 325-650mg (b) every 4 hours as needed. Avoid stress, smoking, blinking lights, sleeping late. Reduce stress, adequate sleep, have neck and shoulders massaged with heat or cold pack, relaxation techniques, eat a regular, balanced diet, stay well hydrated. How to improve hemorrhoids Over the counter topical anesthetics such as preparation h, warm or cool sitz baths, avoid constipation, witch hazel pads, avoid straining by elevating feet on a stool when attempting to defecate, apply ice packs or cool compresses, apply petroleum jelly around anus before defecating, avoid prolonged sitting or standing, kegel exercises How to improve urinary frequency and incontinence Resting and sleeping in the lateral recumbent position, kegel exercises, adequate fluid intake How to improve varicosities of vulva and legs Apply support hose and compression stockings by lying flat and raising her legs to drain the veins, wear stockings all day, avoid crossing legs, do not wear knee high stockings or tight bands around the legs, avoid prolonged standing or
sitting, elevate the legs as often as possible, kegel exercises, warm tub baths, avoid leg or vulvar injury, use a perineal pad with sanitary belt or maternity girdle to compress vulvar varicosities. How to improve backache Acetaminophen 325-650mg (b) every 4 hours as needed. Good posture, wearing of low-heeled shoes, pelvis tilt exercises, yoga, physical exercise, rest feet on a stool when sitting for long periods, lateral recumbent position when sleeping with pillows supporting the back and legs, wear a good, supportive bra, massage and relaxation techniques, heating pad, warm tub baths, cold applications for short periods, physical therapy or chiropractor How to improve dyspnea Symptoms may improve when the fetus drops into the pelvis. Do not wear constrictive clothing. Sitting up straight and raising hands above head may improve symptoms, elevate head with pillows, laying in the lateral recumbent position How to improve epistaxis Loosen clothing around the neck, sit with her head tilted forward, pinch her nostrils for 10-15 minutes and apply ice packs to her nose. Light packing with sterile gauze. Avoid overheated air, excessive exertion, and nasal sprays. Saline
Patient can eat ice, educate that nonfood substances can he harmful to mother and baby. Diet high in iron with iron supplements How to improve syncope Rest in the lateral recumbent position, change position gradually, hold onto something while rising, lower the head below the level of the heart if feeling faint, apply compression stockings before getting out of bed and perform leg pumping exercises, eat frequent small meals throughout the day, maintain adequate protein intake How to improve braxton-hicks contractions Empty bladder frequently, stay well hydrated, resting in lateral recumbent position, walking, light exercise, lamaze breathing, relaxation techniques. How to improve discomfort in the upper extremities Wearing a wrist splint especially at hs, raise hands above the head and pump fists, put the hands at the side of the head and shake, wear a well supporting bra, avoid slumping. How to improve edema
Lie in lateral recumbent position for 1-2 hours twice daily and sleep in this position, avoid long periods of sitting or standing, regular aerobic exercise, maternity support pantyhose or abdominal support band, do not curl hands under pillow at night, use of wrist supports, drink 8-10 glasses of fluid daily. How to improve heartburn Antacids then h2 receptor blockers, then ppi if needed. H2 receptor blocker including famotidine, nizatidine (b). Do not lie down for 2 hours after eating, elevate head of bed 6 inches for sleeping, stop smoking, avoid hot, spicy, fatty, gas-forming, and acidic foods, eat small, frequent meals. Sipping water, milk, hot tea, or a tbs of heavy cream, yogurt, or half-and-half or chewing gum may help How to improve insomnia Establish a regular sleep time, exercise, do not exercise 2 hours before sleep, relaxation techniques, sleep hygiene, avoid caffeine after midday and heavy meals at end of the day. Warm milk. Encourage higher fiber intake earlier in the day, avoid high sugar diets. How to improve joint pain/ pelvic girdle pain Acetaminophen as above. Avoid excessive walking, high-heeled shoes, jarring movements, high impact activities. Apply heating pad, warm moist heat, cold pack, reclining on the opposite side, maintaining good posture, place pillows
How can we prevent neural tube defects An estimated 50% of neural tube defects can be prevented with 400 ug of folic acid daily starting before conception. Consumption of fortified foods in addition to supplementation with folic acid or with a prenatal vitamin typically provides adequate recommended daily intake. Treatment of trichomonas Metronidazole (flagyl) 2g, single dose Treatment of bv Metronidazole (flagyl) 500mg bid x 7 days or suppository vaginal of metrogel x 5 nights; can use clindamycin in pregnancy or recurrent cases How to treat yeast infection Miconazole or diflucan 150mg a single dose Treatment of chlamydia Azithromycin 1 g single dose
Treatment of gonorrhea Ceftriaxone 250mg im injection, single dose Treatment of pid Ceftriaxone 250mg im once, plus doxycycline 100mg bid x 14 days plus metronidazole 500mg bid x 14 days Guidelines for pap Start at 21, regardless of sexual activity Every 3 years till 29 Every 5 years 30 - 65 When should testing be repeated if patient has an abnormal pap Repeat annually until 2 normal Pap guidelines for a patient with a history of cervical or uterine cancer Paps yearly until 20 years cancer free
