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TEST |! 1 |! MATERIALS |! NURS |! 5432 |! EXAM |! Latest |! | |!
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- PAP |! smear |! - |! Correct |! Answer-start |! at |! 25year |! per |! ACS, |! HPV |! every |! 5 |! years |! , |! cotesting |! every |! 5 |! years, |! cytology |! every |! 3 |! years
- Breast |! cancer |! screening |! - |! Correct |! Answer-Average |! risk: |! if |! chest |! radiation |! therapy |! before |! 30 |! year, |! genetic |! mutation |! of |! BRCA, |! family/pt |! history |! of |! CA 40-44yr: |! have |! option |! to |! start |! mammogram |! screening |! every |! year |! 45-54yr: |! SHOULD |! get |! mammogram |! every |! year 55 |! and |! up: |! can |! do |! every |! other |! year |! or |! q |! year |! until |! they |! are |! in |! good |! health |! to |! live |! 10 |! more |! years high |! risk: |! Family |! history |! of |! breast |! cancer, |! non-BRCA1 |! or |! BRCA2 |! mutation, |! head |! radiation |! therapy |! to |! chest, |! Li-Fraumeni |! Syndrome, |! Cowden |! Syndrome, |! Banayan-Riley |! Ruvalcoba |! syndrome
- Overdiagnosis |! - |! Correct |! Answer-finding |! cancer |! that |! wouldn't |! have |! been |! a |! problem |! if |! you |! not |! found |! it ACS |! recommend |! AGAINST |! MRI |! if |! cancer |! chance |! is |! <15%c
- cervical |! dysplasia |! - |! Correct |! Answer-the |! growth |! of |! abnormal |! cells |! in |! the |! cervix can |! be |! premalignant |! cervical |! disease |! called |! cervical |! intraepithelial |! neoplasia |! (CIN) CIN |! 1: |! mild |! dysplasia |! with |! low |! grade |! lesion. |! Cellular |! change |! in |! lower |! 1/3rd |! of |! squamous |! epithelium CIN |! 2: |! moderate |! dysplasia |! with |! high |! grade |! lesion. |! Cellular |! change |! in |! lower |! 2/3 |! of |! squamous |! epithelium CIN |! 3 |! or |! Carcinoma |! in |! situ: |! severe |! dysplasia |! with |! high |! grade |! lesion. |! Cellular |! change |! in |! full |! thickness |! of |! squamous |! epithelium -Squamous |! epithelium |! increase |! during |! pregnancy |! but |! reduces |! postpartum -Endocervical |! curettage |! is |! contraindicated |! during |! pregnancy -Unless |! cancer |! is |! identified/suspected |! treatment |! for |! CIN |! is |! contraindicated |! during |! pregnancy
- Digital |! Breast |! Tomosynthesis |! - |! Correct |! Answer-provides |! 3D |! images |! from |! a |! mammogram |! machine |! which |! rotates |! around |! the |! breast
- Fibroadenoma |! - |! Correct |! Answer-a |! round, |! firm, |! rubbery |! mass |! that |! arises |! from |! excess |! growth |! of |! glandular |! and |! connective |! tissue |! in |! the |! breast Fluctuation |! in |! size |! with |! pregnancy |! or |! menstrual |! cycle |! NO |! nipple |! discharge
eliminate |! caffeine, reduce |! dietary |! fat pharm |! management |! for |! fibrocystic |! BD |! - |! Correct |! Answer-vitaminD |! 2000 |! IU |! day spironolactone |! for |! swelling |! (25-200mg |! PO |! daily; |! start |! with |! 100 |! IU |! daily) |! vitamin |! E |! 200 |! IU |! twice |! daily |! or |! 500 |! IU |! daily evening |! primrose |! oil |! 2-4g |! daily |! oral |! contraceptives Intraductal |! papilloma |! (IDP) |! - |! Correct |! Answer-Benign |! tumor |! within |! the |! ductile |! system |! (ductal |! epithelium |! and |! myoepithelial |! cells) |! of |! the |! breast |! that |! may |! occur |! alone |! or |! as |! multiple |! tumors. |! Most |! common |! in |! women |! ages |! 35 |! to |! 50 |! years. |! Ductal |! ectasia |! is |! often |! associated |! with |! IDP For |! bilateral |! nipple |! discharge |! - |! Correct |! Answer-Check |! for |! TSH |! (hypothyroid), |! prolactin |! (pituitary |! tumor) -medications: |! spironolactone, |! antihypertensives, |! antidepressants, |! antidopaminergics, |! estrogen |! OCPs, |! opioids, |! marijuana, |! methyldopa, |! H2 |! receptor |! antagonist Breast |! cancer |! screening |! per |! ACS |! - |! Correct |! Answer-Anual |! between |! 45 |! and |! 54 |! years, |! then |! every |! two |! years |! after |! age |! 55
Breast |! Cancer |! - |! Correct |! Answer-2nd |! most |! cause |! of |! CA |! death |! in |! USA |! women Malignant |! neoplasm |! of |! cells |! native |! to |! breast |! epithelial, |! glandular, |! or |! stoma Hormone |! replacement |! therapy |! is |! a |! RISK |! FACTOR |! for |! Breast |! CA |! - |! Correct |! Answer-(combination |! estrogen-progestrone |! and |! estrogen |! only |! agent) during |! perimenopause |! increases |! breast |! cancer |! risk |! for |! 10 |! years |! after |! medication |! discontinued Treatment |! for |! breast |! CA |! - |! Correct |! Answer-Hormonal |! therapy
- SERMS Tamoxifen |! (20-40mg |! daily; |! if |! more |! than |! 20 |! use |! twice |! daily |! dose) |! Raloxifene |! (60mg |! daily) Calcium |! and |! vitamin |! D |! supplement |! is |! recommended
- |! non-steroidal |! aromatase |! inhibitors |! {lowers |! estrogen |! production} |! Anastrozole |! 1mg |! daily Letrozole |! 2.5mg |! daily
- chemotherapy -radiation |! therapy Benign |! Ovarian |! Tumors |! - |! Correct |! Answer-Non-malignant |! tumor |! of |! the |! ovary |! may |! be |! solid |! or |! cystic
Missed |! Pill |! situation |! - |! Correct |! Answer--If |! you |! miss |! one |! pill |! within |! 12 |! hours |! of |! time |! that |! you |! should |! have |! taken: |! take |! todays |! pill |! immediately -If |! you |! miss |! one |! pill |! more |! than |! 12 |! hours |! of |! time |! that |! you |! should |! have |! taken: |! take |! todays |! pill |! immediately
- |! If |! more |! than |! one |! pill |! missed: |! take |! todays |! pill |! and |! forgotten |! pill |! today |! (two |! tablets |! in |! 1 |! day) If |! she |! has |! at |! least |! seven |! active |! pills |! in |! the |! pack, |! she |! has |! two |! options:
- Take|! the|! rest|! of|! the|! active|! pills,|! skip|!the|! placebo|! pills|! and|! start|! the|! next |! pack |! of |! pills|! without|! interruption|! and|! use |! condom|! or|! abstinence|! for|! seven |! days. OR
- take |! the |! pills |! as |! in |! the |! pack |! and |! use |! condom |! or |! abstinence |! until |! she |! has |! taken |! seven |! of |! the |! pills |! in |! the |! pack Prenatal |! Visits |! - |! Correct |! Answer-every |! 4 |! weeks |! until |! 28 |! weeks |! every |! 2 |! weeks |! until |! 36 |! weeks every |! week |! until |! born First |! trimerster |! - |! Correct |! Answer-0-12week S/S: |! urinary |! frequency, |! breast |! tenderness, |! nausea, |! vomiting, |! fatigue, |! amenorrhea Physical |! Exam |! findings:
- |! softening |! of |! cervix |! (Goodwell's |! sign) -Cervical |! cyanosis |! (chadwicks |! sign) -softening |! of |! cervicouterine |! junction |! (Hegars |! sing),
-Breast |! enlargement,
- |! Fetal |! heart |! tone If |! mom |! on |! thyroid |! medication, |! dose |! needs |! to |! be |! doubled |! the |! 1st |! trimester |! for |! fetus |! cannot |! produce |! their |! own |! at |! this |! time Second |! trimester |! - |! Correct |! Answer-13-27 |! wk S/S: |! fetal |! movement, |! round |! ligament |! pain |! [abdominal |! discomfort |! secondary |! to |! stretching], |! changing |! skin |! color |! such |! as |! Cholasma |! (brown |! or |! gray-broen |! patch |! in |! face), |! syncopal |! episode Physical |! Exam |! findings: -stria |! on |! breast, |! hips, |! abdomen |! (steroid |! cream |! helps) -fundus |! palpable |! at |! umbilicus |! at |! 20 |! wk -Leopold |! maneuvers |! at |! 20wk |! (to |! identify |! the |! position/presentation |! of |! baby) Amniocentesis |! at |! 15-20wk |! if |! family |! abnomalitlies |! Triple |! OR |! Quad |! screen |! at |! 16-20wk Repeat |! CBC, |! US third |! trimester |! - |! Correct |! Answer-28-40wk S/S: |! abdominal |! girth, |! return |! of |! urinary |! frequency |! with |! descent |! of |! presenting |! part, |! increased |! respiratory |! effort, |! Braxton-Hicks |! contraction(d/t/ |! dehydration)
- loss |! of |! mucous |! plug/bloody |! show |! prior |! to |! labor |! by |! approximately |! one |! week
- may |! experience |! increasing |! Braxton-hicks |! contractions/rupture |! of |! membranes |! {within |! 24-48hr |! delivery |! needs |! to |! happen |! d/t |! infection |! chance} Tests: Repeat |! CBC |! RhoGam |! at |! 28wk |! hg/hct US repeat |! gonorrhea/ |! chylamadia |! Group |! A |! beta |! hemolytic |! strep |! culture Diabetes |! screening |! - |! Correct |! Answer-Done |! at |! 24 |! to |! 28 |! weeks |! gestation. |! Diabetes |! screening |! if |! plasma |! glucose |! is |! greater |! than |! 130 |! to |! 140mg/dL Positive |! screening; |! hundred |! G |! glucose |! load |! administered, |! and |! glucose |! values |! are |! measured |! fasting, |! at |! one |! hour, |! two |! hours, |! and |! three |! hours. |! If |! two |! of |! the |! three |! values |! are |! abnormal |! a |! diagnosis |! of |! gestational |! diabetes |! is |! made Naegele's |! Rule |! - |! Correct |! Answer-LMP |! subtract |! 3 |! months, |! add |! 7 |! days
Leopold's |! Maneuvers |! - |! Correct |! Answer-Palpation |! to |! determine |! presentation |! and |! position |! of |! the |! fetus |! and |! aid |! in |! location |! of |! fetal |! heart |! sounds.
Constipation: |! d/t |! increased |! progestrone |! level |! and |! comrpession |! of |! the |! lower |! bowel |! d/t |! uterus |! enlargement. Reduce |! iron |! supplement |! as |! indicated, |! mild |! laxatives |! (prune |! juice, |! milk |! of |! Mg, |! Psyllium, |! docusate |! sodium, |! docusate |! calcium, |! senokot) |! are |! okay. DON'T |! DO |! Harsh |! laxatives |! or |! enema |! for |! it |! can |! induce |! labor. |! NO |! mineral |! oil |! it |! reduce |! nutrition |! absorption. Gerd: |! d/t |! increased |! progestrone. Histamine |! 2 |! blockers, |! tums |! and |! maalox, |! Lansoprazole |! (PPI) |! are |! all |! safe. |! Famotidine |! NOT |! safe |! for |! It |! can |! pass |! through |! placenta. Hemorrhoids: |! d/t |! increased |! rectal |! vein |! pressure |! from |! uterus, |! low |! fiber |! diet, |! obesoty, |! constupation, |! Hx |! of |! hemorrhoids. Anusol |! hemorrhoid |! cream/ointment, |! rectal |! suppository, |! with |! hazel |! medicated |! pads, |! stool |! softeners. Leg |! cramps:usually |! at |! night |! time |! on |! 2nd |! and |! 3rd |! trimester |! from |! involuntary |! muscle |! contractions. |! imbalance |! ca/phos |! ratio increase |! mag-rich |! foods: |! whole |! grain, |! beans, |! dried |! fruits, |! nuts/seed Common |! Pregnancy |! issues |! (continued) |! - |! Correct |! Answer-Always |! refer |! to |! PLLR |! when |! recommending |! pharmacologic |! managements. Leukorrhea: |! thin, |! white |! milky |! vaginal |! discharge, |! mild |! odor. |! Normal |! in |! 1st |! trimester. |! d/t |! elevated |! estrogen |! level. Nasal |! congestion: |! Estrogen |! induced |! hypersecretion |! of |! mucus, |! epistaxis
Consider |! intranasal |! glucocrticoid |! spray |! like |! Rhinocort |! aqua |! (budesonide), |! nosenex |! (mometasone), |! flonase |! (fluticasone). |! AVOID |! all |! antihistamines |! and |! decongestant |! nasal |! spray |! during |! pregnancy. N/V:increase |! in |! human |! chorionic |! gonadotropin |! hormone |! (hCG) |! Ginger, |! Diclegis |! (doxylamine |! 10mg |! and |! pyridoxine |! 10mg) |! can |! be |! used Round |! ligament |! pain: |! from |! stretching |! and |! straining |! of |! round |! ligament |! as |! uterus |! enlarges. |! during |! 2nd |! trimester avoid |! sudden |! movements, |! heating |! pad |! at |! abdomen, |! flex |! hips |! before |! cough |! or |! sneeze, |! stretching |! exercises, |! prenatal |! exercise |! class, |! swimming |! or |! yoga Urinary |! Frequency: |! During |! 1st |! and |! 3rd |! trimester. |! due |! to |! increase |! in |! progesterone |! and |! human |! chorionic |! gonadotropin |! hormone. void |! leaning |! forward, |! avoid |! caffeinated |! stuff, |! increase |! fluid |! intake, |! kegel |! exercise, |! avoid |! drinking |! too |! much |! water |! prior |! to |! bedtime amoxicillin, |! augementin |! or |! cephalosporin |! are |! the |! antibiotics |! you |! use |! for |! UTI |! during |! pregnancy. Varicose |! veins: |! d/t |! increased |! progestin |! cause |! dilation |! of |! veins, |! weight |! gain, |! increased |! age, |! hereditary |! factor. don't |! cross |! leg, |! use |! stocking, |! sleep |! on |! left |! side |! to |! reduce |! pressure |! off |! of |! vena |! cava, |! reduce |! sodium |! intake, |! increase |! water |! and |! fiver |! intake, |! elevate |! legs, |! keep |! walking. hyperemesis |! gravidarum |! - |! Correct |! Answer-Risk |! factors: |! multiple |! gestations, |! hydatidiform |! mole
1st |! trimester: |! d/t |! chromosomal |! abnormalities
2nd |! trimester |! d/t |! cervical |! incompetence, |! infection |! or |! uterine |! abnormalities s/s: |! vaginal |! bleed, |! cramp, |! low |! back |! pain, |! rupture |! of |! membrane, hCH, |! US, |! cbc, |! coagulation Treatment: -surgical |! abortion: vacuum |! D |! and |! C |! to |! 12 |! wk, D |! and |! E |! 13-14wk |! to |! 20-22wk, |! hysterectomy
- medical: Mifepristone |! (Mifeprex) |! AKA |! RU |! 486=ABORTION |! Prostaglandin |! (Misoprostol) pregnancy-induced |! hypertension |! (PIH) |! - |! Correct |! Answer-potentially |! life- |! threatening |! disorder |! that |! usually |! develops |! after |! the |! 20th |! week |! of |! pregnancy BP>140/90 |! or |! rise |! in |! systolic |! >30mmhg contributing |! factors: |! pre-existing |! hypertension, |! renal, |! cardiovascular |! disease, |! diabetes, |! lupus, |! auto |! immune |! disorders, |! multiple |! gestation, |! primigravida, |! personal |! or |! family |! history |! of |! PIH, |! preeclampsia, |! maternal |! age |! at |! the |! end |! of |! reproductive |! timeline testing: |! cbc, |! 24hr |! protein |! urine, |! creatinine/creatinine |! clearance, |! Non-stress |! test. |! (NST) |! if |! post |! 32 |! wk |! pregnancy
TX: |! Magnesium |! sulfate |! (MgSo4) |! to |! break |! seizure |! (valium |! if |! ineffective); |! the |! IV |! drip |! to |! stabilize. |! Delivery |! ASAP |! once |! mother |! is |! stable
HELLP |! syndrome |! - |! Correct |! Answer-hemolysis, |! elevated |! liver |! enzymes, |! low |! platelets s/s: |! Preeclampsia |! + |! nausea |! +jaundice |! +extreme |! fatigue, |! ill |! feeling PE: |! hepatomegaly, |! tenderness |! in |! RUQ |! to |! epigastric, |! jaundice, |! ascites tests: |! thrombocytopenia |! below |! 50,000 |! not |! unusal, |! clotting |! factors |! reduced, |! elevated |! LFT, |! proteinuria Hospitalize, |! deliver |! baby |! ASAP |! once |! mother |! stable placenta |! previa |! - |! Correct |! Answer-implantation |! of |! the |! placenta |! over |! the |! cervical |! opening |! or |! in |! the |! lower |! region |! of |! the |! uterus Cervical |! os |! can |! be |! marginal, |! partial |! or |! completely |! covered |! usually |! caused |! by |! sex |! in |! 2nd |! and |! 3rd |! trimester Risks: |! previous |! c-section |! or |! uterine |! sx, |! multiparity, |! malpresentation |! (breech/transverse |! lie), |! Hx |! of |! placenta |! previa Bleeding |! is |! painless, |! occur |! after |! sex, |! no |! uterine |! tenderness tests: |! US, |! External |! Fetal |! Monitor |! (EFM) |! to |! exclude |! fetal |! distress, |! if |! bleeding |! continuous/severe |! obtain |! CBC
