Exam (elaborations)

NUR 2633 MATERNAL NEWBORN STUDY GUIDE 2020 WITH QUESTIONS,100% CORRECT

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NUR 2633

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nur 2633 maternal newborn study guide 2020 with questions

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NUR 2633 MATERNAL NEWBORN STUDY GUIDE 2020 WITH
QUESTIONS
Women’s health encompasses breast care, GYN exams, and assessments. Be
comfortable with the parameters of education for
a. Breast education-
b. Fluctuating hormone levels during the monthly cycle cause changes in breast
tissue.
i. Following menstruation, when hormone levels are at their lowest, the
breast tissue is smooth and nontender.
ii. As estrogen levels increase mid-cycle, breasts may become more
sensitive. Also, just before menstruation, when progesterone is
elevated, the breasts become swollen and tender, with palpable
nodules.
c. The area between the breasts has several oil and sweat glands, creating
an atmosphere conducive to the growth of bacteria.
d. Pregnancy darkens the color of the nipple, which is an enhancement for the
breastfeeding baby. This darker color does not disappear after pregnancy.
e. Mammography (mammogram) - is an MRI of the breast tissue
used to detect abnormalities (tumors and cysts).
i. Routine mammograms should be performed every 2 years for women ages
50-74
ii. Some gynecologists recommend mammograms begin a yearly
mammogram screening at age 40.
Self-breast exams-
iii. Should be performed every 1-3 years for age 20-29 and every year
for women over 40.
iv. Technique:
Breast Self-Examination (ACS, 2011d) p lxix
1) Lie down on your back and place your right arm behind your head. Remember,
this step is done while lying down. In this position, the breast tissue spreads
evenly over your chest wall and is as thin as possible. This makes it much
easier to feel all of the breast tissue.

2) Use the pads of your three middle fingers on the left hand to feel for lumps in
the right breast. Use overlapping dime-sized circular motions of the finger pads
to feel all of the breast tissue.
3) When feeling the breast tissue, you will use three different levels of pressure.
Light pressure is needed to feel the tissue closest to the skin. Medium pressure
allows you to feel a little deeper, and firm pressure allows you to feel the
tissue closest to your chest and ribs.
o Remember, it is normal to feel a firm ridge in the lower curve of each
breast. If you feel anything else out of the ordinary, be sure to tell your

, health-care practitioner. It is important to use each pressure level to feel
all of the breast tissue before you move on to the next spot.
4) Move around the breast in an up and down pattern, starting at an imaginary
line drawn straight down your side from the underarm and moving across the
breast to the middle of the chest bone (sternum, breastbone).
o Make sure that you check the entire breast area going down until you
feel only your ribs and then up to the neck or collarbone (clavicle).
Using the up and down, or vertical, pattern is probably the most
effective way to examine the entire breast without missing any breast
tissue.

, 5) Repeat step 4 on your left breast, putting your left arm behind your head and
using the finger pads of your right hand to do the exam.

6) Stand before a mirror, place your hands on your hips, and press down firmly.
In the mirror, look at your breasts for any changes of size, shape, contour, or
dimpling or redness or scaliness of the nipple or breast skin. (Pressing down
on your hips contracts the muscles ofthe chest wall and enhances any breast
changes).

7) Sit or stand with your arm only slightly raised so that you can easily feel the
underarm area. Do this on each side, feeling for lumps or thickened areas.
(Raising the arm straight up causes a tightening of the tissue and makes it
more difficult to examine).
Normal menstrual cycle –
v. Occurs approximately every 28 days (calculated from the first day
of last period to the first day of the next), lasts for 2-7 days
vi. Bleeding can be light to heavy, or variate between the two depending
on stage of menstruation.
What is the most common complaint with the menstrual cycle, and complications?
vii. Dysmenorrhea-painful menstruation
1. Production of prostaglandins
2. Tx: NSAIDS—prohibit prostaglandins
viii. PMS-fluctuation of estrogen/progesterone, hyperprolactinemia
increased prolactin secondary to breast development.
1. Tx: exercise, rest, sleep, diet-decrease salt, sugar, caffeine
ix. Endometriosis-growth of endometrial tissue outside of
the uterus
1. During the ischemic menstrual cycle the misplaced tissue
breaks down/bleeds into surrounding tissue—inflammation—
gets trapped causes cysts.
2. Cycles of this result in scarring, fibrosis, and adhesions—
binding organs together—increased abdominal pain, and
infertility
a. S/S: bleeding, pain
b. Dx: palpation, vaginal ultrasound, laparoscopy
c. Tx: pain meds, hormone therapy-shrinks endo tissue,
surgery, oral contraception
• Colorectal screenings, colonoscopy, fecal occult tests are all also
important for women.
STI’s and risks
f. What is HPV?
i. Human papilloma virus (HPV) in an STI which can cause cellular
changes of the cervix- leading to cervical cancer.

, ii. HPV can also lead to the development of papillomas- benign
growths of the genital and anal regions.
iii. Vaccine = Gardasil
1. Protects against HPV types 6, 11, 16, and 18. Newly
approved vaccine (Gardasil 9) covers HPV 6, 11, 16, and 18,
as well as 31, 33, 45, 52, and 58- which are responsible for 1
in 5 cases of HPV-associated cervical cancer.

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