Condensed Final Exam NR 509
Health Promotion
SCREENING GUIDELINES FOR ADULTS
Screening guidelines for adults include:
- Unhealthy weight and diabetes mellitus Overweight (BMI 25 to <30)
- Substance use disorders, including misuse of
- prescription and illicit drugs
- HIV infection
- Sc...
condensed final exam nr 509 health promotion screening guidelines for adults screening guidelines for adults include unhealthy weight and diabetes mellitus overweight bmi 25 to lt30 substanc
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Condensed Final Exam NR 509
Health Promotion
SCREENING GUIDELINES FOR ADULTS
Screening guidelines for adults include:
- Unhealthy weight and diabetes mellitus Overweight (BMI 25 to <30)
- Substance use disorders, including misuse of
- prescription and illicit drugs
- HIV infection
- Screening for IPV, elder abuse, and abuse of vulnerable adults
Colon Cancer
1. who should be screened
2. when should the decision be up to the pt
3. when is screening no longer recommended
1. Adults age 50 to 75 yrs
2. Adults age 76 to 85 yrs—individualized decision making
3. Adults older than age 85
Screening for vulnerable populations would include
IPV, elder abuse & Vulnerable adult
Tobacco Use
1. who should we screen
2. For nonsmokers, ask about
1. all adults, particularly pregnant women
2. exposure to secondhand smoke and tobacco use by other persons in the household
or workplace
Screening and Counseling for STIs
1. what women should be screened.
2. (blank) is highly effective in preventing the transmission of HIV, HPV, and other
STIs
3. Who should be screened for HIV
4. 1. Chlamydia, gonorrhea, and syphilis screening should be done
1. chlamydia and gonorrhea screening in sexually active women aged <24 years and
older women with risk factors such as new or multiple sex partners or a sex partner
infected with an STD
2. condoms when properly worn
3. adolescents and adults from age 15 to 65 years and for screening all pregnant
women & those at increased risk ie MSM
4. at least once a year for all sexually active gay, bisexual, and other MSM
The Five Ps of Sexual screening
- Partners
"When was the last time you had intimate physical contact with someone?
- Practices
"How do you have sex?
- Protection from STIs
- Past history of STIs
,- Pregnancy plans
- Plus
The "plus" should encompass an assessment of trauma, violence, sexual satisfaction,
sexual health concerns/problems, and support for sexual orientation/gender identity
Immunizations
HPV vaccine
Prevents infection from subtypes 16 and 18.
Vaccines and the diseases they prevent Diagram 1
Vaccines and the diseases they prevent Diagram 2
Vaccines and the diseases they prevent Diagram 3
Birth to 6 yrs vaccination schedules
Immunizations for pregnancy
1. give tetanus and influenza vaccinations in the
2. The following vaccines are safe during pregnancy:
3. The following vaccines are NOT safe during pregnancy:
4. Rho (D) immunoglobulin, or RhoGAM, should be given to all
1. second or third trimester.
2. pneumococcal, meningococcal, and hepatitis B.
3. MMR, polio, & varicella. However, all women should have rubella titers drawn during
pregnancy and be immunized after birth if non-immune.
4. Rh-negative women at 28 weeks' gestation and again within 3 days of delivery to
prevent sensitization to an Rh-positive infant
Older Adult Immunizations 2015
1. Influenza Vaccine A/B: The following groups should receive the influenza
vaccine each year:
2. Pneumococcal Vaccine: PCV13 protects against 1
3. Zoster Vaccine; All adults aged ≥60 years, regardless of whether
4. Tetanus/diphtheria (Td) and Tetanus/diphtheria/pertussis (Tdap) Vaccine: All
adults aged ≥19 years, including those aged ≥65 years who have not been
vaccinated with Tdap should receive a single dose; After receiving Tdap, they
should receive
1. All adults ≥50 years, Adults with COPD and CV disorders, immunosuppressed from
medication or HIV, Residents of nursing homes, Household contacts and caregivers of
children under 5 years and adults ≥50 years
2. 3 of pneumococcal bacteria; PPSV23 protects against 23 types of pneumococcal
bacteria, Adults aged ≥65 years: Older adults who have not previously received PCV13
should receive PCV13 first, followed 6 to 12 months later by PPSV23
3. they have already had either chickenpox or shingles, should be vaccinated;
Contraindications: The vaccine should not be given to adults with a history of a primary
or acquired immunodeficiency state
4. Td boosters at 10-year intervals.
Pregnant Populations
Prenatal Laboratory Screenings
1. Initially include,
2. Draw titers and antigens for
, 3. STI screen for
4. Timed screenings include an
1. blood type and Rh, antibody screen, CBC—especially hematocrit and platelet count
2. rubella titer, syphilis test, hepatitis B & HIV
3. gonorrhea and chlamydia and urinalysis with culture
4. oral glucose tolerance test for gestational diabetes around 24 weeks, and a vaginal
swab for group B streptococcus between 35 to 37 weeks' gestation
A woman has a positive pregnancy test and comes to you with left lower
quadrant pain. On bimanual examination, you feel a tender mass. Which of the
following should you suspect?
A) Threatened abortion
B) Appendicitis
C) Ovarian cyst
D) Tubal pregnancy or ectopic pregnancy
D) Tubal pregnancy
1. Increased vascularity throughout the pelvis gives the vagina a bluish color,
known
2. Hegar sign is the
1. as Chadwick sign.
2. palpable softening of the cervical isthmus, the portion of the uterus that narrows into
the cervix
1. Facial edema after 20 gestational weeks
2. Nasal congestion and nose bleeds are
3. As the abd expands in pregnancy purplish striae gravidarum or (blank) and a ,
(blank) a brownish black pigmented vertical stripe along the midline skin, may
appear
4. As tension on the abdominal wall increases with advancing pregnancy, the
rectus abdominis muscles may separate at the midline, called
1. is suspicious for preeclampsia and should be investigated.
2. more common during pregnancy
3. "stretch marks"; linea nigra
4. diastasis recti.
1. Gestational hypertension is
2. Definition of Preeclampsia (see diagram)
1. SBP >140 mm Hg or DBP >90 mm Hg first documented after 20 weeks, without
proteinuria or preeclampsia, that resolves by 12 weeks postpartum
Expected date of delivery (EDD).
1. The EDD is 40 weeks from the
2. Using the Naegele rule, the EDD can be estimated by taking the LMP,
1. first date of the LMP.
2. adding 7 days, subtracting 3 months, and adding 1 year.
Measuring tape when measuring uterus in a pregnant woman pg 944
1. Measure the fundal height if gestational age is >20 weeks, when the fundus
should reach the umbilicus. With a plastic or
2. Extend the tape measure to
3. Though subject to error between 16 and 36 weeks, measurement in centimeters
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