NR 602 Midterm with correct questions and answers.

NR 602 Midterm with correct questions and answers. Presumptive signs of pregnancy - correct answers.Amenorrhea, n/v, increased urinary frequency, excessive fatigue, breast tenderness, quickening @ 18-20 weeks Probable signs of pregnancy - correct answers.Goodell sign- softening of the cervix Chadwicks sign- cervix is blue/purple Hegar's sign- softening of lower uterine segment uterine enlargement Braxton Hicks- can be palpated at 28 weeks uterine souffle- softening blowing sound d/t blood pulsating through the placenta integumentary pigment changes allotment, fetal outline definable, positive pregnancy test Positive signs of pregnancy - correct heart rate auscultated by fetoscope @ 17-20 weeks or doppler 10-12 weeks palpable fetal outline and fetal movement after 20 weeks visual cardiac activity by US fundus - correct answers.@ 12 weeks is @ level of symphysis pubis 16 weeks midway between symphysis pubis and umbilicus 20 weeks funds enlarges until term- approx 1 cm per week when birth approaches fundal height drops slightly lightening - correct birth approaches fundal height drops slightly occurs in a primigravida, around 38 weeks may not occur for multigravida until labor Naegele's Rule - correct answers.EDB for women with 28-day cycles is determined by adding 7 days to first day of LMP and subtracting 3 months Naegeles rule example - correct answers.LMP April 23- 4/23 +7= 4/30 -3 months = January 30 of following year Hematologic changes during pregnancy - correct volume increase by 30-50% OR 1100 to 1600 mL and peaks at 30-34 weeks= improved blood flow to vital organs and prevents excess blood loss during birth. Fetal growth and newborn weight are correlated with degree of BV expansion Blood volume during pregnancy - correct answers.75% is considered to be plasma + slight increase in RBC= hemodilution- leads to states of physiologic anemia during pregnancy. RBC volume increases= increased iron demands WBCs during pregnancy - correct cytosis occurs, can increase to 14-17000 clotting factors during pregnancy - correct ase, which increases risk of clotting disorders during pregnancy SVR= systemic vascular resistance during pregnancy - correct ed d/t effects of progesterone, prostaglandins, estrogen and prolactin. This + IVC compression is responsible for the dependent edema that occurs Epulis of pregnancy - correct trophy of gums can be accompanied by bleeding is d/t decreased vascular resistance and increase in the growth of capillaries Combined oral contraceptives COC - correct of estrogen and progestin- most contain 20-35 mcg of ethinyl estradiol + 1 of 8 available progestins unintended pregnancy - correct answers.r/t misuse or d/c of OCs quick start method of OC's - correct answers.LMP was within last 5 days the method can be started immediately if unprotected sex occurred w/I last 2 weeks start method today and advise patient to return for a pregnancy test in 3 weeks Birth control education - correct using pill patch ring injection or implant should use backup contraceptives for the first 7 days MOA COC's - correct stin and estrogen inhibit hypothalamic-pituitary-ovarian axis and subsequent steroidogenesis progestin - correct actor in preventing pregnancy prevents luteinizing hormone (LH) surge thereby inhibiting ovulation thickens cervical mucous and inhibits sperm penetration and transport changes the fallopian tubes so sperm transport and ova is impaired causes endometrium to become atrophic estrogen - correct its follicle stimulating hormone secretion works synergistically with progestin to affect uterine lining and cervical mucous production candidates for COC's - correct with dysmenorrhea and menorrhagia women wishing to regulate menses women who will consistently use daily method post abortion (any trimester) post ectopic pregnancy advantages of COC's - correct ed menstrual flow and dysmenorrhea reduce risk of ovarian CA 20% for every 5 years even after d/c protection continues for 15-20 years reduce risk of endometrial CA by 40-50% (protection increases w/ duration of use) reduces risk of colon CA 90% protection from ectopic pregnancy reduced incidence of benign breast dx reduction of acne decreases incidence of endometriosis possibly may preserve bone density and protect against iron def. anemia, ovarian cysts and PID Contraindications of COC's - correct ple risk factors of cardiovascular disease; smoking, DM, HTN, known thrombogenic mutations current hx ischemic heart disease, stroke, DVT or PE vascular dx valvular heart dx HTN (SBP 160, DBP100) smoking + age 35 migraines with aura major surgery with prolonged immobilization current breast CA active viral hepatitis severe cirrhosis benign/malignant liver tumors breastfeeding 6 weeks postpartum disadvantages of COC's - correct ty may impair the effectiveness of COC's by 8-12%