CMN568/ CMN 568 (Latest 2024/ 2025) Intro to
Family NP Unit 6 Exam Questions and Verified
Answers| 100% Correct| Grade A
Treatment of pregnancy-related anemia
Treatment:
+ Ferrous sulfate 300mg (contains 60 mg of elemental iron) 2-3x day.
(NOTE: Ferrous gluconate is OK, but just be sure that you have enough
elemental iron (60 mg))
+ Continue for 3 months AFTER Hb has returned to normal to replenish
iron stores
+ Take iron on an empty stomach with orange juice to add absorption
+ Encourage diet high in iron: Beef, liver, beans, whole grains, nuts, dark
leafy greens
HERF BBB
Why is cholecystitis/cholelithiasis more likely in pregnancy? What are
S/S and expected labs?
WHY:
+In pregnancy, bile is more likely to form stones and the gallbladder has
reduced contractility.
--Bile just sits there (sludge!) and you are more likely to form stones.
SYMPTOM MGMT:
+Bowel rest, IV hydration, analgesics, antibiotics
HERF BBB
Risk factors for ectopic pregnancy
+ Smoking
+ IUD use
+ Assisted reproductive technology
+ PID (scarring of fallopian tubes, chlamydia known for this)
+ Endometriosis
+ Previous tubal surgery
+ Previous ectopic
HERF BBB
Signs/symptoms of ectopic pregnancy
+ Pelvic/abdominal pain especially cervical motion tenderness or
adnexal (lower abdomen laterally, where ovaries are) pain
---NOTE: In some cases, referred pain is felt in the shoulders with an
ectopic pregnancy.
+ Abnormal uterine bleeding: light spotting to heavy bleeding
,+ Poorly rising BHCG levels in serial titers: should rise 50% every 48 hr
+Absent intrauterine gestational sac - intrauterine sac should be visible
when BHCG is 1500-2000
HERF BBB
When do most ectopic pregnancy ruptures occur?
Between 6 and 12 weeks gestation
HERF BBB
Management of ectopic pregnancy
+ If < 200 BHCG, it may resolve in its own
+ If < 3 cm adnexal mass and no fetal heart motion: Can use
methotrexate protocol (one dose or two doses) NOTE: Beyond scope of
primary care NP.
HERF BBB
Fetoplacental factors contributing to intrauterine growth restriction
(IUGR)
+ Genetic disorders
+ TORCH infection (Toxoplasmosis, Rubella Cytomegalovirus, Herpes
simplex, and HIV. O means "other" and can be syphyillis, varicella,
parvovirus, fifths disease)
+ Placental disorders
+ Multiple gestation
Herf BBB
What is PUPPP? When does it happen? How is it treated?
+ Pruritic urticarial papules and plaques of pregnancy
-- "white halo" around umbilicus, where rash does not appear
-- No lab diagnosis
+ Usually happens in 3rd trimester and disappears 2 weeks postpartum
+ Treat with topical steroids, antihistamines and Sarna lotion
Herf BBB, DeCherney p 505
Definition of chronic HTN in pregnancy
BP > 140/90 before 20th week of pregnancy, OR persistent HTN > 12
weeks postpartum
Herf BBB, DeCherney p 455-457
Treatment of chronic HTN in pregnancy
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