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NR 601 MIDTERM EXAM: 2024 NEWEST VERSION. EXPERT VERIFIED ANSWERS| MASTERING HEALTH ASSESSMENT, DIAGNOSTICS, AND KEY CONCEPTS FOR SUCCESS£25.39
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NR 602 MIDTERM STUDY GUIDE: 2024 NEWEST VERSION. EXPERT VERIFIED ANSWERS| MASTERING HEALTH ASSESSMENT, DIAGNOSTICS, AND KEY CONCEPTS FOR SUCCESS Presumptive signs of pregnancy Amenorrhea, n/v, increased urinary frequency, excessive fatigue, breast tenderness, quickening @ 18 -
20 weeks Probable signs of pregnancy 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 fetal heart rate auscultated by fetoscope @ 17 -20 week s or doppler 10 -12 weeks palpable fetal outline and fetal movement after 20 weeks visual cardiac activity by US fundus @ 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 when birth approaches fundal height drops slightly occurs in a primigravida, around 38 weeks may not occur for multigravida until labor Naegele's Rule EDB f or women with 28 -day cycles is determined by adding 7 days to first day of LMP and subtracting 3 months Naegeles rule example LMP April 23 - 4/23 +7= 4/30 -3 months = January 30 of following year Hematologic changes during pregnancy blood volume increas e 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 75% is cons idered 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 leukocytosis occurs, can increase to 14 -17000 clotting factors during pregnancy increase, which increases risk of clotting disorders during pregnancy SVR= systemic vascular resistance during pregnancy reduced d/t effects of progesterone, prostaglandins, estrogen and prolactin. This + IVC compression is respo nsible for the dependent edema that occurs Epulis of pregnancy hypertrophy of gums can be accompanied by bleeding is d/t decreased vascular resistance and increase in the growth of capillaries Combined oral contraceptives COC combo of estrogen and prog estin - most contain 20 -35 mcg of ethinyl estradiol + 1 of 8 available progestins unintended pregnancy r/t misuse or d/c of OCs quick start method of OC's 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 women using pill patch ring injection or implant should use backup contraceptives for the first 7 days MOA COC's progestin and estrogen inhibit hypothalamic -pituitary -ovarian axis and subsequent steroidogenesis progestin main 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 inhibits follicle stimulating hormone secretion works synergistically with progestin to affect uterine lining and cervical muc ous production
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