NURS 629 MVU exam 1 2022 with complete solution – Maryville/ Graded A+

1. How do you measure fundal height: symphysis pubis to top of uterus 2. When can you start to hear fetal heart tones?: around 12 wks 3. What is quickening?: fetal movements felt by the mother 4. When is quickening felt: between 16-20 weeks 5. Abnormal Complaints in first trimester: 1st trimester: Vaginal bleeding Book: spotting, bleeding, cramping, painful urination, severe vomiting and/or di- arrhea, fever > 100.4, symptoms of vaginal infection or STI; persistent or severe low abdominal pain, lightheadedness or dizziness (particularly if accompanied by shoulder pain) 6. What vaccines should be avoided during pregnancy?: Live vaccines: MMR ,HPV, varicella, and live attenuated influenza vaccine 7. What labs are drawn at first visit?: CBC, RH (antibody screen) & TYPE, HIV, RPR, MMR TITER, HEP B TITER, R/O STI's, FULL UA 8. What info is obtained at first OB visit?: PMH, Fx history, Genetic hx (mom & dad) 9. What is indicated when clu cells are seen?: BV 10. What is the treatment for BV: metronidazole (Flagyl) 500mg BID x 7 days 11. What are presumptive (subjective) signs of pregnancy?: Amenorrhea, N/V, FATIGUE, urine frequency, breast changes, quickening, pigment, striae 12. What are probable (objective) signs of pregnancy?: + HCG, enlarged Abdo, fetal outline, Balloment, Braxton, Chadwick's, Goodall's, Hegar's signs 13. What are positive signs of pregnancy?: Fetal HT, U/S, fetal movement 14. What does a bluish cervix indicate?: Chadwick's sign 15. How to use Nageles rule: + 7 days - 3 mos 16. What are signs of preeclampsia?: rapid weight gain, edema to hands and face, HTN, H/A, visual changes, proteinuria, epigastric pain 17. What is the treatment of preeclampsia?: Bedrest, (nifedipine, hydralazine) if severe delivery of the fetus 18. What does HELLP stand for?: hemolysis, elevated liver enzymes, low platelets 19. S/S of HELLP: EDEMA, N/V, RUQ pain 20. What should 'at home' plan be for preeclampsia?: high protein diet, daily kick counts, wkly non-stress test & contraction monitor, monitor for hand and face edema, visual changes, B/P, epigastric pain 21. When will you see a drop in the fundal height?: at 36 weeks as the head drops into canal 22. When is subinvolution suspected: when lochia turns bright red with clots 23. How would you treat subinvolution?: Methergine 0.2mg PO TID for up to a week 24. what education should be given with a subinvolution?: if filling pad in an hour or lemon size clots go to ED, if fever culture discharge 25. Clinical presentation of mastitis?: unilateral breast red, painful, warm to touch usually clogged milk duct 26. What education do you give with mastatitis: Continue to BF, Pump if breast are still hard after feeding, warm compress 27. What B/C is used if still breastfeeding?: Progesterone only 28. When and how to screen for 1 hr GTT: between 24-28 wks, no need to fast, if over 140 then 3 hr GTT is needed 29. How is gestational diabetes diagnosed?: if the 1 hr gtt is >180 auto dx; if 3 hr gtt is 95 fasting, >180 @ 1hr, >153 @ 2 hr, >140 @ 3 hr