MVU NURS 629 Final Exam Latest Update 2023/2024 Rated 100% (Questions With Answers)

MVU NURS 629 Final Exam Latest Update 2023/2024 Rated 100% (Questions With Answers). What are the normal, non-worrisome complaints during each trimester and what complaints would need to be evaluated further? 1. 1 st Trimester: 1. Increasing tenderness and size of breasts: Changes in breast or nipple size, shape, symmetry, as these s&s may indicate other condition. 2. Constipation: Should not include change in stool, fever, weight-loss, anorexia, periumbilical pain, fever, rectal bleeding, pus, or mucous. 3. Excessive salivation (ptyalism), bad taste in mouth: Refer client with dental disease. 4. Fatigue: Refer if psychosocial stress increases. Expected in 1st and 3rd trimester 5. Flatulence: Refer to a mental health care provider if symptoms of psychosocial stress are evident. 6. Headache: If headache is severe, change in vision, severe swelling of hands and feet, if painkillers don’t respond. 7. Hemorrhoids: Rectal lesions (condyloma acuminate cancerous lesion) 8. Nausea and vomiting: Weight loss, dehydration, ketonuria, and hypokalemia. 9. Urinary frequency and incontinence: Frequently repeated UTI’s 10. Varicosities of vulva and legs: Vascular disease, deep vein thrombosis, 2. 2 nd Trimester: 1. Backache: Refer if pain does not improve 2. Dyspnea: S&S of respiratory infection, PE, cardiac problems, or anemia. 3. Epistaxis: Nasal polyps and evidence of cocaine use 4. Leukorrhea: Green, watery or bloody stools, foul or fishy smelling odor, vaginal itching or discomfort, fever, flulike sx, abdominal pain, or bleeding after intercourse, dysuria or dyspareunia. 5. Ligament pain: Anorexia, flank pain, vomiting blood, low-grade fever, diarrhea, vomiting, or a tender lump in the groin that tends to worsen. 6. Muscle cramps in calf, thigh, or buttocks: Homan’s sign, no redness, tenderness, heat or swelling should be noted. 7. Pica: If eating dangerous items consult psychologist. (sign of iron deficiency). 8. Syncope: Substance abuse, sinus, hearing, or ear problems, numbness or tingling in digits around the mouth, melena, heart palpitations, SOB, anxiety/depression, nausea, vomiting. 3. 3 rd Trimester: 1. Braxton-hicks contractions: If labor is continuous, no vaginal bleeding, if contractions begin getting closer together. 2. Discomfort in the upper extremities: Recurrent hyperventilation warrants further investigation 3. Edema: Visual changes, headache, fatigue, nausea, vomiting, abdominal pain, decreased urine output. 4. Heartburn: SOB, chest pain, hypertension, palpitations, sweating, flulike sx, right shoulder pain. 5. Insomnia: Psychosocial stress, anxiety, s&s of suicide 6. Joint pain/ache: Signs of labor, signs of tick bites, symptoms of uti, redness of joints, intermittent claudication, stiffness, flulike symptoms, fever. ○ What OCP can be given to breastfeeding women? 1. Progestin-only pill (POP) also called the “mini-pill” ○ What immunizations can be given in pregnancy? 1. Flu 2. TDAP 3. Possible Hep B 4. Chickenpox (varicella) vaccine, measles, mumps and rubella (MMR) vaccine, shingles vaccine. ○ How to screen for gestational DM (See Assessment PPT) 1. 1 hour GTT (24-28 weeks). Drink 50g of glucose. If 1 hour BG is ≥130-140 proceed below 2. 3 hour GTT high carb died x2 days, then NPO after MN. FBS, then drink 100g of glucose 3. Gest diabetes is diagnosed with 1 hour (180), 2 hour (153). 4. Two Step - If the value meets or exceeds the thresholds below and is ≤ 200 mg administer a 100-g oral glucose tolerance test. 1. 50g oral glucose challenge – 140mg after 1 hour threshold 2. 100g oral glucose test – 1 hour (180), 2 hour (155), 3 hour (140). 5. One Step 1. Administer 75 g oral glucose – 1 hour (180), 2 hour (153). At risk if over 35, overweight, previous FBS 110-125, previous gest diabetes, previous infant 9lbs, previous unexplained stillbirth, family history of diabetes. ○ Treatment of mild PIH 1. Bed rest, lay on left side, methyldopa, labetalol. 1. Second line – verapamil nifedapine, hydralazine (bad hypertension), may use diuretics ○ s/s of mastitis 1. Subjective: Malaise, fever, chills. Also a tender, hot, red, painful area or lump in the breast. 2. Objective: Fever (often high), tachycardia. Warmth, redness and swelling of breasts. Breast distended with milk. Nipple may be cracked or abraded. ○ s/s of gestational HTN 1. Subjective: Headache, edema, weight gain, vision changes, nausea, vomiting, pain in upper right side of stomach, making small amounts of urine 2. Objective: elevated blood pressure, proteinuria, edema. ○ What should the fundal height be at various prenatal visits? 1. 6 weeks: Hegars (softening of lower uterine segment is present)