Women’s Health Quiz 3
Chapter 5:
 STI - High risk populations and behaviors
 African American youths
 Abused youths
 Homeless youths
 Young men having sex with men
 Gay, lesbian, bisexual, transgender, and intersex youths
 Having multiple partners or unprotected sex
 CDC classifications of STIs
 Vaginal dischargevaginitis
 vulvovaginal candidiasis
 Method(s) of transmission*not considered an STI
 Yeast/monilia/fungal infection
 Sign/Symptoms (manifestations)*
 Diagnosis*
 Speculum exam
 Presence of typical clinical manifestations
 Nursing Management/Treatment*
 Wear cotton underwear
 Avoid irritants
 Good body hygiene
 Avoid douching & superabsorbent tampons
 Impact on fetus/newborn (chart)
 Trichomoniasis
 Method(s) of transmission*
 both sexually and non-sexually (through poorly maintained hot tubs and
drains)
 Sign/Symptoms (manifestations)*
 may be asymptomatic, dysuria, urinary frequency, vaginal discharge,
dyspareunia
 Diagnosis*
 Microscopic visualization of motile flagellated trichomonad
 Vaginal pH of >4.5 is typical
 OSOM trichomonas rapid test
 Affirm VPIII
 Nursing Management/Treatment*
 Single 2g oral dose of:
 Metronidazole (Flagyl)
 Tinidazole (Tindamax)
 No alcohol during treatment! (will cause severe n/v)
 Impact on fetus/newborn (chart)
 Premature rupture of membranes, preterm birth, low birth weight
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Gardnerella vaginalis
 Method(s) of transmission*
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Bacterial imbalances in the vaginanot spread but sex but associated with
it
 Sign/Symptoms (manifestations)*
 Diagnosis*
 3 of 4 criteria must be met…
 Thin, greyish white vaginal discharge which adheres to the vaginal
mucosa
 Vaginal pH > 4.5
 Positive whiff test (vaginal secretion is mixed with a drop of 10%
potassium hydroxide; positive = a stale, fishy odor
 Microscopic visualization of clue cells
 Nursing Management/Treatment*
 Oral metronidazole (flagyl)
 Clindamycin cream (cleocin)
 Impact on fetus/newborn (chart)
Cervicitis:
Chlamydia
 Most common bacterial STI in the United States; majority are “silent” infections
 Cause: Chlamydia trachomatis (intracellular parasite)
 Risk Factors: Adolescence, multiple sex partners, new sex partner, sex without
condom, oral contraceptive use, pregnancy, history of another STI
 Manifestations: may be asymptomatic, mucopurulent vaginal discharge,
endocervicitis, inflammation of the rectum & lining of the eye, can infect the
throat
 Diagnosis: Urine testing, Swab specimen culture, Enzyme immunoassay
 Treatment: Antibiotics (doxycycline, azithromycin). Combo therapy if also
positive for gonorrhea
Gonorrhea
 2nd most common STI in the U.S; HIGHLY CONTAGIOUS
 Cause: aerobic gram-negative intracellular diplococcus
 Risk Factors: Low SES, urban living, single status, inconsistent use of
barrier contraceptives, age < 20, multiple sex partners
 Transmission: Sexual Contact
 Manifestations: Most is asymptomatic, dysuria, urinary frequency,
vaginal discharge, dyspareunia, endocervicitis, arthritis, PID, rectal
infection
 Diagnosis: Culture
 Nursing Management/Treatment: Antibiotics
 Neonatal conjunctivitis if woman gives birth vaginally
 Genital ulcers
 genital herpes simplex
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syphilis
 Vaccine preventable
 Hep A
 Hep B
 Hep C
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HPV
 Ectoparasitic infections
 pediculosis pubis
 scabies
For Each STI (include HIV & Zika)
Zika:
 Method(s) of transmission*
 Bite of an infected mosquito; blood transfusion; sexual contact; vertical
transmission in utero
 Sign/Symptoms (manifestations)*
 fever, rash, headaches, bone pain, muscle and joint tenderness, and
conjunctivitis
 Diagnosis*
 Urine or serology testing
 Nursing Management/Treatment*
 Supportive therapy
 Rest
 Fluids
 Acetaminophen for fever & pain (no NSAID until dengue can be r/o)
 Impact on fetus/newborn (chart)
 *Pay closest attention to the content in red
Differentiate the various stages of syphilis & HIV
Guidelines on pregnancy - post Zika
 Females: Wait ≥8 weeks after symptoms first appeared to try to conceive
 Males: Wait ≥6 months after symptoms first appeared to try to conceive
Guidelines on pregnancy and postpartum for HIV positive mom & her baby
 Nursing Management/Treatment HIV:
• Take an oral antiretroviral agent from 14 weeks gestation through pregnancy
• An antiretroviral agent is given to the mother by IV, during labor, until
delivery
• An antiretroviral syrup is administered to the infant within 12 hours of birth
• Enhance the immune system by doing the following:
• Get 7-9 hours of sleep each night
• Avoid infections (good hand hygiene, avoid crowds)
• Decrease stress
• Consume adequate protein & vitamins
• Increase fluid intake to 2L/day to stay hydrated
• Plan periodic rest periods to prevent fatigue
• Encourage compliance with the prescribed ART drug therapy to reduce the
chance of perinatal transmission
• Antiretroviral treatment decreases transmission to fetus to 1-2%.
• C/S birth is recommended
Chapter 11:
 Presumptive (subjective) vs. probable (objective) vs. positive (definitive) signs
of pregnancy
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Presumptive:
 Breast tenderness (3-4 wks)
 Amenorrhea (4 wks)
 Nausea & vomiting (4-14 wks)
 Breast enlargement (6 wks)
 Urinary frequency (6- 12 wks)
 Uterine enlargement (7-12 wks)
 Fatigue (12 wks)
 Hyperpigmentation (16 wks)
 Fetal movements *quickening* (16- 20 wks)
Probable:
 Positive pregnancy test (4- 12 wks)
 Goodell’s sign (5 wks)
 Chadwick’s sign (6-8 wks)
 Hegar’s sign (6-12 wks)
 Abdominal enlargement (14 wks)
 Ballottement (16- 28 wks)
 Braxton Hicks contractions (16- 28 wks)
Positive:
 Ultrasound verification of embryo or fetus
 (4-6 wks)
 Auscultation of fetal heart tones via Doppler (10- 12 wks)
 Fetal movement felt by clinician (20wks)
 Fetal movement visible (late pregnancy)
Body systems adaptations:
Uterus
 Changes in size, shape, and position
 Positive Hegar’s sign
 Enhanced contractilityBraxton Hicks
 Fundal height at 20 wks at umbilicus=20cm
Cervix
 SofteningGoodell’s sign
 Mucus plug formsoperculum
 Increased vascularizationChadwick’s signblueish discoloration of vag
mucosa & cervix
Ovaries
 Enlargement until 12th-14th week
 Cessation of ovulation
Vagina
 Increased vascularity w/ thickening
 Leukorrheawhitish vaginal discharge
Breasts
 Increased size & tenderness
 Increased vascularity
 Areolalarger & deeply pigmented
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Skin
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Montgomery tuberculeskeep nipples lubricated for breastfeeding
Colostrumcreamy yellowish, produced during 1st 3 days during pregnancy
Hyperpigmentation
 Chloasma mask of pregnancy
 Linea nigraabd, breast, buttocks
 Striae gravidarum
 Varicositiesvascular spiders on legs, thighs, breast
 Palmar erythemaincreased total blood vol & RBCs
 Decline in hair growth & increased hair growth
Endocrine
 Relaxin
 Increases flexibility of pubic symphysis for ease of delivery
 Suppresses the release of oxytocin delaying the onset of labor contractions
 Estrogen
 Promotes enlargement and increased vascularity/vasodilation of the
genitals, uterus, & breasts
 Progesteronesmooth muscle relaxation
 Hormone of pregnancy
 hPL/hCS – Human Chorionic Somatommotropin:
 Prepares mammary glands for lactation
 Antagonist of insulin
 hCG Human Chorionic Gonadotropin:
 Maintains the corpus luteum
 Basis of pregnancy tests
 Production peaks at 8 weeks & gradually declines
Nutrition guidelines
 Eat 2 or more servings fish (one being oily)
 2 quarts water per day
 Increase fruits, veggies, iron, folic acid, & calories
Foods to avoid
 Artificial sweeteners
 Fish high in mercury
 Alcohol
 Listeria contaminated food
 Hot dogs, lunch meats, sushi, deli meat
 Soft cheesesBrie, feta, blu chz
 Smoked seafoodlox or jerky
 Raw milk
 Salads premade at storeegg salad, tuna salad, chicken salad
Weight gain
 Underweight BMI (<18.5):
 28-40 lbs total weight gain
 Normal Weight BMI (18.5-24.9):
 25-35 lbs total weight gain
 Overweight BMI (25-29.9):
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15-25 lbs total weight gain
Obese BMI (30 or greater):
 11-20 lbs total weight gain
Special considerations
 Pica
 Compulsive ingestion of nonfood substances
 Common cravings: soil or clay, ice, laundry starch
 Cause is unknown, more common in African Americans, rural women,
and those with family
history of it
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Maternal emotional responses
 Ambivalence
 Conflicting feelings
 Excited and proud, but fearful and anxious
 Completely normal during 1st trimester
 Introversion
 Focus on oneself and the fetus
 Normal adaptation
 Acceptance
 Physical changes bring reality and validity to pregnancy
 Occurs primarily in 2nd trimester
 Mood swings
 Common, normal during pregnancy
 “emotional rollercoaster”
 Changes in body image
 Normal but stressful
Maternal role tasks
 Ensuring safe passage throughout pregnancy & birth
 Primary focus of the woman’s attention
 1st Trimester: woman focuses on herself, not the fetus
 2nd Trimester: woman develops attachment to fetus
 3rd Trimester: woman has concern for herself & her fetus as a unit
 Seeking acceptance of infant by others
 1st Trimester: acceptance of pregnancy by herself & others
 2nd Trimester: family needs to relate to the fetus as a member
 3rd Trimester: unconditional acceptance without rejection
 Seeking acceptance of self in maternal role to infant
“Binding in”…
 1st Trimester: mother accepts idea of pregnancy, but not the infant
 2nd Trimester: with quickening, mother acknowledges fetus as a separate
entity within her
 3rd Trimester: mother longs to hold infant & becomes tired of being
pregnant
 Learning to give of oneself
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1st Trimester: identifies what must be given up to assume new role
2nd Trimester: identifies with infant, learns how to delay own desires
3rd Trimester: questions her ability to become a good
mother to the infant
Chapter 12:
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Menstrual history
 Age at menarche
 Days in cycle
 Flow characteristics
 Discomforts
 Use of contraception
 Date of last period
Nägele’s Rule
 Calculation of estimated or expected date of birth (EDB) or delivery (EDD)
 Assumes a regular 28 day cycle
 Formula Calculation:
 Determine the 1st day of LMP
 Subtract 3 calendar months
 Add 7 days
 Add 1 year
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Obstetric history
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Gravid
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The state of being pregnant
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Gravida
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Woman who is pregnant
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Gravidity
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The number of times that the woman has been pregnant, irrespective o
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Nulligravida
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A woman who has never been pregnant
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Primigravida
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A woman pregnant for the first time
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Multigravida
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A woman pregnant for at least a 2nd time
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Para
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The number of deliveries at 20 weeks or greater
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Parity
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The number of pregnancies, not the number of fetuses, carried to the p
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Primipara
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A woman who has completed one pregnancy with a fetus or fetuses w
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Multipara
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Woman who has had two or more pregnancies resulting in viable offs
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Nullipara
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A woman who has not completed a pregnancy with a fetus or fetuses w
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Viability
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Capacity to live outside the uterus
GP and GTPAL methods
 GTPAL
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GP
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Ggravida current pregnancy is included in the count
Tterm birthsnumber of term gestations delivering btwn 38-42wks
Ppreterm births The number of preterm pregnancies ending >20
weeks (or age of viability), but before completion of 37 weeks
Aabortions The number of pregnancies ending before 20 weeks or the
age of viability (miscarriages or VIPs)
Llivingnumber of children currently living
Number of pregnancies & the number of births carried to a viability (at
least 20 weeks)
 Ex. G4 P2
Fundal height measurement
 Distance in cm from top of the pubic bone to the fundus with woman lying on her
back with her knees slightly flexed.
 (McDonald’s method)
 20- 36 weeks20 at umbilicus after 36 wk not considered reliable
Danger signs during pregnancy
 First Trimester
 Spotting/bleeding (miscarriage)
 Painful urination (UTI)
 Severe persistent vomiting (hyperemesis gravidarum)
 Fever >100°F (infection)
 Lower abdominal pain, shoulder pain, dizziness (ruptured ectopic
pregnancy)
 Second Trimester
 Uterine contractions (preterm labor)
 Pain in calf, especially with foot flexion (DVT)
 Gush/leakage of fluid from vagina (PROM)
 Absence of fetal movement for >12 hours (fetal distress or demise)
 Third Trimester
 Sudden weight gain, periorbital/facial edema, severe upper abdominal
pain, headache with visual changes
 Decrease in fetal movement for >24 hrs (fetal demise)
 Any of the other signs listed in 1st or 2nd trimesters
Assessment of fetal well being
 Ultrasonography:
 High frequency sound waves used to visualize the fetus
 Non-invasive
 Considered safe, accurate, & cost-effective
 Doppler Flow Studies:
 Measures velocity of blood flow in the umbilical vessels (via RBCs)
 Non-invasive
 Alpha-fetoprotein Analysis
 Produced by fetal liver between weeks 13-20 of gestation
 Optimal testing is 16-18 weeks gestation
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High levels can indicate an open neural tube defect, multiples, GI defects,
or underestimation of gestational age
 Low levels can indicate fetal demise, hydatidiform mole, Down
syndrome (Trisomy 21), Edward’s syndrome (Trisomy 18), or
overestimation of gestational age
 Minimally invasive (venipuncture) for maternal serum AFP
Free Cell DNA Tests:
 Non-invasive
 During pregnancy, cell-free DNA—short DNA fragments—of the mother and the
fetus circulate in maternal blood
 Free cell DNA tests analyze fragments from fetal chromosomes
 Results in higher accuracy (~99%) trisomy risk assessments
Nuchal Translucency Screening:
 Done at 11-14 weeks
 Examines via ultrasound the accumulation of fluid behind the fetal neck
 Increases are associated with chromosomal abnormalities (trisomy 21, 18, & 13)
Amniocentesis:
 Transabdominal puncture of the amniotic sac to obtain fetal cells (within the
amniotic fluid) for analysis
 Performed under ultrasound to identify a pocket of amniotic fluid
 22 gauge, 5 inch needle
 Definitive results
 Can be performed any trimester, but earlier = higher risk of spontaneous
miscarriage
 Risks include: spontaneous abortion (1 in 200), maternal or fetal infection, fetalmaternal hemorrhage, leakage of amniotic fluid & maternal discomfort
Chorionic Villus Sampling (CVS):
 Tests for: chromosomal disorders, enzyme deficiencies, gender, sex-linked
disorders
 Performed at 10-13 weeks gestation
 Transcervical or transabdominal (with ultrasound guidance)
 Risks: bleeding & cramping, spontaneous abortion, limb abnormalities, infection,
chorio, fetal-maternal hemorrhage
 Rh negative women should receive RhoGAM
Percutaneous Umbilical Blood Sampling (PUBS):
 Collection of fetal blood specimen
 Done under ultrasound guidance
 Performed anytime after 16 weeks gestation
 Risks: blood leakage, cord laceration, infection, preterm labor, PRO
Non-Stress Test
 Indirect measurement of uteroplacental function
 Noninvasive
 Assesses fetal movement & heart rate patterns
 20-30 minutes on fetal & uterine monitors
 Client “marks” movement when perceived
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Reactive = 2 fetal heart rate acceleration periods of 15bpm for at least 15 sec.
from baseline
 Non-reactive = absence of 2 acceleration periods within 40 minutes
Biophysical profile (BP)
 5 components:
 NST
 Fetal tone
 Breathing
 Motion
 Amniotic fluid volumelittle pockets
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Each component scored 0-2 points0 non, 2 they see it
Final Score: 8-10 is normal, <6 needs further investigation and may indicate fetal
compromise
Modified BPP:
 NST & amniotic fluid volume only
Amniotic fluid analysis
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Lecithin- to- sphingomyelin ratio (L/S ratio)
 2:1 ratio indicates fetal lung maturity
 A ratio of less than 2 indicates pulmonary immaturity and subsequent
respiratory distress syndrome
 Administer corticosteroid (Betamethasone)
 Alpha- fetoprotein (AFP)
 Inappropriate increased indicate neural tube defects, impending fetal
death, congenital nephrosis, or contamination of fetal blood
 Phosphatidylglycerol (PG)
 Normal = present
 Absence indicates pulmonary immaturity, fetal distress
Preparation for labor and birth
Checklist:
 Childbirth class
 Birth setting selected
 Expectations set
 Tour birthing facility
 Suitcase packed
 Sibling/pet arrangements made
 Know S/S of labor
 Know to call for ROM
 Know how to reach OB
 Determined pain management desired
 Understand possibility of cesarean section with complications
 Selected feeding method (breast/bottle)
 Circumcision decision
 Purchased infant seat
 Selected pediatrician
 Obtained necessary newborn items (clothes, diapers, crib, feeding supplies)
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Method of family planning selected
Chapter 19:
Please understand disease process, therapeutic management, nursing assessment, and nursing
management of:
 Spontaneous abortion
 Loss of pregnancy before 20 wks
 Cause unknown and highly variable
 1st trimester commonly due to fetal genetic abnormalities (80%)
 2nd trimester more likely related to maternal conditions (20%)
 Nursing Assessment
 Vaginal bleeding
 Cramping or contractions
 Vital signs
 Pain level
 Client’s understanding
 Nonmedical term = miscarriage
 Types of spontaneous abortion (table 19.1)
 Threatened: slight bleeding, no cervical changes
 Inevitable: greater vaginal bleeding, ROM, cervical dilation, strong cramping,
possible passage of “POC”
 Incomplete: heavy bleeding, intense cramping, cervical dilation
 Complete: history of vaginal bleeding & abdominal pain, passage of “POC” with
subsequent decrease in pain & bleeding
 Missed: irregular spotting, absent contractions, ultrasound to confirm presence of
“POC”
 Habitual: history of 3 or more consecutive spontaneous abortions (recurrent)
 Spontaneous abortion nursing management
 Monitor:
 Vaginal bleeding
 Passage of POC
 Pain level
 Preparation for procedures
 Administer RhoGAM prn (if mom is A negative)
 Support
 Answer questions & prepare her for procedures
 Reassure the woman that she is not the cause of the loss
 Encourage verbalization of feelings
 Grief support
 Referral to community support group
 Ectopic pregnancy
 Fertilized ovum implants outside the uterine cavity
 Most common spot is fallopian tube
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Ruptured ectopic pregnancy is a medical emergency! Organ rupture & massive
hemorrhage can occur.
 Ectopic pregnancy is responsible for 9% of all pregnancy related deaths
 Most common cause is tubal scarring secondary to Pelvic Inflammatory Disease
 Therapeutic management:
Depends upon if the tube is ruptured or intact…
 Intact = Medical Management
 Tube must be intact
 Patient must be hemodynamically stable
 Mass must be <4cm
 Drug therapy can include methotrexate (1st choice), prostaglandins,
misoprostol, and actinomycin
 Rupture= Surgery
 Salpingostomy (remove just ectopic preg) vs. salpingectomy
(remove total tube)
 Rh immunoglobin if woman Rh negative (give rhogam)
 Monitor serum HcG levels (want them to go down)
 Nursing management ectopic pregnancy
 Hallmark signs & symptoms (classic triad):
 Abdominal pain
 Spotting
 6-8 weeks after a missed menstrual period
 Contributing factors: history of STIs, previous ectopic, endometriosis, use
of fertility drugs, use of progestin-only mini pill, smoker, >35
Gestational trophoblastic disease
 Spectrum of neoplastic disorders originating in the placenta
 Gestational tissue is present, but pregnancy is not viable
 Exact cause unknown, possible genetic link
 Two most common types:
 Hydatidiform Mole yields 69 chromosomes
 Complete (empty egg fertilized by one normal sperm)
 Partial (normal egg fertilized by two normal sperm)
 Choriocarcinoma
 Aggressive, virulent cancer which rises from trophoblastic tissue and often
metastasizes
 Nursing Assessment:
 Normal signs of pregnancyamenorrhea, fatigue, breast tenderness
 Clinical manifestations:
 Severe morning sicknesstriggered by high HcG
 Brownish vaginal spotting/bleeding
 Therapeutic Management:
 Immediate evacuation of uterine contents via D&C
 Avoid pregnancy for 1 year
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Cervical insufficiency
 Premature, spontaneous dilation of the cervix
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Etiology is unknown
Associated with
 Cervical trauma/ damage
 Previous precipitous birth
 Multiple gestation ( 2babies pressing down vs 1)
 Hydramnios-excessive amniotic fluid
 Shorter cervical length
 Risk Factors
 Previous trauma/surgery
 Prior preterm labor
 Complaints of…
 Pink- tinged vaginal discharge
 Increase in pelvic pressure
 Treatment
 Bed rest
 Pelvic rest
 Avoid heavy lifting
 Cervical cerclage
 Nursing management:
 Monitor for signs of preterm labor
 Low, dull backache
 Increase in vaginal discharge
 Rupture of membranes
 Uterine contractions
 Emotional support
 Educationregular follow up care, prep for clerage, activity restriction
Placenta previa
 A bleeding condition that occurs over the last 2 trimesters
 Occurs when the embryo implants in the lower uterine segment
 Placenta is birthed FIRST before BABY
 Placenta covers some to all of the cervical os
 s/s:
 Painless, bright red, vaginal bleeding occurring during the second or
third trimester
 Bleeding starts and stops spontaneously
 Soft, non- tender uterus
 Normal fetal heart rate
Abruptio placentae
 Separation of a normally located placenta leading to hemorrhage and
compromised fetal blood supply
 Etiology unknown
 Medical emergency
 Risks:
 Maternal: hemorrhage, need for blood transfusion, emergency
hysterectomy, DIC, renal failure
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Fetal: low birth weight, preterm delivery, asphyxia, stillbirth, perinatal
death
Mortality rate
Maternal ~6%
Fetal ~ 20- 40%
Assessment signs
 Dark red blood
 Firm/rigid abdomen
 Fetal distress present
Therapeutic management
 Control & restoration of blood loss
 Start 2 large-bore IVs with NS or LRin case we need fluids in
1 line & blood in the other
 Draw labs for type & cross matching & evaluation of woman’s
hemodynamic status
 Immediate cesarean delivery if fetal distress is present (notify NICU)
 Prevention of DIC
 Transfuse with fresh frozen plasma & cryoprecipitate
 Packed RBCs
 Platelet concentrates
 Albumin
Nursing Management
 Vitals q15
 Foley
 Assess fundal height frequency for any changes
 Monitor for s/s of DIC
 Electronic fetal monitoring
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Hyperemesis gravidarum
 Severe, persistent, uncontrollable nausea and vomiting
 Etiology unknownhigher HcG levels
 Therapeutic management:
 1st line= conservative management at home
 NPO for 24-36 hrs for gut rest
 CAM can be helpfulacupuncture, ginger, seabands, etc
 Physical assessment including:
 Inspection of mucous membranes & skin turgor
 Assess blood pressure for any changes from patient’s baseline
 Note any complaint of weakness, fatigue, dizziness, or sleep disturbances
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Hypertensive disorders of pregnancy
Chronic HTNBP exceeds 140/90 before pregnancy or before 20 weeks
Gestational HTNHTN w/o proteinuria
PreeclampsiaHTN w/ proteinuria after 20wks gestation
Eclampsiaoccurs with onset of siezures
Superimposed Preeclampsia
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
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HELLP
 Hemolysis: RBCs become fragmented as they pass through small, damaged blood
vessels
 Elevated Liver enzymes: Fibrin deposits reduce blood flow to the liver,
hyperbilirubinemia & jaundice result
 Low Platelets: platelets aggregate at various sites of vascular damage,
thrombocytopenia results
Blood incompatibility
 Rh: Occurs in mothers with any blood type with negative Rh factor and a fetus
with any blood type with positive Rh factor
 ABO: Type O mothers with type A, B, or AB fetuses
 For Coombs negative mothers, RhoGAM is given at 28 weeks gestation, also
if any event occurs where there is possible maternal & fetal blood exchange,
and within 72 hours of delivery
Hydramnios too much amniotic fluid
Oligohydramniosdecreased amount of amniotic fluid
PROM vs. PPROM
 PROM: Rupture of the bag of waters before the onset of labor, after a woman has
reached 37 weeks gestation
 PPROM: Rupture of membranes prior to the onset of labor, before a woman has
reached 37 weeks gestation
 Increased risk for recurrence
Vocab
L.
Hepatitis C4. Vaccine-preventable STIs
Chlamydia2. Characterized by cervicitis
Trichomoniasis1.characterized by vaginal discharge
Syphilis 3. Characterized by genital ulcers
Genital herpes simplex3. Characterized by genital ulcers
Hepatitis A4. Vaccine-preventable STIs
Scabies5. Ectoparasitic infections
Vulvovaginal candidiasis 1. characterized by vaginal discharge
Human papillomavirus (HPV) 4. Vaccine-preventable STIs
Gonorrhea 2. Characterized by cervicitis
Hepatitis B4. Vaccine-preventable STIs
Vulvovaginal candidiasis1. characterized by vaginal discharge
M.
Pediculosis pubis5. Ectoparasitic infections
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
A.
B.
Hyperemesis Gravidarumsevere form of persistent, uncontrollable
nausea and vomiting resulting in dehydration and electrolyte imbalances
PreeclampsiaHTN which develops after 20 weeks with proteinuria
C.
D.
E.
F.
G.
H.
Placenta Previaplacenta covers some to all of the cervical os
Gestational HypertensionHTN w/o proteinuria after 20wks gestation
Abruptio Placentaeseparation of a normally located placenta leading
to hemorrhage & compromised fetal blood flow
Ectopic Pregnancyfertilized ovum implants outside the uterine cavity
Gestational Trophoblastic Diseaseneoplastic disorder where
gestational tissue is present, but pregnancy is NOT viable
Chronic HypertensionBP exceeds 140/90 before pregnancy or
before 20 weeks gestation
Amniocentesistransabdominal puncture of the amniotic sac to
obtain fetal cells within the amniotic fluid for analysis
B. Nuchal Translucencyexamines via ultrasound the accumulation
of fluid behind the fetal neck
C. NSTassesses fetal movement & heart rate patterns; reactive if 2
fetal HR acceleration periods of 15bpm for at least 15 sec from baseline
D. L/S Ratioamniotic fluid analysis; 2:1 ratio indicates fetal lung
maturity
E. Free Cell DNA Test analyzes fragments from fetal chromosomes
in maternal circulation to detect fetal aneuploidy
F. Percutaneous Umbilical Blood Samplingcollection of a blood
specimen directly from the fetal circulation via the fetal umbilical vein;
allows for rapid chromosomal analysis
A. Doppler Flow Studiesmeasures velocity of blood flow in
umbilical vessels
B. Maternal Serum AFPenters the maternal circulation by crossing
the placenta, and high levels in the maternal serum may indicate a neural
tube defect, multiples, or GI defects
A.
Threatened abortionvaginal bleeding early in a pregnancy. No
cervical dilation or change in cervical consistency. Closed cervical os.
No passage of fetal tissue. Mild abdominal cramping.
B. Inevitable abortionvaginal bleeding, rupture of membranes,
cervical dilation, strong abdominal cramping, possible passage of
products of conception
C. Incomplete abortionPassage of some of the products
of conception. Intense abdominal cramping, heavy vaginal bleeding,
cervical dilation
A.
Complete abortionPassage of all products of conception. Passage
of tissue with subsequent decrease in pain and decrease in
vaginal bleeding
E. Missed abortionNonviable embryo retained in utero for at least 6
weeks. Absent uterine contractions, irregular spotting
F. Recurrent/ habitual abortionhistory of three or more
consecutive spontaneous abortions
D.
Q’s;
Which finding would the nurse expect to assess in a woman with placenta previa?
a. Dark red vaginal bleeding
b. Uterine tenderness
c. Fetal distress
d. Painless, bright- red vaginal bleeding
Is the following statement true or false?
The onset of seizures indicates severe preeclampsia.
a. True
b. False
**Seizures denote the onset of eclampsia.
Hyperemesis Gravidarum has a higher incidence in which of the following high- risk
pregnancies: (SATA)
A. Multiple Gestations
B. Obesity
C. Oligohydramnios
D. Molar Pregnancy
E. Spontaneous Abortion
Is the following statement true or false?
A positive pregnancy test is a positive sign of pregnancy.
a. True
b. False
**a positive test is a PROBABLE sign
When assessing a pregnant woman, which of the following would the nurse expect to find?
a. Increase in blood pressure
b. Complaints of nausea
c. Dry mouth
d. Diarrhea
Is the following statement true or false?
Ambivalence is a normal response during the first trimester of pregnancy.
a. True
b. False
The nurse is concerned that a client is not obtaining enough folic acid. Which test would the
nurse anticipate being used to evaluate the fetus for neural tube defects?
A. Doppler flow study
B. Alpha- fetoprotein analysis
C. L/S ratio
D. Chorionic villus sampling