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Cardiac Decompensation, STIs, and Perinatal Mood Disorders: Exam 3 Study Guide, Exams of Nursing

Indiana University Purdue University (IUPUI)Nursing

This study guide provides a comprehensive overview of key concepts related to cardiac decompensation, sexually transmitted infections (stis), and perinatal mood disorders. It includes a series of questions and answers covering various aspects of these topics, such as symptoms, diagnosis, treatment, and management. The guide is particularly useful for nursing students preparing for exams or seeking to deepen their understanding of these critical areas in healthcare.

Typology: Exams

2024/2025

Available from 11/16/2024

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NURS 332 - Exam 3 Revision Questions And Answers
(study guide) 2023-2024
cardiac decompensation symptoms - ans- -subjective: fatigue, breathing difficulties, smothering feeling,
frequent cough, palpitations, generalized edema
-objective: irregular, weak, rapid pulse, generalized edema, crackles in lungs, orthopnea, tachypnea,
most frequent cough, lip and nail bed cyanosis
What are three things that can prevent straining of the heart with bowel movements? - ans- 1. Colase
2. high fiber diet and fluids
3. avoiding the Valsalva maneuver
What position should the woman be in intrapartum with cardiac decompensation? - ans- side lying with
the HOB elevated, also avoid stirrups (they impact the popliteal artery)
uterotonic medication and indications - ans- -methergine
-raises BP so take it before
-other: Petocin
tocolytic medication and indications - ans- -Terbutaline
-given to stop contraction
-SE: increased HR
What birth control to avoid with cardiac decompensation? - ans- -estrogen
-give only progesterone birth control or barrier method
-24-48 hours are the most difficult
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Download Cardiac Decompensation, STIs, and Perinatal Mood Disorders: Exam 3 Study Guide and more Exams Nursing in PDF only on Docsity!

NURS 332 - Exam 3 Revision Questions And Answers

(study guide) 2023- 2024

cardiac decompensation symptoms - ans- - subjective: fatigue, breathing difficulties, smothering feeling, frequent cough, palpitations, generalized edema

  • objective: irregular, weak, rapid pulse, generalized edema, crackles in lungs, orthopnea, tachypnea, most frequent cough, lip and nail bed cyanosis What are three things that can prevent straining of the heart with bowel movements? - ans- 1. Colase
  1. high fiber diet and fluids
  2. avoiding the Valsalva maneuver What position should the woman be in intrapartum with cardiac decompensation? - ans- side lying with the HOB elevated, also avoid stirrups (they impact the popliteal artery) uterotonic medication and indications - ans- - methergine
  • raises BP so take it before
  • other: Petocin tocolytic medication and indications - ans- - Terbutaline
  • given to stop contraction
  • SE: increased HR What birth control to avoid with cardiac decompensation? - ans- - estrogen
  • give only progesterone birth control or barrier method
  • 24 - 48 hours are the most difficult
  • 2 week period where cardiac decompensation may occur chlamydia symptoms - ans- - spotting, postcoital bleeding, mucoid or purulent discharge, dysuria, can be asymptomatic
  • baby: conjunctivitis and pneumonia When should the patient get tested for chlamydia? - ans- - annually
  • during pregnancy in the first trimester, and retested in the third trimester
  • if positive, retest in 3-4 weeks and 3 moths after chlamydia treatment - ans- - Azthromycin during pregnancy
  • Doxycycline Gonorrhea symptoms - ans- - often asymptomatic
  • can have purulent discharge, irregular periods, pain in lower abdomen, if rectal - backache, bloody stool, rectal itchiness, fullness, pressure, diarrhea, swollen labia
  • in pregnancy: PPROM, preterm birth, chorio, IUGR, sepsis, blindness in newborn Gonorrhea screening and diagnosis - ans- - during first trimester and then at 36 weeks Gonorrhea treatment - ans- - Ceftriaxone treatment
  • erythromycin to prevent blindness in babies Syphilis symptoms - ans- - primary (5-90 days after infection): painless papule to an ulcer or lesion
  • secondary (6 weeks to 6 months): maculopapular rash on palms and soles, fever, headache, malaise, condylomata lata (broad painless pink gray wartlike lesions)
  • tertiary: develops in one third of women infected, neurologic, cardiovascular, musculoskeletal,
  • wear cotto nlined underwear
  • Tylenol/Motrin to help with pain
  • antiviral medications control symptoms: acyclovir, valacyclovir, famciclovir Maternal and fetal effects of HSV - ans- - do not want baby to be exposed to active lesions, so if there are signs of an outbreak do a C section general hepatitis symptoms - ans- sick, tired, fever, changes in stool and skin (jaundice), abdominal pain Hepatitis A symptoms - ans- - flulike symptoms with malaise, fatigue, anorexia, nausea, pruritus, fever, and RUQ pain Hepatitis B symptoms - ans- - arthritis, N/V, headache, fever, mild abdominal pain, clay colored stools, dark urine, jaundice Hep B tx - ans- - no specific tx
  • recovery spontaneous within 3-16 weeks
  • give baby vaccine Hepatitis C indications - ans- - can breastfeed unless they get cracked nipples Hep C testing - ans- - one time in adults 18 and older without other risk factors HIV symptoms - ans- fever, headache, night sweats, malaise, generalized lymphadenopathy, myalgia, nausea, diarrhea, weight loss, sore throat, and rash HIV with pregnancy - ans- - if viral load is 1000 copies/mL at 38 weeks have a C section
  • if viral load is less than 1000 copies/mL at 36 weeks vaginal birth
  • should not be breastfeeding bacterial vaginosis symptoms - ans- fishy odor, profuse, thin, white, gray, or milky discharge, irritation, pruritus bacterial vaginosis treatment - ans- - Flagyl - used for protozoa
  • indications: do not drink alcohol and protect fragile skin candidiasis predisposing factors - ans- antibiotic therapy, diabetes, pregnancy, obesity, diets high in refined sugars, use of corticosteroids and hormones, immunosuppressed states candidiasis symptoms - ans- pruritus, vaginal discharge, thick white and clumpy discharge, red and swollen
  • tx: antifungal trichomoniasis symptoms - ans- (sexually transmitted)
  • yellowish to greenish frothy discharge, pruritus, inflammation, dysuria trichomoniasis management - ans- Flagyl (used for protozoa) TORCH infections - ans- T - toxoplasmosis O - other (syphilis, hepatitis, HIV)) R - rubella C - cytomegalovirus H - herpes

postpartum depression with psychotic features (postpartum psychosis) - ans- - trying to harm self or baby, rapid mood swings, confusion, seeing or hearing things not there

  • associated with bipolar disorder
  • requires inpatient psychiatric care neonatal abstinence syndrome (NAS) types - ans- tobacco: smaller/preterm baby alcohol: different appearance or developmental delay opioids: NAS cocaine and amphetamines: placental abruption neonatal abstinence syndrome symptoms - ans- more irritable, increased suck, nasal flaring, increased respiratory rate, poor feeds, diarrhea, tremors, seizures, tense muscles, marbling of skin, excoriation (from moving chin back and forth), frequent sneezing, yawning, sloppy feeders, do not want to go to sleep after How to assess NAS - ans- eat, sleep console NAS care - ans- - go to NICU and get weaned off of morphine
  • smaller feeds, do not distract while feeding, reduce stimulation criteria for preterm labor - ans- regular contractions with cervical changes (effacement or dilation or both) how to predict spontaneous preterm labor and birth - ans- - fetal fibronectin (fFN) test, predicts who will not go into preterm labor bc negative predictive value is high
  • women with negative test have <1% chance of giving birth within 2 weeks

What to do if you start going into preterm labor - ans- stop what you are doing, lie on your side, drink 2- 3 glasses of water, wait 1 hour, and if symptoms get worse call provider or go to the hospital, if symptoms come back call the provider PPROM is often preceded by... - ans- infection such as chorioamnionitis, fetal tachycardia, temp What should all women receive with PPROM? - ans- - glucocorticoids

  • 7 day course of broad spectrum antibiotics
  • magnesium sulfate for fetal neuroprotection chorioamnionitis findings - ans- - maternal fever, maternal and fetal tachycardia, uterine tenderness, foul odor of amniotic fluid, abnormal discharge, concerns of fetal movement post-term maternal and fetal risks - ans- perineal injury, PPH, infection, birth interventions, maternal morbidity, fetal abnormal growth, cord compression, shoulder dystocia, fetal injury, placenta ages, meconium stained fluid, post-maturity syndrome obese pregnant women are at risk for... - ans- spontaneous abortion and stillbirth, pregnancy-associated hypertensive disorders, gestational diabetes, fetal congenital abnormalities, Cesarean birth, venous thromboembolism, increased incidence of post-term pregnancy and longer labori When should an external cephalic version be performed? - ans- At 36-37 weeks When can induction of labor be initiated? - ans- At 39 weeks Avoid cervical ripening agent in: - ans- complications with pregnancy (placenta previa), previous C section delivery (worry about uterine rupture) uterine tachystole definition - ans- more than 5 contractions in 10 minutes; single contraction lasting >

patent ductus arteriosus (PDA) - ans- - fails to close after birth

  • dx: echocardiogram
  • tx: Indomethacin or ibuprofen: helps with vasoconstriction
  • symptoms: murmur, crackles, tachypnea, bounding pulses necrotizing enterocolitis symptoms - ans- abdominal distention, bloody stools, bile stained residual, pale apnea, hypotonia, decreased activity, bradycardia NEC treatment - ans- NPO and TPN, GI rest, surgery ABO incompatibility - ans- - O mother with A, B, or AB infant
  • can lead to jaundice Rh incompatibility - ans- - Coombs test (if ratio is 1:8 or greater there are more antibodies present and infant is at higher risk) hyperbilirubinemia - ans- physiologic jaundice: after 24 hours of birth pathologic jaundice: within 24 hours of birth risks: Rh negative mother, ABO incompatibility, polycythemia, bruising, hx with other children, preterm postpartum hemorrhage definition - ans- either cumulative blood loss >1000mL or bleeding associated with signs/symptoms of hypovolemia within 24 hours of the birth process regardless of type of birth different types of PPH - ans- - early, acute, or primary occurs within 24 hours of birth
  • late or secondary PPH occurs more than 24 hours but up to 12 weeks after birth subinvolution of the uterus - ans- - when the uterus is not shrinking as it should
  • signs: late postpartum bleeding, prolonged lochial discharge, irregular or excessive bleeding who is at risk for PPH? - ans- atony, high parity, hydramnios, macrosomia, obesity, multifetal gestation, anesthesia and analgesia: general or halogenated, long labor/Pitocin induced, obesity, trauma during birth PPH care management - ans- - initial intervention: firm massage of the uterine fundus to express clots
  • continuous IV infusion of 10-40 units of oxytocin added to 1000mL fluid
  • additional meds: methergine, Cytotec, Hemabate, tranexamic acid
  • large bore IV
  • quantify blood loss
  • surgical management
  • position in supine or trendelenburg
  • ask if dizzy, lightheaded, pale, vital signs, urinary output disseminated intravascular coagulation (DIC) meaning - ans- clotting that is diffuse and consumes large amounts of clotting factors, causing widespread external bleeding, internal bleeding, or both DIC symptoms - ans- tachycardia, hypotension, hematomas, bruising, petechiae, oozing at IV site, spontaneous bleeding from different sites, peripheral cyanosis, renal impairment, drowsy, confused, coma, GI bleeding, hematuria DIC labs - ans- - platelets decreased (helps with blood clot formation)
  • fibrinogen decreased (essential for clot formation)
  • prothrombin time prolonged (amount of time it takes for blood to clot)
  • activated partial thromboplastin prolonged (amount of time for blood to clot)
  • fibrin split products increased (breaks down clots)