Download Nurs 7310 Exam 3 Questions and Answers: Comprehensive Guide to Maternal and Newborn Health and more Exams Nursing in PDF only on Docsity!
Nurs 7310 exam 3 Questions With Complete Solutions 100% sensitivity means what? Correct Answers the test identifies EVERY PERSON who HAS THE DISORDER 4 major components of BPP Correct Answers - body limb movement: muscle tone, CNS activity
- fetal breathing movement: swallowing, CNS health
- amniotic fluid volume: placental perfusion, kidney function
- fetal heart rate: more than 2 accelerations of >15 BMP lasting longer than 15 seconds in 40 minutes according to jordan, what test should a woman at increased risk of aneuploidy take Correct Answers NIPT, and then dx test if they screen positive
- overall reduction in unnecessary, highly invasive interventions acts of oxytocin during breast feeding Correct Answers - help myocytes to contract to get milk to baby
- stimulate materal brain to love and attach to baby
- uterine contractions amniocentesis Correct Answers - used in prenatal care
- fetal tissue for genetic testing: aneuploidy and AFP baby's physiological adaptation to breast feeding Correct Answers - thicker and fuller tongue than adult tongue to be able to breathe, suckle, and swallow at the same time
- intermittent, shallow breathing to maximize oxygenation while eating
benefit of high sensitivity testing Correct Answers good at finding TRUE POSITIVES-- false negatives are ARE RARE benefit of kick counting Correct Answers maternal pt can notice changes in normal fetal circadian rhythm before other s/sx of fetal hypoxia manifest benefit of specificity Correct Answers give true NEGATIVES, NO FALSE POSITIVES benefits of breastfeeding Correct Answers decreased rates of : celiac disease, IBD, HTN, high cholesterol, childhood obesity improved: cognitive abilities benefits of skin to skin Correct Answers - physiological stability (glucose)
- warmth
- enhancing feeding opportunity
- baby can self-attach to breast biochemistry components of milk production Correct Answers
- exocytosis
- pinocytosis -diffusion biophysical profile assumes... Correct Answers healthy well- oxygenated fetus behaves in characteristic ways and show evidence of CNS activity
changes to nipples in post partum period Correct Answers will change from edematous (s/t increased fluids) to elastic (with suckling) characteristics of colostrum Correct Answers - low in water content (low volume)
- high in nutrients & protein
- low in fat & sugar
- present 5 days PP
- high in immunoglobulins (IgA) characteristics of mature milk Correct Answers - occurs 14 days PP
- thin, creamy, white
- increased volume
- increased fat
- immunoglobulins and protein decrease characteristics of transitional milk Correct Answers - days 5- PP -production occurs with expulsion of placenta
- higher water content than colostrum (increases overall volume)
- contains lactose molecules
- "milk has come in" chorionic villus sampling Correct Answers - placental tissue for genetic testing chromosomal abnormalities cause... Correct Answers aneuploidy
clinical implication if woman has asymptomatic GBS Correct Answers antibiotic treatment if colony count is 10^5 (100,00) or greater. if it is lower than 10^5, you do not have to treat at that time but antibiotic treatment at labor is still indicated clinical implication if woman has symptomatic GBS Correct Answers (complaining of urination problems) prompt antibiotic treatment at time of diagnosis & ppx antibiotic treatment at delivery clinical implications for cc of nipple discharge Correct Answers
- always do hemoccult testing in case there is trace blood
- assess frequency, location, spontaneous vs non spontaneous, associated symptoms clinical implications if atypia is noticed Correct Answers - mammogram + MRI yearly rotating every 6mo
- Tyrer-Cuzick scale or Gail score to assess risk common red flags to observe when taking family hx, indications for possible genetic screening Correct Answers - onset of disease in early age
- multiple affected people
- clustering of diagnosis
- single family member with multiple cancer
- presence of disease in people who are generally healthy Remember that lack of family hx does not rule out genetic cause!!
definition of single gene defect Correct Answers caused by mutations in DNA sequencing or activation of specific gene
- autosomal dominant, recessive, and x-linked definition of specificity Correct Answers ability of the test to detect ONLY individuals that have the disease diagnose: Firm, non-tender benign breast mass found incidentally diagnosis w/ biopsy Correct Answers hamartoma diagnose: localized breast pain NOT centralized to the breast Correct Answers extramammary breast pain (ddx: costochondritis, pulled muscle, etc) diagnose: RAPIDLY GROWING round, oval, nontender, firm, well- circumscribed, marble. Correct Answers phyllodes tumor diagnose: round, oval, nontender, firm, well-circumscribed, marble. super common in teenagers, people <25 Correct Answers fibroadenoma diagnose: soft, non-tender, benign mass difficult to see on mammogram and U.S Correct Answers lipoma diagnose:
- benign breast masses on the ducts leading up to the nipple
- with or without nipple discharge
- diagnosed with imaging Correct Answers intraductal papilloma diagnose: BILATERAL breast pain that occurs a few days prior to menses, resolves at completion. described as "dull, heavy" Correct Answers cyclic mastodynia diagnose: firm, ill defined, non-tender, non-mobile breast mass. found along scar line Correct Answers fat necrosis diagnose: unilateral breast pain, described as tight/burning/stabbing. reported at any time of the month. Correct Answers non-cyclic mastodynia diagnose: very tender, fluid filled with MILK, smooth and mobile mass Correct Answers galactocele diagnose: very tender, fluid filled, smooth and mobile mass Correct Answers cyst does breastfeeding or hormones contribute more to aesthetic changes in breast shape Correct Answers hormones: progesterone and relaxin relax coopers ligaments in addition to hormonal changes causing increase in breast size themselves
fetal non stress test assumes... Correct Answers that healthy, well-oxygenated fetuses have characteristic heart rate accelerations associated with movement First Maneuver of Leopold's Correct Answers - identify the part in the fundus head= smooth, globular, ballottable ^ * they are breech Fourth Maneuver of Leopold's Correct Answers is the presenting part engaged? what side is the forehead palpable? good non pharm intervention for engorgement Correct Answers a little manual expression, cold compress, cabbage < good technique for reducing amount of drug that crosses to baby Correct Answers admin right after feeding herbs used in menstrual disorder Correct Answers - magnesium: improved PMS, decreased migraines, lower GI distress
- chasteberry: PMS, breast pain hormones in pregnancy that finalize mammogenesis Correct Answers estrogen, progesterone, hPL, hCG, prolactin
how did modern medicine disprove the previous understanding of breast anatomy Correct Answers - ultrasound, MRI
- can use live women how do drugs cross over to breast milk Correct Answers - transcellular diffusion
- intracellular movement
- passive diffusion
- carrier mediated diffusion how do the breast buds turn into breasts Correct Answers secondary buds become ductal system/canals via the fat pads in mature breasts how does MSAFP work Correct Answers AFP enters the maternal blood stream if there are open abdominal or neural tube defects in the fetus
- AFP is NOT a NORMAL FINDING how is prolactin inhibiting factor overridden Correct Answers nipple stimulation how long are BPP tests Correct Answers 40 minutes. of note, observation must be conducted for 30 minutes straight to be able to determine a score of 0 to account for fetal sleep-wake cycles how long can you store milk Correct Answers 4 days in fridge, or frozen for longer how long do NST last Correct Answers 40 mins
indications for formula feeding Correct Answers - very low birth weight
- hypoglycemia that does not resolve with breastfeeding
- severe maternal illness
- metabolism errors
- acute dehydration not responsive to other interventions
- maternal meds incompatible with breastfeeding is double pumping your breasts better than expressing milk one breast at a time Correct Answers yes: increase prolactin levels better than single pump format is it safe for babies to have goat milk Correct Answers false, should have only breast milk or formula is mammogram or ultrasound imaging better for younger women Correct Answers although mammogram is considered the gold standard for breast imaging, ultrasound is actually better at visualizing masses in dense breasts is spontaneous or regular nipple discharge more concerning Correct Answers spontaneous kick counting edu Correct Answers - start counting fetal movements at the same time each morning
- count how long it takes to perceive 10 movements (any movement counts) lactational amenorrhea Correct Answers - must be exclusively breast feeding
- must be amenorrheic
- must be within 6 months PP lactational amenorrhea MOA Correct Answers prolactin, triggered by suckling, inhibits hypothalamus release of GnRH. this suppresses ovulation low bishop score (>5) Correct Answers consider cervical ripening before induction maternal benefit of breastfeeding Correct Answers - decreased risk of PP bleeding s/t oxytocin contractions
- more rapid uterine involution
- decreased menstrual blood loss
- increased child spacing
- lactational amenorrhea method decreased risk of
- RA
- obesity
- CVD
- breast cancer maternal diet impacts on milk production Correct Answers - fat
- flavor: spices can cross into milk
- color: sports drink color can cross into milk Maternal serum alpha-fetoprotein (MSAFP) Correct Answers - screen for NTD and ventral wall disorders
- highly SENSITIVE detect cases of fetal compromise
- not good predicted of which fetuses are most compromised (not SPECIFIC) phase one of lactogenesis Correct Answers - occurs mid to late pregnancy
- differentiation of alveolar cells from secretory cells
- prolactin influence limited (milk production is not occurring, just prepping the ducts)
- colostrum (16 weeks) phase two of lactogenesis Correct Answers - occurs postpartum with the expulsion of the placenta
- decrease in levels of progesterone & estrogen
- transitional milk within 2-4 days
- onset of copious milk secretion
- switch from endocrine to autocrine control, where nipple stimulation/feeding drives milk production pregnancy changes to EXTERNAL breasts Correct Answers - darkening of areola
- enlarged montegomery tubercles
- thinned skin with more prominent vessels pregnancy changes to INTERNAL breasts Correct Answers - proliferating ductal system
- lobules increase in size
- epithelium transforms to enable milk production previous understanding of breast tissue Correct Answers - data drawn from postmortem lactating women
- described lactiferous sinuses that were s/t wax injection & rigor mortis probiotics found in breast milk Correct Answers - oligosaccharides
- lysozymes
- paroxidase destroy bacteria process of involution of lactocytes Correct Answers - milk stasis
- no suckling decreases hormone response
- apoptosis proteins that impact milk production Correct Answers - asein
- whey
- IgA red flags to conduct prenatal genetic counseling Correct Answers - risk based / disorder specific tests Correct Answers - indicated based on exposure, whether a single- gene disorder (cystic fibrosis, tay sachs), or an environmental risk, or exposure to teratogen
- screening & diagnostic depending on who is being tested risks of using formula Correct Answers - derived from cow's milk which doesn't have the same biochemical properties
- long term effects of GI flora
t/f AFP levels are influenced by # of fetuses Correct Answers true: multiple gestations will increase AFP levels t/f AFP levels are influenced by ploidy Correct Answers true: AFP will be reduced with aneuploidy t/f alcohol, drugs, nicotine effect breastfeeding Correct Answers true! nicotine narrows ducts and slows flow t/f amniocentesis findings are considered diagnostic Correct Answers true: contain fetal karyotypes from within the amniotic fluid t/f artificial nipples are perfect replicas of real nipples Correct Answers false: baby has access to high volumes of milk without having to utilize the same degree physiological mechanisms to attain milk t/f bishop scores predict likelihood of vaginal birth Correct Answers false: think of it more as the success or failure of an induction low bishop score= higher risk for c section s/t failed induction high bishop score = lower risk for c section s/t successful induction t/f both breast reduction AND breast augmentation increase risk of breast cancer Correct Answers false!! neither do
t/f BPP is considered to have high reliability Correct Answers true: very low rates of false negatives/ false positives poor predictive value t/f breast augmentation effects breast feeding Correct Answers false: more likely with breast reduction t/f breast color will return to baseline Correct Answers false, but will lighten over time t/f breast reduction surgery is more damaging that breast augmentation for breastfeeding Correct Answers true t/f breastfed infants should get vit D supplements Correct Answers true: 400 IU for 6 mos (prevent rickets) t/f breastfeeding people should always take a multivitamin Correct Answers false: unless not getting adequate calcium from other sources t/f caffeine can be transferred in breast milk Correct Answers true: baby will be fussy, and have issues sleeping t/f cervical exams are routine during 35-40 EGA Correct Answers FALSE!!!! !!
- can rupture membranes
- increases risk for maternal infection
