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Name some instances a child under 18 (or 21, depending on state law) can give informed consent.
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Where can stem cells be found?
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OB Quiz 1 Hondros
Hondros RN OB Midterm
| Question | Answer |
|---|---|
| Name some instances a child under 18 (or 21, depending on state law) can give informed consent. | (-) When they are the minor parents of a child client. (-) When they are emancipated minors. (-)When they are between 16 and 18, seeking BC, mental counseling, or substance abuse treatment. |
| Where can stem cells be found? | Embryonic tissue and the primordial cells of a fetus. |
| This refers to the ability to understand and respond to needs in patients from different cultural backgrounds. | Cultural competence |
| What are the two phases of the ovarian cycle? | Follicular (day 1 through 14) and Luteal (day 15 to 28) |
| What are the four phases of the uterine cycle? | Menstrual (approx day 1 to 6), Proliferative (day 7 to 14), Secretory (day 15 to 26), and Ischemic (day 27 and 28) |
| In this uterine phase, estrogen drops sharply and progesterone dominates. | Secretory phase. |
| In this ovarian phase, the ovum leave the follicle, and the follicle develops into the corpus luteum. | Luteal phase. |
| During this uterine phase, estrogen and progesterone levels drop, and the lining prepares to be shed. | Ischemic phase. |
| During this phase, the endometrium is shed. | Menstrual phase. |
| In this ovarian phase, FSH and LH influence the follicles to mature. | Follicular phase. |
| During this uterine phase, estrogen peaks and the mucus is more favorable to sperm. | Proliferative phase. |
| Define menarche. | First period: the onset of puberty. |
| Define oligomenorrhea | Scant flow or decreased flow, with intervals greater than 35 days. |
| This is the term for menstruation occurring more than once every 21 to 24 days. | Polymenorrhea. |
| What phase is PMS associated with? | Luteal. |
| Name treatments for PMS. | (-)Avoid ETOH, caffeine, nicotine, red meat, salt, sugar. (-) diuretics, vitamins, HRT (-) Increase exercise, carbs, protein, and frequency of meals. |
| When is the best time each month for a breast self exam in a premenopausal woman? | 1 week after the period. |
| Give examples of "situational" contraceptives. | Abstinence, coitus interrupts (withdrawal, or in Dennis's terms "pull and pray") |
| Name examples of barrier methods of birth control. | Condoms, diaphrams, cervical cap, vaginal sponge. |
| This is menstruation that is frequent, irregular, and excessive. | Menometorrhagia. |
| When are COC (combined oral contraceptives) contraindicated? | Over age 30, smokers, cardiovascular disease. |
| When teaching a patient about oral contraceptives and when to see a doctor, you teach "ACHES". What does it stand for? | Abdomen pain, Chest pain, Headaches, Eye problems, Severe leg pain |
| What is a multiphasic pill? | The pills vary in amount of estrogen and progestin through the cycle. |
| How does estrogen inhibit ovulation? | It suppresses FSH. |
| How does progesterone inhibit ovulation? | By suppressing LH. |
| Which type of oral contraceptive can be given to breast feeding moms? | POP, or progestin oral pills. Are not as effective as COCs. |
| If a patient is on Depo-Provera, how often do they have to get shots? | Every 3 months. |
| How often is the transdermal patch Ortho Evra applied? | Once a week - be sure to rotate sites! |
| How long after unprotected intercourse can Plan B be given? | 72 hours. |
| Are RU-486 and Plan B the same thing? | No. Plan B prevents an egg from implanting. RU-486 forces uterine contractions - a medical abortion. |
| This is defined as the absence of menses for one full year. | Menopause. |
| What is the longest HRT should be given to menopausal women? | 2 years. |
| What types of cancer may a patient be at an increased risk for if they use HRT long term? | Breast and uterine. |
| Who cannot take HRT? | Women who have had cancer, or any blood/clotting disorder (include hx of stroke or clots). |
| When is a woman said to be PERImenopausal? When is a woman POSTmenopausal? | Peri - 2 to 8 years prior to menopause. Post - when signs and symptoms have stopped. |
| This disorder is characterized by the presence of endometrium outside of the uterine cavity. | Endometriosis. |
| Signs and symptoms of endometriosis. | Dysmenorrhea, dyspareunia, menorrhagia. |
| Treatment of endometriosis | NSAIDS, HRT, removal of ectopic tissue, possible complete hysterectomy (TAH). |
| Endocrine disorder and ovarian dysfunction that may cause androgen excess. | PCOS (polycystic ovarian syndrome) |
| Signs and symptoms of PCOS | Irregular/heavy periods, hyperandrogenism (acne, baldness, hirsutism), Obesity, diabetes, infertility |
| Treatment of PCOS | Oral contraceptives, antiandrogens (aldactone and spironolactone), metformin, exercise and diet. |
| Biggest differences between a fibroadenoma and breast cancer. | Fibroadenoma is solid, delineated, and freely moveable. Cancer is irregularly shaped, very hard, and not usually moveable. |
| This is a downward displacement of the bladder, appearing as a bulge in the anterior vaginal wall. | Cystocele. (leads to stress incontinence. Tx: kegels or surgery). |
| When the rectum sags forward into the vagina due to weak posterior vaginal wall. | Rectocele. |
| Which is a normal result for a pap smear: negative or positive? | Negative - they are /negative/ for abnormal cells. |
| What kind of pap smear result would HPV cause? | ASC-US (atypical squamous cell of undeterminded significance). This is the most common abnormal pap result. |
| What is the name for a lower UTI? Upper UTI? | Cystitis = lower UTI. Pyelonephritis = upper UTI. |
| What organism causes toxic shock syndrome? | Staph aureus |
| Signs and symptoms of toxic shock syndrome. | High fever, trunk rash, desquamation on palms and soles, hypotension, n/v/d |
| How is TSS treated? | IV fluids, broad spectrum ATBs. In severe cases, may have to receive dialysis. |
| How is bacterial vaginosis caused? | Douching and frequent sex, especially without condoms. |
| What are the signs of vaginosis? | Clue cells on wet mounts, excessive fishy discharge, pH greater than 4.5 |
| How is bacterial vaginosis treated? | Flagyl (which has an ant-abuse reaction with alcohol, so be sure to teach them to not come into contact with alcohol, including mouthwash!) |
| The signs and symptoms of trichomoniasis | Yellow to green frothy, odorous discharge, strawberry cervix. Mostly asymptomatic in men. |
| What is another name for condylomata acuminata? | Genital warts |
| What is the treatment for syphilis? | Penicillin G |
| What is the first stage of syphilis? | Painless chancre that lasts up to four weeks. May have flulike symptoms (fever, weight loss, malaise). |
| What is the secondary stage of syphilis? | Wartlike, infectious plaques (condylomata lata), arthritis, enlarged liver and spleen |
| Can syphilis cross the placenta? | Yes - it causes fetal growth restrictions, preterm birth, and stillbirth. |
| How does HSV 1 present? | Cold sores, although it can cause genital herpes through oral-genital contact. |
| How does HSV 2 present | Spontaneous rupture of open painful blisters. Flulike symptoms, pruritis. |
| Which STI causes ophthalmia neonatorum? | Chlamydia (treat it with erythromycin ointment at birth) |
| What can be some consequences of untreated chlamydia? | PID, infertility, ectopic pregnancy |
| This is an umbrella term for inflammatory disorders of the upper genital tract in females | Pelvic Inflammatory Disease (PID) |
| What organisms cause PID? | Chlamydia and gonorrhea |
| Signs and symptoms of PID | Sharp cramping pains in LQ, fever, chills, purulent discharge. However, may be asymptomatic. |
| Which types of hepatitis are transmitted sexually? | B & C. |
| How long is an egg viable for? How long is sperm viable for? | Ovum are viable for 24 hours, sperm are viable for 48 to 72. |
| What occurs 7 to 10 days after conception? | Implantation. Also, the embryonic membranes (chorion and amnion) become present. |
| What happens 10 to 14 days after conception? | Differentiation in the 3 germ layers (Ectoderm, mesoderm, endoderm). |
| What part of the zygote produces primitive red blood cells? | Yolk sac. It develops as part of the blastocyst, and eventually becomes part of the umbilical cord. |
| How many veins and arteries are in the umbilical cord? | Two arteries, one vein (think AVA) |
| When does placental development begin? Which side is maternal and which is fetal? | Placental development begins in the third week. Maternal side = red and fleshy(dirty duncan) and fetal is shiny gray (shiny shultz) |
| Describe the major events at 4 and 6 weeks of development. | 4: brain and neural tube formed, heart beats, GI system starts. 6: skeletal shape, respiratory system and ears begin. |
| Describe the major events at 12, 16, and 20 weeks of development. | 12: ossification of skeleton, production of hepatic RBCs. 16: teeth, meconium, kidneys. 20: suck and swallow, vernix. |
| When does surfactant production begin? | 24 weeks (this is why it is often considered the age of viability) |
| What may indicate a need for fertility treatments? | Tubal blockages, mucus abnormalities, low sperm count or defects, or immunological infertility. |
| If a disease is autosomal dominant, what percentage of chance is there for each pregnancy to carry the disease? | 50%. Autosomal dominant only requires one gene to be expressed. |
| In autosomal recessive disorders, do one or both parents need to be affected to pass it on? | Both. Each offspring has a 25% chance of the disorder, but a 50% chance of being a carrier. |
| What does it mean if a disease is "x-linked recessive"? | There is no father to son transmission, but a 50% chance for any child to be a carrier (100% if it is the daughter of an affected father). |
| What do high levels of alpha-fetoprotein mean? What about low levels? | High levels between 15 and 22 weeks are associated with neural tube defects. Low levels are associated with Down Syndrome. |
| What is PUBS? | Percutaneous umbilical blood sampling. Blood is taken from the cord to do genetic testing. |
| What is an amniocentesis, and when is it performed? | A needle is used to obtain amniotic fluid for genetic disorders. The earliest it can be collected is 14 weeks. |
| What is the recommended weight gain for a person with normal weight? | 25 to 35 lbs. |
| Describe common complaints during pregnancy for the GI and GU system. | N/V, heartburn, flatulence, increased urination/nocturia, bladder pressure. |
| What are some points of breast care for pregnant women? | Wear supportive bra, avoid soap on breasts, nipple stimulation to prepare for breastfeeding (avoid if theres been previous preterm labor) |
| What are common complaints of the reproductive system during pregnancy? | Abdomen enlargement, braxton-hicks contractions, increased yeast infections, leukorrhea, spotting after vaginal exams. |
| What is the linea nigra? Chloasma? | Linea nigra is the dark line on the belly pregnant women (especially dark skin tones) get. Chloasma is the 'mask' of pregnancy. |
| What are some contraindications for sexual activity during pregnancy? | Preterm labor, multiples, threatened abortion, incompetent cervix, STI |
| What are probable signs of pregnancy? | Goodells sign (cervix softening) Chadwicks sign (blue vagina), positive pregnancy test. |
| What are the positive signs of pregnancy? | Fetal heartbeat, fetal movement, ultrasound visualization, blood pregnancy test |
| What is Couvade Syndrome? | Father experiences the symptoms of pregnancy. |
| Define "gravida". | ANY pregnancy, regardless of duration or whether fetus survived. |
| Define "parity" (para) | Birth after 20 weeks gestation, may be alive or dead. |
| Define the terms for TPAL. | T: "term" infants born (38+ wks), P: preterm infants (<37 wks), A: abortion L: number of living children |
| Describe the pattern of prenatal visits. | Q 4 weeks for first 28, Q 28 weeks until 36, Q week until childbirth. |
| What tests may be performed between 24 to 28 weeks? | Glucose testing, Hgb, Hct, Rhogam (if needed), Indirect coombs test. |
| When is a mother tested for vaginal beta strep? | 36 weeks. |
| What development events occur at 28 weeks? | Adipose tissue accumulates, eyes are open, nails are present. |
| In the second and third trimester, how much should a woman increase her calories? | 300 extra calories per day. |
| How many extra calories should a woman consume during lactation? | 500/day |
| What are the presumptive signs of pregnancy? | Amenorrhea, nausea, urinary frequency, quickening |
| When is chorionic villus sampling done? | 8 to 10 weeks. |
| This is a comprehensive assessment of fetal breathing, movement, tone, fluid volume, and a non-stress test. | Biophysical profile |
| How is fetal lung maturity determined? | Lecithin/spingomyelin ratio. This should be 2:1 for maturity (3:1 if diabetic). |
| What is considered normal for the AFI (amniotic fluid index)? | 8-10 cm. <5=Oligohydramnios |
| Is it good or bad for phosphatidylglycerol to be present in amniotic fluid? | GOOD - the risk of respiratory distress syndrome is much lower. This is assessed starting at 33 weeks. |
| Do you want a positive or negative non-stress test? | Positive/reactive "Non-reactive non-stress is not good" |
| This is a method of monitoring fetal activity in which the client lies on their side and counts fetal movements over a one to 3 hour period. | Cardiff Counting Method |
Created by:
hondrosrn