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FAMILY NURSING -Exam two
Gonorrhea
Mechanism
Neisseria gonorrhoeae
Assessment
Dysuria
Yellowish-Green Discharge
Increased Urinary Frequency
Women Often Asymptomatic
Interventions
Ceftriaxone (IM)
Chlamydia
Doxycycline
Azithromycin
Considerations
Treat Partners
2 mins
Ovulatory Hormones II - Luteal Phase
Days 15-28
Corpus Luteum
Secretes Progesterone
Negative Feedback inhibits FSH and LH
No pregnancy forms Corpus Albicans
Stops Estrogen Secretion
Endometrial Sloughing - Menses
GnRH secretion produces new follicular phase
2 mins
Ovulatory Hormones I - Follicular Phase
Characteristics
0-14 Days
GnRH Stimulates FSH and LH
Follicle Secretes Estrogen
Negative Feedback from Estrogen
Increased Estrogen Leads to Positive Feedback
FSH and LH Surge
LH Spike Leads to Ovulation
2 mins
Chlamydia
Mechanism
Chlamydia trachomatis
Assessment
May Be Asymptomatic
Dysuria
Epididymitis
Discharge
Dyspareunia
Interventions
Doxycycline
Azithromycin
No Intercourse for 1 Week
Treat Partners
2 mins
Genital Warts - Condylomata Acuminata
Mechanism
Human Papillomavirus (HPV)
Assessment
Papillary Cauliflower Like Growths
Bleeding
Vaginal Discharge
Interventions
Wart Removal
Trichloroacetic acid (TCA)
Podophyllin resin
Cryotherapy
Considerations
HPV Vaccine
Cervical Cancer
2 mins
Genital Herpes
Mechanism
Herpes Simplex Virus 1 and 2 (HSV)
Assessment
May Be Asymptomatic
Oral or Genital Lesions
Vesicles in Clusters
Pain
Flu-like Symptoms
Antiviral Medications
Acyclovir
Valacyclovir
Famciclovir
Considerations
Infectious During Recurrences
2 mins
Syphilis
Mechanism
Treponema pallidum
Assessment
Primary Stage
Painless Chancre
Secondary Stage
Rash on Palms and Soles
(Generalized) Lymphadenopathy
Condylomata Lata
Latent Stage
Asymptomatic
Tertiary (Late) Stage
Aortitis
Neurosyphilis
Gummas
Interventions
Penicillin
Jarisch-Herxheimer Rash
3 mins
Transdermal Medication Administration
Application
Patch or Disc
Directly on Skin of Arms, Chest, Upper Back
Benefits
Avoids First Pass Metabolism
Sustained Administration of Medication
Nursing Considerations
Clean Skin After Removal
Rotate Sites of Patches
Apply to Dry Skin
Avoid Shaved Skin
Avoid Heat
Nitro Effects Lost After 24 Hours
2 mins
Presumptive Signs of Pregnancy
Amenorrhea
Fatigue
Urinary Frequency
Nausea and Vomiting
Breast Changes
Quickening
1 min
Probable Signs of Pregnancy
Goodell Sign
Chadwick Sign
Hegar Sign
Positive Serum and Urine Sample
Braxton Hicks Contractions
Ballottement
2 mins
Positive Signs of Pregnancy
Fetus on Ultrasound
Fetal Heart Rate by Doppler or Fetoscope
Fetal X-ray
Fetal Movements
1 min
Discomforts of Pregnancy - First Trimester
Breast Tenderness
Supportive Bra
Nausea and Vomiting
Frequent Small Meals
Urinary Frequency and Urgency
Frequently Empty Bladder
Leukorrhea
Perineal Pad
Ptyalism
2 mins
Discomforts of Pregnancy - Second Trimester
Supine Hypotension
Side-lying Position
Food Cravings
Heartburn (Pyrosis)
Constipation
Moderate Exercise
Varicose Veins
Elevate Legs
Backache
Pelvic Tilt Exercise
Considerations
Nutrition
2 mins
Discomforts of Pregnancy - Third Trimester
Shortness of Breath (SOB)
Rest Periods
Return of Urinary Frequency and Urgency
Empty Bladder Regularly
Leg Cramps
Stretching Exercises
Ankle Edema
Elevate Legs
2 mins
Placental Implantation Abnormalities
Mechanism
Placenta Adheres Directly to Myometrium
Placenta Accreta
Placenta Increta
Placenta Percreta
Caused by Scar Tissue
Hemorrhage
Diagnosis
Ultrasound is First-line, then MRI
Treatment
C-section Delivery
Artery Ligation or Embolization
2 mins
Placenta Previa
Mechanism
Placenta Covers Cervical Os
Assessment
Painless
Bright Red Vaginal Bleeding
Interventions
Stable Fetus
Bed Rest
Observation
Unstable Fetus
C-section Delivery
Considerations
Risk for Shock
Magnesium Sulfate
Tocolysis
3 mins
Abruptio Placentae
Mechanism
Premature Separation of Placenta
Assessment
Tearing Pain
Bleeding (Often Concealed)
Rigid Uterus
Contractions
Interventions
Corticosteroids as Needed
Emergent Delivery
Considerations
Increased Risks for Neonate
Rh (Rhesus) Incompatibilities
Increased Risk for Shock
Monitor Fetal Heart Rate
3 mins
Ectopic Pregnancy
Signs and Symptoms
Lower Abdominal Pain
Delayed Menses
Abnormal Vaginal Bleeding
Shock
Referred Shoulder Pain
Cullen Sign
Considerations
Methotrexate
Surgery
RhoGAM
2 mins
Tetracyclines Side Effects
Side Effects
Superinfection
Clostridioides difficile
Discoloration of Teeth
Bone Deformities
Photosensitivity
Contraindications
Children Under 8
Pregnancy
1 min
Aminoglycoside Side Effects
Side Effects
Ototoxicity
Nephrotoxicity
Respiratory Paralysis
Contraindications
Pregnancy
Considerations
Peak and Trough
Never Mix with Penicillin in Same IV
2 mins
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