Exam 1 study guide for NUR 113 (fall semester). Study guide has all relevant exam content and topics with detailed information pertaining to each topic.
Sexually Transmitted Infections (STI’s)
STIs: caused by bacteria; transmitted by vaginal, oral, and anal intercourse/contact
STDs: caused by viruses (HPV, HSV, HIV)
The 5 P’s:
o Partners
o Practices
o Protection from STIs
o Past history of STIs
o Prevention of pregnancy
Risk Factors:
o multiple sexual partners/new sexual partner
o drug/alcohol use (lowers inhibition)
o immune suppression caused by HIV
Prevention:
o based on principles of:
education
detection
effective diagnosis
treatment of infected individual
evaluation/treatment/counseling of sex partners of infected individual
Human Papilloma Virus (HPV)
most common STI
causitive agent to many genital cancers; genital warts
diagnosed due to abnormal pap
often women DO NOT have symptoms
Expected findings:
bumps in genital area (might not itch or hurt)
vaginal discharge
dyspareunia
bleeding after intercourse
small warts in genital area with cauliflower appearance
Client Education:
Vaccines recommended; indicated for 9-26 yr of age; typically given at 11-12; 3 doses in 6 mo
period
If therapy deferred until after pregnancy, lesions are still infectious
Herpes Simplex Virus (HSV)
Not a reportable STI HSV-1 (cold sores)
HSV-2 transmitted during sexual activity/childbirth
Prodromal symptoms (painful blisters, tender lymph nodes, lesions)
Treatment focuses on relieving symptoms and preventing spreading
Chlamydia
Most commonly reported bacterial STI in US
Most women asymptomatic
If left untreated, can lead to PID, causing infertility and ectopic pregnancy
Invades cervix in women, urethra in men
If untreated during pregnancy, can cause premature ROM, preterm labor, postpartum
endometriosis
If transmitted to neonate, can cause conjunctivitis and pneumonia after delivery
Pregnant patients should be retested 3 wks after completing treatment
,Expected findings:
Men
o penile discharge
o dysuria
o testicular edema/pain
Women
o dysuria
o urinary frequency
o spotting/postcoital bleeding
o vulvar itching
o gray-white discharge
Medications:
Doxycycline (contraindicated during pregnancy); reduces effectiveness of oral contraceptives
Azithromycin/Amoxicillin (prescribed during pregnancy)
Erythromycin (administered to neonate following birth)
Gonorrhea
2nd most common reported STI in US
many men/women asymptomatic
can cause blindness in newborns (opthalmia neonatorum)
Expected findings:
anal lesions (if present): itching, irritation, rectal bleeding, diarrhea, painful defecation
oral lesions (if present): lip ulcerations, tender gums, pharyngitis
Men:
o dysuria
o testicular edema/pain
o penile discharge (white, green, yellow, clear)
Women:
o Often no manifestations
o dysuria
o vaginal bleeding between periods
o dysmenorrhea
o yellowish-green vaginal discharge
Medications:
Ceftriaxone (IM)
Azithromycin (PO)
Syphilis
Reportable STI; caused by spirochete
Can infect almost any body tissue/organ
If not treated appropriately, will progress in 4 stages
o Can be transmitted to neonate and cause stillborn birth/congenital defects
o Infection of eye (blindness)
o Infection of nervous system (H/A, numbness, paralysis, dementia)
Stages:
Primary: presence of sore (on genital area), large lymph nodes
Secondary: rash (hands/soles of feet), sore throat, flu-like symptoms
Latent: no symptoms; transmission possible
Tertiary: damage to internal organs; manifestations include blindness, difficulty coordinating
muscle movements
Medications:
Penicillin IM G (safe during pregnancy)
, Doxy/tetracycline (if penicillin allergy; contraindicated in pregnancy)
TORCH Infections
Infections that cross the placenta and have teratogenic effects on fetus
T – Toxoplasmosis
O – Other (Hep B, Syphillis, Varicella)
R – Rubella (German measles)
C – Cytomegalovirus (Herpes family)
H – Herpes Simplex Virus (HSV)
Medications:
Antibiotics (as prescribed)
For toxoplasmosis:
o Sulfanomides
o OR combination of pyrimethamine and sulfadiazine
Antepartum Care
Naegele’s Rule: 1st day of LMP + 7 days – 3 months + 1 yr = Estimated Due Date
GTPAL:
o Gravida – number of pregnancies
o Para – number of births after 20 wks
o Five-digit system
G – total number of pregnancies
T – full-term pregnancies (37-40 wks)
P – preterm deliveries (20-36 wks)
A – abortions/miscarriages (before 20 wks)
L – living children
Umbilical cord:
o 1 vein
o 2 arteries
Fundal height:
o bladder must be empty
o tape measure stretched from top of pubic bone to top of fundus
o approximately equal to number of months pregnant
Biophysical Profile (BPP):
o assessment of 5 variables over 30 min; used when there’s risk of placental
insufficiency/fetal compromise
o B – breathing/movement of fetus
o A – amniotic fluid volume
o T – tone of fetus
o M – movement of fetus
o N – non-stress test (NST)
Intrapartum Care
5 P’s (Birthing Process):
o
HTN Disorders
HTN disorders in pregnancy 2nd leading cause of maternal death (behind maternal hemorrhage)
Gestational HTN diseases associated with placental abruption, kidney and liver failure, preterm
birth, and fetal/maternal mortality
Medications:
Methyldopa (Aldomet) (anti-HTN)
Nifedipine (Procardia) (anti-HTN)
Hydralazine (Apresoline) (anti-HTN)
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