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Questions and Answers
What is the primary cause of secondary amenorrhea?
What is the primary cause of secondary amenorrhea?
What is a common sign of chlamydia infection?
What is a common sign of chlamydia infection?
At what gestational age can fetal movements typically be felt?
At what gestational age can fetal movements typically be felt?
Which contraceptive method requires knowledge of the menstrual cycle for effectiveness?
Which contraceptive method requires knowledge of the menstrual cycle for effectiveness?
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What is a characteristic symptom of herpes simplex virus (HSV-2) infection?
What is a characteristic symptom of herpes simplex virus (HSV-2) infection?
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How often should a self-breast exam be performed?
How often should a self-breast exam be performed?
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What does GTPAL stand for in obstetric terms?
What does GTPAL stand for in obstetric terms?
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Which of the following is a risk factor for Pelvic Inflammatory Disease (PID)?
Which of the following is a risk factor for Pelvic Inflammatory Disease (PID)?
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Which symptom is associated with bacterial vaginosis?
Which symptom is associated with bacterial vaginosis?
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What should be counted during fetal kick counts?
What should be counted during fetal kick counts?
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Which hormonal method can cause thrombolytic events and is contraindicated in individuals at risk?
Which hormonal method can cause thrombolytic events and is contraindicated in individuals at risk?
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What is the maximum amount of amniotic fluid in oligohydramnios typically measured?
What is the maximum amount of amniotic fluid in oligohydramnios typically measured?
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What is the method for calculating a due date according to Naegel's rule?
What is the method for calculating a due date according to Naegel's rule?
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What is the primary purpose of administering vitamin K to newborns?
What is the primary purpose of administering vitamin K to newborns?
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What is the average time frame for umbilical cord separation in newborns?
What is the average time frame for umbilical cord separation in newborns?
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Which reflex allows newborns to grasp objects placed in their palms?
Which reflex allows newborns to grasp objects placed in their palms?
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What is the typical indication of pathologic jaundice in a newborn?
What is the typical indication of pathologic jaundice in a newborn?
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What is a significant sign of neonatal abstinence syndrome?
What is a significant sign of neonatal abstinence syndrome?
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What is the primary risk associated with untreated hyperbilirubinemia?
What is the primary risk associated with untreated hyperbilirubinemia?
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Kangaroo care is primarily beneficial for which purpose?
Kangaroo care is primarily beneficial for which purpose?
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What should be the initial action when using a bulb syringe to suction a newborn's airway?
What should be the initial action when using a bulb syringe to suction a newborn's airway?
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Which condition is characterized by the presence of 'stork bites' on a newborn's skin?
Which condition is characterized by the presence of 'stork bites' on a newborn's skin?
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When should a newborn feeding occur according to recommended guidelines?
When should a newborn feeding occur according to recommended guidelines?
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What skin condition typically appears 24-72 hours after birth and requires no treatment?
What skin condition typically appears 24-72 hours after birth and requires no treatment?
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Which sign indicates a newborn may be experiencing pain?
Which sign indicates a newborn may be experiencing pain?
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What indicates that a newborn is safely placed for sleep according to guidelines?
What indicates that a newborn is safely placed for sleep according to guidelines?
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What should be monitored in a macrosomic infant weighing greater than 4000-4500g?
What should be monitored in a macrosomic infant weighing greater than 4000-4500g?
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Study Notes
Chapter 2: Family Structures
- Nuclear families consist of a husband, wife, and their children (biological or adopted).
- Extended families include grandparents, aunts, uncles, and other relatives living nearby or in the same household.
- Multigenerational families include three or more generations.
- Non-biological families include adopted, foster, or kinship (close relative) families.
- Married-blended families consist of stepsiblings.
- Cohabitating families are unmarried parents.
Chapter 3: Breast Self-Exam
- The best time to perform a breast self-exam is 5-7 days after menstruation.
- During the exam, observe for any lumps, changes in nipple inversion, dimpling, redness, or pain.
- The exam is performed in both a supine and standing position, using the opposite hand to examine the breast.
Chapter 4: Amenorrhea
- Primary amenorrhea is the absence of menstruation by age 13.
- Secondary amenorrhea is the absence of menstruation for 2 cycles or 6+ months.
- Pregnancy is a common cause of secondary amenorrhea.
- Other causes of amenorrhea include eating disorders, low body weight, excessive exercise, oral contraceptive use, and issues with hormone levels (hyper/hypothyroidism).
Chapter 4: Sexually Transmitted Infections & Pelvic Inflammatory Disease Treatment
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Bacterial Infections (Chlamydia):*
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Symptoms can be asymptomatic, or include dysuria, vaginal itching, and discharge.
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Treatment: Azithromycin (1 dose) or Doxycycline (7 days), both safe for breastfeeding and pregnant women.
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Bacterial Infections (Gonorrhea):*
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Symptoms include dysuria, pelvic pain, and yellow/green discharge.
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Treatment: Ceftriaxone IM (1 dose).
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Bacterial Infections (Syphilis):*
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Symptoms include chancre (painless lesion), skin rashes on palms/soles, and lymph node edema.
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Treatment: Penicillin G IM.
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Viral Infections (HPV):*
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Symptoms include genital warts, and bleeding after sex.
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Treatment: Cryotherapy for removal of warts, or TCA (chemical treatment).
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Herpes Simplex Virus (HSV-2):*
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Symptoms include painful genital lesions, itching, fever, malaise, and tender lymph nodes.
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Treatment: Acyclovir (oral antiviral).
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Vaginal Infections (Bacterial Vaginosis):*
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Symptoms include fishy odor.
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Treatment: Metronidazole (oral).
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Vaginal Infections (Candidiasis):*
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Symptoms include vaginal itching and thick, cottage cheese-like discharge.
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Treatment: Monistat (antifungal cream).
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Vaginal Infections (Trichomoniasis):*
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Symptoms include yellow-green discharge with a foul odor, and strawberry cervix.
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Treatment: Metronidazole.
Chapter 5: Contraceptive Methods
- Coitus interruptus: the withdrawal method, does not protect against STDs.
- Fertility awareness methods (FAMs): tracking ovulation times, cervical mucous, basal body temperature, less accurate.
- Barrier methods: condoms, diaphragms, cervical caps, and sponges prevent pregnancy, does not prevent STDs.
Chapter 6: Fetal Movement and Kick Counts
- Fetal movements can be felt between 16-20 weeks gestation.
- Count fetal movements (kicks/activities) several times a day.
- If there are no noticeable movements within 12 hours, contact a healthcare provider.
Chapter 6: Placenta and Amniotic Fluid
- The placenta is an organ that provides nourishment and oxygen to the fetus. It also helps remove waste products from the fetus.
- The amniotic fluid helps maintain temperature, cushions the fetus, and helps with growth.
Chapter 7: Viability, Term, Pre-term, and Post-dates
- Viability: The point at which a fetus can survive outside the womb, usually between 22-24 weeks.
- Term: Pregnancy lasting from 37 weeks to 41 6 weeks.
- Preterm: Pregnancy lasting from 20 to 36 6 weeks.
- Postdates: Pregnancy lasting longer than 42 weeks.
Chapter 7: Physiological Changes of Pregnancy
- Reproductive system: The uterus grows, and estrogen and progesterone levels increase.
- Cardiovascular system: Blood volume and cardiac output increase. Hematocrit and hemoglobin may decrease.
- Respiratory system: Respiratory rate may increase slightly.
- Gastrointestinal system: Nausea and vomiting (morning sickness) are common. Heartburn may increase.
Chapter 8: Pregnancy Warning/Danger Signs
- First trimester warning signs may include severe vomiting (hyperemesis gravidarum), chills, fever, abdominal pain or cramping/bleeding, and diarrhea.
- Second/third trimester warning signs include sudden vaginal discharge, vaginal bleeding, visual disturbances, swelling of the face, headaches, seizures or epigastric pain.
Chapter 10: Fetal Kick Counts
- Count kicks frequently; starting around 12 weeks gestation.
- Count kicks for 2 hours or until 10 kicks are detected.
- If 10 kicks are not detected in 2 hours, contact provider.
Chapter 10: Biophysical Profile (BPP)
- The BPP is used to assess fetal well-being.
- Usually performed late in the 2nd or third trimester.
Chapter 11: Pre-Gestational and Gestational Diabetes
- Pre-gestational diabetes refers to diabetes diagnosed before 20 weeks of pregnancy.
- Gestational diabetes refers to diabetes diagnosed during pregnancy (after 20 weeks).
Chapter 12: Pre-Eclampsia, HELLP
- Pre-eclampsia is diagnosed through blood pressure greater than 140/90 and protein in the urine. The diagnosis is made after 20 weeks.
- HELLP syndrome is characterized as hemolysis, elevated liver enzymes and low platelets (elevated hematocrit and hemoglobin) in the presence of pre-eclampsia.
Chapter 12: Placental Abruption, Placenta Previa, Ectopic Pregnancy
- Placental Abruption is a partial/complete separation of the placenta from the uterine wall. Typically indicated by bright red bleeding.
- Placenta Previa is a condition in which the placenta covers the cervix. This condition is characterized by painless vaginal bleeding occurring in the absence of uterine contractions.
- Ectopic pregnancy refers to a pregnancy that occurs outside the uterus.
Chapter 13: Changing Positions During Labor
- Upright/lateral, squatting, side-lying, and hands-on-knees (cat/cow) positions are beneficial for labor.
Chapter 15: Electronic Fetal Monitoring
- Variable decelerations are U, V, or W shaped and indicate cord compression.
- Early decelerations are indicative of head compression.
- Late decelerations indicate placental insufficiency.
Chapter 16: Rupture of Membranes
- When membranes rupture, it is important to monitor maternal temperature, fetal heart rate and blood pressure.
- Ensure that membrane rupture is reported to healthcare provider to monitor for infection.
- Monitor for odor and color.
Chapter 17: Amniotomy (Artificial Rupture of Membranes)
- Amniotomy is contraindicated in presence of active infection or a cervix that has not yet dilated.
Chapter 17: Shoulder Dystocia and Prolapsed Cord
- Shoulder dystocia: interventions are based on the use of labor tools and hands to move the baby.
- Prolapsed cord: Interventions include vaginal exam, keeping hand on presenting part, and getting ready for C-section.
Chapter 18: Normal Maternal Physiological Changes Postpartum
- Cardiovascular: Heart rate, blood pressure.
- Respiratory: Respiration rate, oxygen levels.
- GI: Bowel habits and constipation.
- Renal: Diuresis and fluid retention.
Chapter 19: Normal Newborn Physiological Changes
- Blood Pressure; Respiration rate; Body Temperature.
Chapter 19: Lochia, Perineal Care
- Lochia is vaginal discharge after birth.
- Perineal care includes cleaning the perineal area after urination or defecation and/or delivery.
Chapter 20: Newborn Safe Sleep
- Newborns should be placed on their backs to sleep.
- Avoid extra blankets and pillows.
Chapter 21: Breastfeeding
- Exclusively breastfeed for the first 6 months of life.
- Signs of effective latch: baby is suckling comfortably with rounded cheeks.
- Signs of poor latch: pain, ineffective sucking
Chapter 22: Newborn Vitals
- Assessing newborn's blood pressure, respiration rate and body temperature.
Chapter 22: Newborn Skin Conditions
- Vernix Caseosa: protective coating, usually disappears on its own.
- Mongolian Spots: bluish/gray or dark spots on the skin, normal.
- Erythema Toxicum Neonatorum (ETN): temporary rash
Chapter 23: Newborn Head Abnormalities
- Caput succedaneum: swelling of the scalp, resulting from pressure on the head during labor. It usually subsides in a few days.
- Cephalhematoma: collection of blood between the skull bones.
- Subgaleal hemorrhage: bleeding under the scalp.
Chapter 24: Hyperbilirubinemia
- Physiologic Jaundice: elevated bilirubin, typically occurring after birth.
- Pathologic Jaundice: Elevated bilirubin usually requires intervention to avoid kernicterus.
Chapter 25: Newborn Pain
- Signs of pain include high pitched cries, grimacing, quivering tongue, open mouth, and changes in activity/behavior.
- Non-pharmacological interventions: breastfeeding, skin-to-skin, and holding.
- Pharmacological interventions: analgesic medication.
Chapter 26: Newborn Pain Interventions
- Signs of pain ( high pitched cry, grimacing) and interventions are applicable to the different situations depending on the cause.
Chapter 27: APGAR Scoring
- A scoring system used to evaluate the newborn's condition immediately after birth 5 minutes.
Chapter 28: Neonatal Abstinence Syndrome (NAS)
- NAS develops in newborns exposed to illicit drugs. The withdrawal symptoms can vary in severity.
Chapter 29: Signs of Fetal Alcohol Syndrome
- Signs of fetal alcohol syndrome in newborns include small eyes, thin upper lip, flat midface, and indistinct philtrum.
Chapter 30: Newborn Safe Sleep Practices
- Ensuring newborn safety during sleep includes swaddling, no extra blankets, no toys, and proper placement in a crib, bassinet or crib.
Chapter 31: Neonatal Skin Conditions
- Vernix caseosa: a white or cheesy substance that protects the baby's skin and is considered normal.
- Mongolian spots: bluish to darker colored spots that are considered normal.
- Erythema toxicum neonatorum (ETN): a rash.
Chapter 32: NEC
- Necrotizing enterocolitis (NEC) is a serious intestinal disorder in newborns, especially in preterm or low-birth-weight infants
Chapter 33: Retinopathy of Prematurity
- Retinopathy of prematurity (ROP) is an eye disease that can affect premature infants due to abnormal blood vessel growth.
Chapter 34, 35: Newborn Sepsis
- Sepsis is a serious infection that can affect the body.
- Signs and treatment for a newborn with sepsis are specific to the situation/circumstance.
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