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259 Cards in this Set
- Front
- Back
diaphragm |
requires application of spermicide |
|
phenlyketonuria |
TX before conception. if not tx, fetus at increased risk for mental retardation, microcephaly, congenital heart defects & growth retadation. tx with low phenylalanine diet (low protein) |
|
progesterone |
prepares uterus for implantation by decreasing g motility & contractility imparted by estrogen during menstrual cycle |
|
positive hep B surface antigen |
requires immediate intervention for neonate. unTXed infection may cause cirrhosis if the liver or liver CA in adulthood |
|
mother w/ type 1 diabetes |
infant at risk for macrosomia due to fetal exposure to mother's insulin & sugar imbalances |
|
hemophilia |
pt may need factor VIII replacement during pregnancy | sex-linked recessive trait carried fromasymptomatic females to male offspring. 80% of hemophilia is x-linked recessive. mother is the carrier & child is male. female child can acquire hemophilia if mother is carrier & father has hemophilia |
|
pre-eclampsia diet |
mod - high protein diet to replace protein lost in urine & prevent dietary deficiency |
|
foods containing folic acid |
organ meats, asparagus, dark green leafy veggies & oranges (4mg of folic acid qd @ least a month before conception) | decreases likelihood of neural tube defects |
|
immediately following amniotomy |
mntr fetal heart rate to assess for prolapse cord. if presenting part is not engaged, cord may prolapse when membranes rupture |
|
transition phase |
intense, painful & erratic mother feels like she can't continue |
|
some women bleed twice as much |
changing 2 pads w/in 2 hrs is normal |
|
increase of circulating plasma volume |
physiologic anemia |
|
beta-mimetics (brethine) |
for pre-term labor (off labe) poses significant risk to maternal cardiovascular function w/ cardiac arrhythmia, tachycardia, palpitations & ischemia as serious effect |
|
oxytocin once dilated 5-6 cm |
decrease by decrements per agency protocol since less medication is needed |
|
episiotomy incision |
inflammation after 48 hrs may be sign of localized infection |
|
uterine atony |
failure of uterus to maintain a steady state of contraction & causes postpartum hemorrhage |
|
uterine involution |
fundal decent. by 10th postpartum day uterus should not palpable |
|
uterine subinvolution |
palpation of uterus above symphysis pubis at 10th day. uterus fails to return to its pre-pregnant state promptly & healing of the placental site is delayed |
|
reva rubin |
(maternal development tasks)
taking-hold taking-in letting-go |
|
postpartum sepsis |
can be prevented by taking sitz baths bid & good perineal hygiene |
|
maternal insulin requirements |
often decrease dramatically during labor |
|
engorgement (prevent) |
breast-feed often |
|
breast exam (abnormal) |
retraction of breast or nipple skin dimpling creasing |
|
exposure to DES (diethylstilbestrol) in utero |
increases risk for developing cervical CA |
|
women w/ BRCA-1 or BRCA-2 mutations |
50% - 90% chance of developing breast CA |
|
pt w/ dilatation & curettage (nursing care) |
provide perineal care w/ pad checks to discourage infection & monitor bleeding pads |
|
test for alpha-fetoprotein |
done during amniocentesis, screens for neural tube defects |
|
screening of inborn errors of metabolism |
triple marker screen test, chorionic villus sampling & amniocentesis |
|
ventriculoperitoneal shunt |
may cause peritonitis or post-op ileum. observe for ab distention | pt should be placed on unoperated side to prevent pressure on shunt valve | greatest risk is infection & malfunction of shunt | shunt malfunction can cause behavior changes |
|
hirschsprung disease |
watch for distention post-op | colostomy is temporary |
|
duchenne muscular dystrophy (goal) |
primary goal is to maintain optimal function in all muscles |
|
down's syndrome |
depressed nasal bone, presence of palmar crease, & protruding tongue (can cause a chronic problem of inadequate drainage of mucus & thrusting out of food) | short neck muscle hypertonicity (could determine the child's readiness for self-feeding; including ability to maintain head/trunk support) | arched palate & shortened rib cage (may compromise respiratory expansion & contribute to RI) | small teeth & hypoplastic mandible | hearing loss is fairly common | respiratory function is a priority assessment. decreased muscle tone causes children to have difficulty w/ expansion | hyperflexability w/ ROM |
|
patent ductus arteriosus |
med tx: indomethacin (indocin) se: oliguria |
|
congenital heart failure |
very high metabolic rate b/c their cardiac function is poor & their heart & respiratory rates are ^ | they need additional calories & have difficulty maintaining | condition causes them to fatigue easily |
|
osteogenesis imperfecta |
characterized by bone fragility. brittle bones & extreme susceptibility to fractures |
|
metatarsus adductus |
abnormal positioning of foot that fx involves rigidity |
|
clubfoot |
involves bone deformity not fragility |
|
hemophilia (contra meds) |
indomethacin (indocin) b/c it inhibits platelet function
|
|
mental retardation (risks) |
children tend to be very open & persuadable, displaying poor judgement putting them at risk for sexual exploitation |
|
cleft lip palate (nursing dx) |
growth failure r/t to feeding difficulties nursing dx: altered nutrition: less than body requirements r/t to physical defects |
|
furosemide |
k-losing diuretic |
|
preterm infants: respiratory distress syndrome |
tachypnea w nasal flaring, chest retractions & expiratory grunt |
|
post-term infants |
dry, peeling skin which is benign |
|
sponge baths (umbilical cord) |
should be given until cord falls off. usually for first 2 wks to prevent infection entering through umbilicus. |
|
neurotoxicity |
caused by abnormally high toxic accumulation of bilirubin in the CNS fissures |
|
phytonadione (aquaMEPHYTON)/vitamin K |
admin 1mg w/in 1 hr of birth | prevents hemorrhagic disease which results from absence of gut bacterial flora which influences production of vit K b/c prothrombin lvls are low in first few days of life |
|
apgar score |
[color (0: blue, pale | 1: pink body, blue extremities | 2: completely pink)] [heart rate (0: absent | 1: slow, <100 | 2: >100) [reflex irritability (0: no response | 1: grimace | 2: vigorous cry)] [muscle tone (0: flaccid | 1: some flexion of extremities | 2: well-flexed)] [respiratory effort (0: absent | 1: slow, irregular, weak cry | 2: good, strong cry)] |
|
risk for impaired skin integrity r/t hyperactive movements (prevent) |
swaddling newborn has a calming effect & will decrease hyperactive mvmnts in-turn decreasing skin irritation |
|
testicular torsion |
dusky scrotum & solid testis (requires immediate attention from physician) |
|
circumcision |
wash w/ water around circumcised area | petroleum gauze or A & D ointment will prevent the diaper from sticking to raw area | watery pink-yellow oozing may be observed but no bright red bleeding | diaper should be loosely fasten |
|
delivery by forceps (negative) |
can damage facial nerve resulting in facial palsy w/ absent toothing, sucking & swallowing reflexes |
|
tracheoesophageal fistula |
may prevent infant from swallowing. risk for aspiration |
|
atopy |
allergy w/ hereditary element, usually manifested by skin inflammation |
|
plantar creases |
on anterior of sole of foot, are a reliable indicator of newborn gestational age (breast tissue & lanugo can also help determine gestational age) |
|
bleeding after 1 year (post-menopause) |
maybe be a sign of uterine CA. ultrasound & biopsy should be done immediately
|
|
post-menopause (pre-disposed to) |
women are predisposed to bacterial infections b/c the vaginal pH rises creating a medium for bacterial growth. increased risk for developing gardnerella |
|
hormone replacement therapy |
when you instruct pt to perform BSE @ end of 1 med cycle provides a definitive time that pt is not likely to forget | DVT is a fx complication, notify physician immediately if leg pain occurs | conta in women w/ hx of liver disease since estrogen is metabolized by the liver |
|
endometriosis |
benign disorder of the repro tract | presence & growth of endometrial tissue outside of uterus | women 30-40 are most likely to develop | endometrial tissue may implant on fallopian tubes, ovaries & tissues surrounding the lining of the pelvis | misplaced endometrial tissue breaks down & bleeds into the surrounding tissue, causing inflammation where blood becomes trapped in the surrounding tissues & causes the development of blood-containing cysts | recurring inflammation in the areas outside of the uterus eventually result in scarring, fibrosis & development of adhesions, scar tissues that binds the organs together causing increased ab pain & risk of infertility |
|
endometriosis (s/s) |
pain of varying intensities is most common, but degree of pain is not a reliable indicator of the extent of the disorder. pain during ovulation (mittelschmerz) | heavy bleeding during menstruation | episodes of diarrhea & constipation | dyspareunia or pain during defecation |
|
how do you dx endometriosis |
through pelvic exam & vaginal ultrasound to provide imaging of displaced endometrial tissue or cyst. also a laparoscopy |
|
endometriosis (med mngmnt) |
pain control. hormonal therapy to shrink abnormal tissue (stabilizes release of estrogen & progesterone to decrease tissue swelling & bleeding) oral contraception can also be used to suppress ovulation |
|
cervical CA |
develops gradually | majority is squamous cell carcinomas | screening & tx of dysplasia significantly reduces chances that carcinoma will develop | primary risk factor is HPV (there is a STRONG correlation btwn high-risk types of HPV & development of cervical CA (sometimes surgery to remove abnormal tissue) |
|
HPV |
associated w/ the development of papillomas | no tx but vaccine, quadrivalent human papillomavirus recombinant vaccine (3 doses. 2nd dose is admin 2 months after 1st. 3rd dose is admin 6 mnths after 1st dose) | med management is determined by biopsy & staging of the CA |
|
varicocele |
abnormal enlargement of the pampinifrm venous plexus (which drains the testicles) in the scrotum; swollen, twisted vein | may cause increased infertility | abnormal dilatation of the veins from the testis & the epididymus of the spermatic cord is associated w/ infertility | (varicose veins that cause swelling & discomfit in the scrotum) is the leading cause of male infertility |
|
transurethral resection of the prostate (turp) |
effectiveness of continuous bladder irrigation 24 hrs after turp; urine is reddish pink after surgery & then clears to light pink w/in a few hrs |
|
TSE |
should be perform once a month | scrotum should be held in the palms of the hands & each testicle examined w/ the thumb & fingers of both hands. roll testis gently btwn the thumb & fingers & feel for any lump or abnorm | usually after a warm bath or shower when scrotum is more relaxed. testicles rolled gently btwn thumb & finger. epidermis is palpated w/ one hand, one side then the other. epididymis is located in scrotal sac & can't be visually seen |
|
benign prostatic hyperplasia |
non-CA enlargement or hypertrophy of the prostate | oliguria, dysuria & hesitancy in starting |
|
erectile dysfunction |
impotence, inability to either achieve or maintain erection | contras: adrenergic blocking agents (impotence is a SE) | tx: penile implants, negative-pressure vacuum device; pharma: injection, urethral suppository oral meds |
|
semen analysis |
pt must remain abstinent for 3-4 days to increase quality of sperm |
|
non-bacterial prostatitis |
inflammation of prostate gland resulting in painful ejaculation s/s: prostatodynia (pain on voiding or perineal pain) |
|
trichomonoiasis |
pts taking metronidazole (flagyl) | contra: alcoholic beverages (flagyl & alcohol puts pts at risk for experiencing flushing, palpitations, tachycardia & n/v) |
|
anterior pituitary gland |
controls onset of secondary sex characteristics in males |
|
oral contraceptives (when missed) |
when 2 or more pills are missed use an alternative form of contraception.. continue until on the pill for at least 7 days. STOP once pregnancy is suspected |
|
HPV (risks) |
associated w/ a higher risk for cervical CA & if pt smokes this increases importance of addressing HPV infection & starting pt on scheduled frequent pap smears |
|
puberty in girls |
breast buds is usually first sign. pubic hair is usually second & menses is third |
|
oral contraceptives |
s/s of wt gain & breast tenderness. s/s will subside in 4-6 weeks risks from OC is increased when liver enzymes are elevated | women taking OC & being TXed w/ antibiotics must use additional form of contraception due to decreased effectiveness of OC while on antibiotics |
|
rape trauma syndrome (goals of management) |
provide support, reduce emotional trauma & gather evidence for possible legal proceedings
|
|
genital herpes type 2 |
females: pap smear is important procedure & genital herpes is a possible risk factor for development of cervical CA. should be done annually | causes leisons on cervix, vagina, & external vagina |
|
vasectomy (post) |
apply ice bags to scrotum intermittently for several hours to reduce swelling & discomfort |
|
undescended testicles (risk) |
men have 35 times greater chance of developing testicular CA
|
|
small hard lumps on anterior or lateral aspect of testis |
may indicate malignancy & requires referral to the physician |
|
chlorthiazide sodium (diuril) |
associated w/ impotence, decreased libido & difficulty in gaining & sustaining an erection |
|
premenstrual syndrome |
generally dx after 2 months of recording symptoms in a menstrual log. caffein, high-fat foods & refined sugars may increase symptoms |
|
prolapsed uterus |
uterus works its way down the vaginal canal & even appears outside the vaginal orifice | aggravated by coughing, lifting heavy objects or standing for long periods of time |
|
1 way to increase change of pregnancy immediately after intercourse |
elevate woman's hips for 20-30 mins after intercourse to limit leakage of sperm & allow seminal fluid to liquify & direct the sperm toward the egg
|
|
vaginal sponge |
has spermicide built in that is activated by moistening the sponge w/ water before use. can be left in place for 24 hrs & allows for multiple acts of intercourse |
|
abruptio placenta
|
(premature separation of placenta) frequently results in fetal death. common reason for disseminated intravascular coagulation is prolonged retention of dead fetus |
|
phenylkentonuria test (PKU) |
best to obtain blood from newborn after 72 hrs of life. early specimens tend to produce false positives for some inborn errors of metabolism |
|
physiologic jaundice |
normally occurs 24 hrs after birth. early jaundice indicates ABO or Rh incompatibility btwn mother & neonate & should be reported immediately |
|
how to assess sucking reflex |
feeling strength of suck is most effective method |
|
urinary output (postpartum) |
should increase in first 24 hrs so urine would not be concentrated.urinary specific gravity: 1.005 - 1.030 |
|
mother on drugs |
most drugs cross into the breast to some degree |
|
stool (while breast fed) |
yellow stool is normal | hard, dry stool: infant is dehydrated | orange or green stool may indicate intestinal infection |
|
chlamydia present at time of vaginal birth |
5%-20% exposed infants will develop pneumonia w/in first 3 months of life |
|
changes once newborn enters extrauterine life |
respiratory & cardiac system undergo the most rapid change to support extrauterine life. developmental reflexes should be present & disappear by 10 months
|
|
immunization |
hep B: can be given from birth - 2 mnths | polio: first given at 2 mnths | haemophilus influenzae type b: first given at 2 mnths | mmr: first given at 12-18 mnths |
|
newborn sinus arrhythmia |
(irregular heart rate) normal & abdominal breathing |
|
newborn ubmilical cord |
keep umbilical cord free from wetness or urine to promote natural drying & drop-off of cord over 10-14 days |
|
eye prophylaxis |
admin shortlyafter birth & can cause swelling, inflammation & discharge in first 48 hrs. parents should observe for ophthalmia neonatorum starting 3 days after birth |
|
premature (characteristics) |
barely visible areolae | scrotum free of rugae is normal (of concern in term newborn) | the more lanugo & less breast tissue, the more preterm |
|
post-term (characteristics) |
cracked, parchment-like skin |
|
vaccination |
women should not become pregnant for 3 months after vaccination. should be done after birth to avoid viral infection to fetus |
|
nonstress test (NST) |
purpose to identify the compromised fetus & is not indicative of reediness of fetus to be delivered | reactive: fetal heart rate accelerations in response to fetal activity indicating intact central & autonomic nervous system | nonreactive: fetus is experiencing uteroplacental insufficiency. also if fetal age is less than 32 wks due to CNS immaturity |
|
uterus pressing on vena cava |
dizziness can be caused, this decreases blood to the R atrium. tx: lay pt on L side shifts wt off vena cava |
|
L/S (lecithin/sphingomyelin) ratio |
1:1 - lungs are immature | 2:1 - fetal lung maturity | amniotic fluid is used to test L/S ratio & can't be done if membranes have ruptured |
|
epidural black (contra) |
allergy to specific class of local anesthetic agents |
|
bloody show |
occurs when cervix begins to dilate & efface (sign of impending labor) |
|
fetal presentation |
breech occurs in up to 4% of births | brow least common | shoulder (transverse lie) occurs in 1 out of q 300 term births | vertex (head-first) occurs in about 97% of all births, MOST COMMON |
|
vertex presentation |
fetal head has a larger contact point in the posterior position & presses on the sacral nerve, causing intense back pain & pressure |
|
shorten 2nd stage of labor |
studies have shown that active breathing & vocalization can help shorten second stage of labor. focus on breathing rather than urged to push or bare down if woman is not yet 10 cm dilated |
|
fetal monitors allow... |
women to assume position of greatest comfort |
|
late decelarations |
ominous sign & require intervention. associated w/ fetal hypoxia |
|
functional murmurs |
may be heard during transition from fetal to newborn circulation |
|
presenting part not engage when ROM |
umbilical cord may prolapse resulting in cord compression which is a medical emergency |
|
hyperventilation |
indicated by lightheadedness & tingling lips w/ a resulting over-concentration of 02 in the body. have pt cup hand over face & breathe in & out which is a simple remedy that causes rebreathing of CO2 |
|
congenital anomalies (dx) |
can be visualized at 18-20 wks gestation through ultrasound screening b/c fetal structures have completed development |
|
congenital anomalies (nursing intervention)
|
nurse would emphasize child's abilities rather than disabilities. identify need for counseling & referral & not make any conclusions.parents should be given clear/simple explanations & advice w/ opportunity to ask questions. information & options should be provided before any formal decisions are made |
|
goal for neurogenic bladder |
preserve renal function |
|
neonatal abstinence syndrome |
twitching of extremities & irritability (b/c mother took addictive drugs & baby is experiencing withdrawal symptoms |
|
tracheoesophageal fistula |
high-pitched cry & cyanosis w/ feeding |
|
myelomeningocele & intracranial infections |
increase head circumference & bulging fontanelles |
|
cerebral palsy |
neuromuscular impairments like purposes, uncontrollable mvmnts of the face & extremities along w/ difficulty w/ fine & gross motor skills make it difficult to take in sufficient calories by mouth & has negative impact on nutritional status | muscle tone & posture are abnormal in child w/ spastic cerebral palsy. many reflexes that can usually be expected to disappear in 1st yr of life will persist in these children |
|
mental retardation (IQ) |
IQ 50-75: mild mental retardation | IQ 35-55: mod mental retardation | IQ 20-40 severe mental retardation
focus on child's routine |
|
pyloric stenosis |
palpable, olive-shaped epigastric mass. hypertrophy & hyperplasia causes constriction of pyloric muscle & obstruction of gastric outlet |
|
galactosemia (tx) |
tx: eliminating all milk & lactose containing foods, including breast milk |
|
developmental dysplasia of the hip |
clear indicator is limited abduction of the affected hip |
|
abdominal distention |
occurs in both celiac disease & cystic fibrosis reflecting malnutrition from poor absorption of nutrients |
|
tetralogy of fallot |
aorta overrides asd, pulmonary stenosis, R ventricle hypertrophy & vsd | infant distress form anoxia: knee-chest position allows more blood flow to pulmonary artery by reducing return from legs & increasing vascular resistance | bluish skin during crying & feeding, clubbing |
|
scoliosis |
classic indicator is rib hump & flank assymetry |
|
2 year old |
goes upstairs placing both fee on each step | throws ball overhead |
|
4 year old |
can stand on one foot for 2 seconds | jump off bottom step |
|
fetal cirrculation |
placenta > ductus venosus > inferior vena cava > R atrium > foramen ovale > left atrium > left ventricle > aorta > head, upper extremities & lower extremities > superior vena cava, R atrium & right ventricle, pulmonary artery > ductus arteriosus > descending aorta > remaining blood flows to pulmonary circulation to support lung development > pulmonary vein > L atrium > L ventricle > aorta > placenta |
|
fetal hemoglobin |
has lower oxygen content that that of the adult. low PO2 lvl keeps ductus arteriosus open & pulmonary vascular bed constricted |
|
solid foods |
should be introduced @ least 4 months |
|
teething |
begins 4-7 months (increased drooling, irritability, desire to chew on objects, crying episodes, disrupted sleeping & eating patterns) |
|
play |
infant: solitary play toddler: parallel play preschooler: associative play school-age & adolescent: cooperative play |
|
climacteric |
transitional time marked by declining ovarian function & decreased hormone production & ends w/ cessation of postmenopausal symptoms |
|
menopause |
refers to last menstrual period & can be dated w/ certainty only 1 year after menstruation ceases | s/s: night sweats, hot flashes, vaginal dryness | HRT is contra |
|
pelvic floor dysfunction |
pelvic muscles atrophy after menopause b/c weak & unable to support pelvic structures & organs |
|
cystocele |
bladder herniates into vagina. s/s: dysuria, incontinence & dyspareunia |
|
rectocele |
muscles behind vagina are damaged cause rectum to press into vagina |
|
enterocele |
muscle damage occurs in higher location in the colon. s/s of both: constipation, difficulty in completing a bm, & dyspareunia |
|
menopausal period |
postmenopausal: life after menopause perimenopause: period of time around menopause climacteric: period of menopausal transition |
|
FSH |
follicle-stimulating hormone: stimulates estrogen production & ovulation |
|
fetal heart rate (best heard) |
cephalic presentation: below maternal umbilicus roa: R lower quad breech: above maternal umbilicus lsa: upper L quad
|
|
terbutaline SO4 |
maintains uterine activity |
|
ritodrine |
relaxes uterine muscles |
|
rhogam |
w/in 72 hrs Rh- mom & Rh + newborn |
|
prostiglandins |
cervical softening to prepare for labor induction |
|
involution |
return of reproductive organs to pre-pregnancy state |
|
opiod analgesics |
may cause bradycardia, tachycardia, hypotension & respiratory depression |
|
progesterone |
relaxes smooth muscles. maintains uterine lining & prevents uterine contractions & helps prepare breast for lactation | raises body temp at ovulation |
|
hirschsrpung's disease |
no intestinal mobility, absence of ganglion cells | more males | newborns have delayed meconium passage | vomiting, distended abdomen | tx w/ fluids, enemas, decompressions & maybe surgery | nursing dx: risk fro injury r/t lack of intestinal motility |
|
tracheoesophageal fistula |
increased incidence in LBW infants |
|
hypertrophic pyloric stenosis |
one of the most common surgical disorders of early infancy | 5x more common in males |
|
intussusception |
one of most frequent causes of intestinal obstruction in children | telescoping of one portion of intestine into another | "currant jelly" stools |
|
atrial septal defect |
abnormal opening between atria, allowing blood from higher-pressure L atrium to flow into lower-pressure R atrium | surgical dacron patch closure of mod - large defect |
|
ventricular septal defect |
occurs when ventricular septum fails to complete its formation between ventricles resulting in L-R shunt | s/s: respiratory distress, tachycardia, tachypnea, cyanosis | dx: chest x-ray showing cardiomegaly w/ large L atrium & ventricle | tx: pulmonary artery banding to prevent HF & permanent correction w/ a patch later when heart is larger. spontaneous closure is possible by age 3 | digoxin & diuretics may be used |
|
congenital heart disease |
ACYANOTIC ^ pulmonary blood flow: asd, vsd, patent ducutus arteriosus, atrioventricular canal obstruction to blood flow from ventricles: coarctation of aorta, aortic stenosis, pulmonic stenosis
CYANOTIC decreased pulmonary blood flow: tetralogy of fallot, tricuspid atresia mixed blood flow: trasposition of great arteries, total anomalous pulmonary venous return, trucus arteriosus, hypoplastic L heart syndrome |
|
atrioventricular canal defect |
incomplete fusion of endocardial cushions | low asd that is continuous w/ high vsd & clefts of mitral & tricuspid valves creating large valve that allows bld to flow between all chambers |
|
patent ductus arteriosus |
resulting from failure of ductus (between aorta & pulmonary artery) to close causing shunting of blood to pulmonary artery | s/s: mild cyanosis, machinelike heart murmur, respiratory distress, tachycardia, tachypnea | dx: chest x-ray shows prominent pulmonary vasculature & enlargement of L ventricle & aorta | tx: ligation of patent ductus arteriosus |
|
coarctation of the aorta |
localized narrowing near insertion of the ductus arteriosus resulting in ^ pressure proximal to defect & decreased pressure distal to obstruction |
|
aortic stenosis |
narrowing or stricture of aortic valve causing decreased cardiac output | non-sx tx: dilations w/ balloon angioplasty |
|
pulmonic stenosis |
narrowing at entrance to pulmonary artery | pulmonary atresia is extreme form |
|
tricuspid atresia |
failure of tricuspid valve to develop |
|
transposition of the great arteries |
pulmonary artery leaves L ventricle & aorta exits from R ventricle |
|
ICP |
bulging fontanels | irritable, n/v | raise head of bead, O2 |
|
neuroblastoma |
most common CA in infants |
|
truncus arteriosus |
failure of normal septation & division of the embryonic bulbar trunk into the pulmonary artery & aorta resultin gin a single vessel that overrides both ventricles |
|
hypoplastic L heart syndrome |
underdevelopment of the L side of the heart resulting in hypoplastic L ventricle & aortic atresia |
|
near drowning
|
2nd cause of accidental death in children
|
|
neonatal meningitis |
inflammation of the meninges due to bacterial invasion in the 1st 90 days of life | s/s: sepsis, CNS irritation (lethargy, seizure, vomiting, irritability, nuchal rigidity, bulging or full fontanelle), & cranial nerve abnormalities | dx: lumbar puncture | tx: antibiotics |
|
encephalitis/encephalomyelitis |
inflammation of parenchyma of the brain/brain & spinal cord resulting from virus or foreign protein | s/s: fever, h/a, & altered mental status often accompanied by seizures or focal neurologic deficits | dx: requires CSF analysis & neuro-imaging | tx: supportive & sometimes antivirals
|
|
reye's syndrome
|
rare form of acute encephalopathy & fatty infiltration of the liver that tends to follow acute viral infections, particularly when salicylates are used | cause unknown | affects mitochondrial function causing disturbance in fatty acid & carnitine metabolism
|
|
rabies |
viral encephalitis transmitted by saliva of infected bats & certain infected mammals | s/s: depression & fever followed by agitation, excessive salivation & hydrophobia | dx: serologic tests or biopsy | vaccination indicated for those at high risk for exposure | tx: wound care & passive & active immunoprophylaxis | almost universally fatal |
|
seizure disorder |
symptomatic (symtpom of a known cause) |
|
febrile seizures |
occur in children < 6 yrs w/ body temp > 38C & no previous afebrile seizures | tx: seizures more than 15 mins IV lorazepam & if persistent IV fosphenytoin |
|
hydrocephalus |
imbalance of CSF, either too much produced in ventricles of brain or inadequate absorption of CSF | ventriculoperitoneal shunts used for management, will transport CSF from ventricles of brain to peritoneal area for absorption | infection becomes HUGE issue | etiology: congenital (developed wrong or infection while in utero), acquired (neoplasm, hemorrhage, infection, meningitis | s/s: bulging fontanelles, increased ICP, h/a, vomiting, double vision, enlarged ventricles, enlarged skull, separation of sutures of the skill |
|
Hypopituitarism (Pituitary Dwarfism) |
in children typically results in abnormally slowgrowth and short stature with normal proportions usually due to pituitary tumor but may be idiopathic | dx: measurement of growth hormone levels, baseline & response to pharma stimuli |
|
pituitary hyperfunction |
gigantism & acromegaly are syndromes of excessive secretion of growth hormone almost always due to a pituitary adenoma gigantism later results in acromegaly | tx: removal or destruction of responsible adenoma |
|
syndrome of inappropriate antidiuretic hormone section (siadh) |
hypersecretion of ADH, vasopressin (^ in conditions especially infections, tumors & trauma of CVS) | directly r/t fluid retention & hypotonicity which causes kidneys to reabsorb h2o ^ing fluid volume & decreasing serum osmolality | s/s: primarily neurologic, h/a, confusion & stupor. seizure & coma may occur | tx: restrict h2o intake & promoting it's loss, replacing any Na deficit & TXing cause |
|
hypothyroidism |
in infants & young children may be congenital or neonatal | most fx cause is dysgenesis, either absence or underdevelopment of thyroid gland | rare in US but common in certain developing countries | hypothyroidism results from maternal iodine deficiency | s/s: endemic cretinism, mental retardation & spasticity | unTXed usually slows CNS development mod-severely & may be accompanied by low muscle tone, prolong hyperbilirubinemia, umbilical hernia, respiratory distress, macroglossia, large fontanelles, poor feeding & hoarse crying | delayed dx & tx of severe hypothyroidism can lead to mental retardation & short stature | most cases require lifelong thyroid hormone replacement |
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congenital goiter |
diffuse or nodular enlargement of the thyroid gland present at birth | dx: confirming thyroid size w/ ultrasonography | tx: thyroid hormone replacement when hypothyroidism is the cause. surgery indicated when breathing or swallowing is impaired |
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lymphocytic thyroiditis |
chronic autoimmune inflammation of the thyroid w/ lymphocytic infiltration | s/s: painless thyroid enlargement & symptoms of hypothyroidism (endemic cretinism, mental retardation & spasticity) |
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candida (vaginal discharge) |
itching, irritation; yeast odor or none; thick curdlike, white in color |
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bacterial vaginosis (vaginal discharge) |
fishy odor, often noticed post intercourse, thin/gray or yellow color |
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trichomonas (vaginal discharge) |
irritation/odor; malodorous, copious, often frothy/yellow green color |
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atrophic (vaginal discharge) |
vulvar or vaginal dryness; occasional mild malodor; usually scant & mucoi/may be blood tinged |
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perineal pruritus |
common symptom in older women & should be evaluated to r/o diabetes or malignancy. may also indicated vulvar dystrophy which may need biopsy to r/o CA |
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dilation & curettage (D&C) |
endometrium is scraped w/ a curette to control abnormal uterine bleeding | therapeutic measure for incomplete abortion
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perimenopause |
period extending form 1st signs of menopause to beyond cessation | s/s: hot flashes, vaginal dryness & irregular menses |
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menorrhagia |
prolonged or excessive bleeding in early life, maybe d/t endocrine disturbance, later in life d/t inflammatory disturbances, tumors or hormonal imbalance
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metrorrhagia |
bleeding between regular menstrual periods | may be sign of CA, benign tumors or uterus or other BYN problems |
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menometrorrhagia |
heavy vaginal bleeding between & during periods |
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postmenopausal bleeding |
bleeding 1 year after menses ceases must be investigated | endometrial biopsy or d&c is indicated |
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depo-provera |
IM long acting progestin | q 3 months | inhibits ovulation & provides reliable & convenient contraception | can be used by those lactating, w/ HTN, liver disease, migraine, heart disease & hemoglobinopathies |
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intrauterine device |
small plastic, usually t-shaped | inserted into uterus | prevents conception by creating a local inflammatory reaction | copper bearing paraguard is effective for 8 yrs (has an anti-spermatic effect) |
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emergency contraceptives |
estrogen-progestin - not more than 72 hrs after postcoital intrauterine device - insert no later than 5 days after abortion - 5-6 months |
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retrograde ejaculation |
when semen enters bladder instead of emerging through penis | not harmful but can cause infertility | tx: for purpose of restoring fertility |
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vulvitis |
inflammation of vulva | diabetes, dermatologic, poor hygiene, stds |
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vulvodynia |
intense burning & inflammation, may be r/t & levels of Ca Oxalate crystals in urine |
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vaginits |
occurs when candida, trichomonas, or other bacteria invade vagina |
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candidiasis |
fungal or yeast infection | pregnancy may trigger | tx: monistat, mycostatin, gyne-lotrimin, terazol creams, diflucan oral |
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bacterial vaginosis |
overgrowth of bacteria normally found in vagina | tx: flagyl (metronidozole), cleocin |
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trichomoniasis |
flagellated protozoan std | asymptomatic carrier may harbor in the urogenital tract |
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bartholinitis |
form of e-coli, staph, strep, trichomoniasis |
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human papillomavirus (hpv) |
some strains associated w/ cervical abnormalities, dysplasia & CA |
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toxic shock syndrome (tss) |
staphylococcus aureus enters the bloodstream | tampon
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chlamydia & gonorrhea |
often co-exist | may cause PID & sterility |
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pelvic inflammatory disease (pid) |
inflammatory condition of pelvic cavity usually caused by bacteria but may be attributed to virus, fungus or parasite | usually caused by chlamydia & gonorrhea |
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vulvar cysts (bartholin's cyst)
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most common tumor, may be asymptomatic | skene's duct cysts may result in dyspareunia, altered urinary stream & dysuria
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vulvar dystrophy |
found in older women | causes dry thickened skin or whitish papules, fissures or macules |
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fibroids (leiomyomas & myomas) |
myomatous tumors almost always benign |
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prostatitis |
inflammation of prostate gland caused by infection, stricture or hyperplasia |
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cryptorchidism |
congenital condition - undescended testes |
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orchitis |
inflammation of testses cause by pyogenic, viral, spirochete, parastic, traumatic, chemical, or unkown |
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epididymitis |
infection usually descends from infected prostate or UTI or complication of std |
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testicular CA |
common CA in 15-35, 35 times more greater in cryptochidism or prenatal exposure to DES |
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hydrocele |
collection of fluid in tunica vaginalis of testis |
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phimosis |
foreskin constricted | cannot be retracted occurs congenitally or from inflammation & edema |
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priapism |
uncontrolled, persistent erection occurring from either neural or vascular causes |
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peyronie's disease |
buildup of fibrous plaques in sheath of corpus cavernosum causing curvature of erect penis |
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urethral stricture |
section of urethra is narrowed, congenital or from scarring | tx: dilation or removal |
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pre-menstrual syndrome (pms) |
may be caused by ^ estrogen & decreased progestrerone during luteal phase | increase intake of magnesium |
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post-menopausal women should increase dietary intake of what? |
calcium |
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norplant (common se & advantage) |
irregular bleeding | allows coitus independence (sex at will) |
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most common location of ectopic pregnancy |
fallopian tubes |
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ICSI (forced fertilization) |
injecting a sperm into an oocyte |
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spermatogenesis |
spermatozoa develop at puberty under the influence of hormones |
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part of uterus above insertion of fallopian tubes |
fundus |
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where fertilization occurs |
ampulla |
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mammogram |
should be schedule q yr after age 50 |
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prep for pap smear |
no douching for 24 hrs before test |
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low estrogen r/t heart disease |
alters HDL levels |
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mittelschmerz |
pain during ovulation
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order hormone levels increase during menstrual cycle |
gonadotropin-releaseing hormone | follicle-stimulating hormone | luteinizing hormone | progesterone |
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estrogen & progesterone before menstruation when pregnancy is not present |
both levels drop & then menstruation follows |
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spinnbarkeit
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"thread" that is created when vaginal discharge is elastic & slippery at time of ovulation |
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how sperm travels through body during ejaculation |
testes > epididymis > vas deferens > prostate > urethra |
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infertility increases risk of what in women |
ovarian CA |
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in vitro, why pergonal (menotropins) |
stimulates ovulation | if pt experiences abdominal bloating & dark urine client should be seen by infertility doctor asap | common se: mood swings & depression |
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in vitro (extra embryos) |
preserved if individual/couple wishes to conceive again in the future |
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infertility in women (some causes/signs) |
dyspareunia (may be symptom of STI or endometriosis), PID, & hirsutism (often have polycystic-ovarian syndrome |
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ferning capacity |
used to evaluate whether cervical mucus contains enough estrogen to support sperm motility | there is sufficiant estrogen when evaluated under a microscope & practitioners observes "ferning" a fern like shape |
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postcoital test for infertitliy |
female will undergo speculum exam when cervical mucus will be harvested | test is done 1-2 days prior to ovulation |
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hysterosalpingogram |
to learn whether or not fallopian tubes are patent | x-ray |
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reciprocal translocation noted in genetic analysis |
can result in infertility |
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nuchal fold scan |
done either late in the 1st trimester or w/ the quad 2nd trimester screen | indicates baby may have down syndrome but definitive dx can only be made via genetic testing |
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uterine massage |
enables immediate contraction of the uterus to prevent bleeding |
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levels of fundal decent |
immediately following delivery nurse should palpate fundus halfway between umbilicus & symphysis pubis | 2 hrs postpartum fundus should be palpated at level of umbilicus | after first 12 hrs fundus should decrease 1 fingerbreath (1cm) per day | by 9th or 10th day fundus is not usually palpable |
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muslim tradition when child is first delivered |
believed that the first sound baby should hear should be from the Koran | father chants song in Arabic while holding neonate as praise & supplication to Allah |
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return to pre-pregnancy weight |
if wt gain was normal & not due to complications, she should return to pre-pregnancy wt by 6 weeks |
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cystic fibrosis |
malabsorption syndrome (1 of the most common inherited): increased viscosity of mucous gland secretions causes ducts of pancreas to b/c blocked, pancreatic enzymes necessary for digestion & absorption of nutrients from reaching duodenum | adolescents have a more difficult time w/ chronic cough | those chronically colonized w/ common pathogens have lower survival | salty taste on skin, steatorrhea | simple activities that help stimulate mucus secretions & provide sense of well-being or increased self-esteem can help toddler attain goals of therapy | pancreatic enzymes are mixed w/ meals to ensure digestive enzymes are mixed w/ food in the duodenum, fat-soluble multivitamins, high protein diet, chest physiotherapy
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Depo-provera |
Back (Definition) |
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Depo-provera |
Back (Definition) |
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Erectile dysfunction (drugs) |
Back (Definition) |
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Depo-provera |
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Erectile dysfunction (drugs) |
Back (Definition) |
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Oxytocin |
Back (Definition) |