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161 Cards in this Set
- Front
- Back
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Pregnancy Classification:
adequate well controlled studies have not shown any increase in human fetal abnormalities during any tirmester |
A
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Pregnancy Classification: Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate and well controlled studies in pregnant women
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B
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Pregnancy Classification: Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstarte a risk in any trimester
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B
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Pregnancy Classification:Animal studies have shown an adverse effect and there are no adequate and well controlled studies in pregnant
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C
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Pregnancy Classification:No animal studies have been conducted and there are no adequate and well-controlled studies in pregnant women
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C
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Pregnancy Classification:Adequate well-controlled or observational studies in pregnant women have demonstarted a risk to the fetus. However, the benefits of therapy may outweigh the potantial risk
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D
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Pregnancy Classification: adequate well-controlled or observational studies in animals or pregannt women have demonstarted positive evidence of fetal abnormalities or risks. The use of the product is contraindicated in women who are or may become pregnant
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X
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Do antidepressants cross the placenta?
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yes
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First choice antidepressants
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selective seratonin reuptake inhibitors
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What pregnancy category do the SSRIs fall under
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B or C
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What are examples of SSRIs
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Prozac paxil and zoloft
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Second choice antidepresants
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Tricyclic antidepressants
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What pregnancy pregnancy category does tricyclic antidepressants fall under?
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C or D
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What are examples of tricyclic antidepressants?
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Avantil, Elavil,Norpramin and Tofranil
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What is an adjustment reaction with depressed mood?
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baby blues or transient depression
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What is a postpartum mood disorder?
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postpartum depression without delusions
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What is a postpartum psychosis
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postpartum with delusions
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Etiology of depression
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hypothalmic pituaitary-adrenal axis imbalances
hypothalmic pituitary thyroid axis imbalances Dopamine D2 receptor hypersensitivity increased growth hormone |
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When do postpartum blues start?
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3-7 days after delivery (every other day)
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How long does postpartum blues last?
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1-2 weeks
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The "blues" are attributes to hormonal shifts in:
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estrogen, progestorone, prolactin
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"Intense or pervasive sadness with severe and labile mood swings"
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postpartum depression
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When is the greatest risk for postpartum depression?
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around 4th week postpartum when restarting menses and weaning baby from breast
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What is required for a diagnosis of postpartum depression
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5 or more symptoms daily
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"a syndrome characterized by depression, delusions, and thoughts by the mother of harming either the baby or herself"
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postpartum psychosis
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What might prevent postpartum psychosis?
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estrogen replacement
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When do symptoms are postpartum psychosis begin
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2-3 weeks after delivery
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What is the key symptom in postpartum psychosis?
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suspiciousness
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Examples of psychotic
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thorazine and haldol
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periods of extreme activity alternating with periods of extreme depression
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bipolar disorder
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What is required to be diagnosed with bipolar disorder
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3 or more persisting symptoms for more than one week
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What is a key symptom of bipolar disorder?
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disractibility and oreoccupation
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What is the drug of choice for manic side of bipolar disorder?
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lithium
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What are the two most important screening questions for depression?
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In the past two weeks have you felt down, depressed, or hopeless?
Little interest or pleasure in doing things? |
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Hills crisis assessment model assesses:
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feeling about the event
perceptions of the event support networks available |
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reduced fertility=
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subfertility
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Factors needed for fertility
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functioning hypothalmic pituitary gonadal axis, structural system, neurological responses and right timing
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Main STDs associated with infertlity
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chlamydia and gonorhhea
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Labs drawn for infertility
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LH, FSH, thyroid hormone, prolactin, testosterone
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Whar is a hysterosalpinogram?
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floroscope of uterus and fallopian tubes
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what is a laparoscopy?
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to look for visual scarring of uterus
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What us hypospadius?
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abnormal opening in penis
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what is varicoceles?
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wrinkly scrotum
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liquidification of sperm should happen in how long
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one hour
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volume of sperm should be more than
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2ml.
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ph of sperm is
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7-8
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sperm count should be greater than
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20 million
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What % of sperm should be normal
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30
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What % of sperm should be motile
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50
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the ova penetration tests
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sperm enzyme
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When should postcoital test be done?
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within 2 hours
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Sperm agglutination tetss for?
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antibodies to sperm
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How long should a man wear condoms to decrease antibodies
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6 months
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What is the only assisted reporduction oked by the church?
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gamete intrafallopian tube transplant
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Preterm birth occurs before the end of the ___ week of gestation
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37th
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four pathways that lead to preterm birth
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inflammation
decidual hemorrhage uterine over distention premature initiators of labor |
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main biochemical marker for preterm labor
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fetal fibronectin
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Drug therapy for preterm labor
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Tocolysis:
brethine Mag sulfate Procardia |
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What is the most common cause of preterm labor
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premature ROM
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What are the risks for premature ROM
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Infection: chorioamnionitis and endometritis
abruptio placentae |
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S&S of chorioamnionitis
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odor of fluid
fever tachycardia tenderness |
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WWhat test do you use to test amniotic fluid in premature ROM?
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fern test or nitrazine
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biophysical profile consists of
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ultrasound for muscle tone, breathing, movements, fluid volume, placental grading
AND NST |
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What score is reassuring for biophysical profile?
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8
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What score is worrisome for biophysical profile
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2
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long difficult abnormal labor
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dystocia
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prolonged latent phase
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longer than 20 hours nullipara or 14 hours multipara
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protracted active phase
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dilation is less than 1.2 cm/hour nulli or 1.5 cm/hour multi
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secondary arrest
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no change in dilation for more than 2 hours
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protracted descent
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change in descent is less than 1 cm/hr nulli or 2cm/hour multi
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arrested descent
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if there is no change in descent for more than 1 hour nulli and 1/2 hour multi
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in precipitous labor the entire process occurs within ___hours with dilation more than ____
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3; 5cm/hour nulli and 0 cm/hour multi
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What is the psychologic effect of dystocia
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reduced uterine contractility
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What is laminaria
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seaweed for induction of labor
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what is amniotomy
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AROM for induction of labor
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0 bishop score for dilation
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1
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0 bishop score for effacement
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0-30
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0 bishop score for station
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-3
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0 bishop score for cervical consistency
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firm
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0 bishop score for cervix position
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posterior
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3 bishop score for dilation
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5-6
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3 bishop score for effacement
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80
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3 bishop score for station
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-1
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3 bishop score for cervical consistency
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soft
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3 bishop score for cervix position
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anterior
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What is the half life of Pitocin
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3-5 min
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How long does it take Pitocin to reach a steady concentration
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40 minutes
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With pitocin induction observe for
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hyperstimulation
water intoxification decrease than increase in BP |
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post date labor in labor beyond __ weeks
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42
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care for uterine rupture
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obtain CBC and platelets stat
O2 DC oxytocin prep for surgery |
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postpartum hemorrhage is marked by a __% drop in hct from predelivery levels
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10
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May not note hemorrhagic shock until what % blood volume loss
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30-40
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pathologic clotting with widespread bleeding
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disemminated intravascular coagulation
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management of DUC
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prevent hypovolemia no less than 18 G IV
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idiopathic thrombocytopenia purpura platelets
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below 50,000
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management of ITP
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IV IGg and steroids
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Symptom of postpartum infection
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temp at 38 C or more for 2 successive days within 10 days postpartum
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low birth weight is
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<2500 grams
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Kcal increase required during 2nd and 3rd trimesters
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300
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Fluid requirements during pregnancy
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1500-2000 ml a day
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necessary for mineralization of fetal bones and teeth
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calcium and phosphorous
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mineral requirments
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iodine sodium zinc and magnesium
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iodine ex.
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iodized salt
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ex of zinc
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milk shellfish liver
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ex of magnesium
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milk whole grains
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iron supplement recommended
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30 mg/day
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ex of iron
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lean meats, green veggies, beans
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involved in growth of epitheliail cells; metabolizes fats and carbs; prevents night blindness
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Vit A
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ex of Vit A
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green vegetables and liver
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helps in absorption of Calcium and phosphorous for fetal skeletal devlopment
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Vit D
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ex of Vit D
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dairy and seafood
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antioxidant protects cell membranes
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Vit E
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ex of Vit E
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fish, liver green veggies
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essential factor in blood clotting
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Vit K
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ex of Vit K
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green leafy and liver
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a collagen forming connective and vascular system
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Vit C
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ex of vit C
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citrus fruits and tomatoes
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vital to coenzyme reactions:cell respirations, glucose oxidation
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Vit B
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deficiencies of folic acid may cause
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neural tube defects
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ex of folic acid
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green leafy beans, oranges
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How much folic acid do all women of childbearing age need?
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0.4mg
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If a vegetarian is pregnant, what supplementrs would she need?
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B vitamins, iron, and zinc
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underweight BMI
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<19.8
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Normal BMI
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19.8-26
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overweight BMI
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26-29
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obese bmi
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>29
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If normal weight how much weight should you gain if oregnant
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25-25
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What is the least amount fo weight you ahouold gain if obese
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15
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In 2nd and 3rd trimesters how much weight should you gain per week
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1 pound
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symptoms of lactose intolerance relieved by
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Rx lactase
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persistent eating of abnormal substances
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pica
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pica may be sign of
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iron deficiency
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adolescents are physiologically mature when?
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4 years after menarche
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Calorie requirement for nursing mothers
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500 over prepregnant
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Calcium requirements for nursing mothers
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stays the same
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Infant milk requirements
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2-3 oz/lb a day
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1 oz of breast milk is how many calories
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20
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human breats milk is recommended until how old
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6 months
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baby fluid requirements
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140-160 ml/kg/day
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baby calorie requirement
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105-108 kcal/kg/24 hours
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how many ml. do you give to bottle fed baby at a time?
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7.5-15ml.
progress to 90--150 by 2nd week |
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how often do you feed a bottle fed baby?
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q 3-4 hours
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LATCH stands for
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Latch on
Audible swallowing Type of nipple Comfort Hold |
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newborns suckling stimulates the release of what from post. pituitary gland?
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oxytocin
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how long can you store expressed milk in a fridge?
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72 hours
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how long can you freeze expressed milk?
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2 weeks
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how long can you store expressed milk in a freezer chest?
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6 months
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How long after thawing should you use expressed milk?
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24 hours
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fat soluble vitamins
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A D E and K
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production of what may be inhibited by antibiotics?
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vit K
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vit D and sunlight
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30 minutes a week is adequate
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lack of what leads to neonatal hypocalcemia and tetany
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Vit D
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required to meet cellular and energy needs
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thiamin and niacin
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ex of thiamin and niacin
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meat and liverq
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aids in absorption and tissue integrity
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vit C
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Vitamin especially important for smokers
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Vit C
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High doses of what vitamin prenatally can result in scurvy after birth
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C
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required for production of RBCs and lactation
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folic acid
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additional sources of calcium for lactose intolerant
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canned fish, green leafy, tofu
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lack of what can result in mental retardation of the child
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iodine
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if woman is being treated for anemia with iron/folic acid supplements, what deficiency is common
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zinc
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