Neonatal Size Risk

Front 1

Hypertension, smoking, infection, and multiples?

Back 1

Cause IntraUterine Growth Retardation

Front 2

Babies with IUGR that are semetrical have long-term growth restriction and deficient number of cells causing them?

Back 2

To have an abnormal brain.

Front 3

Babies with IUGR that are asymetrical had decreased growth later, giving them a longer growth time and a normal number of cells with decreased size, causing them to possibly have?

Back 3

Normal brain function

Front 4

Less than 2500g or 5lbs 8oz?

Back 4

Low birth weight

Front 5

Less than 1500g or 3lbs 5oz?

Back 5

Very LBW

Front 6

Less than 1000g?

Back 6

Extremely low birth weight

Front 7

Weight less than the 10%ile for weeks gestation?

Back 7

SGA

Front 8

Greater than three to 5 times mortality with more anomalies?

Back 8

SGA

Front 9

Often having impaired gas exchange and asphyxia, aspiration of amniotic fluid and meconium?

Back 9

SGA

Front 10

Hematologic: polycythemia >65%?

Back 10

SGA

Front 11

Metabolic: hypoglycemia, hypothermia?

Back 11

SGA

Front 12

Big but not mature, may have delayed lung maturation?

Back 12

LGA

Front 13

Weight in the 10th to 90th%ile?

Back 13

AGA

Front 14

Weght > 90%ile, may be 4000-4500 grams, usually born to a diabetes mellitus mom, but not always?

Back 14

LGA

Front 15

Greater birth trauma and increased mortality, increased vacuum extractions, injuries, hypoglycemia and polycythemia?

Back 15

LGA

Front 16

Risk for hypoglycemia, RDS, hyperbilirubin, lethargic, poor feeders, macrosomic?

Back 16

Infant of Diabetic Mother, LGA

Front 17

White's A-C - moms with gestational diabetes only, giving birth to LGA, not showing maturity to gestationlal age, delayed lung development?

Back 17

Moms with no vascular impairment

Front 18

White's classification D - SGA babies, mature lung/liver, risks for asphyxia, polycythemia, hyperbilirubin, hypocalcemia, anomalies?

Back 18

Moms with chronic diabetes with vascular damage.

Front 19

After 42 weeks gestation ?

Back 19

Post term delivery

Front 20

Risk for failing placental function, weight loss and distress during labor?

Back 20

Post term delivery risks

Front 21

Virth asphyxia, meconium aspiration, due to a full bowel, hypoglycemia, hypocalcemia, hypothermia, polycythemia, hypoxic-ischemic encephalopathy?

Back 21

Post Maturity Syndrome

Front 22

Decreased O2 to the brain?

Back 22

Encephalopathy

Front 23

Can decrease weight in-utero?

Back 23

Post Maturity Syndrome

Front 24

When born preterm, who does better, girls or boys?

Back 24

Girls

Front 25

Born after wk 20 and before end of wk 27, immaturity of all systems, ineffective gas exchange, RDS, apnea, persistent fetal ciculation, metabolic hyperthermia, hypoglycemia, problems with nutritional absorption?

Back 25

Premature

Front 26

Renal/Skin/Resp., fluid electrolyte imbalance, substance toxicity, skin infections due to lack of barrier, may feel pain at 28 weeks, have fragile capillaries and greater risk for brain bleeds, may have bleeding issues, hemolysis, hyperbilirubinemia>ernicterus?

Back 26

Preterm baby

Front 27

Insensible water loss, 2nd to thin skin, larger suface area, extended posture, rapid respirations, Impaired kidney regulation, loss of fluid throught the GI, warmers may dehydrate?

Back 27

Preterm Infants fluid and electrolyte issues

Front 28

Regulate fluids, humidify or swamp, plastic cover shield - clear for visual purposes, strict I&O, daily weight, urine specific gravity 1.003-1.030 - ranges will vary according to GA?

Back 28

Preterm Infants fluid and electrolyte interventions

Front 29

Early, small-volume enteral feedings stimulate what?

Back 29

Gut hormones & mature intestine

Front 30

Requires more protein, calcium, phosphorus, kcal 120-150/kg/day?

Back 30

Preterm growth

Front 31

Best for >1500 gram baby?

Back 31

Preterm human milk

Front 32

Preterm human milk requires supplement fortifier, hindmilk, 24kcal/ox, artificial, term 20k?

Back 32

Baby <1500 grams

Front 33

Have higher tcPO2 and temp than during bottle-feeding?

Back 33

Breastfeeding preterm infants

Front 34

If <32-34wks/1200 grams, lacking coordinated suck swallow, resp. >60?

Back 34

Preterm infant will require alternate feeding method

Front 35

Intragastric or transpyloric, bolus or coninuous, residual <30%/2ml?

Back 35

Gavage feeding for a preterm infant

Front 36

If nonnutritive sucking, gavage not working, preterm infant may need?

Back 36

TPN via perpheral or central line

Front 37

Kangaroo care will stabilize what and may help with what?

Back 37

May stabilize their vital signs and help with feeding

Front 38

Impaired gas exchange=hypoxia, hypercarbia, acidosis>multisystem ischemia
Primary apnea: rapid breathing, HR falls- stimulation induces respirations
Secondary apnea: gasp attempts, BP falls - req. immediate positieve-pressure ventilation
Don't wait for APGAR, reasses every 30 sec.

Back 38

Asphyxia, Infant

Front 39

If the birth is a term gestation, has clear amniotic fluid, infant is breathing or crying and has good muscle tone, what type of care will they receive?

Back 39

Routine Care

Provide Warmth
Clear Airway
Dry
Assess color

Front 40

If the birth is nat a term gestation, and/or does not have clear amniotic fluid, and/or the infant is not breathing or crying and/or has good muscle tone, what is to be done?

Back 40

Provide warmth
Position; clear airway (administer epinephrine)(as necessary)
Dry, stimulate, reposition

Front 41

After the first 30 seconds of a birth of an imperfect infant, what do you evaluate?

Back 41

Evaluate respirations, heart rate, and color.

Front 42

After evaluating respirations, heart rate, and color at the beginning of the second 30 second interval after birth, if the infant is breathing normally, and their HR is greeater than 100, and their color is pink, what type of care do you give?

Back 42

Observational Care

Front 43

After evaluating respirations, heart rate, and color at the beginning of the second 30 second interval after birth, if the infant is breathing normally, and their HR is greeater than 100, and they are cyanotic, what do you give?

Back 43

Give spplemental oxygen.

Front 44

If, after you give supplemental oxygen to a newborn who appeared cyanotic and their respirations and heart rate were normal, they turn pink, what kind of care do you give them?

Back 44

Observational care

Front 45

If, after you give supplemental oxygen to a newborn who appeared cyanotic and their respirations and heart rate were normal, they stay cyanotic, what do you give them?

Back 45

Provide postitive-pressure ventilation.

Front 46

If, after evaluating the newborns respirations, heart rate and color, they are apneic or their heart rate is <100, what do you give them?

Back 46

Provide positive-pressure ventilation

Front 47

Are they term, have they aspirated meconium, are they breathing, crying, pink?

Back 47

Questions to ask for newborn resuscitation

Front 48

First, warm the baby, position their head in the sniff postion, clear the mouth and nose, dry, stimulate, reposition, free flow of 100% O2 blowby, evaluate respirations, heart rate and color after rescucitaion?

Back 48

Newborn Resuscitation #1

Front 49

Second, postive-pressure, vent with bag +100% O2 at a rate of 40-60 (if apnea or HR<100), if intervention not working, endotracheal intubation considered?

Back 49

Newborn Resuscitation #2

Front 50

Third, Use positive-pressure ventilation with chest compression at a rate of 120 if heart rate is less than 60-80?

Back 50

Advanced resuscitation #3

Front 51

Fourth, drug tx with epinephrine, IV/ET, naloxone IV/ET and volume expanders, document vital signs, color, O2 percentage, your method, blood glucose, drug doses and routes?

Back 51

Advance Resuscitation #4

Front 52

Impaired gas exchange rt alveolar blockage and chemical pneumonia, can be an LGA or SGA
Suction the airway as shoulders are delivered, deep ETracheal suction at breathe, O2, mechanical vent, antibiotics, possible ECMO?

Back 52

Meconium Aspiration Syndrome

Front 53

Associated with feeding, differentiated from normal periodic breathing which is 5-10 sec cessation?

Back 53

Apnea spells lasting longer than 15-20 sec with or without cyanosis and bradycardia

Front 54

Should clear up within hours or 2-3 days causes ineffective airway clearance rt delayed reabsorption of lung fluid often secondary to C-sec?

Back 54

Transient TachyPnea of the Newborn or wet lung

Front 55

Type I - hyaline membrane dis. - risk are <32-35 wks, <1500 grams, and Infant D.mom, rare without intrauterine stress, steroids that cross the placenta?

Back 55

Idiopathic Respiratory Distress Syndrome

Front 56

Increased surface tension of the alveoli (sufactant deficiency) - alveolar collapse, atelectasis, increased work load to expand with each breath
Impaired gas exchange - hypoxemia + hypercapnia with resp acidosis
Increased pulmonary vascular resistance - hyperprofusion of pulmonary circulation
Hypoperfusion (c hypoxemia) - tissue hypoxia + metabolic acidosis
Increased transudation of fluid into lung - hyaline membrane form, impaired gas exchange?

Back 56

RDS pathophysiology

Front 57

Respirations >60, may be 80-120, labored, flaring nares, retractions, grunt
later - cyanosis, apneic episodes?

Back 57

Symptoms of RDS

Front 58

Maintain effective ventilation (open the alveoli) - surfactant, O2, I/E 2:1 - CPAP/IPPV with PEEP
correct the acid-base imbalance
maintain optimal thermoregulation
maintain hematorcrit and blood pressure
balance hydration and caloric support
prevent infection

Back 58

RDS supportive care

Front 59

Patenet Ductus Arteriosus
Persistent Pulmonary Hypertension
Peri-Intra Ventricular Hemorrhage
Retinopathy
BronchoPulmonary Dysplaia (if <28wks)?

Back 59

Risks and Complications for RDS

Front 60

Cold stress causes incresaed use of glucose and O2, greater RDS, acidosis, hypoglycemia, jaundice
Risk: premature, SGA, hypoxic, hypoglycemic, CNS depressed
Assess: axillary/skin temp
-Hypothermia <36.5 C (97.7 F)
-Hyperthermia >37.5 C (99.5F)?

Back 60

Hypothermia - Ineffective Thermoregulation

Front 61

Ax<36.5C or 97.7F?

Back 61

Hypothermia

Front 62

Ax >37.5C or 99.5F?

Back 62

Hyperthermia

Front 63

Prevent radiation, evaporation, convection, conduction?

Back 63

Temperature Regulation

Front 64

32-34C for a term baby, higher for VLBW infants?

Back 64

Neutral thermal environment

Front 65

Rewarm gradually to avoid apnea?

Back 65

Thermoregulation of the Neonate

Front 66

An Rh negative mom with an Rh positive fetus, or an O mom with an AB fetus
Antibodies destroy fetal RBC's > anemia, hydrops {edema}; newborn patho jaundice
Trauma: enclosed hemorrhage (hematoma, bruising) 2nd to breech/extraction
Sepsis; enzyme deficient: G6PD, galactosemia?

Back 66

Hemolysis and Bilirubin

Front 67

Polycythemia (hct>65%) - hyperviscosity: - tachypnea, tachycardia, CHF, NEC, seizure
Ative rt increased erythropoiesis 2nd to hypoxia; passive to transfusion (twin, late clamp) - increase fluids, partial exchange transfusion
Delayed feeding +/or stooling allows intestinal deconjugation>reabsorption - at breastfeeding jaundice?

Back 67

Increased Production of Bilirubin

Front 68

Symptoms: tremors/jittery/seizures, irregular respirations, lethargy - poor feeding, cyanosis?

Back 68

Hypoglycemia

Front 69

Dx: <40mg/dl first 24 hr:<40-50 p 24 hr - heel - reagent strip <45-55 confirm by lab?

Back 69

Hypoglycemia

Front 70

Intervene <47: early feed - retest 30-60"p?

Back 70

Hypoglycemia

Front 71

Symptoms/ <25: D10 IV minibolus, cont. - some, as IDM, require higher rates?

Back 71

Hypoglycemia

Front 72

Glucagon IV/IM max 1mg; steroids?

Back 72

Hypoglycemia

Front 73

Premature lack stores; asphyxia depletes; blood transfusion - anticoag citrate binds?

Back 73

Hypocalcemia

Front 74

Symptoms: jittery, tremulous; associated with hypohlycemia?

Back 74

Hypocalcemia

Front 75

DX: <7mg/dl; poss phosphate >8mg?

Back 75

Hypocalcemia

Front 76

Tx: calcium gluconate to enteral feedings?

Back 76

Hypocalcemia

Front 77

Slow IV central cath {infiltrate>necrosis}?

Back 77

Hypocalcemia

Front 78

NOC Muscle Function?

Back 78

Hypocalcemia

Front 79

Dx: serum bili>6mg/dl in 1st 24 hr; rise>5mg/dl/day; >12mg direct>1.5-2 - Assess: jaundice, anemia, VS, BP, wt, liver size, I&O, neuro (risk kernicterus)?

Back 79

Hyperbilirubinemia

Front 80

Tx choice by serum bili, wt, age condition?

Back 80

Hyperbilirubinemia

Front 81

Severe: exchange transfusion (albumin 1st)
Phototherapy: decomp bili, Increased IWL, bowel - expose skin; check eyes/skin/T; hydrate, feed?

Back 81

Hyperbilirubinemia

Front 82

Necrosis of bowel mucosa rt LBW/GA 2o asphyxia?

Back 82

Necrotizing EnteroColitis

Front 83

Ischemic gut allows bacteria to grow on formula > gas distention > perforation?

Back 83

Necrotizing EnteroColitis

Front 84

Early Symptoms: residuals, abd. circ., stool guaiac
Bowel rest, TPN; possible resection
slow reintroduction of feedings?

Back 84

Necrotizing EnteroColitis

Front 85

Common Drugs That May Alter Menstrual Bleeding

Amphetamines

Back 85

Common Drugs That May Alter Menstrual Bleeding

Desoxyn, Obetrol

Front 86

Common Drugs That May Alter Menstrual Bleeding

Desoxyn, Obetrol

Back 86

Common Drugs That May Alter Menstrual Bleeding

Amphetamines

Front 87

Common Drugs That May Alter Menstrual Bleeding

Benzodiazepines, Diazepam, Oxazepam

Back 87

Common Drugs That May Alter Menstrual Bleeding

Valium, Serax

Front 88

Common Drugs That May Alter Menstrual Bleeding

Valium, Serax

Back 88

Common Drugs That May Alter Menstrual Bleeding

Benzodiazepines, Diazepam, Oxazepam

Front 89

Common Drugs That May Alter Menstrual Bleeding

Butyrophenones

Back 89

Common Drugs That May Alter Menstrual Bleeding

Haldol, Inapsine

Front 90

Common Drugs That May Alter Menstrual Bleeding

Halodo, Inapsine

Back 90

Common Drugs That May Alter Menstrual Bleeding

Butyrophenones

Front 91

Common Drugs That May Alter Menstrual Bleeding

Cimetidine

Back 91

Common Drugs That May Alter Menstrual Bleeding

Tagamet

Front 92

Common Drugs That May Alter Menstrual Bleeding

Tagamet

Back 92

Common Drugs That May Alter Menstrual Bleeding

Cimetidine

Front 93

Common Drugs That May Alter Menstrual Bleeding

Isoniazid

Back 93

Common Drugs That May Alter Menstrual Bleeding

INH

Front 94

Common Drugs That May Alter Menstrual Bleeding

INH

Back 94

Common Drugs That May Alter Menstrual Bleeding

Isoniazid

Front 95

Common Drugs That May Alter Menstrual Bleeding

Methyldopa

Back 95

Common Drugs That May Alter Menstrual Bleeding

Aldomet

Front 96

Common Drugs That May Alter Menstrual Bleeding

Aldomet

Back 96

Common Drugs That May Alter Menstrual Bleeding

Methyldopa

Front 97

Common Drugs That May Alter Menstrual Bleeding

Opiates

Back 97

Common Drugs That May Alter Menstrual Bleeding

Morphine, Heroin, Methadone

Front 98

Common Drugs That May Alter Menstrual Bleeding

Morphine, Heroin, Methadone

Back 98

Common Drugs That May Alter Menstrual Bleeding

Opiates

Front 99

Common Drugs That May Alter Menstrual Bleeding

Phenothiazines

Back 99

Common Drugs That May Alter Menstrual Bleeding

Compazine, Thorazine, Phenergan

Front 100

Common Drugs That May Alter Menstrual Bleeding

Compazine, Thorazine, Phenergan

Back 100

Common Drugs That May Alter Menstrual Bleeding

Phenothiazines

Front 101

Common Drugs That May Alter Menstrual Bleeding

Reserpine

Back 101

Common Drugs That May Alter Menstrual Bleeding

Serpasil

Front 102

Common Drugs That May Alter Menstrual Bleeding

Serpasil

Back 102

Common Drugs That May Alter Menstrual Bleeding

Reserpine

Front 103

Common Drugs That May Alter Menstrual Bleeding

Spironolactone

Back 103

Common Drugs That May Alter Menstrual Bleeding

Aldactone

Front 104

Common Drugs That May Alter Menstrual Bleeding

Estrogen

Back 104

Common Drugs That May Alter Menstrual Bleeding

Premarin (also oral contraceptives)

Front 105

Common Drugs That May Alter Menstrual Bleeding

Progesterones

Back 105

Common Drugs That May Alter Menstrual Bleeding

Provera (also oral contraceptive)

Front 106

Common Drugs That May Alter Menstrual Bleeding

Premarin (also oral contraceptives)

Back 106

Common Drugs That May Alter Menstrual Bleeding

Estrogen

Front 107

Common Drugs That May Alter Menstrual Bleeding

Provera (Also oral contraceptive)

Back 107

Common Drugs That May Alter Menstrual Bleeding

Progesterones

Front 108

Common Drugs That May Alter Menstrual Bleeding

Testosterone

Back 108

Common Drugs That May Alter Menstrual Bleeding

Android

Front 109

Common Drugs That May Alter Menstrual Bleeding

Thioxanthenes

Back 109

Common Drugs That May Alter Menstrual Bleeding

Navene

Front 110

Common Drugs That May Alter Menstrual Bleeding

Android

Back 110

Common Drugs That May Alter Menstrual Bleeding

Testosterone

Front 111

Common Drugs That May Alter Menstrual Bleeding

Navene

Back 111

Common Drugs That May Alter Menstrual Bleeding

Thioxanthenes

Front 112

Common Drugs That May Alter Menstrual Bleeding

Tricyclic antidepressants

Back 112

Common Drugs That May Alter Menstrual Bleeding

Elavil

Front 113

Common Drugs That May Alter Menstrual Bleeding

Elavil

Back 113

Common Drugs That May Alter Menstrual Bleeding

Tricylcic antidepressants

Front 114

Premenopause, Hormonal Fluctuation and Well-Being

Increased Estorgen, and decreased progesterone leads to?

Back 114

Premenopause, Hormonal Fluctuation and Well-Being

Increased Serotonin
FOLLICULAR PHASE
(Stable emotions and postive well-being)

Front 115

Premenopause, Hormonal Fluctuation and Well-Being

Increased Follicle Stimulating Hormone and increased Luteninizing hormone, leads to?

Back 115

Premenopause, Hormonal Fluctuation and Well-Being

Increased Increased Endorphins
OVULATION PHASE
(Euphoria)

Front 116

Premenopause, Hormonal Fluctuation and Well-Being

Decresed Estrogen and Increased Progesterone leads to?

Back 116

Premenopause, Hormonal Fluctuation and Well-Being

Decreased serotonin
LUTEAL PHASE
{endorfin withdrawal because it follows ovulation phase and now the endorfins are gone}
(Unstable emotions, brain chemical imbalance, PMS symptoms, sugar, fat, chocolate cravings, Increased insulin sensitivity, 10lbs shift in weight)

Front 117

What's the average length of the menstrual cycle?

Back 117

28 days

Front 118

What is the average duration of the menstrual cycle?

Back 118

4 days

Front 119

What is the average flow of the menstual cycle?

Back 119

30-35cc blood

Front 120

What is the length range, not average, of the menstrual cycle?

Back 120

21-35 days

Front 121

What is the duration range, not the average, of the menstrual cycle?

Back 121

2-6 days

Front 122

What is the flow range, not the average, of the menstrual cycle?

Back 122

20-80cc blood

Front 123

Women in industrialized Western societies experience ~___ ovulations and menses
Preagricultural foraging societies experience ~___ ovulations
(No health benefits proven to menstration)

Back 123

Women in industrialized Western societies experience ~450 ovulations and menses
Preagricultural foraging societies experience ~160 ovulations
(No health benefits proven to menstration)

Front 124

Caution: douches, scent, soaps, oils
Evaluate abnormal dc/odor/exposure
TSS caused by Staph a. toxin, most associate with tampon use during menses, ? Barrier
Symptoms: T>38.9C/102F; GI; muscular myalgias; rash, palm/sole desquam; alt LOC
Lab latelets<100,000; UAwbc; renal/liver
Hospitalize, antibiotics; recur with menses?

Back 124

Hygiene / Toxic Shock Syndrome

Front 125

Oligomenorrhea: infrequent, irregular cycles >35days, related to meical/ stress/exercise/dieting
PCO/HyperandrogenicChronicAnovulation
PRIMARY - never menses, ? secondary sexual characteristics
SECONDARY - previously menstruating missed 3+periods/6+months?

Back 125

Amenorrhea

Front 126

Hx: OB, sex, bleed/spot, contraceptives, exercise, nutrition
Exam: 2nd sex characteristics; pelvic/bimanual for vagina/cervix/uterus
Lab: HCG, vag cytology, thyroid, prolactin, progesterone/estrogen + progesterone challenge?

Back 126

Evaluation Amenorrhea

Front 127

Treat underlying problem
Surgery
Hormones: thyroxine, bromocriptine, OCPs, HRT, DMPA, GnRH agonists
Teach/Refer: Nutrition; Stress
Management; Support?

Back 127

Resolve Amenorrhea

Front 128

PRIMARY: lifelong normal menstrual cramps
often with Nausea/V, diarrhea, HAs, vasomotor - weak, faint
excess protaglandins produce IUP = labor
SECONDARY: later onset crampy pelvic pain 2nd to disorder/disease
preg: ectopic, SAB; gyn-PID, endometriosis, leiomyomata, endo CA?

Back 128

Dysmenorrhea

Front 129

Dx: History + exam with cultures; dx lap
Tx: Prostaglandin inhibitors - NSAIDS; cont. (6-9 wk) active OCs; DEpo-MPA; TENS/ diuretics/ analgesics/ narcotics
TEACH: heat with rest; orgasm; reg exercise include core; balance diet - suppl omega-3 pfa stress management?

Back 129

Resolve Dysmenorrhea

Front 130

Abnormal Uterine Bleeding

Shrot intervals <21 days?

Back 130

Polymenorrhea

Front 131

Abnormal Uterine Bleeding

Heavy bleeding >80cc blood loss or >7 days with regular intervals?

Back 131

Menorrhagia

Front 132

Abnormal Uterine Bleeding

Prolonged heavy, irregular frequency - gushing?

Back 132

Metromenorrhagia

Front 133

Dysfunction Uterine Bleed

90% ________: adol/perimenopause with irreg. bleeding rt unopposed estrogen, excess vasodilating prostaglandin PGE?

Back 133

Anovulatory

Front 134

Abnormal Uterine Bleeding

10% _______: repro age with predictable prolonged excessive bleed rt inadequate amount vasoconstricting prostaglandin PGF?

Back 134

Ovulatory

Front 135

Dx: HCG; cultures; CBC/diff; bleed/clot time; PT/PTT; thyroid; liver; BBT char; progesterone
Pelvic evaluation - exam, endo biopsy, US, D&C hysteroscopy?

Back 135

Evaluation DUB

Front 136

Tx Acute: estrogens IV>oral, progestins, hi-dose OCs, D&C
Tx Chronic: NSAIDs; OCs cont/cyclic; progestins oral/depot/IUS; and/or danazol; GnRH agonists; endometrial ablation/hysterectomy
Teach: nutrition - iron; exercise effects; stress management; support

Back 136

Resolve Dubq

Front 137

Causes unclear; brain/ovary secretions
Symptoms cylical luteal, not follicular
Anxiety, irritability, tension, depression, insomnia, forgetful, cry
Pain - uterine, back, breast
Hypoglycemia crave foods -sugar/chocolate, fatigue, dizzy, headache, heart pound, fluid retention/shift gain, bloat, tender breast?

Back 137

PreMensS>PMDD /LLPDD
(only luteal PMS)

Front 138

Dx: chart monthly luteal recur symptoms; r/t systemic, psychiatric
Med Tx: placebo, SSRI antidepres-Prozac, anxiolytic -Zanax, buspirone, PG Inhibirots, suppress ovulation -cont. comb OCs, damazp;/GnRH agonist SEs limit 4-6 month
diuretic spironolactone before symptomspyridoxine (B6) 200-800mg/day oral?

Back 138

PMS effective treatments

Front 139

NUTRITION: several small meals thru day; hi complex carb, lo refined sugar +Na; lo-mod protein/alt red meat; H2O, K-rich; decrease caffeine/ methylxanthine/ ETOH/ decrease smoking, supplement vitamin E, Calcium, magnesium
Regular Aerobic Exercise, rest
Stress reduce, avoid triggers, biofeedback
Phototherapy {SAD coexist}?

Back 139

PMS nursing management