2023 EXAM GRADED A - Reproductive Health Care LATEST VERSION 2023 EX...

NRNP 6552 Advanced Nurse Practice in Reproductive Health Care LATEST VERSION

2023 EXAM GRADED A+

Abnormal Uterine Bleeding (Diagnostics and lab tests) - Ans The Graves speculum is the most common variety used by OB/GYNs. This vaginalspeculum is commonly available in multiple sizes: small, medium and large. The bills of the Graves speculum, which resemble a duck's mouth, are wider than the bills of the Pederson speculum, and the sides are also curved

Diagnostics Pap smear Vaginal culture pelvic ultrasound EMB-Endometrial biopsy

Lab Tests qualitative/quantitative HcG, CBC with platelets, Pt and PTT, FHS, Progesterone, TSH, Iron, and Prolactin

(Lab Tests Explained) Prolactin-High levels interfere with the normal production of other hormones such as estrogen and progesterone. This can result in irregular or missed periods, and prevent ovulation. Some women can have high levels and be completely asymptomatic FHS-

History (EXTRA INFO TO KNOW)

• Pelvic pain? think....

Miscarriage, ectopic pregnancy, PID, trauma, sexual abuse or assault

• Nausea, weight gain, urinary frequency, fatigue? think...

Pregnancy

• Weight gain, cold intolerance, constipation, fatigue? think.....

Hypothyroidism 4.Weight loss, sweating, palpitations?.....Hyperthyroidism 5.Easy bruising, tendency to bleed? think... Coagulopathy

• Jaundice, history of hepatitis? Think...

Liver disease

• Hirsutism, acne, acanthosis nigricans, obesity? Think

Polycystic ovary syndrome

• Postcoital bleeding (spotting or bleeding after intercourse unrelated to menstrual

cycle)? Think...Cervical dysplasia, endocervical polyps 9.Galactorrhea, headache, visual-field disturbance?Think Pituitary adenoma 1 / 2

• Weight loss, excessive exercise, stress? Think

Hypothalamic suppression

• Thyromegaly, weight gain, edema?

Hypothyroidism

• Thyroid tenderness, tachycardia, weight loss, velvety skin? Think...

Hyperthyroidism

• Bruising, jaundice, hepatomegaly? Think..

Liver disease

• Enlarged uterus?

Pregnancy, leiomyoma, uterine cancer

• Firm, fixed uterus? Think

Uterine cancer

• Adnexal mass? Think..

Ovarian tumor, ectopic pregnancy, cyst Uterine tenderness, cervical motion tenderness PID, endometritis Laboratory tests Beta-subunit human chorionic gonadotropin Pregnancy

Complete blood count with platelet count and coagulation studies Coagulopathy

Liver function tests, prothrombin time Liver disease

Thyroid-stimulating hormone Hypothyroidism, hyperthyroidism

Prolactin Pituitary adenoma

Blood glucose Diabetes mellitus

DHEA-S, free testosterone, 173-hydroxyprogesterone if hyperandrogenic Ovarian or adrenal tumor

Papanicolaou smear Cervical dysplasia

Cervical testing for infection Cervicitis, PID Imaging and tissue sampling Endometrial biopsy or dilatation and curettage Hyperplasia, atypia, or adenocarcinoma

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